Patricia Alupo, MBChB, MMED

GHES LMIC Fellow 2017-2018

Home Institution: Makerere University, Kampala, Uganda
U.S. Institution: Yale University

Project Title: Immunological profiles of patients with HIV associated cryptococcal meningitis relapse on treatment with adjunctive sertraline therapy and their associated neurocognitive outcomes.

Primary Objectives
1. To characterise the clinical and immunological profiles of patients with CM relapse
2. To evaluate immunological changes attributable to sertraline in this patient category during the course of their treatment with sertraline.

Secondary objective
To compare the cytokine run versus the neurocognitive outcomes in these patients

This is a nested study within an independent ongoing study at the infectious disease Institute, Kampala. The study is a phase III randomized trial to evaluate the effect of sertraline when added to standard therapy for CM, with the hypothesis that adjunctive sertraline will lead to faster fungal clearance from the brain parenchyma and improved survival.  We hypothesize that patients with higher TH1 cytokines like TNF-α, IFN-γ will have worse cognitive outcomes compared to those with lower ones.

This study will generate data to help better understand the immune profiles and immune modulatory mechanisms of sertraline in patients with relapse and associated neurocognitive outcomes. This could guide future therapeutic efforts in management of patients with CM relapse.