Characterisation and variables associated with mortality in a population with HIV and central nervous system opportunistic infections in a Colombian public hospital in Bogotá

• Published in: Neurology perspectives 2023-07, Vol.3 (3), p.100127, Article 100127
• Main Authors: Torres-Urazán, Daniela, Cajicá-Martínez, Gina, Valencia-Enciso, Natalia, Espinosa-Jovel, Camilo
• Format: Article
• Language: English
• Subjects: Antiretroviral therapy; Human immunodeficiency virus (HIV); Infección oportunista; Meningitis; Mortalidad; Mortality; Opportunistic infection; Terapia antirretroviral; Virus de inmunodeficiencia humana (VIH)
• ISSN: 2667-0496; 2667-0496
• DOI: 10.1016/j.neurop.2023.100127

HIV-associated mortality after a central nervous system opportunistic infection can reach up to 78%. In populations with limited economic resources, few studies have evaluated the clinical outcomes of these infections in patients with HIV. We performed an observational analytical study using our hospital's database. Sociodemographic, clinical, and paraclinical data were gathered from patients with HIV-associated opportunistic neurological infections attended between January 2019 and January 2021. The aim of the study was to describe the in-hospital mortality rate and to establish associations with sociodemographic, clinical, and paraclinical variables. Seventy-five patients were included, with a mean age of 38.7 years. Fourteen (31.8%) were receiving antiretroviral therapy at the time of admission. The most frequent neurological infections were cerebral toxoplasmosis (37.3%, n = 28), meningeal cryptococcosis (20%, n = 15), and neurosyphilis (20%, n = 15). The in-hospital mortality rate was 25.3% (n = 19). The variables associated with increased mortality risk were diagnosis of meningeal cryptococcosis, admission to the ICU, and presence of fever. The variables associated with decreased mortality risk were CSF/blood glucose ratio > 0.5 and normal body mass index (18–25). In a population of patients with HIV-associated opportunistic neurological infections, in-hospital mortality was 25.3%. The diagnosis of meningeal cryptococcosis, admission to the ICU, and the presence of fever are associated with higher mortality risk. To the contrary, CSF/blood glucose ratio > 0.5 and normal body mass index are associated with lower mortality risk. La mortalidad asociada al VIH luego de una infección oportunista del SNC puede ser hasta del 78%. En poblaciones de bajos recursos económicos, existen pocos estudios que evalúen el desenlace clínico de estas infecciones en pacientes con VIH. Estudio observacional analítico usando la base de datos del hospital base de los investigadores. Se extrajeron datos sociodemográficos, clínicos y paraclínicos de los pacientes con neuroinfecciones oportunistas asociadas a VIH, entre enero del 2019 y enero del 2021. Se busca describir la mortalidad al final de la hospitalización y establecer asociaciones con las variables sociodemográficas, clínicas y paraclínicas. Se incluyeron 75 pacientes. La edad media fue 38.7 años. El 31.8% (n = 14) estaba recibiendo terapia anti-retroviral al momento del ingreso. Las neuroinfecciones más frecuentes f