The management of post-infectious hydrocephalus in people living with HIV: a prospective observational study

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dc.contributor.advisorFieggen, Graham
dc.contributor.advisorDlamini, Sipho K
dc.contributor.authorLekoloane, Reneiloe M
dc.date.accessioned2024-11-04T07:09:09Z
dc.date.available2024-11-04T07:09:09Z
dc.date.issued2024
dc.date.updated2024-07-09T13:29:32Z
dc.description.abstractPost-infectious hydrocephalus (PIH) in people living with HIV (PLHIV) is a common complication presenting to neurosurgeons in South Africa, but there is limited evidence to guide management of these patients. Objectives The study aimed to prospectively document the in-hospital management and 12 month neurological and survival outcomes of PIH in people living with HIV (PLHIV). Methods The study included a consecutive series of 23 people living with HIV (PLHIV) presenting to a tertiary hospital in 2018 with a diagnosis of post infectious hydrocephalus who were followed up for a 12-month period. Baseline demographics, HIV data, and Glasgow Coma Score, aetiology of post infectious hydrocephalus and treatment modality were documented. Survival outcomes and neurological function (modified Rankin Scale) were assessed. The cohort was divided into non-randomised treatment groups, surgical (ventriculoperitoneal shunts/ external ventricular drain) and medical (lumbar spinal taps) based on institutional practice. Results PIH aetiologies were noted as tuberculous in 78.3% (n=18) and cryptococcal in 21.7% (n=5). Overall survival at discharge was 69,9% (n=16) and 47.8% (n=11) at 12 months follow up. Functional outcomes expressed as mRS, resembled the survival data, showing favourable outcomes at 12 months within the survival group. Linear regression analysis showed that the cohort had an unchanged mRS during the 12-month period (p=0.008) Conclusion The limited data from this study suggest that a proactive therapeutic approach to PIH should be offered to virologically suppressed individuals. A tiered treatment algorithm is proposed to guide the treatment of these patients. Further studies using this treatment algorithm could provide a more accurate representation of outcomes in this population.
dc.identifier.apacitationLekoloane, R. M. (2024). <i>The management of post-infectious hydrocephalus in people living with HIV: a prospective observational study</i>. (). ,Faculty of Health Sciences ,Division of General Surgery. Retrieved from http://hdl.handle.net/11427/40670en_ZA
dc.identifier.chicagocitationLekoloane, Reneiloe M. <i>"The management of post-infectious hydrocephalus in people living with HIV: a prospective observational study."</i> ., ,Faculty of Health Sciences ,Division of General Surgery, 2024. http://hdl.handle.net/11427/40670en_ZA
dc.identifier.citationLekoloane, R.M. 2024. The management of post-infectious hydrocephalus in people living with HIV: a prospective observational study. . ,Faculty of Health Sciences ,Division of General Surgery. http://hdl.handle.net/11427/40670en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Lekoloane, Reneiloe AB - Post-infectious hydrocephalus (PIH) in people living with HIV (PLHIV) is a common complication presenting to neurosurgeons in South Africa, but there is limited evidence to guide management of these patients. Objectives The study aimed to prospectively document the in-hospital management and 12 month neurological and survival outcomes of PIH in people living with HIV (PLHIV). Methods The study included a consecutive series of 23 people living with HIV (PLHIV) presenting to a tertiary hospital in 2018 with a diagnosis of post infectious hydrocephalus who were followed up for a 12-month period. Baseline demographics, HIV data, and Glasgow Coma Score, aetiology of post infectious hydrocephalus and treatment modality were documented. Survival outcomes and neurological function (modified Rankin Scale) were assessed. The cohort was divided into non-randomised treatment groups, surgical (ventriculoperitoneal shunts/ external ventricular drain) and medical (lumbar spinal taps) based on institutional practice. Results PIH aetiologies were noted as tuberculous in 78.3% (n=18) and cryptococcal in 21.7% (n=5). Overall survival at discharge was 69,9% (n=16) and 47.8% (n=11) at 12 months follow up. Functional outcomes expressed as mRS, resembled the survival data, showing favourable outcomes at 12 months within the survival group. Linear regression analysis showed that the cohort had an unchanged mRS during the 12-month period (p=0.008) Conclusion The limited data from this study suggest that a proactive therapeutic approach to PIH should be offered to virologically suppressed individuals. A tiered treatment algorithm is proposed to guide the treatment of these patients. Further studies using this treatment algorithm could provide a more accurate representation of outcomes in this population. DA - 2024 DB - OpenUCT DP - University of Cape Town KW - General Surgery LK - https://open.uct.ac.za PY - 2024 T1 - ETD: The management of post-infectious hydrocephalus in people living with HIV: a prospective observational study TI - ETD: The management of post-infectious hydrocephalus in people living with HIV: a prospective observational study UR - http://hdl.handle.net/11427/40670 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/40670
dc.identifier.vancouvercitationLekoloane RM. The management of post-infectious hydrocephalus in people living with HIV: a prospective observational study. []. ,Faculty of Health Sciences ,Division of General Surgery, 2024 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/40670en_ZA
dc.language.rfc3066Eng
dc.publisher.departmentDivision of General Surgery
dc.publisher.facultyFaculty of Health Sciences
dc.subjectGeneral Surgery
dc.titleThe management of post-infectious hydrocephalus in people living with HIV: a prospective observational study
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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