A Medical Research Council and France Recherche Nord & Sud Sida-hiv Hepatites (ANRS) funded trial supervised by Tom Harrison (UK) with Olivier Lortholary being principal investigator “north” for Cameroon sites is being implemented in Malawi, Zambia and Cameroon: “ACTA” trial.
ACTA is the largest (680 patients) phase III, randomized, controlled trial for the treatment of HIV-associated cryptococcal meningitis ever performed which evaluates the best antifungal strategy (i.e. oral high dose fluconazole plus flucytosine or one week amphotericin B-based therapy (+ fluconazole or flucytosine) versus the currently recommended two weeks amphotericin B-based therapy.
The primary objective is the assessment of overall survival at 2 weeks per treatment arm, before the introduction of highly active antiretroviral therapy then survival at 10 weeks.
Ancillary studies (pharmacokinetics/pharmacodynamics studies, cost effectiveness analysis, typing of isolates, proteomic and immunological analyses and host genetic studies) will be further developed.
External Collaborations: Prof. Tom Harrison (St Georges Hospital, University of London, UK); Dr MC Fonkoua (Centre Pasteur du Cameroun), Dr Charles Kouanfack (Hôpital central Yaoundé, Cameroun), Dr Yacouba Mapouré (Hôpital général Douala, Cameroun).