Abstract | OBJECTIVES: METHODS: We searched PubMed and four other databases to identify randomized controlled trials (RCTs) and cohort studies. Two independent reviewers searched the databases, identified studies and extracted data. Risk ratios (RRs) were pooled across studies using random-effects models. RESULTS: Nine studies were included (five RCTs, three retrospective cohort studies and one prospective cohort study). In comparison to P-S, treatment with P-C or TMP-SMX was associated with similar rates of partial or complete clinical response [P-C: RR 0.87; 95% confidence interval (CI) 0.70-1.08; TMP-SMX: RR 0.97; 95% CI 0.78-1.21], radiological response (P-C: RR 0.92; 95% CI 0.82-1.03), skin rash (P-C: RR 0.81; 95% CI 0.56-1.17; TMP-SMX: RR 0.17; 95% CI 0.02-1.29), gastrointestinal impairment (P-C: RR 5.16; 95% CI 0.66-40.11), and drug discontinuation because of adverse events (P-C: RR 0.32; 95% CI 0.07-1.47). Liver impairment was more frequent with P-S than P-C (P-C vs. P-S: RR 0.48; 95% CI 0.24-0.97). CONCLUSIONS: The current evidence fails to identify a superior regimen in terms of relative efficacy or safety for the treatment of HIV-associated cerebral toxoplasmosis. Use of TMP-SMX as preferred treatment may be consistent with the available evidence and other real-world considerations. Larger comparative studies are needed.
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Authors | A V Hernandez, P Thota, D Pellegrino, V Pasupuleti, V A Benites-Zapata, A Deshpande, A C Penalva de Oliveira, J E Vidal |
Journal | HIV medicine
(HIV Med)
Vol. 18
Issue 2
Pg. 115-124
(02 2017)
ISSN: 1468-1293 [Electronic] England |
PMID | 27353303
(Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
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Copyright | © 2016 British HIV Association. |
Chemical References |
- Antiprotozoal Agents
- Sulfadiazine
- Clindamycin
- Trimethoprim, Sulfamethoxazole Drug Combination
- Pyrimethamine
|
Topics |
- Adult
- Antiprotozoal Agents
(adverse effects, therapeutic use)
- Clindamycin
(adverse effects, therapeutic use)
- Cohort Studies
- Female
- HIV Infections
(complications)
- Humans
- Male
- Middle Aged
- Pyrimethamine
(adverse effects, therapeutic use)
- Randomized Controlled Trials as Topic
- Sulfadiazine
(adverse effects, therapeutic use)
- Toxoplasmosis, Cerebral
(drug therapy)
- Trimethoprim, Sulfamethoxazole Drug Combination
(adverse effects, therapeutic use)
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