Prevalence of CSF HIV VIRAL Escape and Associations With Neurocognitive Outcomes Among HIV-Associated Meningitis Survivors: A Cohort Study

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Secondary cerebrospinal fluid (CSF) HIV viral escape was prevalent in 43% of Ugandan adults surviving HIV-associated meningitis.
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CSF viral escape was associated with better neurocognitive outcomes at 3 months post-meningitis diagnosis.
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Participants with secondary CSF HIV viral escape were more likely to be antiretroviral therapy (ART)–naïve and exhibit CSF pleocytosis.
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The study included 93 participants, with 69% having cryptococcal meningitis and a median age of 35 years.
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Overall, 75% of participants had plasma viremia, and 78% had CSF HIV viremia, indicating significant viral presence.

Open Forum Infectious Diseases

by Laura Nsangi, Gila Hale, Biyue Dai, Kathy Huppler Hullsiek, Asmus Tukundane, Alice Namudde, Grace B Menya, Peruth Ayebare, Lydia Nankungu, Olivie C Namuju, Susan Mulwana, Mable Kabahubya, David B Meya, David R Boulware, Fiona V Cresswell, Nathan C Bahr, Mahsa Abassi, Jayne Ellis
February 12, 2026

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