Journal
TUBERCULOSIS
Volume 90, Issue 6, Pages 367-374Publisher
CHURCHILL LIVINGSTONE
DOI: 10.1016/j.tube.2010.08.006
Keywords
HIV; Tuberculosis; Tuberculous meningitis; Diagnosis; Management
Categories
Funding
- United States Agency for International Development (USAID)
- President's Emergency Plan for AIDS Relief (PEPFAR)
- Fogarty International Center South Africa [NIH/FIC 1U2RTW007373-01A1]
- Medical Research Council [G0802079] Funding Source: researchfish
- MRC [G0802079] Funding Source: UKRI
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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. (C) 2010 Elsevier Ltd. All rights reserved.
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