Tessa Adzemovic, MD, MSc
Nominated From: University of Michigan
Research Site: Makerere University
Research Area:Cryptococcal Meningitis, HIV/AIDs, Neurocognitive Outcomes
Primary Mentor: Dr. David Boulware, Dr. Radha Rajasingham, Dr. David Meya
Research Project
Neurocognitive Outcomes on Encochleated Oral Amphotericin for Cryptococcal Meningitis: sub-study of the EnACT3 Phase III Trial
Cryptococcal meningitis has emerged as one of the most frequent and deadly opportunistic infections in patients living with HIV. Neurocognitive outcomes for patients with cryptococcal meningitis, the largest source of morbidity for these patients, are both under-studied and poorly understood.
Historically, IV amphotericin has been considered the “gold standard” in the treatment of cryptococcal meningitis, but its use is limited both by side effects as well as cost. In animal models, oral amphotericin has shown comparable efficacy to IV amphotericin.
My research seeks to understand neurocognitive outcomes in subjects being treated for cryptococcal meningitis with oral amphotericin in comparison to IV amphotericin as part of a randomized control trial at Mulaggo and Kiruddu hospitals in Kampala, Uganda. I hypothesize that there will be improvement in neurocognitive outcomes in the first three months.
Research Significance
Oral amphotericin may provide a safer, more cost-effective way to treat individuals with cryptococcal meningitis. Given that neurocognitive outcomes are the largest source of morbidity for patients with cryptococcal meningitis, understanding the possible effects of oral amphotericin is crucial to further alleviating disease burden for affected patients.
This information may help to predict whether these individuals will be able to return to healthy, independent lifestyles. It will also help clinicians in counseling patients on short-term expectations and increased knowledge around prognostication for those with cryptococcal meningitis.
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