Cerebrospinal Fluid Culture Positivity and Clinical Outcomes After Amphotericin-Based Induction Therapy for Cryptococcal Meningitis
Identifieur interne : 000138 ( Main/Exploration ); précédent : 000137; suivant : 000139Cerebrospinal Fluid Culture Positivity and Clinical Outcomes After Amphotericin-Based Induction Therapy for Cryptococcal Meningitis
Auteurs : Melissa A. Rolfes ; Joshua Rhein [Ouganda] ; Charlotte Schutz [Afrique du Sud] ; Kabanda Taseera [Ouganda] ; Henry W. Nabeta [Ouganda] ; Kathy Huppler Hullsiek ; Andrew Akampuira [Ouganda] ; Radha Rajasingham [Ouganda] ; Abdu Musubire [Ouganda] ; Darlisha A. Williams [Ouganda] ; Friedrich Thienemann [Afrique du Sud] ; Paul R. Bohjanen [Ouganda] ; Conrad Muzoora [Ouganda] ; Graeme Meintjes [Afrique du Sud, Royaume-Uni] ; David B. Meya [Ouganda] ; David R. BoulwareSource :
- Open Forum Infectious Diseases [ 2328-8957 ] ; 2015.
Abstract
Url:
DOI: 10.1093/ofid/ofv157
PubMed: 26716103
PubMed Central: 4692307
Affiliations:
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Le document en format XML
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<author><name sortKey="Rolfes, Melissa A" sort="Rolfes, Melissa A" uniqKey="Rolfes M" first="Melissa A." last="Rolfes">Melissa A. Rolfes</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Medicine</addr-line>
,<institution>Medical School, University of Minnesota</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rhein, Joshua" sort="Rhein, Joshua" uniqKey="Rhein J" first="Joshua" last="Rhein">Joshua Rhein</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Medicine</addr-line>
,<institution>Medical School, University of Minnesota</institution>
</nlm:aff>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af2"><institution>Infectious Diseases Institute, Makerere University</institution>
,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Schutz, Charlotte" sort="Schutz, Charlotte" uniqKey="Schutz C" first="Charlotte" last="Schutz">Charlotte Schutz</name>
<affiliation wicri:level="1"><nlm:aff id="af3"><addr-line>Institute of Infectious Disease and Molecular Medicine and Department of Medicine</addr-line>
,<institution>University of Cape Town</institution>
,<country>South Africa</country>
</nlm:aff>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Taseera, Kabanda" sort="Taseera, Kabanda" uniqKey="Taseera K" first="Kabanda" last="Taseera">Kabanda Taseera</name>
<affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Internal Medicine, Faculty of Medicine</addr-line>
,<institution>Mbarara University of Science and Technology, Mbarara</institution>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Nabeta, Henry W" sort="Nabeta, Henry W" uniqKey="Nabeta H" first="Henry W." last="Nabeta">Henry W. Nabeta</name>
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,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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</author>
<author><name sortKey="Huppler Hullsiek, Kathy" sort="Huppler Hullsiek, Kathy" uniqKey="Huppler Hullsiek K" first="Kathy" last="Huppler Hullsiek">Kathy Huppler Hullsiek</name>
<affiliation><nlm:aff id="af5"><addr-line>Division of Biostatistics</addr-line>
,<institution>School of Public Health, University of Minnesota</institution>
,<addr-line>Minneapolis</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Akampuira, Andrew" sort="Akampuira, Andrew" uniqKey="Akampuira A" first="Andrew" last="Akampuira">Andrew Akampuira</name>
<affiliation wicri:level="1"><nlm:aff id="af2"><institution>Infectious Diseases Institute, Makerere University</institution>
,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af6"><addr-line>Department of Microbiology</addr-line>
,<institution>College of Health Sciences, Makerere University</institution>
,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Rajasingham, Radha" sort="Rajasingham, Radha" uniqKey="Rajasingham R" first="Radha" last="Rajasingham">Radha Rajasingham</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Medicine</addr-line>
,<institution>Medical School, University of Minnesota</institution>
</nlm:aff>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af2"><institution>Infectious Diseases Institute, Makerere University</institution>
,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Musubire, Abdu" sort="Musubire, Abdu" uniqKey="Musubire A" first="Abdu" last="Musubire">Abdu Musubire</name>
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,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Williams, Darlisha A" sort="Williams, Darlisha A" uniqKey="Williams D" first="Darlisha A." last="Williams">Darlisha A. Williams</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Medicine</addr-line>
,<institution>Medical School, University of Minnesota</institution>
</nlm:aff>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af2"><institution>Infectious Diseases Institute, Makerere University</institution>
