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Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
Published on: October 31, 2010
Prognostic markers in AIDS-related cryptococcal meningitis.
S Majumder1, S K Mandal, D Bandyopadhyay
1Apollo Gleneagles Hospital, Kolkata, West Bengal.
The Journal of the Association of Physicians of India
|July 15, 2011
Summary
Cryptococcal meningitis (CM) in HIV patients has high mortality. Poor prognostic factors include low GCS, papilledema, high CSF pressure, and lack of HIV care, identifiable with simple bedside tools.
Area of Science:
- Infectious Diseases
- Neurology
- Public Health
Background:
- HIV-associated cryptococcal meningitis (CM) remains a major cause of death in resource-limited settings.
- Antiretroviral therapy (ART) has improved outcomes but CM still poses a significant threat.
Purpose of the Study:
- To identify prognostic factors for poor outcomes in HIV patients with CM.
- To evaluate the utility of simple clinical tools for risk stratification in CM patients.
Main Methods:
- Prospective study of 30 HIV patients with CM over 6 months.
- Analysis of clinical, biochemical, and mycological parameters.
- Identification of factors associated with mortality.
Main Results:
- Mortality rate was 36.7%.
- Poor prognostic factors identified: low Glasgow Coma Scale (GCS) score, papilledema, elevated cerebrospinal fluid (CSF) opening pressure (>250 mmH2O), and lack of regular HIV care.
- CSF pleocytosis was higher in the mortality group.
Conclusions:
- Simple bedside tools like ophthalmoscopy and CSF manometry are valuable for risk stratification in HIV-CM.
- Focus on prognostic markers in Asian populations with AIDS-related CM is needed.
