Clinical Features of HIV-Associated Tuberculous Meningitis in Vietnam
Author Information
Author(s): Torok M. Estee, Chau Tran Thi Hong, Mai Pham Phuong, Phong Nguyen Duy, Dung Nguyen Thi, Chuong Ly Van, Lee Sue J., Caws M., de Jong Menno D., Hien Tran Tinh, Farrar Jeremy J.
Primary Institution: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
Hypothesis
What are the clinical and microbiological features, outcomes, and baseline variables predictive of death in Vietnamese adults with HIV-associated tuberculous meningitis?
Conclusion
HIV-associated tuberculous meningitis has a high mortality rate and is associated with specific clinical and laboratory features.
Supporting Evidence
- 67.2% of patients died within a median time of 20 days.
- High rates of smear and culture positivity were observed in CSF samples.
- Three baseline variables were predictive of death: increased TBM grade, lower serum sodium, and decreased CSF lymphocyte percentage.
Takeaway
This study looked at patients in Vietnam with a serious brain infection caused by tuberculosis and found that many of them died quickly after getting sick.
Methodology
This was a prospective, observational cohort study involving routine clinical and laboratory assessments of patients with HIV-associated tuberculous meningitis.
Potential Biases
Potential bias due to the observational nature of the study and the lack of randomization.
Limitations
The study did not include cranial imaging for most patients and could not determine the cause of death in all cases.
Participant Demographics
The majority of participants were young, male intravenous drug users with advanced HIV disease.
Statistical Information
P-Value
p=0.002
Confidence Interval
95% CI 1.08–2.76
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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