Development of a risk scoring system for prognostication in HIV-related toxoplasma encephalitis

• Published in: BMC infectious diseases Vol. 20; no. 1; pp. 923 - 8
• Main Authors: Li, Yao, Zeng, Yan-Ming, Liu, Min, Lu, Yan-Qiu, Liu, Xue-Yan, Zhang, Yu-Lin, Jiang, Zhong-Sheng, Yang, Tong-Tong, Sun, Yan, Lan, Ke, Chen, Yao-Kai
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 04.12.2020; BioMed Central; BMC
• Subjects: Accuracy; Acquired immune deficiency syndrome; Adult; AIDS; AIDS-Related Opportunistic Infections - epidemiology; AIDS-Related Opportunistic Infections - virology; CD4 antigen; Comorbidity; Complications and side effects; Consciousness; Death; Encephalitis; Female; Fever; Health risks; HIV; HIV infection; Human immunodeficiency virus; Humans; Immunological memory; Infectious diseases; Infectious Encephalitis - epidemiology; Infectious Encephalitis - mortality; Infectious Encephalitis - parasitology; Laboratories; Laboratory tests; Lymphocytes T; Male; Medical prognosis; Memory; Middle Aged; Mortality; Prognosis; Prospective Studies; Public health; Regression analysis; Research Design; Retrospective Studies; Retrospective study; Risk analysis; Risk Factors; Risk scoring system; Scoring models; Sensitivity and Specificity; Software; Therapeutic applications; Toxoplasma; Toxoplasma encephalitis; Toxoplasmosis; Toxoplasmosis, Cerebral - epidemiology; Toxoplasmosis, Cerebral - mortality; Toxoplasmosis, Cerebral - parasitology; Variables; Taiwan; Death; Retrospective study; HIV; Risk scoring system; Toxoplasma encephalitis
• DOI: 10.1186/s12879-020-05651-x
• ISSN: 1471-2334

This study aims to evaluate specific risk factors influencing prognosis of HIV-infected patients with toxoplasma encephalitis (TE) in order to develop a prognostic risk scoring system for them. This is a six-center retrospective study of hospitalized HIV/TE patients. Data including six-week mortality after diagnosis, baseline characteristics, clinical features, laboratory tests and radiological characteristics of eligible patients were assimilated for risk model establishing. In this study, the six-week mortality among 94 retrospective cases was 11.7% (11/94). Seven specific risk factors, viz. time from symptom onset to presentation, fever, dizziness, CD4+ T-cell counts, memory deficits, patchy brain lesions, and disorders of consciousness were calculated to be statistically associated with mortality. A criterion value of '9' was selected as the optimal cut-off value of the established model. The AUC of the ROC curve of this scoring model was 0.976 (p < 0.001). The sensitivity and specificity of the risk scoring model was 100.0 and 86.9%, respectively, which were 81.8 and 94.1% of this scoring model in the verification cohort, respectively. The developed scoring system was established with simple risk factors, which also allows expeditious implementation of accurate prognostication, and appropriate therapeutic interventions in HIV-infected patients with TE.