Tnf Inhibitors to Reduce Mortality in HIV-1 Infected PAtients With Tuberculosis meNIngitis

This study is testing whether a class of drugs called TNF inhibitors (which dampen inflammation) can reduce deaths in HIV-positive patients with tuberculosis meningitis — a severe infection of the fluid and membranes around the brain. Current treatment with antibiotics and steroids still leaves many patients at risk. **You may be eligible if...** - You are 18 years or older - You are HIV-positive - You have a confirmed or probable diagnosis of tuberculosis meningitis - You started standard TB treatment (antibiotics and high-dose steroids) within the last 3 days **You may NOT be eligible if...** - You have another brain infection (like toxoplasmosis, cryptococcal meningitis, or bacterial meningitis) - You have active hepatitis B or C - Your liver enzymes are severely elevated - Your TB is resistant to rifampicin (a key antibiotic) - You have had TB meningitis before Talk to your doctor to see if this trial is right for you.