A clinical rule for the prediction of meningitis in HIV patients in the era of combination antiretroviral therapy

El‐Wahab, Ekram W. Abd; Farrag, Talaat; Metwally, Mohammed

doi:10.1093/trstmh/trz107

Cited by 3 publications

(1 citation statement)

References 69 publications

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“…Despite advances in CM diagnostic and therapeutic strategies, early mortality from CM in the developing world remains high during the therapeutic antifungal induction and consolidation phases [ 5 ]. It has been proposed that the reason for this is that early diagnosis of CM has always been clinically challenging [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Establishment of a novel scoring model for mortality risk prediction in HIV-infected patients with cryptococcal meningitis

Zhao

Nie

et al. 2021

BMC Infect Dis

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Background Cryptococcal meningitis (CM) remains a leading cause of death in HIV-infected patients, despite advances in CM diagnostic and therapeutic strategies. This study was performed with the aim to develop and validate a novel scoring model to predict mortality risk in HIV-infected patients with CM (HIV/CM). Methods Data on HIV/CM inpatients were obtained from a Multicenter Cohort study in China. Independent risk factors associated with mortality were identified based on data from 2013 to 2017, and a novel scoring model for mortality risk prediction was established. The bootstrapping statistical method was used for internal validation. External validation was performed using data from 2018 to 2020. Results We found that six predictors, including age, stiff neck, impaired consciousness, intracranial pressure, CD4+ T-cell count, and urea levels, were associated with poor prognosis in HIV/CM patients. The novel scoring model could effectively identify HIV/CM patients at high risk of death on admission (area under curve 0.876; p<0.001). When the cut-off value of 5.5 points or more was applied, the sensitivity and specificity was 74.1 and 83.8%, respectively. Our scoring model showed a good discriminatory ability, with an area under the curve of 0.879 for internal validation via bootstrapping, and an area under the curve of 0.886 for external validation. Conclusions Our developed scoring model of six variables is simple, convenient, and accurate for screening high-risk patients with HIV/CM, which may be a useful tool for physicians to assess prognosis in HIV/CM inpatients.

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Section: Introductionmentioning

confidence: 99%

Establishment of a novel scoring model for mortality risk prediction in HIV-infected patients with cryptococcal meningitis

Zhao

Nie

et al. 2021

BMC Infect Dis

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Effect of IL-10 in the pathogenesis of HIV/AIDS patients with cryptococcal meningitis

et al. 2022

Mol Cell Biochem

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Spatio-temporal Distribution of Meningitis in HIV Patients in Northern Egypt (2000-2018)

El‐Wahab

Hegazy

Farrag

et al. 2020

CHR

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Background: Meningitis is a leading cause of death among patients living with HIV. There is no adequate tracking of the disease occurrence, distribution and etiologic agents among this risk group in Egypt, although the pattern could differ than that of the general population. Objectives: We aimed to describe the spatio-temporal distribution of meningitis in HIV patients in a region of Northern Egypt over an 18-years period (2000-2018). Methods: We conducted a retrospective study of 352 adults HIV patients admitted to a tertiary care fever hospital with neurological manifestations suggesting meningitis. We retrieved from inpatient records all data relevant to patient demographics, clinical presentation, diagnostic work-up, results of laboratory investigations (CSF, blood, imaging), definitive diagnosis, and in-hospital mortality. Results: The overall trend over 2 decades showed fluctuating incidence of meningitis in HIV infected patients and increasingly spread into rural areas, with a uniform circulation among adult males. Cryptococcal meningitis was the most common etiologic agent (26.9%) and was associated with worse outcomes. Focal neurological deficit (38.5%), cranial nerve involvement (48.1%) were common features in TB Meningitis. The mortality was high (56.8%) and was significantly associate with low CD4+ count, advanced AIDs clinical stage and the presence of co-morbidities. Conclusion: Despite the availability of cART, meningitis particularly cryptococcal is common in HIV/AIDS population in Egypt. Continued efforts are desperately needed to improve outcomes of HIV-infected patients.

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A clinical rule for the prediction of meningitis in HIV patients in the era of combination antiretroviral therapy

Cited by 3 publications

References 69 publications

Establishment of a novel scoring model for mortality risk prediction in HIV-infected patients with cryptococcal meningitis

Establishment of a novel scoring model for mortality risk prediction in HIV-infected patients with cryptococcal meningitis

Effect of IL-10 in the pathogenesis of HIV/AIDS patients with cryptococcal meningitis

Spatio-temporal Distribution of Meningitis in HIV Patients in Northern Egypt (2000-2018)

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