Amphotericin B Colloidal Dispersion is Efficacious and Safe for the Management of Talaromycosis in HIV-Infected Patients: Results of a Retrospective Cohort Study in China

Min Liu,* Honghong Yang,* Qian Liu,* Kun He, Jing Yuan, Yaokai Chen Department of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, 400036, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yaokai Chen, Email [email protected]: Amphotericin B deoxycholate (AmB-D) have potential toxic effects in the treatment of talaromycosis, and high-quality, non-generic liposomal AmB (L-AMB) is still inaccessible in many regions of China. As such, the efficacy and safety of alternative drugs warrant further investigation for the management of talaromycosis. This study aimed to compare the efficacy and safety of Amphotericin B Colloidal Dispersion (ABCD) and AmB-D for the treatment of talaromycosis in a retrospective cohort of HIV-infected patients.Methods: This was a retrospective study and the data of HIV-infected patients with talaromycosis who received ABCD or AmB-D from January 2018 to December 2022, were retrospectively collected and analyzed. We compared the efficacy and safety of the two antifungal drugs.Results: Overall, 38 patients receiving ABCD and 33 patients receiving AmB-D were included. The conversion rates to fungal negativity at one week post-treatment were 86.84% (33/38) in the ABCD group and 90.09% (30/33) in the AmB-D group, which reached 100.00% in both groups at two weeks post-treatment. A higher symptom remission rate was observed at two weeks in the ABCD group compared with the AmB-D group (94.74% vs 75.76%; p=0.003). Additionally, the serum creatinine level significantly increased from baseline in the AmB-D group, whereas it did not increase significantly in the ABCD group. Furthermore, significantly fewer patients discontinued antifungal treatment due to drug intolerance in the ABCD group, and the incidences of leukopenia and elevated creatinine levels were lower in the ABCD group compared with the AmB-D group.Conclusion: ABCD has a clinical efficacy comparable to AmB-D, with higher symptom remission rate, lower nephrotoxicity, and lower bone marrow suppression, indicating that ABCD may be an appropriate alternative option for the clinical management of talaromycosis.Keywords: talaromycosis, human immunodeficiency virus, amphotericin B deoxycholate, amphotericin B colloidal dispersion, efficacy, safety