Cryptococcal meningitis and tuberculosis are leading causes of mortality in patients initiating antiretroviral therapy in Africa. We hypothesized that a history of tuberculosis may predispose to the development of cryptococcal meningitis and examined the association using multivariate logistic regression in a cohort of patients initiating antiretroviral therapy. History of pulmonary tuberculosis was independently associated with the development of cryptococcal meningitis (odds ratio = 6.6; 95% confidence interval = 1.3–32.7) after adjustment for covariates, including CD4 cell counts. A number of potential mechanisms may underlie this association.
aDesmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
bDepartment of Cellular and Molecular Medicine, Centre for Infection, St George's University of London, London, UK
cInfectious Diseases Research Unit, GF Jooste Hospital, South Africa
dDivision of Infectious Diseases, Department of Medicine, University of Cape Town, Cape Town, South Africa
eDepartment of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
fMalawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi.
Received 9 October, 2009
Revised 9 November, 2009
Accepted 11 November, 2009
Correspondence to Joseph N. Jarvis, Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Faculty of Health Sciences, Anzio Road, Observatory 7925, Cape Town, South Africa. Tel: +27 21 650 6987; fax: +27 21 650 6963; e-mail: firstname.lastname@example.org