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Effect of successful treatment with amphotericin B on Histoplasma capsulatum variety capsulatum polysaccharide antigen levels in patients with AIDS and histoplasmosis.
Am J Med. 1992 Feb; 92(2):153-60.AJ

Abstract

PURPOSE

The purpose of this study was to establish the effect of induction and maintenance treatment with amphotericin B on levels of Histoplasma capsulatum var. capsulatum polysaccharide antigen (HPA) in the urine and blood of patients with acquired immunodeficiency syndrome (AIDS) and disseminated histoplasmosis.

PATIENTS AND METHODS

This was a retrospective study of the effect of amphotericin B treatment on levels of HPA in the urine or serum from 70 patients with AIDS and disseminated histoplasmosis. All patients received initial intensive induction treatment with amphotericin B, and a subset continued to receive amphotericin B at less frequent intervals for maintenance therapy to prevent relapse. Treatment regimens varied in intensity and duration and specimens were obtained at irregular intervals. Urine and serum specimens were stored and retested for HPA in the same radioimmunoassay.

RESULTS

HPA levels in serum decreased by at least 2 units during induction therapy in all 19 (100%) patients with initial levels of greater than or equal to 2.6 units and reverted to negative in 40.9% of those with initial levels of greater than or equal to 1.0 unit. HPA in urine decreased by at least 2 units in 84.8% and reverted to negative in 17.3% of patients. During induction treatment, HPA cleared more rapidly from serum than from urine. During maintenance treatment, HPA levels in serum decreased by at least 2 units in 100% and became negative in 66.7%. HPA in urine decreased by at least 2 units in 54.5% and reverted to negative in 20.0%. Rates of clearance of HPA from the serum and urine were similar, 0.01 unit/week compared with -0.04 unit/week, respectively, but less than rates during induction treatment.

CONCLUSIONS

Successful therapy of histoplasmosis with amphotericin B is associated with reduction of HPA in body fluids. Periodic measurement of HPA levels offers a method for monitoring the response to therapy and for comparing new treatments for histoplasmosis.

Authors+Show Affiliations

Department of Internal Medicine, Indiana University School of Medicine, Indianapolis.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

1543199

Citation

Wheat, L J., et al. "Effect of Successful Treatment With Amphotericin B On Histoplasma Capsulatum Variety Capsulatum Polysaccharide Antigen Levels in Patients With AIDS and Histoplasmosis." The American Journal of Medicine, vol. 92, no. 2, 1992, pp. 153-60.
Wheat LJ, Connolly-Stringfield P, Blair R, et al. Effect of successful treatment with amphotericin B on Histoplasma capsulatum variety capsulatum polysaccharide antigen levels in patients with AIDS and histoplasmosis. Am J Med. 1992;92(2):153-60.
Wheat, L. J., Connolly-Stringfield, P., Blair, R., Connolly, K., Garringer, T., Katz, B. P., & Gupta, M. (1992). Effect of successful treatment with amphotericin B on Histoplasma capsulatum variety capsulatum polysaccharide antigen levels in patients with AIDS and histoplasmosis. The American Journal of Medicine, 92(2), 153-60.
Wheat LJ, et al. Effect of Successful Treatment With Amphotericin B On Histoplasma Capsulatum Variety Capsulatum Polysaccharide Antigen Levels in Patients With AIDS and Histoplasmosis. Am J Med. 1992;92(2):153-60. PubMed PMID: 1543199.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of successful treatment with amphotericin B on Histoplasma capsulatum variety capsulatum polysaccharide antigen levels in patients with AIDS and histoplasmosis. AU - Wheat,L J, AU - Connolly-Stringfield,P, AU - Blair,R, AU - Connolly,K, AU - Garringer,T, AU - Katz,B P, AU - Gupta,M, PY - 1992/2/1/pubmed PY - 1992/2/1/medline PY - 1992/2/1/entrez SP - 153 EP - 60 JF - The American journal of medicine JO - Am J Med VL - 92 IS - 2 N2 - PURPOSE: The purpose of this study was to establish the effect of induction and maintenance treatment with amphotericin B on levels of Histoplasma capsulatum var. capsulatum polysaccharide antigen (HPA) in the urine and blood of patients with acquired immunodeficiency syndrome (AIDS) and disseminated histoplasmosis. PATIENTS AND METHODS: This was a retrospective study of the effect of amphotericin B treatment on levels of HPA in the urine or serum from 70 patients with AIDS and disseminated histoplasmosis. All patients received initial intensive induction treatment with amphotericin B, and a subset continued to receive amphotericin B at less frequent intervals for maintenance therapy to prevent relapse. Treatment regimens varied in intensity and duration and specimens were obtained at irregular intervals. Urine and serum specimens were stored and retested for HPA in the same radioimmunoassay. RESULTS: HPA levels in serum decreased by at least 2 units during induction therapy in all 19 (100%) patients with initial levels of greater than or equal to 2.6 units and reverted to negative in 40.9% of those with initial levels of greater than or equal to 1.0 unit. HPA in urine decreased by at least 2 units in 84.8% and reverted to negative in 17.3% of patients. During induction treatment, HPA cleared more rapidly from serum than from urine. During maintenance treatment, HPA levels in serum decreased by at least 2 units in 100% and became negative in 66.7%. HPA in urine decreased by at least 2 units in 54.5% and reverted to negative in 20.0%. Rates of clearance of HPA from the serum and urine were similar, 0.01 unit/week compared with -0.04 unit/week, respectively, but less than rates during induction treatment. CONCLUSIONS: Successful therapy of histoplasmosis with amphotericin B is associated with reduction of HPA in body fluids. Periodic measurement of HPA levels offers a method for monitoring the response to therapy and for comparing new treatments for histoplasmosis. SN - 0002-9343 UR - https://www.unboundmedicine.com/medline/citation/1543199/Effect_of_successful_treatment_with_amphotericin_B_on_Histoplasma_capsulatum_variety_capsulatum_polysaccharide_antigen_levels_in_patients_with_AIDS_and_histoplasmosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0002-9343(92)90106-L DB - PRIME DP - Unbound Medicine ER -