caa a22 4500 475832779 CHVBK 20180406123845.0 cr unu---uuuuu 170329e20000301xx s 000 0 eng 10.1007/s100960050436 doi (NATIONALLICENCE)springer-10.1007/s100960050436 Thrice-Weekly Sulfadiazine-Pyrimethamine for Maintenance Therapy of Toxoplasmic Encephalitis in HIV-Infected Patients [Elektronische Daten] [D. Podzamczer, J. M Miró, E. Ferrer, J. M Gatell, J. M. Ramón, E. Ribera, G. Sirera, A. Cruceta, H. Knobel, P. Domingo, R. Polo, M. Leyes, J. Cosin, M. C. Fariñas, J. Arrizabalaga, J. Martínez-Lacasa, F. Gudiol]  An open, randomised, multicentre trial was conducted to evaluate the efficacy of thrice-weekly versus daily therapy with sulfadiazine-pyrimethamine in the prevention of relapses of toxoplasmic encephalitis in HIV-infected patients. Between February 1994 and July 1997, 124 patients with HIV infection were enrolled after resolution of the first acute episode of toxoplasmic encephalitis treated with sulfadiazine-pyrimethamine. Patients were randomly assigned to receive either a daily regimen consisting of sulfadiazine (1 g) twice a day plus 25 mg pyrimethamine and 15 mg folinic acid daily (n=58), or a thrice-weekly regimen consisting of the same doses of sulfadiazine and folinic acid plus 50 mg pyrimethamine (n=66). After a median follow-up period of 11 months (range 1-39 months), no differences were found in the incidence of toxoplasmic encephalitis relapses between the groups, there being 14.9 episodes per 100 patient-years (95% CI: 2.8-20.2) in the daily-regimen group versus 14.1 episodes (95% CI: 2.3-17.2) in the intermittent-regimen group. The estimated cumulative percentages of relapse at 12 months were 17% and 19%, respectively (P=0.91). In a Cox multivariate analysis, not taking antiretroviral therapy was the only variable independently associated with relapse (adjusted risk ratio: 4.08; 95%CI: 1.32-12.66). Baseline CD4+ cell counts, prior AIDS, mental status, sequelae and allocated maintenance therapy regimen were not independent predictors of relapse. No differences were observed in the survival rate (P=0.42), or in the incidence of severe adverse effects (P=0.79). The efficacy of the thrice-weekly regimen was similar to that of the daily regimen in the prevention of relapses of toxoplasmic encephalitis. Administration of antiretroviral therapy was the only factor associated with a lower incidence of relapse. Springer-Verlag Berlin Heidelberg, 2000 Podzamczer D. Infectious Disease Service, Ciutat Sanitària de Bellvitge, c/Feixa Llarga s/n. L'Hospitalet, 08907 Barcelona, Spain e-mail: dpodzamczer@csub.scs.es, ES aut Miró J. M. Institut d'Investigacions Biomèdiques August Pi i Sunyer, Infectious Disease Service, Hospital Clínic, c/Casanovas 143, 08036 Barcelona, Spain, ES aut Ferrer E. Infectious Disease Service, Ciutat Sanitària de Bellvitge, c/Feixa Llarga s/n. L'Hospitalet, 08907 Barcelona, Spain e-mail: dpodzamczer@csub.scs.es, ES aut Gatell J. M. Institut d'Investigacions Biomèdiques August Pi i Sunyer, Infectious Disease Service, Hospital Clínic, c/Casanovas 143, 08036 Barcelona, Spain, ES aut Ramón J. M. Preventive Medicine Service, Ciutat Sanitària de Bellvitge, c/Feixa Llarga, s/n. L'Hospitalet, 08907 Barcelona, Spain, ES aut Ribera E. Infectious Disease Service, Hospital Vall d'Hebró, Passeig, Vall d'Hebró 119-129, 08035 Barcelona, Spain, ES aut Sirera G. AIDS Unit, Hospital Germans Trías, Crta. Canyet, s/n. Badalona, 08015 Barcelona, Spain, ES aut Cruceta A. Institut d'Investigacions Biomèdiques August Pi i Sunyer, Infectious Disease Service, Hospital Clínic, c/Casanovas 143, 08036 Barcelona, Spain, ES aut Knobel H. Infectious Disease Service, Hospital del Mar, PO Marítimo, s/n. 08003 Barcelona, Spain, ES aut Domingo P. AIDS Unit, Hospital Sant Pau, Avda. Sant Antoni Ma Claret 167, 08025 