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  1. Fluconazole compared with endoscopy for human immunodeficiency virus-infected patients with esophageal symptoms.

    Article - En anglais

    Background & Aims 

    The best initial treatment of human immunodeficiency virus (HIV) - infected patients with esophageal symptoms is unknown.

    The outcome, including safety and cost-effectiveness, of fluconazole compared with endoscopy as a treatment strategy for HIV-infected patients with new-onset esophageal symptoms was evaluated.

    Methods 

    During a 53-month period, 134 HIV-infected patients with esophageal symptoms were randomized prospectively to groups receiving either standard doses of fluconazole or endoscopy.

    Results 

    Among the 68 patients in the fluconazole group, a complete symptomatic response was observed in 56 patients (82%), usually within 1 week.

    The most common endoscopic findings in the 66 patients in the endoscopy group included Candida esophagitis alone in 42 patients (64%) and ulcerative esophagitis in 10 patients (15%). Patients responding to empirical antifungal therapy or who had Candida esophagitis alone at endoscopy were less likely to have severe symptoms (P=0.027) or odynophagia as the only symptom (P<0.001) but more frequently had odynophagia and dysphagia (P=0.007) and thrush (P=0.002).

    Empirical fluconazole was cost-effective, saving $738.16 per patient.

    Conclusions 

    Empirical oral antifungal therapy with fluconazole is highly efficacious, safe, and cost-effective for HIV-infected patients with new-onset esophageal symptoms.

    Mots-clés Pascal : SIDA, Virose, Infection, Virus immunodéficience humaine, Lentivirinae, Retroviridae, Virus, Complication, Symptomatologie, Oesophage, Stratégie, Traitement, Chimiothérapie, Antifongique, Fluconazole, Endoscopie, Etude comparative, Analyse avantage coût, Homme, Immunopathologie, Immunodéficit, Oesophage pathologie, Appareil digestif pathologie

    Mots-clés Pascal anglais : AIDS, Viral disease, Infection, Human immunodeficiency virus, Lentivirinae, Retroviridae, Virus, Complication, Symptomatology, Esophagus, Strategy, Treatment, Chemotherapy, Antifungal agent, Endoscopy, Comparative study, Cost benefit analysis, Human, Immunopathology, Immune deficiency, Esophageal disease, Digestive diseases

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0308029

    Code Inist : 002B06D01. Création : 10/04/1997.