Fighting cryptococcal meningitis with better treatments and improved access

In summary

Cryptococcal meningitis, a life-threatening fungal infection affecting people with advanced HIV, causes 180,000 deaths each year.

In Africa, where 70% of patients die within three months, Professor Tom Harrison and the Cryptococcal Meningitis Group are pioneering safer treatment regimens and working to make essential medicines accessible to all.

What did we explore and how?

Professor Tom Harrison, alongside Angela Loyse, Sile Molloy, and Tihana Bicanic at City St George’s, has led global clinical trials into better treatment options for cryptococcal meningitis.

Their work showed that shortening the amphotericin treatment from two weeks to one significantly reduces side effects while maintaining effectiveness.

They also developed a safer alternative: a combination of flucytosine and fluconazole, avoiding the toxic effects of amphotericin.

We have shown that reducing the amphotericin course from two weeks to one is better for patients because they get the benefit of the drug while avoiding the side effects.

Based on our results, the WHO immediately revised their treatment guidelines for cryptococcal meningitis.

Early experiences are encouraging, So we should see a reduction in the number of deaths from cryptococcal meningitis over the next few years.

Benefits and influence of this research

The research directly influenced the World Health Organization’s global treatment guidelines, which were updated based on results from City St George’s clinical trials.

However, access to flucytosine has long been a challenge in Africa. Thanks to a $20 million grant from Unitaid, supply and affordability are now improving across several countries.

I am now back on my feet, and so could be many other people living with HIV if we only made testing and treatment of opportunistic infections available to them.