,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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</author>
<author><name sortKey="Thienemann, Friedrich" sort="Thienemann, Friedrich" uniqKey="Thienemann F" first="Friedrich" last="Thienemann">Friedrich Thienemann</name>
<affiliation wicri:level="1"><nlm:aff id="af3"><addr-line>Institute of Infectious Disease and Molecular Medicine and Department of Medicine</addr-line>
,<institution>University of Cape Town</institution>
,<country>South Africa</country>
</nlm:aff>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Bohjanen, Paul R" sort="Bohjanen, Paul R" uniqKey="Bohjanen P" first="Paul R." last="Bohjanen">Paul R. Bohjanen</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Medicine</addr-line>
,<institution>Medical School, University of Minnesota</institution>
</nlm:aff>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af2"><institution>Infectious Diseases Institute, Makerere University</institution>
,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Muzoora, Conrad" sort="Muzoora, Conrad" uniqKey="Muzoora C" first="Conrad" last="Muzoora">Conrad Muzoora</name>
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,<institution>Mbarara University of Science and Technology, Mbarara</institution>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Meintjes, Graeme" sort="Meintjes, Graeme" uniqKey="Meintjes G" first="Graeme" last="Meintjes">Graeme Meintjes</name>
<affiliation wicri:level="1"><nlm:aff id="af3"><addr-line>Institute of Infectious Disease and Molecular Medicine and Department of Medicine</addr-line>
,<institution>University of Cape Town</institution>
,<country>South Africa</country>
</nlm:aff>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af7"><addr-line>Department of Medicine</addr-line>
,<institution>Imperial College London</institution>
,<country>United Kingdom</country>
</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Meya, David B" sort="Meya, David B" uniqKey="Meya D" first="David B." last="Meya">David B. Meya</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Medicine</addr-line>
,<institution>Medical School, University of Minnesota</institution>
</nlm:aff>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af2"><institution>Infectious Diseases Institute, Makerere University</institution>
,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af8"><institution>School of Medicine, College of Health Sciences, Makerere University</institution>
,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Boulware, David R" sort="Boulware, David R" uniqKey="Boulware D" first="David R." last="Boulware">David R. Boulware</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Medicine</addr-line>
,<institution>Medical School, University of Minnesota</institution>
</nlm:aff>
</affiliation>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Cerebrospinal Fluid Culture Positivity and Clinical Outcomes After Amphotericin-Based Induction Therapy for Cryptococcal Meningitis</title>
<author><name sortKey="Rolfes, Melissa A" sort="Rolfes, Melissa A" uniqKey="Rolfes M" first="Melissa A." last="Rolfes">Melissa A. Rolfes</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Medicine</addr-line>
,<institution>Medical School, University of Minnesota</institution>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rhein, Joshua" sort="Rhein, Joshua" uniqKey="Rhein J" first="Joshua" last="Rhein">Joshua Rhein</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Medicine</addr-line>
,<institution>Medical School, University of Minnesota</institution>
</nlm:aff>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af2"><institution>Infectious Diseases Institute, Makerere University</institution>
,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Schutz, Charlotte" sort="Schutz, Charlotte" uniqKey="Schutz C" first="Charlotte" last="Schutz">Charlotte Schutz</name>
<affiliation wicri:level="1"><nlm:aff id="af3"><addr-line>Institute of Infectious Disease and Molecular Medicine and Department of Medicine</addr-line>
,<institution>University of Cape Town</institution>
,<country>South Africa</country>
</nlm:aff>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Taseera, Kabanda" sort="Taseera, Kabanda" uniqKey="Taseera K" first="Kabanda" last="Taseera">Kabanda Taseera</name>
<affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Internal Medicine, Faculty of Medicine</addr-line>
,<institution>Mbarara University of Science and Technology, Mbarara</institution>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Nabeta, Henry W" sort="Nabeta, Henry W" uniqKey="Nabeta H" first="Henry W." last="Nabeta">Henry W. Nabeta</name>
<affiliation wicri:level="1"><nlm:aff id="af2"><institution>Infectious Diseases Institute, Makerere University</institution>
,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Huppler Hullsiek, Kathy" sort="Huppler Hullsiek, Kathy" uniqKey="Huppler Hullsiek K" first="Kathy" last="Huppler Hullsiek">Kathy Huppler Hullsiek</name>
