dc.contributor.author | Pastick, Katelyn A | |
dc.contributor.author | Bangdiwala, Ananta S | |
dc.contributor.author | Abassi, Mahsa | |
dc.contributor.author | Flynn, Andrew G | |
dc.contributor.author | Morawski, Bozena M | |
dc.contributor.author | Musubire, Abdu K | |
dc.contributor.author | Eneh, Prosperity C | |
dc.contributor.author | Schutz, Charlotte | |
dc.contributor.author | Taseera, Kabanda | |
dc.contributor.author | Rhein, Joshua | |
dc.contributor.author | Hullsiek, Kathy Huppler | |
dc.contributor.author | Nicol, Melanie R | |
dc.contributor.author | Vidal, Jose E | |
dc.contributor.author | Nakasujja, Noeline | |
dc.contributor.author | Meintjes, Graeme | |
dc.contributor.author | Muzoora, Conrad | |
dc.contributor.author | Meya, David B | |
dc.contributor.author | Boulware, David R | |
dc.date.accessioned | 2022-05-25T12:22:33Z | |
dc.date.available | 2022-05-25T12:22:33Z | |
dc.date.issued | 2019 | |
dc.identifier.citation | Pastick, K. A., Bangdiwala, A. S., Abassi, M., Flynn, A. G., Morawski, B. M., Musubire, A. K., ... & Boulware, D. R. (2019, November). Seizures in HIV-associated Cryptococcal Meningitis: Predictors and Outcomes. In Open Forum Infectious Diseases. | en_US |
dc.identifier.uri | http://ir.must.ac.ug/xmlui/handle/123456789/2046 | |
dc.description.abstract | Background: Seizures commonly occur in patients with cryptococcal meningitis, yet risk factors and outcomes related to seizures are not well described.
Methods: We performed post-hoc analyses on participants prospectively enrolled in three separate HIV-associated cryptococcal meningitis clinical trials during 2010–2017. Documentation of seizures at presentation or during hospitalization, and anti-seizure medication receipt identified participants with seizures. We summarized participant characteristics by seizure status via Kruskal-Wallis and Chi-square tests. Cox proportional hazards models analyzed the relationship between seizures and mortality. We compared mean quantitative neurocognitive performance Z (QNPZ-8) scores, and individual domain z-scores, at 3-months using independent t-tests.
Results: Among 821 HIV-infected cryptococcal meningitis participants, 28% (231/821) experienced seizures: 15.5% (127/821) experienced seizures at presentation, and 12.7% (104/821) experienced incident seizures. Participants with seizures at presentation had a significantly lower Glasgow coma scale (GCS<15) (p<0.001), CD4 count (<50 cells/mcL) (p=0.02), and higher cerebrospinal fluid (CSF) opening pressure (>25 cm H2O) (p=0.004) when compared with participants who never experienced seizures. CSF fungal burden was higher among those with seizures at presentation (125,000 Cryptococcus colony forming units (CFU)/mL CSF) and with seizures during follow-up (92,000 CFU/mL) compared with those who never experienced seizures (36,000 CFU/mL, p<0.001). Seizures were associated with increased 10-week mortality (adjusted Hazard Ratio = 1.45, 95%CI: 1.11, 1.89). Participants with seizures had lower neurocognitive function at 3-months (QNPZ-8 = -1.87) compared with those without seizures (QNPZ-8 = -1.36; p<0.001).
Conclusions: Seizures were common in this HIV-associated cryptococcal meningitis cohort and were associated with decreased survival and neurocognitive function. | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | In Open Forum Infectious Diseases | en_US |
dc.subject | Meningitis | en_US |
dc.subject | Cryptococcal | en_US |
dc.subject | Cryptococcus | en_US |
dc.subject | Seizures | en_US |
dc.subject | HIV | en_US |
dc.subject | Cohort studies | en_US |
dc.title | Seizures in HIV-associated Cryptococcal Meningitis: Predictors and Outcomes | en_US |
dc.type | Article | en_US |