Pattern of HIV infected meningitis patient investigated in a tertiary care institute of eastern India
Keywords:HIV, CD4 count, Cryptococcal meningitis, TB meningitis
Background: This study was started in the aim of determining the pattern of meningitis and their clinico-laboratorial presentation among HIV infected patients.
Methods: This secondary data based cross-sectional study was conducted on 2010 in a tertiary care institute of eastern India among HIV infected meningitis patients. From June 2009 to May 2010, 92 patients were included in our study. Bed head tickets, laboratory reports and registers were used for data collection. Chi square test was applied for the test of significance.
Results: 70.7% cryptococcal and 29.3% tubercular meningitis cases were found. Mean CD4 cell count, CSF protein, CSF glucose, WBC cell count of TB and cryptococcal meningitis patients were 143 cells/cumm, 546.1 mg/dl, 26.8 mg/dl, 550 cells/ cumm and 175 cells/ cumm, 189.1 mg/dl, 30.1 mg/dl, 36 cells/ cumm respectively. 29.2% patients of Cryptococcal meningitis were presented with mental change, confusion or psychological disorders, but these symptoms were not observed among TB meningitis patients.
Conclusions: This study provided a baseline data about epidemiology and clino-laboratorial features of HIV meningitis patients of eastern India and will help for further investigation in this field.
UNAIDS: Fact Sheet November 2016. Available at: http://www.unaids.org/en/resources/fact-sheet. Accessed on 23 February 2017.
Bergemann A, Karstaedt AS. The spectrum of meningitis in a population with high prevalence of HIV disease. Quarterly J Med. 1996;89:499–504.
Matee MIN, Matre R. Pathogenic isolates in meningitis patients in Dar es Salaam, Tanzania. East African Med J. 2001;78(9):458–60.
Bhagwan S, Naidoo K. Aetiology, clinical presentation, and outcome of meningitis in patients coinfected with human immunodeficiency virus and tuberculosis. AIDS Res Treatment. 2011;2011:6.
Hakim JG, Gangaidzo IT, Heyderman RS, Mielke J, Mushangi E, Taziwa A, et al. Impact of HIV infection on meningitis in Harare, Zimbabwe: a prospective study of 406 predominantly adult patients. AIDS. 2000;14(10):1401–7.
Chhin S, Rozycki G, Pugatch D, Harwell JI. Aetiology of meningitis in HIV-infected patients in a referral hospital in Phnom Penh, Cambodia. Int J STD AIDS. 2004;15(1):48–50.
Wajanga BM, Kalluvya S, Downs JA, Johnson WD, Fitzgerald DW, Peck RN. Universal screening of Tanzanian HIV-infected adult inpatients with the serum cryptococcal antigen to improve diagnosis and reduce mortality: an operational study. J Int AIDS Society. 2011;14(1):48.
Jarvis JN, Boulle A, Loyse A, Bicanic T, Rebe K, Williams A, et al. High ongoing burden of cryptococcal disease in Africa despite antiretroviral roll out. AIDS. 2009;23(9):1182–3.
Jarvis JN, Harrison TS. HIV-associated cryptococcal meningitis. AIDS. 2007;21(16):2119–29.
Jarvis JN, Meintjes G, Williams A, Brown Y, Crede T, Harrison TS. Adult meningitis in a setting of high HIV and TB prevalence: findings from 4961 suspected cases. BMC Infectious Dis. 2010;10:67.
Marais S, Pepper DJ, Schutz C, Wilkinson RJ, Meintjes G. Presentation and outcome of tuberculous meningitis in a high HIV prevalence setting. PLoS ONE. 2011;6(5):e20077.
Powderly WG. Meningitis in HIV-positive patients. Neuro Aids. 2001;4(3).
Boaz MM, Kalluvya S, Downs JA, Mpondo BCT, Mshana SE. Pattern, Clinical Characteristics, and Outcome of Meningitis among HIV-Infected Adults Admitted in a Tertiary Hospital in North Western Tanzania: A Cross-Sectional Study. J Tropical Med. 2016;2016:6573672.
Der EM, Damnyag JB, Wiredu EK, Gyasi RK, Anim JT. HIV/AIDS and tuberculous meningitis: a five year retrospective autopsy study at the korle-Bu Teaching Hospital Accra Ghana. Pathol Discovery. 2014;2(3).
Dash M, Padhi S, Sahu R, Turuk J, Pattanaik S, Misra P. Prevalence of cryptococcal meningitis among people living with human immunodeficiency virus/acquired immunodeficiency syndrome in a Tertiary Care Hospital, Southern Odisha, India. J Nat Sci Biol Med. 2014;5(2):324–8.
Kumar NM, Kaulgud RS, Reddy H, Swamy M. CD4 count in patients with HIV and Tuberculous Meningitis co-infection. - A perfect surrogate marker of disease severity? Int J Biomed Res. 2013;4(10):532-7.
Aslam SMS, Chandrasekhara P. Study of Cryptococcal Meningitis in HIV Seropositive Patients in a Tertiary Care Centre. JIACM. 2009;10(3):110-5.
Khan A, Jamil B, Ali R, Sultan S. Tuberculous and Cryptococcal meningitis in a setting with high TB and low HIV prevalence. J Coll Physicians Surg Pak. 2009;19(8):487-91.