The influence of HIV infection on clinical presentation, response to treatment and outcome in adults with tuberculous meningitis

Guy E. Thwaites, Nguyen Duc Bang, Nguyen Huy Dung, Hoang Thi Quy, Do Thi Tuong Oanh, Nguyen Thi Cam Thoa, Nguyen Quang Hien, Nguyen Tri Thuc, Nguyen Ngoc Hai, Nguyen Thi Ngoc Lan, Nguyen Ngoc Lan, Nguyen Hong Duc, Vu Ngoc Tuan, Cao Huu Hiep, Tran Thi Hong Chau, Pham Phuong Mai, Nguyen Thi Dung, Kasia Stepniewska, Cameron P. Simmons, Nicholas J. White & 2 others Tran Tinh Hien, Jeremy J. Farrar

Research output: Contribution to journalArticleResearchpeer-review

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.

Original languageEnglish
Pages (from-to)2134-2141
Number of pages8
JournalJournal of Infectious Diseases
Volume192
Issue number12
DOIs
Publication statusPublished - 15 Dec 2005

Cite this

Thwaites, G. E., Bang, N. D., Dung, N. H., Quy, H. T., Oanh, D. T. T., Thoa, N. T. C., ... Farrar, J. J. (2005). The influence of HIV infection on clinical presentation, response to treatment and outcome in adults with tuberculous meningitis. Journal of Infectious Diseases, 192(12), 2134-2141. https://doi.org/10.1086/498220
Thwaites, Guy E. ; Bang, Nguyen Duc ; Dung, Nguyen Huy ; Quy, Hoang Thi ; Oanh, Do Thi Tuong ; Thoa, Nguyen Thi Cam ; Hien, Nguyen Quang ; Thuc, Nguyen Tri ; Hai, Nguyen Ngoc ; Lan, Nguyen Thi Ngoc ; Lan, Nguyen Ngoc ; Duc, Nguyen Hong ; Tuan, Vu Ngoc ; Hiep, Cao Huu ; Chau, Tran Thi Hong ; Mai, Pham Phuong ; Dung, Nguyen Thi ; Stepniewska, Kasia ; Simmons, Cameron P. ; White, Nicholas J. ; Hien, Tran Tinh ; Farrar, Jeremy J. / The influence of HIV infection on clinical presentation, response to treatment and outcome in adults with tuberculous meningitis. In: Journal of Infectious Diseases. 2005 ; Vol. 192, No. 12. pp. 2134-2141.
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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.",
author = "Thwaites, {Guy E.} and Bang, {Nguyen Duc} and Dung, {Nguyen Huy} and Quy, {Hoang Thi} and Oanh, {Do Thi Tuong} and Thoa, {Nguyen Thi Cam} and Hien, {Nguyen Quang} and Thuc, {Nguyen Tri} and Hai, {Nguyen Ngoc} and Lan, {Nguyen Thi Ngoc} and Lan, {Nguyen Ngoc} and Duc, {Nguyen Hong} and Tuan, {Vu Ngoc} and Hiep, {Cao Huu} and Chau, {Tran Thi Hong} and Mai, {Pham Phuong} and Dung, {Nguyen Thi} and Kasia Stepniewska and Simmons, {Cameron P.} and White, {Nicholas J.} and Hien, {Tran Tinh} and Farrar, {Jeremy J.}",
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Thwaites, GE, Bang, ND, Dung, NH, Quy, HT, Oanh, DTT, Thoa, NTC, Hien, NQ, Thuc, NT, Hai, NN, Lan, NTN, Lan, NN, Duc, NH, Tuan, VN, Hiep, CH, Chau, TTH, Mai, PP, Dung, NT, Stepniewska, K, Simmons, CP, White, NJ, Hien, TT & Farrar, JJ 2005, 'The influence of HIV infection on clinical presentation, response to treatment and outcome in adults with tuberculous meningitis' Journal of Infectious Diseases, vol. 192, no. 12, pp. 2134-2141. https://doi.org/10.1086/498220

The influence of HIV infection on clinical presentation, response to treatment and outcome in adults with tuberculous meningitis. / Thwaites, Guy E.; Bang, Nguyen Duc; Dung, Nguyen Huy; Quy, Hoang Thi; Oanh, Do Thi Tuong; Thoa, Nguyen Thi Cam; Hien, Nguyen Quang; Thuc, Nguyen Tri; Hai, Nguyen Ngoc; Lan, Nguyen Thi Ngoc; Lan, Nguyen Ngoc; Duc, Nguyen Hong; Tuan, Vu Ngoc; Hiep, Cao Huu; Chau, Tran Thi Hong; Mai, Pham Phuong; Dung, Nguyen Thi; Stepniewska, Kasia; Simmons, Cameron P.; White, Nicholas J.; Hien, Tran Tinh; Farrar, Jeremy J.

In: Journal of Infectious Diseases, Vol. 192, No. 12, 15.12.2005, p. 2134-2141.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The influence of HIV infection on clinical presentation, response to treatment and outcome in adults with tuberculous meningitis

AU - Thwaites, Guy E.

AU - Bang, Nguyen Duc

AU - Dung, Nguyen Huy

AU - Quy, Hoang Thi

AU - Oanh, Do Thi Tuong

AU - Thoa, Nguyen Thi Cam

AU - Hien, Nguyen Quang

AU - Thuc, Nguyen Tri

AU - Hai, Nguyen Ngoc

AU - Lan, Nguyen Thi Ngoc

AU - Lan, Nguyen Ngoc

AU - Duc, Nguyen Hong

AU - Tuan, Vu Ngoc

AU - Hiep, Cao Huu

AU - Chau, Tran Thi Hong

AU - Mai, Pham Phuong

AU - Dung, Nguyen Thi

AU - Stepniewska, Kasia

AU - Simmons, Cameron P.

AU - White, Nicholas J.

AU - Hien, Tran Tinh

AU - Farrar, Jeremy J.

PY - 2005/12/15

Y1 - 2005/12/15

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=28844483878&partnerID=8YFLogxK

U2 - 10.1086/498220

DO - 10.1086/498220

M3 - Article

VL - 192

SP - 2134

EP - 2141

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

SN - 0022-1899

IS - 12

ER -