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?

While cryptococcal antigen is an excellent diagnostic marker for this infection, with excellent sensitivity and specificity, it is not reliable for tracking response to therapy. An initially high CSF antigen level has been identified as a sign of poor prognosis in patients with AIDS, but multiple st...