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Neurological TB in HIV

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HIV and Tuberculosis

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Abstract

Central nervous system (CNS) tuberculosis (TB) is the worst form of TB and may present as (1) intracranial pathology, including tuberculous meningitis (TBM), tuberculoma/abscess, and rarely cerebritis or encephalopathy (described in children) and, (2) intraspinal disease. HIV co-infection increases the risk of developing CNS TB substantially, especially in patients with severe immunosuppression (CD4 count <100 cells/μL). In this chapter, we discuss the pathogenesis, clinical and imaging findings, management and outcomes of the most frequent forms of CNS TB in HIV co-infected patients. We further review the features and management of a frequently fatal complication related to starting antiretroviral therapy (ART), namely neurological TB immune reconstitution inflammatory syndrome (IRIS).

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Author information

Authors and Affiliations

  1. Neurosciences Department, John Radcliffe Hospital, Oxford, UK

    Louise Bovijn

  2. Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa

    Regan Solomons

  3. Department of Neurology, Inkosi Albert Luthuli Central Hospital, Durban, South Africa

    Suzaan Marais

  4. Department of Medicine, University of KwaZulu-Natal, Durban, South Africa

    Suzaan Marais

Authors
  1. Louise Bovijn
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  2. Regan Solomons
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  3. Suzaan Marais
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Editor information

Editors and Affiliations

  1. National Institute of Health, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA

    Irini Sereti

  2. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Gregory P. Bisson

  3. Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, Department of Medicine, University of Cape Town, Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa

    Graeme Meintjes

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Bovijn, L., Solomons, R., Marais, S. (2019). Neurological TB in HIV. In: Sereti, I., Bisson, G.P., Meintjes, G. (eds) HIV and Tuberculosis. Springer, Cham. https://doi.org/10.1007/978-3-030-29108-2_13

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