Deferred HIV Therapy After Meningitis Infection Improves Survival Chances

Meningitis is one of the common opportunistic diseases affecting individuals with HIV.

In fact, an estimated 100,000 Ugandans are said to get infected with meningitis every year. It is said that 50 per cent of these die from the infection. To save lives, health personnel recommended that patients with both aanced Aids and cryptococcal meningitis should be started on ART within two weeks of a cryptococcal meningitis diagnosis.

However, researchers from Mulago and Mbarara universities, in collaboration with researchers from the University of Cape Town and University of Minnesota, have found that delaying HIV therapy after a cryptococcal meningitis diagnosis improves a patient’s chances of survival.

In a study consisting of 177 participants – half of whom were put on deferred therapy while the other half was put on hastened therapy – it was found that starting a patient, who has recently suffered from cryptococcal meningitis, on ART four to six weeks after the meningitis infection improved their chances of survival by 15 per cent.

Study participants who were started on HIV therapy within two weeks (hastened therapy) of a cryptococcal meningitis diagnosis had lower survival rates. It is now being recommended that first, treatment of cryptococcal meningitis is done after which HIV drugs are started four to six weeks after a meningitis diagnosis.

It is posited that patients started on HIV therapy earlier than four to six weeks have lower survival rates because the rapid increase in immunity after a patient is started on HIV therapy causes inflammation in the brain, resulting in death.

The study findings were published in the June 26, 2014 issue of the New England Journal of Medicine.

Source : The Observer

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