Chapter 15 : Prevention of Human Infection

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The benefits of prevention are obvious given that cryptococcal infections require prolonged therapy, have high mortality and morbidity despite appropriate therapy, and are virtually incurable in patients with severely impaired immune function. The inadequacy of existing therapies is further exemplified by their inability to eradicate most cryptococcal infections in patients with severe immunological impairment, such as those with late-stage human immunodeficiency virus (HTV) infection. Chemoprophylaxis involves the administration of antifungal drugs to high-risk patients to reduce the probability of primary infection or recurrence of infection. The introduction of safe and effective oral azole drugs in the early 1990s made feasible the design of effective, low-toxicity regimens for preventing cryptococcal infections. The experience with infections in patients with AIDS is different from that in other patient groups in that cryptococcal infection in patients with AIDS is seldom curable. It is important to consider that non-antifungal drugs and/or dietary practices may conceivably reduce the risk of cryptococcal infection in some patients. The availability of a sensitive and specific diagnostic test for infection in the form of the cryptococcal antigen detection assay suggests the feasibility of screening high-risk populations for early signs of cryptococcosis. Several studies have shown that screening of high-risk patients for cryptococcal antigen can identify some cases of cryptococcal infection. The conjugate vaccine is based on the premise that a vaccine that elicits a strong antibody response will protect against infection in susceptible hosts.

Citation: Casadevall A, Perfect J. 1998. Prevention of Human Infection, p 519-530. In . ASM Press, Washington, DC. doi: 10.1128/9781555818241.ch15
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Table 1

Strategies for the prevention of infection

Citation: Casadevall A, Perfect J. 1998. Prevention of Human Infection, p 519-530. In . ASM Press, Washington, DC. doi: 10.1128/9781555818241.ch15

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