Dermot H. Kennedy

Treatment and prognosis in tuberculous meningitis

Summary The prognosis in tuberculous meningitis depends principally on the delay between onset and the institution of adequate chemotherapy. Therapy, other than that specifically directed against Mycobacterium tuberculosis may be important and should be pursued energetically in view of the fact that cases with severe disease may still make a good, even complete, recovery.

Tuberculous meningitis in pregnancy

Summary. Four women with tuberculous meningitis in association with pregnancy are described to illustrate both the serious nature and varied presentation of this condition. Mortality or neurological morbidity may occur more frequently during pregnancy, but in general correlate closely with delay in diagnosis and initiation of appropriate therapy. Treatment often needs to be started empirically, and neurosurgical intervention may prove life saving.

Estimates of HIV infection among injecting drug users in Glasgow, 1985-1990.

ObjectiveTo use research and surveillance studies in Glasgow (Scotland, UK) to estimate the number of current injectors infected with HIV, the total number of injectors infected up to the end of 1990 and the recent incidence of infection. Design(A) Prevalence of injecting drug use was estimated using log-linear modelling. (B) Prevalence of HIV infection was determined from voluntary testing of a community-wide sample of injectors

Efficacy and safety of combination therapy with delavirdine and zidovudine: a European:Australian phase II trial

The objective of the study was to investigate the safety and antiviral effect of three delavirdine dose regimens or placebo in combination with zidovudine in patients who were already taking zidovudine. Eighty-nine symptomatic HIV-1 seropositive individuals with CD4 cell counts between 50 and 350 cells/microl were included in this trial The influence of combination therapy on viral susceptibility to both zidovudine and delavirdine was investigated. Death or the occurrence, or re-occurrence of an AIDS-defining illness was considered as a clinical endpoint. The addition of delavirdine to the antiretroviral treatment regimen resulted in a significant, but transient, reduction in virus load, as determined by quantitative RNA measurements. CD4+ cell count did not change significantly. Susceptibility to zidovudine remained unchanged after 12 weeks of combination therapy, while 70% of the patients demonstrated a substantial decrease (> 10-fold) in sensitivity to delavirdine. Two patients suffered from an AIDS-defining disease during the study. No deaths occurred. Generally, the drug appeared to be safe. Skin rash was the most frequently observed adverse event (52%). In most patients the rash either resolved spontaneously or was treated successfully with a short course of antihistamines. The definite place of the compound in the management of HIV disease, in particular when given in combination with other antiretroviral agents, remains to be further explored.