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Published in: BMC Infectious Diseases 1/2020

Open Access 01-12-2020 | Toxoplasmosis | Research article

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

Authors: Yao Li, Yan-Ming Zeng, Min Liu, Yan-Qiu Lu, Xue-Yan Liu, Yu-Lin Zhang, Zhong-Sheng Jiang, Tong-Tong Yang, Yan Sun, Ke Lan, Yao-Kai Chen

Published in: BMC Infectious Diseases | Issue 1/2020

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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.
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Literature
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go back to reference McFarland M, Bartlett M, Davis P. Toxoplasmic Encephalitis. Edition: 1, Chapter: 1, Publisher: Avid Science, Editors: Avid Science. Encephalitis; 2016. p. 2–52. McFarland M, Bartlett M, Davis P. Toxoplasmic Encephalitis. Edition: 1, Chapter: 1, Publisher: Avid Science, Editors: Avid Science. Encephalitis; 2016. p. 2–52.
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go back to reference Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: Recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America.[EB/OL]. http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf [accessed May 16, 2020]. Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: Recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America.[EB/OL]. http://​aidsinfo.​nih.​gov/​contentfiles/​lvguidelines/​adult_​oi.​pdf [accessed May 16, 2020].
Metadata
Title
Development of a risk scoring system for prognostication in HIV-related toxoplasma encephalitis
Authors
Yao Li
Yan-Ming Zeng
Min Liu
Yan-Qiu Lu
Xue-Yan Liu
Yu-Lin Zhang
Zhong-Sheng Jiang
Tong-Tong Yang
Yan Sun
Ke Lan
Yao-Kai Chen
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2020
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-020-05651-x

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