TB meningitis in HIV-positive patients in Europe and Argentina: Clinical dutcome and factors associated with mortality

Anne Marie W. Efsen, Alexander M. Panteleev, Daniel Grint, Daria N. Podlekareva, Anna Vassilenko, Aza Rakhmanova, Indra Zeltina, Marcelo H. Losso, Robert F. Miller, Enrico Girardi, Joan Caylá, Frank A. Post, Jose M. Miro, Mathias Bruyand, Hansjakob Furrer, Niels Obel, Jens D. Lundgren, Amanda Mocroft, Ole Kirk, J. J. ToibaroE. Warley, N. Tamayo, M. Cristina Ortiz, P. Scapelatto, E. Bottaro, F. Murano, M. Miachans, J. Contarelli, L. Massera, J. Corral, M. Hualde, C. Miglioranza, M. Corti, H. Metta, A. Casiro, R. Cuini, H. Laplume, D. David, C. Marson, S. Lupo, L. Trape, O. Garcia Messina, O. Gear, J. M. Bruguera, I. Karpov, E. Skrahina, A. Skrahin, S. Zhavoronok, V. Mitsura, D. Ruzanov, V. Bondarenko, O. Suetnov, D. Paduto, J. Gerstoft, G. Kronborg, C. Pedersen, C. S. Larsen, G. Pedersen, A. L. Laursen, L. Nielsen, J. Jensen, F. Dabis, G. Chene, S. Lawson-Ayayi, R. Thiebaut, L. Wittkop, P. Morlat, F. Bonnet, N. Bernard, M. Hessamfar, D. Lacoste, M. A. Vandenhende, M. Dupon, F. A. Dauchy, H. Dutronc, M. Longy-Boursier, P. Mercie, P. Duffau, J. Roger Schmeltz, D. Malvy, T. Pistone, M. C. Receveur, D. Neau, C. Cazanave, A. Ochoa, M. O. Vareil, J. L. Pellegrin, J. F. Viallard, C. Greib, E. Lazaro, H. Fleury, M. E. Lafon, S. Reigadas, P. Trimoulet, D. Breilh, M. Molimard, S. Bouchet, K. Titier, J. F. Moreau, I. Pellegrin, F. Haramburu, G. Arcachon, A. Dupont, Y. Gerard, L. Caunegre, K. Andre, F. Bonnal, S. Farbos, M. C. Gemain, J. Ceccaldi, S. Tchamgoue, S. De Witte, K. Courtault, E. Monlun, V. Gaborieau, P. Lataste, J. P. Meraud, I. Chossat, A. C. Carvalho, R. Basche, I. E. Hamad, B. A. Ricci, F. Maggiolo, V. Ravasio, C. Mussini, F. Prati, S. Castelletti, A. Ammassari, A. Antinori, R. Bellagamba, E. Busi Rizzi, S. Cicalini, A. Corpolongo, A. Capaldo, A. Di Caro, D. Goletti, S. Grisetti, G. Gualano, F. N. Lauria, L. Parracino, F. Palmieri, N. Petrosillo, C. Pinetti, A. Sampaolesi, M. Moroni, G. Angarano, O. Armignacco, A. d'Arminio Monforte, F. Castelli, R. Cauda, G. Di Perri, M. Galli, R. Iardino, G. Ippolito, A. Lazzarin, C. F. Perno, F. von Schloesser, P. Viale, A. Castagna, F. Ceccherini-Silberstein, A. Cozzi-Lepri, S. Lo Caputo, M. Puoti, M. Andreoni, C. Balotta, P. Bonfanti, S. Bonora, M. Borderi, M. R. Capobianchi, A. Cingolani, P. Cinque, A. De Luca, A. Di Biagio, N. Gianotti, A. Gori, G. Guaraldi, G. Lapadula, M. Lichtner, G. Madeddu, G. Marchetti, S. Marcotullio, L. Monno, E. Quiros Roldan, S. Rusconi, P. Cicconi, I. Fanti, T. Formenti, L. Galli, P. Lorenzini, A. Giacometti, A. Costantini, C. Carrisa, C. Suardi, E. Vanino, G. Verucchi, C. Minardi, T. Quirino, C. Abeli, P. E. Manconi, P. Piano, J. Vecchiet, K. Falasca, L. Sighinolfi, D. Segala, F. Mazzotta, G. Cassola, G. Viscoli, A. Alessandrini, R. Piscopo, G. Mazzarello, C. Mastroianni, V. Belvisi, I. Caramma, A. P. Castelli, G. Rizzardini, A. L. Ridolfo, R. Piolini, S. Salpietro, L. Carenzi, M. C. Moioli, C. Puzzolante, N. Abrescia, A. Chirianni, M. G. Guida, M. Gargiulo, F. Baldelli, D. Francisci, G. Parruti, T. Ursini, G. Magnani, M. A. Ursitti, V. Vullo, A. d'Avino, L. Gallo, E. Nicastri, R. Acinapura, M. Capozzi, R. Libertone, G. Tebano, A. Cattelan, M. S. Mura, P. Caramello, G. C. Orofino, M. Sciandra, G. Pellizzer, V. Manfrin, V. Riekstina, P. Aldins, D. Duiculescu, E. Malashenkov, A. Kozlov, S. Buzunova, J. F. Garcia-Goez, A. Moreno Camacho, J. A. Martinez, J. Gonzalez, F. Garcia-Alcaide, E. de Lazzari, J. M. Gatell, P. Sanchez, J. L. LopezColomes, X. Martinez-Lacasa, V. Falco, A. Imaz, I. Ocana, R. Vidal, M. A. Sambeat, A. Moreno-Martinez, A. Orcau, R. Weber, M. Battegay, B. Hirschel, M. Cavassini, E. Bernasconi, P. Schmid, M. Rickenbach, L. Campbell, A. Arenas-Pinto, N. Chentsova, J. Kjaer

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives. The study aimed at describing characteristics and outcome of tuberculous meningitis (TBM) in HIV-positive patients and comparing these parameters with those of extrapulmonary TB (TBEP) and pulmonary TB (TBP). Methods. Kaplan-Meier estimation and Poisson regression models were used to assess the mortality following TB diagnosis and to evaluate potential prognostic factors for the 3 groups of TB patients separately. Results. A total of 100 patients with TBM, 601 with TBEP, and 371 TBP were included. Patients with TBM had lower CD4 cell counts and only 17.0% received antiretroviral therapy (ART) at TB diagnosis. The cumulative probability of death at 12 months following TB was 51.2% for TBM (95% CI 41.4-61.6%), 12.3% for TBP (8.9-15.7%), and 19.4% for TBEP (16.1-22.6) (P < 0.0001; log-rank test). For TBM, factors associated with a poorer prognosis were not being on ART (adjusted incidence rate ratio (aIRR) 4.00 (1.72-9.09), a prior AIDS diagnosis (aIRR = 4.82 (2.61-8.92)), and receiving care in Eastern Europe (aIRR = 5.41 (2.58-11.34))). Conclusions. TBM among HIV-positive patients was associated with a high mortality rate, especially for patients from Eastern Europe and patients with advanced HIV-infection, which urgently calls for public health interventions to improve both TB and HIV aspects of patient management.

Original languageEnglish (US)
Article number373601
JournalBioMed research international
Volume2013
DOIs
StatePublished - Jan 1 2013

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)

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