{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T08:53:22Z","timestamp":1780044802442,"version":"3.53.1"},"reference-count":11,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,9,19]],"date-time":"2022-09-19T00:00:00Z","timestamp":1663545600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K23AI140918"],"award-info":[{"award-number":["K23AI140918"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01AI162181"],"award-info":[{"award-number":["R01AI162181"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K23AI138851"],"award-info":[{"award-number":["K23AI138851"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The purpose of this systematic review is to provide updated evidence on the preferred induction therapy for the treatment of HIV\u2010associated cryptococcal meningitis considering the most recent evidence available in order to inform the need for updates to WHO guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched Medline via PubMed, EMBASE, the Cochrane Library and <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link> for published or completed randomized clinical trials that evaluated induction treatment of first episode HIV\u2010associated cryptococcal meningitis from 9 July 2018 (date of last search) to 1 September 2021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One randomized clinical trial of 844 people with HIV\u2010associated cryptococcal meningitis met the inclusion criteria. Participants were randomized to: (1) amphotericin deoxycholate for 7\u2009days, with flucytosine and fluconazole (control); or (2) a single dose of liposomal amphotericin 10\u00a0mg\/kg with flucytosine and fluconazole (intervention).<\/jats:p><jats:p>In the intention\u2010to\u2010treat analysis, 10\u2010week mortality was 24.8% [95% confidence interval (CI): 20.7\u201329.3%] in the single\u2010dose liposomal amphotericin group compared with 28.7% (95% CI: 24.4\u201333.4%) in the control group. The absolute difference in 10\u2010week mortality was \u22123.9% with an upper one\u2010sided 95% CI of 1.2%, within the 10% pre\u2010specified non\u2010inferiority margin. Fewer participants had grade 3 and 4 adverse events in the intervention arm compared with the control arm (50.0% vs. 62.3%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In the single study included in this systematic review, single high\u2010dose liposomal amphotericin B with flucytosine and fluconazole was non\u2010inferior to the WHO\u2010recommended standard of care induction therapy for HIV\u2010associated cryptococcal meningitis, with significantly fewer adverse events.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13412","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T05:09:04Z","timestamp":1663650544000},"page":"507-512","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["An updated systematic review of <scp>HIV<\/scp>\u2010associated cryptococcal meningitis treatment strategies"],"prefix":"10.1111","volume":"24","author":[{"given":"Adrienne E.","family":"Shapiro","sequence":"first","affiliation":[{"name":"Departments of Global Health &amp; Medicine University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark W.","family":"Tenforde","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention (CDC)  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom M.","family":"Chiller","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention (CDC)  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Ford","sequence":"additional","affiliation":[{"name":"Department of HIV and Global Hepatitis Programme World Health Organization  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radha","family":"Rajasingham","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases &amp; International Medicine, Department of Medicine University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30243-8"},{"issue":"7","key":"e_1_2_9_3_1","article-title":"Treatment for HIV\u2010associated cryptococcal meningitis","volume":"2018","author":"Tenforde MW","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_4_1","volume-title":"The Diagnosis, Prevention and Management of Cryptococcal Disease in HIV\u2010Infected Adults, Adolescents and Children","author":"World Health Organization","year":"2018"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1710922"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25416"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2111904"},{"key":"e_1_2_9_8_1","volume-title":"Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events","author":"U.S. Department of Health and Human Services NIoH, National Institute of Allergy and Infectious Diseases, Division of AIDS","year":"2017"},{"key":"e_1_2_9_9_1","unstructured":"Veritas Health Innovation.Covidence systematic review software. Accessed November 1 2021.https:\/\/www.covidence.org\/"},{"key":"e_1_2_9_10_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 6.2","author":"Higgins JPTTJ","year":"2021"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30909-9"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001321"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.13412","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hiv.13412","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.13412","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T01:19:12Z","timestamp":1692667152000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.13412"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,19]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1111\/hiv.13412"],"URL":"https:\/\/doi.org\/10.1111\/hiv.13412","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"value":"1464-2662","type":"print"},{"value":"1468-1293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,19]]},"assertion":[{"value":"2022-06-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}