Treatment and Prevention of Histoplasmosis in Adults Living with HIV
Abstract
1. Introduction
2. Pathophysiology
3. Clinical Manifestations
4. Prevalence
5. Treatment
6. Alternative Regimens
7. IRIS
8. Treatment Guidelines
9. Risk for Histoplasmosis
10. Prophylaxis
11. Non-Pharmacologic Strategies for Prevention
12. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Drug | Indication | Dose | Duration | Resistance | Evidence |
---|---|---|---|---|---|
Itraconazole | Mild–moderate | 200 mg tid for 3 d, then 200 mg bid | 12 months | No | Prospective single-arm study |
Liposomal amphotericin | Moderate or severe | 3–5 mg/kg/d | 1–2 weeks | No | Prospective randomized double-blind study |
Fluconazole | Not recommended | Yes | Prospective single-arm study |
Drug | Dose | Duration | Resistance | Evidence | Comment |
---|---|---|---|---|---|
Itraconazole | 200 mg bid | ≥12 months | No | Prospective single-arm study | Drug of choice Liquid formulation preferred if available |
Posaconazole | 300 mg extended release daily | ≥12 months | No | in vitro and animal model data; case reports | Limited experience |
Voriconazole | 200 mg bid | ≥12 months | Yes | in vitro data; single small case series | Less effective than itraconazole |
Fluconazole | 400 mg daily | ≥12 months | Yes | Prospective single-arm study | High risk of failure due to emergence of resistance |
Amphotericin deoxycholate | 50 mg q 2 weeks | ≥12 months | No | Single arm trial | IV required; potential for toxicity |
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McKinsey, D.S. Treatment and Prevention of Histoplasmosis in Adults Living with HIV. J. Fungi 2021, 7, 429. https://doi.org/10.3390/jof7060429
McKinsey DS. Treatment and Prevention of Histoplasmosis in Adults Living with HIV. Journal of Fungi. 2021; 7(6):429. https://doi.org/10.3390/jof7060429
Chicago/Turabian StyleMcKinsey, David S. 2021. "Treatment and Prevention of Histoplasmosis in Adults Living with HIV" Journal of Fungi 7, no. 6: 429. https://doi.org/10.3390/jof7060429
APA StyleMcKinsey, D. S. (2021). Treatment and Prevention of Histoplasmosis in Adults Living with HIV. Journal of Fungi, 7(6), 429. https://doi.org/10.3390/jof7060429