Adjunctive Sertraline for the Treatment of HIV-Associated Cryptococcal Meningitis

Safety (Occurence of Adverse Events)

Safety and tolerability of adjunctive sertraline (grade 4-5) adverse reactions

Time frame: 18 weeks

Count of Participants With Cerebrospinal Fluid Sterility

Number of participants with sterile cerebrospinal fluid at 2 weeks

Time frame: 14 days

Center for Epidemiologic Studies in Depression (CES-D) Scale

Center for Epidemiologic Studies in Depression (CES-D) scale at 14 weeks. CES-D scores are based on a 20 item survey with total scores ranging from 0 to 60. Higher scores suggest a greater presence of depressive symptoms. A CES-D score of 16 or higher is interpreted to indicate a risk for depression.

Time frame: 14 weeks

Quantitative Neurocognitive Performance Score (QNPZ-8)

Quantitative neurocognitive performance Z-score (QNPZ-8) at 14 weeks. The QNPZ-8 is a mean score of testing of 8 neurocognitive domains. Eqach domain is scaled based on a Z-score where the mean = 0 for the HIV-negative Ugandan population, accounting for age and educational status. Each +1 unit is one standard deviation better than the population norm. Each -1 unit is one standard deviation worse than the population norm.

Time frame: 14 weeks

Fungal Clearance as Determined by Early Fungicidal Activity of CDF

To determine whether adjunctive sertraline will lead to a faster rate of fungal clearance from cerebrospinal fluid (CSF), as measured by early fungicidal activity (EFA) of clearance of the Cryptococcus colony forming units (cfu) per mL of CSF per day, compared to standard therapy alone.