Tuberculosis meningitis in HIV-positive and HIV-negative patients

Abstract

The objective: to study the epidemiological rates of tuberculous meningitis (TM) in Smolensk and Kaluga Oblasts in 2015-2020.Subjects and Methods. 51 medical fles (Form no. 003-u) of patients with TM were analyzed, those patients were treated in in-patient settings in Smolensk and Kaluga Oblasts over a 6-year period (2015-2020).Results. The proportion of TM signifcantly correlates with the prevalence of HIV in 2 Oblasts (r = 0.953, p = 0.140 and r = 0.978, p = 0.095, respectively), which allows stating that HIV is the main risk factor for the development of TM. Tuberculous meningitis is more common in men (70.6%) of working age (94.1%), unemployed (60.8%), in combination with pulmonary tuberculosis (64.7%). Late diagnosis of TM is registered in ⅔ of cases; patients fail to undergo the mandatory minimum diagnostic examination. Among patients with HIV infection, TM more often develops in men (90%) of working age (100%), who do not have a regular job (80%), against the background of risk factors (drug addiction, hepatitis C, experience of incarceration), duration of HIV infection up to 10 years and recurrence of tuberculosis. Among HIV positive patients, a severe state, generalized forms of tuberculosis, including lung lesions with scanty bacterial discharge in sputum are registered in 100% of cases.