New guidelines from WHO recommend a simpler, safer treatment for cryptococcal disease in people living with HIV
New guidelines developed by WHO strongly recommend a single high dose of liposomal amphotericin B as part of the preferred induction regimen for the treatment of cryptococcal meningitis in people living with HIV. This new recommendation was made following the results of a multicentre randomized controlled trial conducted in Botswana, Malawi, South Africa, Uganda and Zimbabwe showing that a simplified regimen with a single high dose of liposomal amphotericin B paired with other standard medicines (flucytosine and fluconazole) is as effective as the previous WHO standard of care, with the benefits of lower toxicity and fewer monitoring demands.
These new guidelines will only translate into lives saved if a proactive approach is taken to improving access to liposomal amphotericin B. At this moment, only a few suppliers have received regulatory approval, and although a preferential pricing agreement has been negotiated with the manufacturer of the originator product, uptake has been low across low- and middle-income countries.