Adjunctive Dexamethasone: Not Beneficial for Managing TB Meningitis in Advanced HIV Disease

In a placebo-controlled trial, up to 8 weeks of adjunctive dexamethasone did not improve survival or reduce risk for IRIS in HIV-positive adults with tuberculous meningitis.

Tuberculous (TB) meningitis in persons living with HIV (PLWH) remains lethal. Adjunctive corticosteroids are recommended with antiretroviral therapy (ART) and anti-TB agents, although supporting data are limited. Investigators in Vietnam and Indonesia evaluated adjunctive dexamethasone in PLWH who had definite, probable, or possible TB meningitis. Participants were randomized 1:1 to receive, double-blinded, placebo or 6–8 weeks of tapering dexamethasone (duration based on TB severity) as well as standard ART and TB therapy (the latter for 12 months). For ART-naive patients, ART was started ≥2 weeks after TB therapy was initiated. The primary endpoint was death from any cause at 12 months. In all, 520 adults were enrolled (median age, 36; 25…

Reviewing Author

Keith Henry, MD

Disclosures

Consultant/Advisory BoardViiV Advisory Board

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes

Keith Henry, MD

Disclosures

Consultant/Advisory BoardViiV Advisory Board

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes

Adjunctive Dexamethasone: Not Beneficial for Managing TB Meningitis in Advanced HIV Disease

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Reviewing Author