{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:01:45Z","timestamp":1792033305912,"version":"4.4.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T00:00:00Z","timestamp":1685059200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Histoplasmosis is a major AIDS-defining illness in Latin America. Liposomal amphotericin B (L-AmB) is the drug of choice for treatment, but access is restricted due to the high drug and hospitalization costs of the conventional long regimens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospective randomized multicenter open-label trial of 1- or 2-dose induction therapy with L-AmB versus control for disseminated histoplasmosis in AIDS, followed by oral itraconazole therapy. We randomized subjects to: (i) single dose 10 mg\/kg of L-AmB; (ii) 10 mg\/kg of L-AmB on D1, and 5 mg\/kg of L-AmB on D3; (iii) 3 mg\/kg of L-AmB daily for 2 weeks (control). The primary outcome was clinical response (resolution of fever and signs\/symptoms attributable to histoplasmosis) at day 14.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 118 subjects were randomized, and median CD4+ counts, and clinical presentations were similar between arms. Infusion-related toxicity, kidney toxicity at multiple time-points, and frequency of anemia, hypokalemia, hypomagnesemia, and liver toxicity were similar. Day 14 clinical response was 84% for single-dose L-AmB, 69% 2-dose L-AmB, and 74% for control arm (P = .69). Overall survival on D14 was 89.0% (34\/38) for single-dose L-AmB, 78.0% (29\/37) for 2-dose L-AmB, and 92.1% (35\/38) for control arm (P = .82).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>One day induction therapy with 10 mg\/kg of L-AmB in AIDS-related histoplasmosis was safe. Although clinical response may be non-inferior to standard L-AmB therapy, a confirmatory phase III clinical trial is needed. A single induction dose would markedly reduce drug-acquisition costs (&amp;gt;4-fold) and markedly shorten and simplify treatment, which are key points in terms of increased access.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciad313","type":"journal-article","created":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T09:33:56Z","timestamp":1685093636000},"page":"1126-1132","source":"Crossref","is-referenced-by-count":43,"title":["Single High Dose of Liposomal Amphotericin B in Human Immunodeficiency Virus\/AIDS-Related Disseminated Histoplasmosis: A Randomized Trial"],"prefix":"10.1093","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6782-5395","authenticated-orcid":false,"given":"Alessandro C","family":"Pasqualotto","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine and Post-Graduation Program in Pathology, Universidade Federal de Ci\u00eancias da Sa\u00fade de Porto Alegre , Porto Alegre ,","place":["Brazil"]},{"name":"Infectious Diseases and Internal Medicine Services, Santa Casa de Miseric\u00f3rdia de Porto Alegre , Porto Alegre ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiane Dalla","family":"Lana","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Post-Graduation Program in Pathology, Universidade Federal de Ci\u00eancias da Sa\u00fade de Porto Alegre , Porto Alegre ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassia S M","family":"Godoy","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital de Doen\u00e7as Tropicais , Goi\u00e2nia ,","place":["Brazil"]},{"name":"Department of Research and Education, Pontif\u00edcia Universidade Cat\u00f3lica de Goi\u00e1s , Goi\u00e2nia ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terezinha do Menino Jesus Silva","family":"Leit\u00e3o","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas , Fortaleza ,","place":["Brazil"]},{"name":"Department of Public Health, Federal University of Cear\u00e1 , Fortaleza ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica B","family":"Bay","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Federal University of Rio Grande do Norte , Natal ,","place":["Brazil"]},{"name":"Infectious Diseases Service, Giselda Trigueiro Hospital and Instituto de Medicina Tropical do Rio Grande do Norte , Natal ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisandra Serra","family":"Damasceno","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas , Fortaleza ,","place":["Brazil"]},{"name":"Department of Public Health, Federal University of Cear\u00e1 , Fortaleza ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata B A","family":"Soares","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital de Doen\u00e7as Tropicais , Goi\u00e2nia ,","place":["Brazil"]},{"name":"Department of Research and Education, Pontif\u00edcia Universidade Cat\u00f3lica de Goi\u00e1s , Goi\u00e2nia ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Kist","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Internal Medicine Services, Santa Casa de Miseric\u00f3rdia de Porto Alegre , Porto Alegre ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa R","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Post-Graduation Program in Pathology, Universidade Federal de Ci\u00eancias da Sa\u00fade de Porto Alegre , Porto Alegre ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denusa","family":"Wiltgen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Post-Graduation Program in Pathology, Universidade Federal de Ci\u00eancias da Sa\u00fade de Porto Alegre , Porto Alegre ,","place":["Brazil"]},{"name":"Infectious Diseases and Internal Medicine Services, Santa Casa de Miseric\u00f3rdia de Porto Alegre , Porto Alegre ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marineide","family":"Melo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital Nossa Senhora da Concei\u00e7\u00e3o , Porto Alegre ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taiguara F","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital de Doen\u00e7as Tropicais , Goi\u00e2nia ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilia R","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Universidade de S\u00e3o Paulo , S\u00e3o Paulo ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hareton T","family":"Vechi","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Federal University of Rio Grande do Norte , Natal ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jac\u00f3 R L","family":"de Mesquita","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas , Fortaleza ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria Regina de G","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Federal University of Rio 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