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Systematic Reviews
Published in: Systematic Reviews 1/2017

Open Access 01-12-2017 | Protocol

Ventriculoperitoneal shunt insertion for hydrocephalus in human immunodeficiency virus-infected adults: a systematic review and meta-analysis protocol

Authors: James J. M. Loan, Ncedile Mankahla, Graeme Meintjes, A. Graham Fieggen

Published in: Systematic Reviews | Issue 1/2017

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Abstract

Background

Hydrocephalus is a recognised complication of human immunodeficiency virus (HIV)-related opportunistic infections. Symptomatic raised cerebrospinal fluid pressure can be treated with ventriculoperitoneal shunt insertion (VPS). In HIV-infected patients however, there is a concern that VPS might be associated with unacceptably high rates of mortality. We aim to systematically review and appraise published literature to determine reported outcomes and identify predictors of outcome following VPS in relevant subgroups of HIV-infected adults.

Methods

The following electronic databases will be searched: The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (PubMed), EMBASE, CINAHL (EBSCOhost), LILACS (BIREME), Research Registry (www.​researchregistry​.​com), the metaRegister of Controlled Trials (mRCT) (www.​controlled-trials.​com), ClinicalTrials.gov (www.​clinicaltrials.​gov) and OpenSIGLE database. Any randomised studies, cohort studies, case-control studies, interrupted time series or sequential case series reporting survival following VPS in HIV-infected individuals will be included. If high-quality homogenous studies exist, meta-analysis will be conducted to determine 1-, 6- and 12-month mortality with comparison made between underlying aetiologies of hydrocephalus.

Discussion and conclusion

This study will generate a comprehensive review of VPS in HIV-infected patients for publication. The primary outcome of meta-analysis is 12-month survival. If only low-quality, heterogeneous studies are available, this study will demonstrate this deficiency and will be of value in justifying and aiding the design of future studies.

