A Study of Itraconazole in Preventing the Return of Histoplasmosis, a Fungal Infection, in Patients With AIDS

Inclusion Criteria Concurrent Medication: Itraconazole therapy must begin no more than 6 weeks after discontinuing primary amphotericin B therapy; itraconazole therapy may begin immediately after stopping the primary therapy with amphotericin B. Allowed: * Oral contraceptives. * Methadone. * Narcotics. * Acyclovir. * Acetaminophen. * Sulfonamides. * Trimethoprim / sulfamethoxazole. * Aerosolized pentamidine for Pneumocystis carinii pneumonia (PCP) or PCP prophylaxis (patients with a total CD4+ count \< 200 or a history of PCP should receive PCP prophylaxis). * Treatment IND drugs. * Zidovudine. * Topical antifungals. * Discouraged: * Antacids. * Sucralfate. * H2 blockers. Concurrent Treatment: Allowed: * Radiation therapy for mucocutaneous Kaposi's sarcoma. Prior Medication: Required: * Prior treatment with amphotericin B for disseminated histoplasmosis: * minimum total dose of 15 mg/kg for patients \< 67 kg, or 1 g for patients \> 67 kg; must have been administered over 6 months or less. Allowed: * Amphotericin B as maintenance therapy for a maximum of 6 weeks following completion of primary therapy. * Zidovudine. * Prophylaxis for Pneumocystis carinii pneumonia. Exclusion Criteria Co-existing Condition: Patients with the following conditions are excluded: * History of allergy to, or intolerance of, imidazoles or azoles. * Clinical findings of active histoplasmosis. * Histoplasmosis of the central nervous system. * Inability to take oral medications reliably or severe malabsorption syndrome. * Malignancies requiring cytotoxic therapy. * Culture-proven systemic Mycobacterium tuberculosis, Mycobacterium avium-intracellulare, coccidioidomycosis, or cryptococcosis. Concurrent Medication: Excluded: * Amphotericin B as maintenance therapy. * Immunostimulants. * Ketoconazole. * Systemic antifungals. * Steroids in excess of physiologic replacement doses. * Cytotoxic chemotherapy. * Investigational agents not specifically allowed. * Antacids for 4 hours before and 4 hours after itraconazole. Concurrent Treatment: Excluded: * Lymphocyte replacement. Patients with the following conditions are excluded: * History of allergy to, or intolerance of, imidazoles or azoles. * Clinical findings of active histoplasmosis. * Histoplasmosis of the central nervous system. * Inability to take oral medications reliably or severe malabsorption syndrome. * Malignancies requiring cytotoxic therapy. * Culture-proven systemic Mycobacterium tuberculosis, Mycobacterium avium-intracellulare, coccidioidomycosis, or cryptococcosis. Prior Medication: Excluded within 30 days of study entry: * Immunostimulants. * Ketoconazole. * Systemic antifungals. * Steroids in excess of physiologic replacement doses. * Cytotoxic chemotherapy. Prior Treatment: Excluded: * Lymphocyte replacement. Risk Behavior: Excluded: * Patients who in the opinion of the investigator would be undependable with regard to adherence to protocol. Inclusion criteria are: * HIV infection documented by presence of antibody, by ELISA with Western blot confirmation, or serum p24 antigen, or by recovery of HIV in culture. * Acute first episode of disseminated histoplasmosis documented by recovery and identification of H. capsulatum from cultures obtained from extrapulmonary sites. * Oriented to person, place, and time, and able to give written informed consent.