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Single high-dose amphotericin B for cryptococcal meningitis: First Indian experience.

Rohit Vashisht¹, Sumit Arora², Abhinav Kumar³

¹Associate Professor, Department of Internal Medicine, Armed Forces Medical College, Pune, India.

Medical Journal, Armed Forces India

|June 4, 2025

Summary

A new, cost-effective liposomal amphotericin B regimen is recommended for cryptococcal meningitis in people living with HIV. This Indian experience highlights its use in two patients managed at military immunodeficiency centers.

Keywords:

Amphotericin Cryptococcal HIV Liposomal Meningitis

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Area of Science:

Infectious Diseases
HIV/AIDS Management
Pharmacology

Background:

Cryptococcus is a significant cause of central nervous system disease in people living with HIV (PLHIV).
Conventional Amphotericin B treatment regimens are often costly and associated with toxicity.
The World Health Organization (WHO) recommends a cost-effective, single high-dose liposomal amphotericin B regimen.

Observation:

This study presents the Indian experience with the WHO-recommended liposomal amphotericin B regimen.
Two patients with cryptococcal meningitis managed at Armed Forces immunodeficiency centers were treated with this regimen.

Findings:

The study details the clinical outcomes and management of these two cases.
This highlights the practical application of the new regimen in an Indian military healthcare setting.

Implications:

The findings suggest liposomal amphotericin B as a viable, cost-effective option for cryptococcal meningitis in PLHIV in India.
This approach may improve treatment accessibility and patient outcomes in resource-limited settings.
Further studies are warranted to evaluate the efficacy and safety in a larger cohort.