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Passive Administration of Monoclonal Antibodies Against H. capsulatum and Others Fungal Pathogens
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Passive Administration of Monoclonal Antibodies Against H. capsulatum and Others Fungal Pathogens

Published on: February 15, 2011

Itraconazole in human histoplasmosis

R Negroni, A M Robles, A Arechavala

    Mycoses
    |March 1, 1989
    PubMed

    Insights

    Itraconazole effectively treated progressive human histoplasmosis in an open trial. Most patients achieved clinical cure with minimal side effects, suggesting it as a preferred treatment for immunocompetent individuals.

    Area of Science:

    • Mycology
    • Infectious Diseases
    • Clinical Pharmacology

    Background:

    • Human histoplasmosis is a serious fungal infection, particularly in its progressive forms.
    • Treatment options for disseminated and chronic histoplasmosis can be limited, especially in immunocompetent patients.
    • Itraconazole is a broad-spectrum antifungal agent with potential utility in histoplasmosis management.

    Purpose of the Study:

    • To evaluate the efficacy and safety of itraconazole in treating progressive forms of human histoplasmosis.
    • To assess treatment outcomes in patients with chronic disseminated, chronic pulmonary, and subacute disseminated histoplasmosis.
    • To determine the long-term impact of itraconazole therapy on clinical status and immunological markers.

    Main Methods:

    • A non-comparative, open-label trial involving 32 patients who completed 6 months of itraconazole treatment.
    • Patients received 100 mg/day orally for 2 months, followed by 50 mg/day for 4 months.
    • Clinical cure, improvement, relapse rates, serological markers (complement fixation titers), skin test conversion, erythrocyte sedimentation rate, and adverse events were monitored.

    Main Results:

    • Clinical cure was achieved in 29 out of 32 patients; two showed significant improvement.
    • No relapses were observed during follow-up exceeding one year in 23 patients.
    • Positive immunological responses included decreasing complement fixation titers (19/32), conversion of negative skin tests to positive (8/10), and reduced erythrocyte sedimentation rates (24/32).
    • Mild, transient elevations in hepatic enzymes were noted in 9 patients, with no significant long-term adverse effects reported.

    Conclusions:

    • Itraconazole demonstrated high efficacy and a favorable safety profile in treating progressive human histoplasmosis.
    • The drug appears to be a promising and potentially preferred treatment option for immunocompetent patients with this fungal infection.
    • Itraconazole therapy led to significant clinical and immunological improvements, supporting its role in managing histoplasmosis.

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