Development of a risk scoring system for prognostication in HIV-related toxoplasma encephalitis
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RESEARCH ARTICLE
Open Access
Development of a risk scoring system for prognostication in HIV-related toxoplasma encephalitis Yao Li1†, Yan-Ming Zeng1†, Min Liu1, Yan-Qiu Lu1, Xue-Yan Liu2, Yu-Lin Zhang3, Zhong-Sheng Jiang4, Tong-Tong Yang5, Yan Sun6, Ke Lan7 and Yao-Kai Chen1*
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: HIV, Toxoplasma encephalitis, Risk scoring system, Death, Retrospective study
Background Toxoplasmosis is a zoonotic parasitic disease caused by Toxoplasma gondii infection [1]. In HIV-infected patients, seropositivity for Toxoplasma antibodies is as high as 10–40%, and it is estimated that a third of those patients will eventually progress to toxoplasma encephalitis (TE) [2], particularly in those with CD4+ T-cell counts 2) in HIV-infected patients with severe cerebral
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