Mar 31, 2011
hi, my 8 year old nephew has been recently diagnosed with hiv + and cryptococus fungus infection although his parents are not detected with hiv +. he is currently getting fungisome injection. please tell me what could be the ideal treatment for him?
Response from Dr. McGowan
I am sorry to hear that your nephew is sick. The fungisome (amphotericin) will be used to suppress the cryptococcal fungus. This will ten be changed to medication by mouth (fluconazole). This medicine will be continued to keep the fungus under control until his immune system heals. Once the crypt is suppressed (usually after 2-3 weeks) medicine to fight the HIV (triple combination therapy) would be started to suppress the HIV. The HIV virus causes the imbalance of the immune system that allowed the crypt to grow. Once the HIV is suppressed his immune system will begin to restore its balance. During that time he has to be watched closely to be sure that as the immune system becomes stronger it does not cause an inflammatory reaction against the remainng cryptococcus. Sometimes, this may cause what looks like a flare-up or treatment failure of the crytp but is really just the immune system getting into the fight. Some people get fevers and can be quite ill during this "reconstitution" phase. As long as he is closely monitored he will get through it and in a few weeks will be much much better than he is now.
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