[Tuberculous meningitis: a comparative study in relation to concurrent human immunodeficiency virus infection]
Carlos Azuaje1, Núria Fernández Hidalgo, Benito Almirante
1Servicios de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain. azuaje@sapo.pt
Enfermedades Infecciosas Y Microbiologia Clinica
|May 27, 2006
Summary
Tuberculous meningitis (MT) occurred more often in patients with human immunodeficiency virus (HIV). However, clinical presentation, treatment, and outcomes were similar between HIV-positive and HIV-negative MT patients.
Area of Science:
- Infectious Diseases
- Neurology
- Public Health
Background:
- Tuberculous meningitis (MT) poses a significant global health challenge, particularly in regions with high tuberculosis and HIV prevalence.
- Coinfection with human immunodeficiency virus (HIV) can alter the epidemiology and clinical course of MT.
- Understanding the interplay between MT and HIV is crucial for effective patient management.
Purpose of the Study:
- To assess the epidemiological and clinical characteristics of tuberculous meningitis (MT) in a recent patient cohort.
- To compare the therapeutic approaches and disease evolution in MT patients with and without concurrent HIV infection.
- To determine if HIV coinfection impacts the clinical presentation, treatment response, or outcomes of MT.
Main Methods:
- A retrospective study analyzing 75 episodes of MT diagnosed between 1987 and 2000.
- Comparative analysis of clinical data, cerebrospinal fluid analysis, and radiological findings between MT patients with and without HIV coinfection.
- Evaluation of treatment regimens, adverse effects, mortality, and neurological sequelae in both groups.
Main Results:
- MT was diagnosed more frequently in HIV-infected patients (6.4% vs. 1.2%, p < 0.01).
- Extrameningeal tuberculosis and radiological alterations were more common in HIV-coinfected patients.
- Despite differences in disease presentation and treatment intensity, no significant variations were observed in clinical manifestations, CSF biochemistry, adverse effects, mortality, or neurological sequelae between HIV-positive and HIV-negative MT patients.
Conclusions:
- Approximately half of the studied MT patients were coinfected with HIV.
- Clinical, microbiological, and evolutionary features of MT were comparable between HIV-positive and HIV-negative individuals.
- Diagnostic and therapeutic strategies for MT can be similarly applied to patients regardless of HIV status.
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