Safety Study of Fluconazole in Combination With Flucytosine for the Treatment of Early Cryptococcal Infection

Inclusion Criteria: * Able and willing to give informed consent * Age \> 18 years * HIV infection as confirmed by HIV-antibody test as per Kenyan guidelines * CD4+ T-cell count ≤100 cells/µl * Serum CrAg titer≥1:2 * Able to travel to district hubs (Sindo District Hospital, Lumumba Health Centre) for regular study visits Exclusion Criteria: * clinical meningitis: * clinical sepsis: * hemiparesis, aphasia, visual field deficit or other finding on neurological examination localizable to the central nervous system * a history of culture proven or suspected (cryptococcal antigen present) cryptococcal meningitis * a history of stroke or other infection of the central nervous system * a seizure within the last 2 months * currently taking or ever taken antiretroviral therapy * currently taking anti-tuberculous therapy * currently or recently (\<2 months) prescribed fluconazole, itraconazole, clotrimazole troches, amphotericin or other oral anti-fungal medications * pregnant or breast-feeding * alanine aminotransferase concentration more than 3 times the upper limit of normal * neutrophil count \<1000x103 cells/mL * hemoglobin \<8g/dL * platelet count \<100,000x 103 platelets/mL * creatinine clearance ≤50 ml/min * individuals with active heavy alcohol use or active recreational drug use