Different amphotericin B formulations-related adverse events in the treatment of invasive fungal disease among AIDS patients
TAN Miao
WU Songjie
ZOU Shi
CHEN Qianhui
LIANG Ke
Abstract：Objective To explore the incidence of adverse events(AEs)of different amphotericin B(AMB)formulations(AmB or liposome AmB(L-AMB)in the treatment of invasive fungal disease(cryptococcal meningitis/meningoencephalitis and talaromycosis)among acquired immune deficiency syndrome(AIDS)patients,and to explore the risk factors associated with the AEs,so as to provide reference for clinical practice.Methods The clinical data of hospitalized AIDS patients with confirmed cryptococcal meningitis/meningoencephalitis and talaromycosis from Zhongnan Hospital of Wuhan university between January 1,2019,and December 30,2022 were retrospectively collected.The incidence of different AEs were analyzed,and a multivariate logistic regression model was used to explore the risk factors associated with the AEs.Results A total of 89 patients were included in our study.Among them,35(39.3％)received AMB and 54(60.7％)received L-AMB therapy.The incidence of total AEs in patients with AmB and L-AmB therapy were 77.8％and 88.6％respectively.with no significant difference(P＞0.05).The incidence of drug withdrawal due to adverse reactions and nephrotoxicity in the L-AMB group was 5.6％and 7.4％,respectively,which were significantly lower than 31.4％and 25.7％in the AMB group(P＜0.05).Multivariate logistic regression analysis showed that in the treatment of AIDS with AMB combined with deep fungal infection,the risk of hematological toxicity in talaromycosis was 6.903 times higher than that in cryptococcal meningitis/meningoencephalitis;The risk of nephrotoxicity with L-AMB was 0.01 1 times higher than that with AMB,and the risk of adverse reactions and withdrawal with L-AMB was 0.137 times higher than that with AMB;The risk of nephrotoxicity in patients with other infections was 9.053 times higher than that in patients without other infections.Conclusions The total incidence of AEs associated with AMB and L-AMB were high in the treatment of AIDS with cryptococcal meningitis/meningoencephalitis and talaromycosis.The AEs should be closely monitored during medication.Compared with AMB,L-AMB had significantly lower incidence of nephrotoxicity and drug discontinuation.
Keywords：amphotericin Bliposomal amphotericinacquired immune deficiency syndromecryptococcal meningitis/meningoencephalitistalaromycosisadverse events
Publication Date：2025-02-27
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 11-15,46 )