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

BMC Infect Dis. 2020 Dec 4;20(1):923. doi: 10.1186/s12879-020-05651-x.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Death; HIV; Retrospective study; Risk scoring system; Toxoplasma encephalitis.

Publication types

  • Multicenter Study

MeSH terms

  • AIDS-Related Opportunistic Infections / epidemiology*
  • AIDS-Related Opportunistic Infections / virology
  • Adult
  • Comorbidity
  • Female
  • HIV*
  • Humans
  • Infectious Encephalitis / epidemiology*
  • Infectious Encephalitis / mortality
  • Infectious Encephalitis / parasitology
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Research Design*
  • Retrospective Studies
  • Risk Factors
  • Sensitivity and Specificity
  • Toxoplasma*
  • Toxoplasmosis, Cerebral / epidemiology*
  • Toxoplasmosis, Cerebral / mortality
  • Toxoplasmosis, Cerebral / parasitology