@article{a5302660e893484ca4450b947bbd557a,
title = "Efficacy and acceptability of different anti-fungal interventions in oropharyngeal or esophageal candidiasis in HIV co-infected adults: a pilot network meta-analysis",
abstract = "Background: Oropharyngeal/esophageal candidiasis are the most common opportunistic infections observed in patients with human immunodeficiency virus (HIV). While the commonly recommended treatment is fluconazole, relapse of oropharyngeal or esophageal candidiasis has been gradually increasing in recent decades. Methods: The current network meta-analysis (NMA) included randomized controlled trials (RCTs) investigating the efficacy and acceptability (i.e. drop-out rate) of different anti-fungal interventions against oropharyngeal or esophageal candidiasis in adults with HIV. All NMA procedures were conducted using the frequentist model. Results: Twenty-seven RCTs and 6277 participants were included. For oropharyngeal candidiasis, photosensitizer-based antimicrobial photodynamic therapy (aPDT) with laser irradiation plus methylene blue was associated with the highest cure rate and the lowest relapse rate among the investigated interventions [odds ratio (OR) = 6.82, 95% confidence intervals (95%CIs) = 0.19 to 244.42, p = 0.293, and OR = 0.03, 95%CIs = 0.00 to 0.77, p = 0.034, compared to fluconazole]. None of the investigated anti-fungal interventions were superior to fluconazole for esophageal candidiasis in respect of cure rates/relapse rates. All investigated anti-fungal interventions were well-accepted. Conclusions: aPDT could be the preferred strategy to manage oropharyngeal candidiasis; however the evidence for esophageal candidiasis still remained inconclusive.",
keywords = "antifungal, Candidiasis, human immunodeficiency virus, network meta-analysis, opportunistic infection",
author = "Zeng, {Bing Syuan} and Zeng, {Bing Yan} and Hung, {Chao Ming} and Chen, {Tien Yu} and Wu, {Yi Cheng} and Tu, {Yu Kang} and Lin, {Pao Yen} and Su, {Kuan Pin} and Brendon Stubbs and Sun, {Cheuk Kwan} and Cheng, {Yu Shian} and Li, {Dian Jeng} and Liang, {Chih Sung} and Hsu, {Chih Wei} and Chen, {Yen Wen} and Tseng, {Ping Tao} and Chen, {Chang Hua}",
note = "Funding Information: The authors of this work were supported by the following grants: Funding Information: The authors of this work were supported by the following grants: B Stubbs is supported by a Clinical Lectureship (ICA-CL-2017-03-001) jointly funded by Health Education England (HEE) and the National Institute for Health Research (NIHR). B Stubbs is part funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust. B Stubbs is also supported by the Maudsley Charity, King?s College London and the NIHR South London Collaboration for Leadership in Applied Health Research and Care (CLAHRC) funding. This paper presents independent research. The views expressed in this publication are those of the authors and not necessarily those of the acknowledged institutions. The work of KP Su is supported by the following grants: MOST 106-2314-B-039-027-MY3; 106-2314-B-038-049; 106-2314-B-039-031; 106-2314-B-039-035; and 105-2918-I-039-001 from the Ministry of Science and Technology, Taiwan; and CMU106-S-33, CRS-106-063, DMR-107-202, DMR-107-204, DMR-107-091, DRM-107-097, DRM-108-091, CRS-108-048 and the Chinese Medicine Research Center from the China Medical University, Taiwan. The work by PY Lin is supported by the following grants: MOST 106-2314-B-182A-085 -MY2 and MOST 105-2314-B-182A-057 from the Ministry of Science and Technology, Taiwan; and CMRPG8F1371, CMRPG8E1061F from Kaohsiung Chang Gung Memorial Hospital, Taiwan. The work of Yu-Kang Tu was supported by a grant from the Ministry of Science and Technology, Taiwan (grant no: 106?2314?B?002 ?098 ?MY3). AR Brunoni receives support from the National Council for Scientific and Technological Development (CNPq-1B) and University of S?o Paulo Medical School (PIPA-A). The Laboratory of Neuroscience receives financial support from the Beneficent Association Alzira Denise Hertzog da Silva and the CAPES/INCT program ?National Institute of Biomarkers in Psychiatry? (INBioN). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Publisher Copyright: {\textcopyright} 2021 Informa UK Limited, trading as Taylor & Francis Group.",
year = "2021",
doi = "10.1080/14787210.2021.1922078",
language = "English",
volume = "19",
pages = "1469--1479",
journal = "Expert Review Of Anti-Infective Therapy",
issn = "1478-7210",
publisher = "Taylor and Francis Ltd.",
number = "11",
}
