학술논문

Advancing Diagnosis and Treatment in People Living with HIV and Tuberculosis Meningitis
Document Type
Review Paper
Source
Current HIV/AIDS Reports. 20(6):379-393
Subject
Tuberculous meningitis
Tuberculosis
TB
Diagnostic tests
Central nervous system infection
Language
English
ISSN
1548-3568
1548-3576
Abstract
Purpose of review: Tuberculous meningitis (TBM) is the most severe form of tuberculosis. Inadequate diagnostic testing and treatment regimens adapted from pulmonary tuberculosis without consideration of the unique nature of TBM are among the potential drivers. This review focuses on the progress being made in relation to both diagnosis and treatment of TBM, emphasizing promising future directions.Recent findings: The molecular assay GeneXpert MTB/Rif Ultra has improved sensitivity but has inadequate negative predictive value to “rule-out” TBM. Evaluations of tests focused on the host response and bacterial components are ongoing. Clinical trials are in progress to explore the roles of rifampin, fluoroquinolones, linezolid, and adjunctive aspirin.Summary: Though diagnosis has improved, novel modalities are being explored to improve the rapid diagnosis of TBM. Multiple ongoing clinical trials may change current therapies for TBM in the near future.