title: Cerebrospinal fluid cytokines and matrix metalloproteinases in human immunodeficiency seropositive and seronegative patients of tuberculous meningitis.
abstract: BACKGROUND
  Some important clinical differences exist between human immunodeficiency virus (HIV)-seropositive and HIV-seronegative patients. Alterations in the cerebrospinal fluid (CSF) cytokines and matrix metalloproteinase have been noted in tuberculous meningitis. In HIV-infected patients, the immunopathogenesis is expected to be different.
  
  
  METHODS
  In this study, 64 patients of tuberculous meningitis (28 HIV seropositive and 36 seronegative) were included. The patients were followed up for six months. Cerebrospinal fluid (CSF) samples of tuberculous meningitis patients and 20 controls were subjected to tissue necrosis factor (TNF)-α, interleukin (IL)-1β, interferon (IFN)-γ, IL-10, matrix metalloproteinase (MMP)-2, and MMP-9 estimations. The levels were correlated with the patients' baseline clinical characteristics, CSF parameters, neuroimaging findings, and the outcome. The outcome was assessed and modified with the Barthel index.
  
  
  RESULTS
  The CSF cytokines and MMP levels were significantly elevated in tuberculous meningitis when compared with the controls. There was no significant difference seen between HIV seropositive and seronegative tuberculous meningitis, except for the IL-1β level, which was significantly lower in the HIV-infected patients. The cytokine and MMP levels did not correlate with the baseline clinical characteristics, disease severity, cerebrospinal fluid characteristics, neuroimaging findings, and outcome.
  
  
  CONCLUSIONS
  In conclusion, HIV infection did not affect a majority of the CSF cytokines and MMP levels in tuberculous meningitis except for IL-1β level. None of the estimated inflammatory parameters correlated with the outcome.
authors.affiliation: Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Dheeraj
authors.initials: D
authors.lastname: Rai
authors.affiliation: Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Ravindra Kumar
authors.initials: RK
authors.lastname: Garg
authors.affiliation: Department of Biochemistry, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Abbas Ali
authors.initials: AA
authors.lastname: Mahdi
authors.affiliation: Department of Microbiology, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Amita
authors.initials: A
authors.lastname: Jain
authors.affiliation: Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Verma
authors.affiliation: HIV Unit, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Anil Kumar
authors.initials: AK
authors.lastname: Tripathi
authors.affiliation: Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Maneesh Kumar
authors.initials: MK
authors.lastname: Singh
authors.affiliation: Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Hardeep Singh
authors.initials: HS
authors.lastname: Malhotra
authors.affiliation: Department of Anesthesia, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Gyan Prakash
authors.initials: GP
authors.lastname: Singh
authors.affiliation: Department of Biochemistry, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Mohammad Kaleem
authors.initials: MK
authors.lastname: Ahmad
keywords: Cytokines; human immunodeficiency virus; matrix metalloproteinases; tuberculous meningitis