<affiliation><nlm:aff id="af5"><addr-line>Division of Biostatistics</addr-line>
,<institution>School of Public Health, University of Minnesota</institution>
,<addr-line>Minneapolis</addr-line>
</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Akampuira, Andrew" sort="Akampuira, Andrew" uniqKey="Akampuira A" first="Andrew" last="Akampuira">Andrew Akampuira</name>
<affiliation wicri:level="1"><nlm:aff id="af2"><institution>Infectious Diseases Institute, Makerere University</institution>
,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af6"><addr-line>Department of Microbiology</addr-line>
,<institution>College of Health Sciences, Makerere University</institution>
,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Rajasingham, Radha" sort="Rajasingham, Radha" uniqKey="Rajasingham R" first="Radha" last="Rajasingham">Radha Rajasingham</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Medicine</addr-line>
,<institution>Medical School, University of Minnesota</institution>
</nlm:aff>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af2"><institution>Infectious Diseases Institute, Makerere University</institution>
,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Musubire, Abdu" sort="Musubire, Abdu" uniqKey="Musubire A" first="Abdu" last="Musubire">Abdu Musubire</name>
<affiliation wicri:level="1"><nlm:aff id="af2"><institution>Infectious Diseases Institute, Makerere University</institution>
,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Williams, Darlisha A" sort="Williams, Darlisha A" uniqKey="Williams D" first="Darlisha A." last="Williams">Darlisha A. Williams</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Medicine</addr-line>
,<institution>Medical School, University of Minnesota</institution>
</nlm:aff>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af2"><institution>Infectious Diseases Institute, Makerere University</institution>
,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Thienemann, Friedrich" sort="Thienemann, Friedrich" uniqKey="Thienemann F" first="Friedrich" last="Thienemann">Friedrich Thienemann</name>
<affiliation wicri:level="1"><nlm:aff id="af3"><addr-line>Institute of Infectious Disease and Molecular Medicine and Department of Medicine</addr-line>
,<institution>University of Cape Town</institution>
,<country>South Africa</country>
</nlm:aff>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Bohjanen, Paul R" sort="Bohjanen, Paul R" uniqKey="Bohjanen P" first="Paul R." last="Bohjanen">Paul R. Bohjanen</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Medicine</addr-line>
,<institution>Medical School, University of Minnesota</institution>
</nlm:aff>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af2"><institution>Infectious Diseases Institute, Makerere University</institution>
,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Muzoora, Conrad" sort="Muzoora, Conrad" uniqKey="Muzoora C" first="Conrad" last="Muzoora">Conrad Muzoora</name>
<affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Internal Medicine, Faculty of Medicine</addr-line>
,<institution>Mbarara University of Science and Technology, Mbarara</institution>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Meintjes, Graeme" sort="Meintjes, Graeme" uniqKey="Meintjes G" first="Graeme" last="Meintjes">Graeme Meintjes</name>
<affiliation wicri:level="1"><nlm:aff id="af3"><addr-line>Institute of Infectious Disease and Molecular Medicine and Department of Medicine</addr-line>
,<institution>University of Cape Town</institution>
,<country>South Africa</country>
</nlm:aff>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af7"><addr-line>Department of Medicine</addr-line>
,<institution>Imperial College London</institution>
,<country>United Kingdom</country>
</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Meya, David B" sort="Meya, David B" uniqKey="Meya D" first="David B." last="Meya">David B. Meya</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Medicine</addr-line>
,<institution>Medical School, University of Minnesota</institution>
</nlm:aff>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af2"><institution>Infectious Diseases Institute, Makerere University</institution>
,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af8"><institution>School of Medicine, College of Health Sciences, Makerere University</institution>
,<addr-line>Kampala</addr-line>
,<country>Uganda</country>
</nlm:aff>
<country xml:lang="fr">Ouganda</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Boulware, David R" sort="Boulware, David R" uniqKey="Boulware D" first="David R." last="Boulware">David R. Boulware</name>
<affiliation><nlm:aff id="af1"><addr-line>Department of Medicine</addr-line>
,<institution>Medical School, University of Minnesota</institution>
</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Open Forum Infectious Diseases</title>
<idno type="eISSN">2328-8957</idno>
<imprint><date when="2015">2015</date>
</imprint>
</series>
