Effect of successful treatment with amphotericin B on Histoplasma capsulatum variety capsulatum polysaccharide antigen levels in patients with AIDS and histoplasmosis

L. Joseph Wheat, Patricia Connolly-Stringfield, Robinette Blair, Kathleen Connolly, Todd Garringer, Barry Katz, Mala Gupta

Research output: Contribution to journalArticle

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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.

Original languageEnglish
Pages (from-to)153-160
Number of pages8
JournalThe American Journal of Medicine
Volume92
Issue number2
DOIs
StatePublished - 1992

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Histoplasma
Histoplasmosis
Amphotericin B
Polysaccharides
Acquired Immunodeficiency Syndrome
Antigens
Urine
Therapeutics
Serum
Body Fluids
Radioimmunoassay

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Effect of successful treatment with amphotericin B on Histoplasma capsulatum variety capsulatum polysaccharide antigen levels in patients with AIDS and histoplasmosis. / Wheat, L. Joseph; Connolly-Stringfield, Patricia; Blair, Robinette; Connolly, Kathleen; Garringer, Todd; Katz, Barry; Gupta, Mala.

In: The American Journal of Medicine, Vol. 92, No. 2, 1992, p. 153-160.

Research output: Contribution to journalArticle

Wheat, L. Joseph ; Connolly-Stringfield, Patricia ; Blair, Robinette ; Connolly, Kathleen ; Garringer, Todd ; Katz, Barry ; Gupta, Mala. / Effect of successful treatment with amphotericin B on Histoplasma capsulatum variety capsulatum polysaccharide antigen levels in patients with AIDS and histoplasmosis. In: The American Journal of Medicine. 1992 ; Vol. 92, No. 2. pp. 153-160.
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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.",
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AU - Katz, Barry

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