FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W3018497553> ?p ?o ?g. }

• W3018497553 abstract "Background Progressive disseminated histoplasmosis (PDH) is a serious fungal infection that affects people living with HIV. The best way to treat the condition is unclear. Objectives We assessed evidence in three areas of equipoise. 1. Induction. To compare efficacy and safety of initial therapy with liposomal amphotericin B versus initial therapy with alternative antifungals. 2. Maintenance. To compare efficacy and safety of maintenance therapy with 12 months of oral antifungal treatment with shorter durations of maintenance therapy. 3. Antiretroviral therapy (ART). To compare the outcomes of early initiation versus delayed initiation of ART. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register; Cochrane CENTRAL; MEDLINE (PubMed); Embase (Ovid); Science Citation Index Expanded, Conference Proceedings Citation Index‐Science, and BIOSIS Previews (all three in the Web of Science); the WHO International Clinical Trials Registry Platform, ClinicalTrials.gov, and the ISRCTN registry, all up to 20 March 2020. Selection criteria We evaluated studies assessing the use of liposomal amphotericin B and alternative antifungals for induction therapy; studies assessing the duration of antifungals for maintenance therapy; and studies assessing the timing of ART. We included randomized controlled trials (RCT), single‐arm trials, prospective cohort studies, and single‐arm cohort studies. Data collection and analysis Two review authors assessed eligibility and risk of bias, extracted data, and assessed certainty of evidence. We used the Cochrane 'Risk of bias' tool to assess risk of bias in randomized studies, and ROBINS‐I tool to assess risk of bias in non‐randomized studies. We summarized dichotomous outcomes using risk ratios (RRs), with 95% confidence intervals (CI). Main results We identified 17 individual studies. We judged eight studies to be at critical risk of bias, and removed these from the analysis. 1. Induction We found one RCT which compared liposomal amphotericin B to deoxycholate amphotericin B. Compared to deoxycholate amphotericin B, liposomal amphotericin B may have higher clinical success rates (RR 1.46, 95% CI 1.01 to 2.11; 1 study, 80 participants; low‐certainty evidence). Compared to deoxycholate amphotericin B, liposomal amphotericin B has lower rates of nephrotoxicity (RR 0.25, 95% CI 0.09 to 0.67; 1 study, 77 participants; high‐certainty evidence). We found very low‐certainty evidence to inform comparisons between amphotericin B formulations and azoles for induction therapy. 2. Maintenance We found no eligible study that compared less than 12 months of oral antifungal treatment to 12 months or greater for maintenance therapy. For both induction and maintenance, fluconazole performed poorly in comparison to other azoles. 3. ART We found one study, in which one out of seven participants in the 'early' arm and none of the three participants in the 'late' arm died. Authors' conclusions Liposomal amphotericin B appears to be a better choice compared to deoxycholate amphotericin B for treating PDH in people with HIV; and fluconazole performed poorly compared to other azoles. Other treatment choices for induction, maintenance, and when to start ART have no evidence, or very low certainty evidence. PDH needs prospective comparative trials to help inform clinical decisions." @default.
• W3018497553 created "2020-05-01" @default.
• W3018497553 creator A5075385818 @default.
• W3018497553 creator A5088299441 @default.
• W3018497553 date "2020-04-28" @default.
• W3018497553 modified "2023-10-18" @default.
• W3018497553 title "Treating progressive disseminated histoplasmosis in people living with HIV" @default.
• W3018497553 cites W124634043 @default.
• W3018497553 cites W1527512666 @default.
• W3018497553 cites W1605275199 @default.
• W3018497553 cites W1672447118 @default.
• W3018497553 cites W1695905849 @default.
• W3018497553 cites W1863084052 @default.
• W3018497553 cites W1943467616 @default.
• W3018497553 cites W1964669822 @default.
• W3018497553 cites W1964956690 @default.
• W3018497553 cites W1972597679 @default.
• W3018497553 cites W1973699476 @default.
