The influence of HIV infection on clinical presentation, response to treatment, and outcome in adults with tuberculous meningitis
The influence of HIV infection on clinical presentation, response to treatment, and outcome in adults with tuberculous meningitis
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DOI：
10.1086/498220
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发表时间：
2005-12-15
影响因子：
6.4
通讯作者：
Farrar, JJ
中科院分区：
文献类型：
--
作者：
Thwaites, GE;Bang, ND;Farrar, JJ
背景。结核性脑膜炎在人类免疫缺陷病毒 (HIV) 感染者中比未感染 HIV 者更常见，但 HIV 感染是否会改变结核性脑膜炎的表现和结果尚不清楚。方法。我们对越南胡志明市 2 家三级转诊医院连续治疗的 528 名结核性脑膜炎成人（96 名感染 HIV 和 432 名未感染 HIV）的临床特征和治疗反应进行了前瞻性比较。使用逻辑回归对与 HIV 感染、9 个月生存率以及复发或药物不良事件的可能性独立相关的变量进行建模。 Kaplan-Meier 估计用于比较生存率和发烧清除、昏迷清除、复发和不良事件的时间。结果。 HIV感染并没有改变结核性脑膜炎的神经系统表现，尽管HIV感染者更有可能发生肺外结核。 HIV感染者的9个月生存率显着下降（全因死亡相对风险，2.91 [95%置信区间，2.14-3.96]；P
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