Efficacy and safety of different preparations of amphotericin B in the treatment of AIDS complicated with talaromycosis
10.16718/j.1009-7708.2025.03.004
- VernacularTitle:不同制剂两性霉素B治疗艾滋病合并马尔尼菲篮状菌病的疗效及安全性分析
- Author:
Qiqi XIAO
1
;
Min YU
;
Jianrong LUO
;
Yonggang CHEN
Author Information
1. 大理大学药学院,云南大理 671000
- Publication Type:Journal Article
- Keywords:
amphotericin B;
acquired immune deficiency syndrome;
talaromycosis;
efficacy;
safety
- From:
Chinese Journal of Infection and Chemotherapy
2025;25(3):259-264
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the anti fungal efficacy and safety of amphotericin B cholesteryl sulfate complex(amphotericin B colloidal dispersion,ABCD)and amphotericin B for injection(amphotericin B deoxycholate,AmB-D)in the treatment of AIDS complicated with talaromycosis(TSM).Methods A total of 80 patients who were diagnosed with AIDS and complicated with TSM from December 2021 to January 2024 in Department of Infection,Kunming Third People's Hospital were included in the study.The patients were randomized to receive ABCD(n=40)via intravenous infusion or AmB-D(control,n=40)via Ⅳ infusion protected from light.The overall treatment efficacy rate,CD4+T lymphocyte count,routine blood tests,liver and kidney function tests,K+concentration,and the incidence of adverse drug reactions(ADR)during study were compared between the two treatment groups.Results The overall efficacy rate was 87.5%(35/40)in ABCD group and 80.0%(32/40)in the control(AmB-D)group(P>0.05).WBC,hemoglobin,and platelet count were significantly higher after treatment compared with pretreatment levels(P<0.05)in both groups.The CD4+T lymphocyte count was higher after treatment compared with pretreatment levels in both groups.And the CD4+T lymphocyte count in ABCD group was significantly higher than that in the control group(P<0.05).The levels of total bilirubin,aspartate aminotransferase,alanine aminotransferase,blood urea nitrogen,and serum creatinine increased after treatment in both groups.Blood urea nitrogen and serum creatinine increased significantly in control group compared with ABCD group(P<0.05).After treatment,serum K+concentration decreased significantly in control group compared with the pretreatment level and compared with ABCD group(P<0.05).The incidence of adverse events in ABCD group was significantly lower than that in the control group.The time to renal injury was delayed significantly(P<0.05).Conclusions In the treatment of AIDS complicated with TSM,the efficacy of ABCD was comparable to AmB-D.The incidence of hepatic impairment did not show significant difference between ABCD and AmB-D.However,ABCD is associated with less renal impairment,lower incidence of adverse events,and better safety,which is valuable for clinical use.