There is a poor prognosis with a high mortality rate in the setting of delayed diagnosis and antifungal therapy. Standard primary treatment is 2 weeks of parenteral amphotericin B at a dose of 0.6 mg/kg/day, followed by 400 mg of itraconazole per day orally in two divided doses for 10 weeks. Prolonged secondary suppressive therapy with oral itraconazole (200 mg once daily) is required to prevent relapse.
All patients with HIV infection and with CD4 counts below 100 cells/ μL who reside or stay for a long period in South East Asia, particularly in rural areas, should be administered primary prophylaxis. Oral itraconazole, 200 mg/day is the preferred choice, but an alternative drug is oral fluconazole 400 mg once weekly. Primary prophylaxis is not formally indicated in other geographic areas to date.