Presentation, Clinical Characteristics, and Treatment Outcomes among Tuberculous Meningitis Patients with and Without HIV Infection at Vajira Hospital, Thailand: A Retrospective Cohort Study

Abstract

To compare the characteristics, presentation, investigations, and outcomes in tuberculous meningitis (TBM) patients with and without human immunodeficiency virus (HIV) coinfection. A retrospective cohort study was conducted on adult (age > 18 years) patients whose final diagnosis was TBM and who were treated at Vajira Hospital, Navamindradhiraj University, Thailand, between January 2005 and December 2016. A final total of 174 individuals were included in the study. Of these, 97 (55.75%) were HIV positive. Treatment was successful in 53 (30.5%) individuals. In HIV-infected TBM patients, there were higher proportions of patients who were younger in age (≤40 years), patients with a low body mass index, history of previous tuberculosis infection, or hepatitis C virus coinfection. A successful treatment outcome rate was lower in HIV-infected TBM patients than in HIV-uninfected TBM patients. Since HIV infection decreases the chance of successful treatment outcomes of TBM patients, future studies are needed to determine the clinical indicators for poorer survival outcomes in HIV-positive TBM patients.