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Tuberculous meningitis and HIV
Authors:Sunil Karande  Vishal Gupta  Madhuri Kulkarni  Anagha Joshi  Mhisti Rele
Institution:(1) Division of Pediatric Neurology, Department of Pediatrics, and Departments of Radiology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India;(2) Division of Pediatric Neurology, Department of Pediatrics, and Departments of Microbiology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India;(3) Flat 24, Joothica, 5th Floor; Opposite Grant Road Post Office; 22A, Naushir Bharucha Road, 400 007 Mumbai, India
Abstract:Objective : To identify factors associated with HIV-infected status in children admitted with tuberculous meningitis (TBM), and to find out whether HIV co-infection affects in-hospital outcome.Methods : This prospective hospital-based study was conducted from May 2000 to August 2003. All consecutive children, aged 1 month to 12 years of age, admitted with a diagnosis of TBM were enrolled. Relationship between 35 featuresviz., two demographic factors, nine clinical features, 13 neurological features, five laboratory (including cerebrospinal fluid) parameters, six radiological (including computed tomography scan brain) features, and the two outcomes (disabled survivor or death); with HIV-infected status was assessed.Results : Of a total 123 TBM cases enrolled, eight (6.5%) were HIV-infected. There was no significant difference between the two groups, except that more children in the HIV-infected group had Hb< 8 gm/dl: both on bivariate analysis, (OR, 12.0; 95% CI, 2.6–55.9; P = 0.001) and on multivariate analysis (OR, 12.30; 95% CI, 1.9–79.6; P = 0.008). Outcome was similar in both the groups.Conclusion: Only presence of Hb< 8 gm/dl was associated with HIV-infected status. HIV co-infection did not affect the outcome.
Keywords:HIV Infections  Multivariate Analysis  Tomography  X-Ray Computed  Treatment outcome  Tuberculosis  Meningeal
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