• W3018497553 cites W1975395332 @default.
• W3018497553 cites W1975950064 @default.
• W3018497553 cites W1981128005 @default.
• W3018497553 cites W1987613532 @default.
• W3018497553 cites W1990430831 @default.
• W3018497553 cites W1991149656 @default.
• W3018497553 cites W1992099768 @default.
• W3018497553 cites W1992562782 @default.
• W3018497553 cites W1995301599 @default.
• W3018497553 cites W1997305420 @default.
• W3018497553 cites W2018222003 @default.
• W3018497553 cites W2018668076 @default.
• W3018497553 cites W2020789506 @default.
• W3018497553 cites W2021905882 @default.
• W3018497553 cites W2029950196 @default.
• W3018497553 cites W2031132841 @default.
• W3018497553 cites W2037683016 @default.
• W3018497553 cites W2039374764 @default.
• W3018497553 cites W2046752598 @default.
• W3018497553 cites W2049442989 @default.
• W3018497553 cites W2051241295 @default.
• W3018497553 cites W2055331429 @default.
• W3018497553 cites W2059918537 @default.
• W3018497553 cites W2062273279 @default.
• W3018497553 cites W2068864263 @default.
• W3018497553 cites W2069578403 @default.
• W3018497553 cites W2070088559 @default.
• W3018497553 cites W2071816590 @default.
• W3018497553 cites W2072337394 @default.
• W3018497553 cites W2074115848 @default.
• W3018497553 cites W2079623898 @default.
• W3018497553 cites W20799351 @default.
• W3018497553 cites W2081805914 @default.
• W3018497553 cites W2081928767 @default.
• W3018497553 cites W2086292685 @default.
• W3018497553 cites W2089591479 @default.
• W3018497553 cites W2093305765 @default.
• W3018497553 cites W2093646756 @default.
• W3018497553 cites W2094704789 @default.
• W3018497553 cites W2097037108 @default.
• W3018497553 cites W2100207838 @default.
• W3018497553 cites W2101992303 @default.
• W3018497553 cites W2102456993 @default.
• W3018497553 cites W2103911482 @default.
• W3018497553 cites W2104711889 @default.
• W3018497553 cites W2105836233 @default.
• W3018497553 cites W2106309542 @default.
• W3018497553 cites W2107615361 @default.
• W3018497553 cites W2110278860 @default.
• W3018497553 cites W2115076078 @default.
• W3018497553 cites W2117574372 @default.
• W3018497553 cites W2124623086 @default.
• W3018497553 cites W2124896317 @default.
• W3018497553 cites W2126413941 @default.
• W3018497553 cites W2130316654 @default.
• W3018497553 cites W2134279666 @default.
• W3018497553 cites W2134494488 @default.
• W3018497553 cites W2138053364 @default.
• W3018497553 cites W2142213453 @default.
• W3018497553 cites W2142827512 @default.
• W3018497553 cites W2143320924 @default.
• W3018497553 cites W2148784609 @default.
• W3018497553 cites W2156446522 @default.
• W3018497553 cites W2157024131 @default.
• W3018497553 cites W2157417559 @default.
• W3018497553 cites W2166258838 @default.
• W3018497553 cites W2168978486 @default.
• W3018497553 cites W2208606682 @default.
• W3018497553 cites W2230722801 @default.
• W3018497553 cites W2312593703 @default.
• W3018497553 cites W2318259553 @default.
• W3018497553 cites W2324490192 @default.
• W3018497553 cites W2334314554 @default.
• W3018497553 cites W2357730895 @default.
• W3018497553 cites W2409859420 @default.
• W3018497553 cites W2417671363 @default.
• W3018497553 cites W2425854497 @default.
• W3018497553 cites W2487279353 @default.
• W3018497553 cites W2520212548 @default.
• W3018497553 cites W2531269403 @default.
• W3018497553 cites W2579989810 @default.
• W3018497553 cites W2605214394 @default.

• next