The Impact of HIV on Tuberculous Meningitis Mortality; Experience from a tertiary care hospital in Pakistan

Abstract

Abstract Background The global death rate from tuberculous meningitis (TBM) is still rather high, making it a dangerous and sometimes fatal infectious condition. The risk of TBM is greatly increased by HIV infection, as is widely known, however new studies indicates that HIV-positive and HIV-negative individuals may not have significantly different death rates. The objective of this research is to examine and clarify this occurrence while also determining the main factors that predict death in individuals with TBM. Materials &Methods: This prospective study was conducted at Department of Neurology of Pakistan Institute of Medical Sciences from June- 2022 to June 2023. Patients exhibiting characteristics suggestive of meningeal tuberculosis and meeting the criteria of the Thwaites index were included and Patients with bacterial meningitis, dengue infection, malaria, fungal infection and neoplasia were excluded. Analysis: SPSS version 25 used, chi square, Phi and Pearson’s coefficient were used to analyze correlation and statistical significance. Results Statistical analysis showed a non-significant association HIV positivity and mortality, Pearson’s chi square test significance was (P- value) 0.424 (it should be less than 0.05). Phi coefficient correlation showed no correlation between HIV and Mortality. In contrast to the above analysis Increasing MRC grade of tuberculosis and Increasing age of Patients were associated with higher mortality and the results are statistically significant. Conclusion HIV although associated with higher incidence of tuberculosis, didn’t increase mortality from TB meningitis, and increasing age and higher severity of disease are predictors of mortality.