Program in Neuroinfectious Diseases

Clinical care activities in the program include both inpatient and outpatient services. Inpatient, our neuroinfectious disease consult service is focused on the specialized care of patients admitted to the hospital with presumed or definitive neurological infections. Working alongside our infectious disease, neuroimmunology, and hospitalist colleagues, we assist in expert consultation and management dedicated to an individualized patient care approach, often utilizing novel antimicrobial and anti-inflammatory therapies. The consult team is led by Dr. Kiran Thakur and Dr. Kathryn Holroyd and is staffed by neuroinfectious diseases fellows and neurology residents.

We also provide neurological care in the outpatient comprehensive HIV program, as well as in a general neuroinfectious diseases clinic. Our team can also provide virtual consultation to aid clinicians in the assessment and management of complex patients with neuroinfectious diseases.

Some of our recent novel clinical treatment activities have included the use of Pocapavir for enterovirus encephalitis, immunomodulatory therapy for arboviruses, including West Nile virus, and best practices for treating some of the most prevalent viral infections, such as Varicella Zoster Virus (VZV) and herpes simplex virus (HSV) encephalitis.

Drs. Thakur and Holroyd co-lead an innovative research program in neuroinfectious diseases that integrates clinical and translational research as well as implementation science:

• Development and expansion of targeted T-cell therapies for refractory and otherwise incurable viral CNS infections (including PML and CMV encephalitis)
• Leadership in translational research on HIV-associated cognitive impairment and vascular risk factors in domestic and international settings
• Implementation science programs improving the diagnosis and treatment of cryptococcal meningitis in New York City and Ethiopia
• Evaluation of advanced diagnostic tools for neuroinfectious diseases
• Collaboration with Encephalitis International and international colleagues to develop cognitive, mood, and functional screening tools for long-term survivors of infectious encephalitis
• Multidisciplinary partnerships across neurology, oncology, infectious diseases, and public health

A major goal of our team is to protect and improve the health of individuals and their communities who are most at risk and suffering from neurological infections, both in our local community and globally.

Our team works closely with the Pan American Health Organization (PAHO), the International Neuro-HIV Cure Consortium (INHCC), and Center for Disease Control and Prevention (CDC) to prioritize neurological infectious diseases in public policy efforts. We are focused on expanding implementation of best practice guidelines for treatment of globally prevalent neuroinfectious diseases, including tuberculous meningitis, cryptococcal meningitis, and the central nervous complications of HIV infection.

Locally, we are working on projects focused on community engagement in Washington Heights, including brain health lectures and community fairs, research working to identify healthcare access gaps, and infectious encephalitis awareness.

Columbia’s neurological tradition dates back to the early twentieth century through the Neurological Institute of New York, one of the first dedicated neurology institutes in the United States. By the 1970s and 1980s, Columbia neurologists increasingly encountered infectious diseases affecting the nervous system, particularly in urban New York populations.

The emergence of HIV/AIDS transformed the field. Neurologists at Columbia began treating patients with encephalitis, meningitis, neuropathies, opportunistic CNS infections, and progressive cognitive decline associated with immunosuppression. This environment created the intellectual and clinical basis for what later became formal neuroinfectious disease program.

Dr. Carolyn Britton’s role in the development of neuroinfectious disease care

The history of neuroinfectious diseases research and clinical care at Columbia University Irving Medical Center developed through the intersection of neurology, infectious diseases, HIV medicine, and public health. A central figure in that history is Carolyn Barley Britton, whose work helped establish Columbia as a major center for neurological complications of infectious disease, especially during the AIDS epidemic.

Carolyn Barley Britton trained at Columbia after graduating from New York University Grossman School of Medicine. She completed residency and fellowship training at Columbia Presbyterian Medical Center and joined the faculty there.

During the early AIDS crisis in the 1980s, Britton became one of the country’s leading experts on the neurologic manifestations of HIV infection. Her early publications examined AIDS-related neurologic syndromes at a time when many clinicians were only beginning to recognize the virus’s effects on the brain and peripheral nervous system. Her work addressed:

• HIV-associated neuropathy 
• Opportunistic CNS infections 
• Progressive multifocal leukoencephalopathy (PML) 
• AIDS dementia complex 
• Neurological complications of immunosuppression 
• Lyme disease and infectious encephalitis 

Her 1984 publication on neurologic complications of AIDS was among the early landmark clinical descriptions of HIV-related neurological disease. 

At Columbia, Britton combined bedside neurology with infectious disease management. This was especially important before effective antiretroviral therapy existed, when many neurological complications were rapidly progressive and fatal. Her clinical practice became known for treating difficult neuroinfectious cases including meningitis, encephalitis, and HIV-associated neurologic disorders.

Columbia and the HIV/neuro-HIV era

By the late 1980s and 1990s, Columbia had become an important center for neuro-HIV research and care. Several institutional strengths converged:

• large HIV patient populations in northern Manhattan 
• strong neurology and infectious disease departments 
• collaborations with public health researchers 
• access to diverse urban patient populations 

Researchers at Columbia studied how HIV affected cognition, cerebrovascular function, peripheral nerves, and CNS inflammation. This work aligned with broader Columbia public health and infectious disease initiatives.

Britton’s work also had an important equity dimension. She advocated for broader HIV testing and attention to racial disparities in care and research participation. Her later leadership as president of the National Medical Association reflected those commitments.

Our neurology and infectious disease trainees have the unique opportunity to learn about neurological infections through our team’s educational leaders, including senior neuroinfectious disease expert Dr. Carolyn Britton and Director of Neuroinfectious Disease education Dr. Kathryn Holroyd. Our group seeks to foster neuroinfectious disease education longitudinally, from the level of medical student to resident to fellow. We also seek to build a collaborative environment of neuroinfectious diseases education both within and across departments at Columbia.

Please visit our education section to learn more about our current available fellowship opportunities.

Below you can find free links to our quarterly international neuroinfectious diseases lecture series. In these lectures, our neuroinfectious diseases fellows describe the epidemiology, pathophysiology, diagnosis, and management of common neuroinfectious conditions. A topic-specific world expert discussant is also present at each talk to provide high-yield clinical pearls during the presentation.

• Tuberculous (TB) meningitis
  Discussant: Dr. Nate Bahr
  [watch video]
• Neurocysticercosis - Part 1
  Discussants: Drs. Christina Coyle and Hugo Garcia
  [download PDF presentation]
• Neurocyticercosis Part II- Extraparenchymal Disease
  Discussants: Drs. Luisa Alviz, Temesgen Nurye, and Anlys Olivera.
  [watch video]
• Toxoplasmosis
  Discussant: Dr. Louis Weiss
  [watch video]
• Cryptococcal meningitis
  Discussant: Dr. David Meya
  [watch video]

To make a donation, please contact:

Matthew Reals
Senior Director of Development
Vagelos College of Physicians and Surgeons
Columbia University Irving Medical Center
Phone: 646-761-0915
Email:mr3134@cumc.columbia.edu