Toward Simpler, Safer Treatment of Cryptococcal Meningitis

Abstract

Cryptococcal meningitis is one of the most common and serious human immunodeficiency virus (HIV)–related opportunistic infections among adults in sub-Saharan Africa, leading to an estimated 135,900 deaths every year.¹ Under the best conditions, cryptococcal meningitis is a challenge to manage and involves high-quality medical and nursing care and often prolonged hospitalization. Much of this is driven by the fact that the best outcomes are seen when the key antifungal agent, amphotericin B, is administered intravenously daily for 1 or 2 weeks.² However, treatment with amphotericin B–based regimens frequently results in substantial toxic effects, including blood dyscrasias, acute kidney injury, electrolyte . . .