title: The influence of HIV infection on clinical presentation, response to treatment, and outcome in adults with Tuberculous meningitis.
abstract: BACKGROUND
  Tuberculous meningitis occurs more commonly in human immunodeficiency virus (HIV)-infected individuals than in HIV-uninfected individuals, but whether HIV infection alters the presentation and outcome of tuberculous meningitis is unknown.
  
  
  METHODS
  We performed a prospective comparison of the presenting clinical features and response to treatment in 528 adults treated consecutively for tuberculous meningitis (96 were infected with HIV and 432 were uninfected with HIV) in 2 tertiary-care referral hospitals in Ho Chi Minh City, Vietnam. Logistic regression was used to model variables associated independently with HIV infection, 9-month survival, and the likelihood of having a relapse or an adverse drug event. Kaplan-Meier estimates were used to compare survival rates and times to fever clearance, coma clearance, relapse, and adverse events.
  
  
  RESULTS
  HIV infection did not alter the neurological presentation of tuberculous meningitis, although additional extrapulmonary tuberculosis was more likely to occur in HIV-infected patients. The 9-month survival rate was significantly decreased in HIV-infected patients (relative risk of death from any cause, 2.91 [95% confidence interval, 2.14-3.96]; P < .001), although the times to fever clearance and coma clearance and the number or timing of relapses or adverse drug events were not significantly different between the groups.
  
  
  CONCLUSIONS
  HIV infection does not alter the neurological features of tuberculous meningitis but significantly reduces the survival rate.
authors.affiliation: Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam. guy.thwaites@btinternet.com
authors.forename: Guy E
authors.initials: GE
authors.lastname: Thwaites
authors.forename: Nguyen
authors.initials: N
authors.lastname: Duc Bang
authors.forename: Nguyen
authors.initials: N
authors.lastname: Huy Dung
authors.forename: Hoang
authors.initials: H
authors.lastname: Thi Quy
authors.forename: Do
authors.initials: D
authors.lastname: Thi Tuong Oanh
authors.forename: Nguyen
authors.initials: N
authors.lastname: Thi Cam Thoa
authors.forename: Nguyen
authors.initials: N
authors.lastname: Quang Hien
authors.forename: Nguyen
authors.initials: N
authors.lastname: Tri Thuc
authors.forename: Nguyen
authors.initials: N
authors.lastname: Ngoc Hai
authors.forename: Nguyen
authors.initials: N
authors.lastname: Thi Ngoc Lan
authors.forename: Nguyen
authors.initials: N
authors.lastname: Ngoc Lan
authors.forename: Nguyen
authors.initials: N
authors.lastname: Hong Duc
authors.forename: Vu
authors.initials: V
authors.lastname: Ngoc Tuan
authors.forename: Cao
authors.initials: C
authors.lastname: Huu Hiep
authors.forename: Tran
authors.initials: T
authors.lastname: Thi Hong Chau
authors.forename: Pham
authors.initials: P
authors.lastname: Phuong Mai
authors.forename: Nguyen
authors.initials: N
authors.lastname: Thi Dung
authors.forename: Kasia
authors.initials: K
authors.lastname: Stepniewska
authors.forename: Cameron P
authors.initials: CP
authors.lastname: Simmons
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: White
authors.forename: Tran
authors.initials: T
authors.lastname: Tinh Hien
authors.forename: Jeremy J
authors.initials: JJ
authors.lastname: Farrar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects; D003128:Coma; D005260:Female; D005334:Fever; D015658:HIV Infections / Q000150:complications*; D006761:Hospitals; D006801:Humans; D007297:Inpatients; D016015:Logistic Models; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification; D011446:Prospective Studies; D012008:Recurrence; D016019:Survival Analysis; D016896:Treatment Outcome; D014390:Tuberculosis, Meningeal / Q000188:drug therapy* / Q000503:physiopathology*; D014744:Vietnam
chemical_list: D000900:Anti-Bacterial Agents