Publications by authors named "Abduljewad Wele"
Cerebrospinal fluid (CSF) protein levels exhibit high variability in HIV-associated cryptococcal meningitis; however, its clinical implications remain unclear. We analyzed data from 890 adults with HIV-associated cryptococcal meningitis randomized into two clinical trials in Uganda between 2015 and 2021. CSF protein was grouped into < 100 mg/dl (72%, n = 641) and ≥ 100 mg/dl (28%, n = 249).
View Article and Find Full Text PDFArticle Synopsis
- Individuals with HIV and cryptococcal antigenemia face a high risk of developing cryptococcal meningitis or death, with factors like baseline CrAg titer and CRP levels being crucial for assessing outcomes.* -
- In a study of 182 participants, those with elevated CRP levels had a higher rate of meningitis or death compared to those with normal CRP levels, specifically revealing that elevated CRP impacted low CrAg titer individuals more significantly.* -
- The research indicates a complex relationship between CrAg titers and CRP levels, suggesting that future studies should further explore this interaction to improve patient risk assessments and outcomes.*
Article Synopsis
- Cryptococcal meningitis poses a significant risk for individuals with AIDS, and the study aims to evaluate if adding a high-dose of liposomal amphotericin B to fluconazole can reduce the incidence of meningitis among asymptomatic CrAg-positive individuals.
- In a trial with participants from Uganda, those with low plasma CrAg titers were given either liposomal amphotericin B with fluconazole or fluconazole alone for 24 weeks to assess meningitis-free survival.
- Results showed no significant difference in meningitis or death rates between the two groups, suggesting that for asymptomatic patients with low CrAg levels, adding liposomal amphotericin B does not improve outcomes and may lead to
Background: Limited data exist on the antifungal activity of daily liposomal amphotericin B with flucytosine induction regimens for cryptococcal meningitis, which are recommended in high-income countries. Liposomal amphotericin B monotherapy at 3 mg/kg previously failed to meet non-inferiority criteria compared to amphotericin B deoxycholate in its registrational clinical trial. We aimed to compare the quantitative antifungal activity and mortality between daily amphotericin B deoxycholate and daily liposomal amphotericin among persons with HIV-related cryptococcal meningitis receiving adjunctive flucytosine 100 mg/kg/day.
View Article and Find Full Text PDFArticle Synopsis
- In a study of 890 adults with HIV-associated cryptococcal meningitis, researchers found that cerebrospinal fluid (CSF) protein levels varied significantly, impacting clinical outcomes.
- Approximately one-third of the participants had elevated CSF protein (≥100 mg/dL), leading to associations with more severe clinical presentations, such as impaired consciousness and seizures, but also indicated better fungal clearance and immune responses.
- The study concluded that higher CSF protein levels could be a useful indicator for immune activation and could help predict patient prognosis in cryptococcal meningitis.
Article Synopsis
- * This study investigates the impact of hyponatremia in asymptomatic individuals who have cryptococcal antigenemia (the presence of cryptococcal antigens in the blood).
- * It finds that having serum hyponatremia levels at or below 130 mmol/L independently raises the risk of developing meningitis and increases mortality in these individuals.