Systematic review registration

PROSPERO CRD42016052239
Appendix
Available only for authorised users
Literature
1.
Buonaguro L, Tornesello ML, Buonaguro FM. Human immunodeficiency virus type 1 subtype distribution in the worldwide epidemic: pathogenetic and therapeutic implications. J Virol. 2007;81(19):10209–19.CrossRefPubMedPubMedCentral
2.
Marlink R, Kanki P, Thior I, Travers K, Eisen G, Siby T, et al. Reduced rate of disease development after HIV-2 infection as compared to HIV-1. Science. 1994;265(5178):1587–90.CrossRefPubMed
3.
4.
5.
Sacktor N. The epidemiology of human immunodeficiency virus-associated neurological disease in the era of highly active antiretroviral therapy. J Neuro-Oncol. 2002;8(Suppl 2):115–21.
6.
McArthur JC, Brew BJ, Nath A. Neurological complications of HIV infection. Lancet Neurol. 2005;4(9):543–55.CrossRefPubMed
7.
Croucher A, Winston A. Neurological complications of HIV. HIV and AIDS. 2013;41(8):450–5.
8.
9.
Greenberg MS. Hydrocephalus—general aspects. In: Greenberg MS, editor. Handbook of neurosurgery. 8th ed. New York: Thieme; 2016. p. 394–413.
10.
Graybill JR, Sobel J, Saag M, van Der Horst C, Powderly W, Cloud G, et al. Diagnosis and management of increased intracranial pressure in patients with AIDS and cryptococcal meningitis. The NIAID Mycoses Study Group and AIDS Cooperative Treatment Groups. Clin Infect Dis. 2000;30(1):47–54.CrossRefPubMed
11.
Filippi CG, Ulug AM, Ryan E, Ferrando SJ, van Gorp W. Diffusion tensor imaging of patients with HIV and normal-appearing white matter on MR images of the brain. AJNR Am J Neuroradiol. 2001;22(2):277–83.PubMed
12.
13.
Figaji AA, Fieggen AG, Peter JC. Endoscopic third ventriculostomy in tuberculous meningitis. Childs Nerv Syst. 2003;19(4):217–25.PubMed
14.
Thwaites GE, Nguyen DB, Nguyen HD, Hoang TQ, Do TT, Nguyen TC, et al. Dexamethasone for the treatment of tuberculous meningitis in adolescents and adults. N Engl J Med. 2004;351(17):1741–51.CrossRefPubMed
15.
Clemente Morgado T, Kinsky M, Carrara H, Rothemeyer S, Semple P. Prognostic value of computed tomography-evident cerebral infarcts in adult patients with tuberculous meningitis and hydrocephalus treated with an external ventricular drain. World Neurosurg. 2013;80(6):e255–60.CrossRefPubMed
16.
Silver RF, Li Q, Ellner JJ. Expression of virulence of Mycobacterium tuberculosis within human monocytes: virulence correlates with intracellular growth and induction of tumor necrosis factor alpha but not with evasion of lymphocyte-dependent monocyte effector functions. Infect Immun. 1998;66(3):1190–9.PubMedPubMedCentral
17.
Sanduzzi A, Fraziano M, Mariani F. Monocytes/macrophages in HIV infection and tuberculosis. J Biol Regul Homeost Agents. 2001;15(3):294–8.PubMed
18.
Jordan CA, Watkins BA, Kufta C, Dubois-Dalcq M. Infection of brain microglial cells by human immunodeficiency virus type 1 is CD4 dependent. J Virol. 1991;65(2):736–42.PubMedPubMedCentral
19.
Peterson PK, Gekker G, Hu S, Sheng WS, Anderson WR, Ulevitch RJ, et al. CD14 receptor-mediated uptake of nonopsonized mycobacterium tuberculosis by human microglia. Infect Immun. 1995;63(4):1598–602.PubMedPubMedCentral
20.
Wallis RS, Vjecha M, Amir-Tahmasseb M, Okwera A, Byekwaso F, Nyole S, et al. Influence of tuberculosis on human immunodeficiency virus (HIV-1): enhanced cytokine expression and elevated beta 2-microglobulin in HIV-1-associated tuberculosis. J Infect Dis. 1993;167(1):43–8.CrossRefPubMed
21.
Curto M, Reali C, Palmieri G, Scintu F, Schivo ML, Sogos V, et al. Inhibition of cytokines expression in human microglia infected by virulent and non-virulent mycobacteria. Neurochem Int. 2004;44(6):381–92.CrossRefPubMed
22.
23.
Pappas PG. Managing cryptococcal meningitis is about handling the pressure. Clin Infect Dis. 2005;40(3):480–2.CrossRefPubMed
24.
Offiah CE, Turnbull IW. The imaging appearances of intracranial CNS infections in adult HIV and AIDS patients. Clin Radiol. 2006;61(5):393–401.CrossRefPubMed
25.
Mankahla NR, Rothemeyer SJ. Neurosurgical complications of HIV. Continuing Med Educ. 2013;31(3):112–3.
26.
Tan K, Roda R, Ostrow L, McArthur J, Nath A. PML-IRIS in patients with HIV infection: clinical manifestations and treatment with steroids. Neurology. 2009;72(17):1458–64.CrossRefPubMedPubMedCentral
27.
Marais S, Scholtz P, Pepper DJ, Meintjes G, Wilkinson RJ, Candy S. Neuroradiological features of the tuberculosis-associated immune reconstitution inflammatory syndrome. Int J Tuberc Lung Dis. 2010;14(2):188–96.PubMedPubMedCentral
28.
Global AIDS update. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS; 2016.
29.
30.
31.
