What is your approach when cryptococcus serum or CSF antigen titers do not change despite treatment in HIV-positive patients with cryptococcal meningitis or invasive disease, but there is clinical improvement and cultures remain negative?

What is your approach when cryptococcal serum or CSF antigen titers do not change despite treatment in HIV-positive patients with cryptococcal meningitis or invasive disease, but there is clinical improvement and cultures remain negative?

• Continue current therapy without changes, relying on clinical improvement and negative cultures as indicators of response
• Transition to oral therapy or scale down the dosage of fluconazole, as clinical improvement and clearing cultures indicate a positive response
• Increase the dosage or duration of antifungal therapy despite clinical improvement, due to persistently high antigen titers
• Other