Because 5-FC is not available, Amph B alone followed by
fluconazole is the treatment of choice in Peru, but its
efficacy has not been extensively evaluated in Peruvian
patients. Some non-statistically significant differences in
CSF sterilization rates between Peruvian and North American
patients were observed by Pappas et al in a double
blind study comparing Amph B with and without interferon
gamma-1b.21 The group of 58 Peruvian participants
achieved a sterilization rate of 26% at week 2, compared
with the 33% sterilization rate of the North American
patients.
Mortality rates for AIDS-associated CM using Amph B with
and without 5-FC in developed countries are reported as
low as 5.5% in the first 2 weeks and 3.9% in the following 8
weeks.13 However, accumulated mortality rates in developing
countries are higher, ranging from 37% to 63%.6,14,22,23
The aim of the study is to describe the efficacy of the
therapy with Amph B alone followed by fluconazole, and to
determine the prognostic factors for failure at weeks 2 and
10 in Peruvian patients with AIDS-associated CM.