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<front><div type="abstract" xml:lang="en"><p><bold><italic>Background.</italic>
</bold>
Amphotericin-based combination antifungal therapy reduces mortality from human immunodeficiency virus (HIV)-associated cryptococcal meningitis. However, 40%–50% of individuals have positive cerebrospinal fluid (CSF) fungal cultures at completion of 2 weeks of amphotericin induction therapy. Residual CSF culture positivity has historically been associated with poor clinical outcomes. We investigated whether persistent CSF fungemia was associated with detrimental clinical outcomes in a contemporary African cohort.</p>
<p><bold><italic>Methods.</italic>
</bold>
Human immunodeficiency virus-infected individuals with cryptococcal meningitis in Uganda and South Africa received amphotericin (0.7–1.0 mg/kg per day) plus fluconazole (800 mg/day) for 2 weeks, followed by “enhanced consolidation” therapy with fluconazole 800 mg/day for at least 3 weeks or until cultures were sterile, and then 400 mg/day for 8 weeks. Participants were randomized to receive antiretroviral therapy (ART) either 1–2 or 5 weeks after diagnosis and observed for 6 months. Survivors were classified as having sterile or nonsterile CSF based on 2-week CSF cultures. Mortality, immune reconstitution inflammatory syndrome (IRIS), and culture-positive relapse were compared in those with sterile or nonsterile CSF using Cox regression.</p>
<p><bold><italic>Results.</italic>
</bold>
Of 132 participants surviving 2 weeks, 57% had sterile CSF at 2 weeks, 23 died within 5 weeks, and 40 died within 6 months. Culture positivity was not significantly associated with mortality (adjusted 6-month hazard ratio, 1.2; 95% confidence interval, 0.6–2.3; <italic>P</italic>
= .28). Incidence of IRIS or relapse was also not significantly related to culture positivity.</p>
<p><bold><italic>Conclusions.</italic>
</bold>
Among patients, all treated with enhanced consolidation antifungal therapy and ART, residual cryptococcal culture positivity was not found to be associated with poor clinical outcomes.</p>
</div>
</front>
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</div1>
</back>
</TEI>
<affiliations><list><country><li>Afrique du Sud</li>
<li>Ouganda</li>
<li>Royaume-Uni</li>
</country>
</list>
<tree><noCountry><name sortKey="Boulware, David R" sort="Boulware, David R" uniqKey="Boulware D" first="David R." last="Boulware">David R. Boulware</name>
<name sortKey="Huppler Hullsiek, Kathy" sort="Huppler Hullsiek, Kathy" uniqKey="Huppler Hullsiek K" first="Kathy" last="Huppler Hullsiek">Kathy Huppler Hullsiek</name>
<name sortKey="Rolfes, Melissa A" sort="Rolfes, Melissa A" uniqKey="Rolfes M" first="Melissa A." last="Rolfes">Melissa A. Rolfes</name>
</noCountry>
<country name="Ouganda"><noRegion><name sortKey="Rhein, Joshua" sort="Rhein, Joshua" uniqKey="Rhein J" first="Joshua" last="Rhein">Joshua Rhein</name>
</noRegion>
<name sortKey="Akampuira, Andrew" sort="Akampuira, Andrew" uniqKey="Akampuira A" first="Andrew" last="Akampuira">Andrew Akampuira</name>
<name sortKey="Akampuira, Andrew" sort="Akampuira, Andrew" uniqKey="Akampuira A" first="Andrew" last="Akampuira">Andrew Akampuira</name>
<name sortKey="Bohjanen, Paul R" sort="Bohjanen, Paul R" uniqKey="Bohjanen P" first="Paul R." last="Bohjanen">Paul R. Bohjanen</name>
<name sortKey="Meya, David B" sort="Meya, David B" uniqKey="Meya D" first="David B." last="Meya">David B. Meya</name>
<name sortKey="Meya, David B" sort="Meya, David B" uniqKey="Meya D" first="David B." last="Meya">David B. Meya</name>
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<name sortKey="Muzoora, Conrad" sort="Muzoora, Conrad" uniqKey="Muzoora C" first="Conrad" last="Muzoora">Conrad Muzoora</name>
<name sortKey="Nabeta, Henry W" sort="Nabeta, Henry W" uniqKey="Nabeta H" first="Henry W." last="Nabeta">Henry W. Nabeta</name>
<name sortKey="Rajasingham, Radha" sort="Rajasingham, Radha" uniqKey="Rajasingham R" first="Radha" last="Rajasingham">Radha Rajasingham</name>
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<name sortKey="Williams, Darlisha A" sort="Williams, Darlisha A" uniqKey="Williams D" first="Darlisha A." last="Williams">Darlisha A. Williams</name>
</country>
<country name="Afrique du Sud"><noRegion><name sortKey="Schutz, Charlotte" sort="Schutz, Charlotte" uniqKey="Schutz C" first="Charlotte" last="Schutz">Charlotte Schutz</name>
</noRegion>
<name sortKey="Meintjes, Graeme" sort="Meintjes, Graeme" uniqKey="Meintjes G" first="Graeme" last="Meintjes">Graeme Meintjes</name>
<name sortKey="Thienemann, Friedrich" sort="Thienemann, Friedrich" uniqKey="Thienemann F" first="Friedrich" last="Thienemann">Friedrich Thienemann</name>
</country>
<country name="Royaume-Uni"><noRegion><name sortKey="Meintjes, Graeme" sort="Meintjes, Graeme" uniqKey="Meintjes G" first="Graeme" last="Meintjes">Graeme Meintjes</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>
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