Clinical characteristics of human immunodeficiency virus antibody positive versus negative patients with cryptococcal meningitis

LI Wu-ming; HU Shui-xiu; LI Hong-ru

doi:10.3969/j.issn.1674-3806.2013.08.06

Abstract： Objective To analyze the clinical characteristics , treatment and prognosis of human immunode-ficiency virus antibody positive versus negative patients with cryptococcal meningitis .Methods The clinical data of 64 patients with cryptococcal meningitis who were treated in our hospital from June 2006 to June 2012 was collected . These patients were divided into 2 groups according to positive and negative for comparing and analyzing their charac-teristics.Results Both groups had the signs of fever , headache and emesis , while companying meningeal irritation and increased intracranial pressure .Compared with HIV negative group , in HIV positive group , onset was faster , fe-ver was more obvious , the time from onset to confirmation was shorter , and with more merging opportunistic infec-tions.In both groups ,cerebrospinal fluid examinations showed cell population and protein content increased , glucose and chloride content decreased .Cerebrospinal fluid cell population of HIV positive group was less than that of HIV negative group .In both groups head imagings showed meningeal change and hydrocephalus , while damaging brain pa-renchyma was found more in HIV positive group .Both groups were treated by single amphotericin B or combination of amphotericin B and other antibiotic therapy .The mortality was higher in patients who was treated without antibiotic therapy and whose intracranial pressure was higher .There were 17 patients died in HIV positive group , 2 patients died in HIV negative group .There was no statisically significant difference in mortality between two groups ( P>0.05 ) .Conclusion The clinical characteristics and laboratory test results of both groups are similar .Amphotericin B combined with other antibiotic therapy has a better therapeutic effect , early diagnosis and actively controlling in-tracranial pressure contribute to improving prognosis .