HIV-associated tuberculous meningitis--diagnostic and therapeutic challenges.
HIV-associated tuberculous meningitis (TBM) poses significant diagnostic and therapeutic challenges and carries a dismal prognosis. In this review, we present the clinical features and management of HIV-associated TBM, and compare this to disease in HIV-uninfected individuals. Although the clinical presentation, laboratory findings and radiological features of TBM are similar in HIV-infected and HIV-uninfected patients, some important differences exist. HIV-infected patients present more frequently with extra-meningeal tuberculosis and systemic features of HIV infection. In HIV-associated TBM, clinical course and outcome are influenced by profound immunosuppression at presentation, emphasising the need for earlier diagnosis of HIV infection and initiation of antiretroviral treatment.
Marais
Suzaan
S
Department of Medicine, GF Jooste Hospital, Manenberg 7764, South Africa. suzaanmarais@gmail.com
Pepper
Dominique J
DJ
Marais
Ben J
BJ
Török
M Estée
ME
D017088:AIDS-Related Opportunistic Infections / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000276:immunology*; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001921:Brain / Q000276:immunology* / Q000382:microbiology; D002675:Child, Preschool; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification* / Q000378:metabolism; D011379:Prognosis; D014390:Tuberculosis, Meningeal / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000276:immunology*
D019380:Anti-HIV Agents