Lucas SB, Hounnou A, Peacock C, Beaumel A, Djomand G, N'Gbichi JM, et al. The mortality and pathology of HIV infection in a west African city. AIDS. 1993;7(12):1569–79.CrossRefPubMed
32.
BL MR, Drouin O, Bartlett G, Nguyen Q, Low A, Gavriilidis G, et al. Incidence and prevalence of opportunistic and other infections and the impact of antiretroviral therapy among HIV-infected children in low- and middle-income countries: a systematic review and meta-analysis. Clin Infect Dis. 2016;62(12):1586–94.CrossRef
33.
34.
Marais S, Pepper DJ, Marais BJ, Torok ME. HIV-associated tuberculous meningitis—diagnostic and therapeutic challenges. Tuberculosis (Edinb). 2010;90(6):367–74.CrossRef
35.
Denning DW, Armstrong RW, Lewis BH, Stevens DA. Elevated cerebrospinal fluid pressures in patients with cryptococcal meningitis and acquired immunodeficiency syndrome. Am J Med. 1991;91(3):267–72.CrossRefPubMed
36.
37.
Bir SC, Patra DP, Maiti TK, Sun H, Guthikonda B, Notarianni C, et al. Epidemiology of adult-onset hydrocephalus: institutional experience with 2001 patients. Neurosurg Focus. 2016;41(3):E5.CrossRefPubMed
38.
Jenkinson MD, Gamble C, Hartley JC, Hickey H, Hughes D, Blundell M, et al. The British antibiotic and silver-impregnated catheters for ventriculoperitoneal shunts multi-centre randomised controlled trial (the BASICS trial): study protocol. Trials. 2014;15:4.CrossRefPubMedPubMedCentral
39.
Greenberg MS. Treatment of hydrocephalus. In: Greenberg MS, editor. Handbook of neurosurgery. 8th ed. New York: Thieme; 2016. p. 414–37.
40.
Patwardhan RV, Nanda A. Implanted ventricular shunts in the United States: the billion-dollar-a-year cost of hydrocephalus treatment. Neurosurgery. 2005;56(1):139–44. discussion 44-5CrossRefPubMed
41.
Wu Y, Green NL, Wrensch MR, Zhao S, Gupta N. Ventriculoperitoneal shunt complications in California: 1990 to 2000. Neurosurgery. 2007;61(3):557–62. discussion 62-3CrossRefPubMed
42.
Gathura E, Poenaru D, Bransford R, Albright AL. Outcomes of ventriculoperitoneal shunt insertion in sub-Saharan Africa. J Neurosurg Pediatr. 2010;6(4):329–35.CrossRefPubMed
43.
Bank TW. World Bank Country and Lending Groups 2017 [updated 2017 Fiscal year.
44.
45.
Sharma RM, Pruthi N, Arimappamagan A, Somanna S, Devi BI, Pandey P. Tubercular meningitis with hydrocephalus with HIV co-infection: role of cerebrospinal fluid diversion procedures. J Neurosurg. 2015;122(5):1087–95.CrossRefPubMed
46.
Nadvi SS, Nathoo N, Annamalai K, van Dellen JR, Bhigjee AI. Role of cerebrospinal fluid shunting for human immunodeficiency virus-positive patients with tuberculous meningitis and hydrocephalus. Neurosurgery. 2000;47(3):644–9. discussion 9-50PubMed
47.
Bach MC, Tally PW, Godofsky EW. Use of cerebrospinal fluid shunts in patients having acquired immunodeficiency syndrome with cryptococcal meningitis and uncontrollable intracranial hypertension. Neurosurgery. 1997;41(6):1280–2. discussion 2-3CrossRefPubMed
48.
Woodworth GF, McGirt MJ, Williams MA, Rigamonti D. The use of ventriculoperitoneal shunts for uncontrollable intracranial hypertension without ventriculomegally secondary to HIV-associated cryptococcal meningitis. Surg Neurol. 2005;63(6):529–31. discussion 31-2CrossRefPubMed
49.
United Kingdom transient ischaemic attack (UK-TIA) aspirin trial: interim results. UK-TIA Study Group. Br Med J (Clin Res Ed). 1988;296(6618):316-20.
50.
Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974;2(7872):81–4.CrossRefPubMed
51.
52.
RevMan. Review Manager. In: Collaboration TC, editor. 5.0 ed. Copenhagen: The Cochrane Collaboration; 2008.
53.
54.
Cochrane handbook for systematic reviews of interventions. Chichester: Wiley-Blackwell; 2008.
55.
56.
Deeks JJ, Dinnes J, D'amico R, Sowden AJ, Sakarovitch C, Song F, Petticrew M, Altman DG. Evaluating non-randomised intervention studies. Health technology assessment (Winchester, England). 2003;7(27):iii–x.
57.
58.
Portegies P, Solod L, Cinque P, Chaudhuri A, Begovac J, Everall I, et al. Guidelines for the diagnosis and management of neurological complications of HIV infection. Eur J Neurol. 2004;11(5):297–304.CrossRefPubMed
59.
Modi M, Mochan A, Modi G. Management of HIV-associated focal brain lesions in developing countries. QJM. 2004;97(7):413–21.CrossRefPubMed
Metadata
Title
Ventriculoperitoneal shunt insertion for hydrocephalus in human immunodeficiency virus-infected adults: a systematic review and meta-analysis protocol
Authors
James J. M. Loan
Ncedile Mankahla
Graeme Meintjes
A. Graham Fieggen
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2017
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-017-0603-7

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