Tuberculous Meningitis in HIV Patients
Author Information
Author(s): Marais Suzaan, Pepper Dominique J., Schutz Charlotte, Wilkinson Robert J., Meintjes Graeme
Primary Institution: University of Cape Town
Hypothesis
Starting patients with HIV-associated tuberculous meningitis on antiretroviral therapy during tuberculosis treatment may increase survival.
Conclusion
Starting ART prior to or during TB treatment may be associated with lower mortality in patients with HIV-associated TBM.
Supporting Evidence
- TBM was diagnosed in 120 out of 211 patients with meningitis.
- Six-month all-cause mortality was lower in those who received ART during TB treatment.
- Low CD4+ count at presentation was associated with higher mortality.
- Higher British Medical Research Council TBM disease grade predicted inpatient mortality.
Takeaway
This study found that giving HIV patients with tuberculous meningitis their HIV medicine early can help them live longer.
Methodology
A retrospective review of cerebrospinal fluid findings and clinical records over a six-month period.
Potential Biases
The decision to perform CSF TB microscopy and culture was not uniform, potentially leading to misclassification.
Limitations
The study was retrospective, and not all information was available for all cases, which may have led to bias.
Participant Demographics
88% of patients with TBM were HIV-infected, median CD4+ count was 79 cells/uL.
Statistical Information
P-Value
0.03
Confidence Interval
95% CI 0.08–0.82
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website