Tuberculous meningitis and HIV

Area of Science:

• Pediatrics
• Infectious Diseases
• Neurology

Background:

• Tuberculous meningitis (TBM) is a severe form of tuberculosis affecting the central nervous system.
• HIV co-infection is a significant concern in pediatric TBM, potentially influencing disease presentation and outcomes.
• Understanding factors associated with HIV status in TBM is crucial for targeted management.

Purpose of the Study:

• To identify clinical, demographic, laboratory, and radiological factors associated with HIV infection in children diagnosed with TBM.
• To determine if HIV co-infection affects in-hospital outcomes (disability or death) in pediatric TBM cases.

Main Methods:

• A prospective, hospital-based study enrolled 123 children (1 month to 12 years) with TBM from May 2000 to August 2003.
• Data collected included demographic factors, clinical and neurological features, cerebrospinal fluid parameters, and radiological findings.
• Statistical analysis assessed the relationship between 35 features and HIV-infected status, as well as in-hospital outcomes.

Main Results:

• Eight (6.5%) of the 123 TBM cases were HIV-infected.
• Children with HIV co-infection were significantly more likely to have low hemoglobin (Hb < 8 gm/dl) on both bivariate and multivariate analyses (P=0.001 and P=0.008, respectively).
• No significant difference in in-hospital outcomes (disabled survivor or death) was observed between HIV-infected and HIV-uninfected TBM groups.

Conclusions:

• Low hemoglobin (Hb < 8 gm/dl) is the sole identified factor associated with HIV-infected status in children with TBM.
• HIV co-infection does not appear to influence the in-hospital outcome for pediatric patients with tuberculous meningitis.