Neurotuberculosis, from treatment to politics – an interview with Guy Thwaites

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Pulmonary tuberculosis may be the most common form of this bacterial infection; however, although neurotuberculosis is much rarer, it has far more severe consequences and is associated with extremely poor prognosis.

We spoke to Guy Thwaites, Director of the Oxford University Clinical Research Unit/Wellcome Program in Vietnam, about this disease and the challenges it faces in terms of treatment, HIV co-infection and the necessary political will to change the landscape of tuberculosis.

First, could you introduce yourself and tell us a bit about your background?

My name’s Guy Thwaites, I’m an infectious disease physician and clinical microbiologist by training and I am currently Director of the Oxford University Clinical Research Unit in Ho Chi Minh City, Vietnam and Professor of Infectious Diseases at the University of Oxford (UK). My research interests are particularly around severe bacterial infections and brain tuberculosis and carrying out clinical trials to find out more about the management of those conditions.

You’re here at ECCMID giving an update on neurotuberculosis – could you tell us about the burden of this form of TB and why you think it’s an area of unmet need?

In terms of infectious disease, TB itself is the biggest single killer in the world causing approximately 1 and a half million deaths a year. However, within this TB meningitis, which is estimated to have approximately 100,000 cases per year, is the most severe form of TB. If left untreated TB meningitis will always be fatal, but even with the best available treatment it kills around 30%, and leaves another 20% with severe neurological disability. So although this form of TB is relatively rare – constituting between 1 and 5% of all forms of TB – it kills more than any other type of TB.

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