Barcelona, Spain, ES aut Polo R. Infectious Disease Service, Instituto Carlos III, C/Sinieso Delgado 6, 28029 Madrid, Spain, ES aut Leyes M. Internal Medicine Service, Hospital Son Dureta, Andrea Doria 55, 07014 Palma de Mallorca, Spain, ES aut Cosin J. HIV-Infectious Diseases Service, Hospital Gregorio Marañón, C/Doctor Esquerdo 46, 28007 Madrid, Spain, ES aut Fariñas M. C. Internal Medicine Service, Hospital Marqués de Valdecillas, Av. Valdecillas, s/n. 39008 Santander, Spain, ES aut Arrizabalaga J. Infectious Disease Service, Hospital Nuestra Sra. de Aranzazu, Paseo Dr. Beguiristain, s/n. 20014 San Sebastián, Spain, ES aut Martínez-Lacasa J. Infectious Disease Service, Hospital Mutua de Tarrasa, Pza. Dr. Robert 5, 08221 Terrassa, Spain, ES aut Gudiol F. Infectious Disease Service, Ciutat Sanitària de Bellvitge, c/Feixa Llarga s/n. L'Hospitalet, 08907 Barcelona, Spain e-mail: dpodzamczer@csub.scs.es, ES aut https://doi.org/10.1007/s100960050436 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s100960050436 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Podzamczer D. Infectious Disease Service, Ciutat Sanitària de Bellvitge, c/Feixa Llarga s/n. L'Hospitalet, 08907 Barcelona, Spain e-mail: dpodzamczer@csub.scs.es, ES aut NATIONALLICENCE 700 1- Miró J. M. Institut d'Investigacions Biomèdiques August Pi i Sunyer, Infectious Disease Service, Hospital Clínic, c/Casanovas 143, 08036 Barcelona, Spain, ES aut NATIONALLICENCE 700 1- Ferrer E. Infectious Disease Service, Ciutat Sanitària de Bellvitge, c/Feixa Llarga s/n. L'Hospitalet, 08907 Barcelona, Spain e-mail: dpodzamczer@csub.scs.es, ES aut NATIONALLICENCE 700 1- Gatell J. M. Institut d'Investigacions Biomèdiques August Pi i Sunyer, Infectious Disease Service, Hospital Clínic, c/Casanovas 143, 08036 Barcelona, Spain, ES aut NATIONALLICENCE 700 1- Ramón J. M. Preventive Medicine Service, Ciutat Sanitària de Bellvitge, c/Feixa Llarga, s/n. L'Hospitalet, 08907 Barcelona, Spain, ES aut NATIONALLICENCE 700 1- Ribera E. Infectious Disease Service, Hospital Vall d'Hebró, Passeig, Vall d'Hebró 119-129, 08035 Barcelona, Spain, ES aut NATIONALLICENCE 700 1- Sirera G. AIDS Unit, Hospital Germans Trías, Crta. Canyet, s/n. Badalona, 08015 Barcelona, Spain, ES aut NATIONALLICENCE 700 1- Cruceta A. Institut d'Investigacions Biomèdiques August Pi i Sunyer, Infectious Disease Service, Hospital Clínic, c/Casanovas 143, 08036 Barcelona, Spain, ES aut NATIONALLICENCE 700 1- Knobel H. Infectious Disease Service, Hospital del Mar, PO Marítimo, s/n. 08003 Barcelona, Spain, ES aut NATIONALLICENCE 700 1- Domingo P. AIDS Unit, Hospital Sant Pau, Avda. Sant Antoni Ma Claret 167, 08025 Barcelona, Spain, ES aut NATIONALLICENCE 700 1- Polo R. Infectious Disease Service, Instituto Carlos III, C/Sinieso Delgado 6, 28029 Madrid, Spain, ES aut NATIONALLICENCE 700 1- Leyes M. Internal Medicine Service, Hospital Son Dureta, Andrea Doria 55, 07014 Palma de Mallorca, Spain, ES aut NATIONALLICENCE 700 1- Cosin J. HIV-Infectious Diseases Service, Hospital Gregorio Marañón, C/Doctor Esquerdo 46, 28007 Madrid, Spain, ES aut NATIONALLICENCE 700 1- Fariñas M. C. Internal Medicine Service, Hospital Marqués de Valdecillas, Av. Valdecillas, s/n. 39008 Santander, Spain, ES aut NATIONALLICENCE 700 1- Arrizabalaga J. Infectious Disease Service, Hospital Nuestra Sra. de Aranzazu, Paseo Dr. Beguiristain, s/n. 20014 San Sebastián, Spain, ES aut NATIONALLICENCE 700 1- Martínez-Lacasa J. Infectious Disease Service, Hospital Mutua de Tarrasa, Pza. Dr. Robert 5, 08221 Terrassa, Spain, ES aut NATIONALLICENCE 700 1- Gudiol F. Infectious Disease Service, Ciutat Sanitària de Bellvitge, c/Feixa Llarga s/n. L'Hospitalet, 08907 Barcelona, Spain e-mail: dpodzamczer@csub.scs.es, ES aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer