scholarly journals Clinical features and diagnosis of tuberculous meningoencephalitis in patients infected with human immunodeficiency virus

2020 ◽  
Vol 22 (2) ◽  
pp. 55-58
Author(s):  
A. A. Milyaev ◽  
V. V. Dantsev ◽  
A. I. Belova ◽  
R. A. Platonova ◽  
B. V. Zaretsky ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cerebrospinal Fluid ◽  
Pulmonary Tuberculosis ◽  
Deoxyribonucleic Acid ◽  
Social Characteristics ◽  
Medical Organization ◽  
Immunodeficiency Virus ◽  
Polymerase Chain ◽  
A Prospective Study ◽  
High Degree

The results of a prospective study of 66 patients aged 32,63,8 years infected with the human immunodeficiency virus who were treated in an anti-tuberculosis medical organization for tuberculosis meningoencephalitis are presented. Of these, 49 (74,2%) were newly diagnosed with tuberculosis, and 17 (25,8%) had relapses and chronic forms of tuberculosis. According to social characteristics, patients were distributed as follows: working - 9 (13,6%), non-working - 57 (86,4%), disabled people with tuberculosis - 4 (6,1%), persons who previously served their sentences in prison - 48 (72,7%). All the surveyed patients had bad habits: they continued to actively use psychoactive substances - 52 (78,8%) people, abused alcohol - 43 (65,2%), smoked - 60 (90,1%). In 97% of cases, tuberculosis of the meninges and Central nervous system was a complication of respiratory tuberculosis: tuberculosis of the intra-thoracic lymph nodes - 42,4%, disseminated pulmonary tuberculosis - 27,3%, infiltrative pulmonary tuberculosis - 22,7%, and caseous pneumonia- 7,6%. The most effective method for diagnosing the tuberculosis etiology of meningoencephalitis in patients infected with the human immunodeficiency virus is the study of cerebrospinal fluid using a polymerase chain reaction. Deoxyribonucleic acid of Mycobacterium tuberculosis was detected in 31 (47%) patients. The characteristics of the cerebrospinal fluid in the examined patients are presented as follows: a decrease in glucose in 45 (68,2%) patients, an increase in protein in 59 (89,4%), and cytosis at the upper limit of normal values in 10 (15,6%). High mortality rates (47,7%) in patients infected with the human immunodeficiency virus in combination with tuberculosis meningoencephalitis are associated with a high degree of immunosuppression.

scholarly journals Relationship of Human Immunodeficiency Virus Viral Load in Cerebrospinal Fluid and Plasma in Patients Co-infected With Cryptococcal Meningitis

2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Christina C. Chang ◽  
Richard Kangethe ◽  
Saleha Omarjee ◽  
Keshni Hiramen ◽  
Bernadett Gosnell ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cerebrospinal Fluid ◽  
Cryptococcal Meningitis ◽  
Cd4 T Cell ◽  
Hiv Rna ◽  
Cell Percentage ◽  
Immunodeficiency Virus ◽  
A Prospective Study ◽  
Relationship Of ◽  
Inflammatory Syndrome

Abstract We measured human immunodeficiency virus (HIV) ribonucleic acid (RNA) in paired cerebrospinal fluid (CSF) and plasma samples in a prospective study of 91 HIV-infected, antiretroviral therapy-naive patients with cryptococcal meningitis. Cerebrospinal fluid HIV RNA was lower than in plasma (median 4.7 vs 5.2 log10 copies/mL, P < .0001) and positively correlated with plasma HIV RNA, peripheral CD4+ T-cell percentage, and CSF CXCL10. Plasma/CSF ratio of HIV RNA ranged widely from 0.2 to 265.5 with a median of 2.6. Cerebrospinal fluid quantitative cryptococcal culture positively correlated with CSF CCL2 and CCL3. CSF-plasma viral discordance was not associated with cryptococcal-associated immune reconstitution inflammatory syndrome.

scholarly journals Cerebrospinal Fluid Bacillary Load by Xpert MTB/RIF Ultra Polymerase Chain Reaction Cycle Threshold Value Predicts 2-Week Mortality in Human Immunodeficiency Virus–Associated Tuberculous Meningitis

2020 ◽  
Author(s):  
Emily M Martyn ◽  
Ananta S Bangdiwala ◽  
Enock Kagimu ◽  
Morris K Rutakingirwa ◽  
John Kasibante ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Polymerase Chain Reaction ◽  
Cerebrospinal Fluid ◽  
Tuberculous Meningitis ◽  
World Health ◽  
Chain Reaction ◽  
Cycle Threshold ◽  
Risk Of Death ◽  
Immunodeficiency Virus ◽  
Polymerase Chain

Abstract Background The World Health Organization recommends GeneXpert MTB/RIF Ultra (Xpert Ultra), a fully automated polymerase chain reaction (PCR) assay, as the initial tuberculous meningitis (TBM) diagnostic test. The assay’s PCR cycle threshold (Ct) values represent the number of PCR cycles required for probe signal to be detected (low Ct value = high bacillary load) and may approximate tuberculosis (TB) bacillary load. We measured the relationship between cerebrospinal fluid (CSF) TB bacillary load with mortality. Methods We prospectively enrolled 102 human immunodeficiency virus (HIV)–positive Ugandans with probable or definite TBM from April 2015 to August 2019. Xpert Ultra Ct tertiles and semi-quantitative categories were separately analyzed as predictors of 2-week mortality. We investigated associations between Ct and baseline clinical and CSF parameters. Results Subjects with Ct values in the low tertile (ie, high bacillary load) had 57% 2-week mortality—worse than the intermediate (17%) and high (25%) Ct tertiles and Xpert Ultra–negative (30%) probable TBM cases (P = .01). In contrast, the reported semi-quantitative Xpert Ultra categorization was less precise; with the medium to low category trending toward worse 2-week survival (42%) compared with very low (28%), trace (26%), and negative (30%) categories (P = .48). Ct tertile was significantly associated with baseline CSF lactate (P = .03). Conclusions High CSF TB bacillary load, as measured by Xpert Ultra Ct tertile, is associated with an almost 2-fold higher 2-week mortality in HIV-associated TBM and is a better predictor than the reported Xpert Ultra semi-quantitative category. Xpert Ultra Ct values could identify TBM patients at increased risk of death who may benefit from enhanced supportive care.

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