{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T16:22:48Z","timestamp":1793895768132,"version":"4.8.0"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["Ricerca Corrente Linea 2"],"award-info":[{"award-number":["Ricerca Corrente Linea 2"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Infection"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>\n                    Cryptococcal meningitis (CM) is a severe opportunistic infection in people living with HIV (PLWH). We report a 54-year-old man with advanced HIV infection who presented with CM due to\n                    <jats:italic toggle=\"yes\">Cryptococcus neoformans<\/jats:italic>\n                    . Induction therapy with liposomal amphotericin B (4\u2009mg\/kg\/day) plus fluconazole (800\u2009mg\/day) was prolonged to 10\u2009weeks because flucytosine was initially unavailable; intravenous flucytosine (25\u2009mg\/kg q6h) was introduced when accessible. Maintenance fluconazole (800\u2009mg\/day) was continued, and antiretroviral therapy (ART) with dolutegravir plus emtricitabine\/tenofovir disoproxil was initiated after 8\u2009weeks. One year later, despite virological suppression, he developed neurological deterioration compatible with recurrent CM in the absence of culture confirmation. He underwent re-induction with liposomal amphotericin B plus flucytosine, followed by off-label secondary prophylaxis with oral isavuconazole (200\u2009mg\/day). Over 6\u2009months, he maintained HIV-RNA suppression, showed CD4+ T-cell recovery (from 94 to 165\u2009cells\/mm\n                    <jats:sup>3<\/jats:sup>\n                    ), and experienced neurological stabilization without further CM episodes or drug-related toxicity. Isavuconazole\u2019s pharmacokinetic profile, oral availability, and limited antiretroviral drug\u2013drug interactions supported its use as extended secondary prophylaxis in this setting, although limited access in low- and middle-income countries remains a concern. This case highlights isavuconazole as a potential alternative prophylactic strategy when fluconazole is ineffective or not tolerated.\n                  <\/jats:p>","DOI":"10.1177\/20499361251395903","type":"journal-article","created":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T04:11:12Z","timestamp":1774066272000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Successful use of isavuconazole as secondary prophylaxis of cryptococcal meningitis in a person living with HIV and AIDS: a case report"],"prefix":"10.1177","volume":"13","author":[{"given":"Carmela","family":"Pinnetti","sequence":"first","affiliation":[{"name":"Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9031-619X","authenticated-orcid":false,"given":"Alessandro","family":"Giacinta","sequence":"additional","affiliation":[{"name":"Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Via Portuense 292, Rome 00149, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Cecilia","sequence":"additional","affiliation":[{"name":"Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy"},{"name":"Infectious Diseases Clinic, Department of Biomedicine and Prevention, Tor Vergata School of Medicine and Surgery, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Baldini","sequence":"additional","affiliation":[{"name":"Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Mondi","sequence":"additional","affiliation":[{"name":"Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saba","family":"Gebremeskel Tekl\u00e8","sequence":"additional","affiliation":[{"name":"Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Grisetti","sequence":"additional","affiliation":[{"name":"Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Camici","sequence":"additional","affiliation":[{"name":"Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatella","family":"Vincenti","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Carrara","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Fontana","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Antinori","sequence":"additional","affiliation":[{"name":"Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30243-8"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.02580-14"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2016.167"},{"key":"e_1_3_4_5_2","unstructured":"Guidelines for The Diagnosis Prevention and Management of Cryptococcal Disease in HIV-Infected Adults Adolescents and Children: Supplement to the 2016 Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection. Geneva: World Health Organization http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK531449\/ (2018 accessed 26 May 2024)."},{"key":"e_1_3_4_6_2","unstructured":"Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents With HIV. Cryptococcosis: Adult and Adolescent OIs | NIH (hiv.gov) (2024 1 July 2021)."},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12747"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1086\/649858"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dki288"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw305"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.26502\/acmcr.96550638"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(23)00731-4"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/mmy\/myz103"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1086\/515110"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-02-0733"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir745"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02474-18"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01292-17"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.3390\/jof7060425"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ571"}],"container-title":["Therapeutic Advances in Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20499361251395903","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20499361251395903","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20499361251395903","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:01:55Z","timestamp":1777593715000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20499361251395903"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":19,"alternative-id":["10.1177\/20499361251395903"],"URL":"https:\/\/doi.org\/10.1177\/20499361251395903","relation":{},"ISSN":["2049-9361","2049-937X"],"issn-type":[{"value":"2049-9361","type":"print"},{"value":"2049-937X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"article-number":"20499361251395903"}}