Predictor of Mortality in Acquired Immunodeficiency Syndrome Patients with Central Nervous System Opportunistic Infections
Abstract: Indonesia’s increase
of acquired immunodeficiency syndrome (AIDS) cases is one of the fastest.
Mortality cases of AIDS also increase per year. Central nervous system (CNS)
opportunistic infection is one of the most likely manifestations on advanced
stage of Human immunodeficiency virus (HIV)/AIDS patients. Common CNS
opportunistic infections are toxoplasma infection and tuberculous meningitis
(TBM). The study aimed to analyze the predictor of mortality in AIDS patients
with CNS opportunistic infections.
Methods: This study reviewed 151 medical records from AIDS patients with
CNS opportunistic infection admitted to the Department of Neurology, Dr. Hasan
Sadikin General Hospital Bandung from 2007-2012. This study was conducted from
April to November 2013. Patients’ clinical manifestations (seizure, headache,
altered consciousness), laboratory examination (CD4+ level count) and treatment
history (antiretroviral or ART and cotrimoxazole) were collected. Chi-square
and logistic regression test were used to determine the mortality predictor in
patients.
Results: Mortality rate was 37.7%. Clinical manifestations from patients
were seizure 29.8%, altered consciousness 66.2%, and headache 88.7%. Patients
had cotrimoxazole treatment 44.4% and 38.4% patients had ART. CD4+ level count
data from 86 patients were obtained, 94% had CD4+ level count ≤200. Bivariate
analysis showed altered consciousness had significant mortality predictor (Odd
ratio (OR): 29.944; 95% Confidence interval (CI) 6.9–129.945; p<0,0).
Multivariate analysis showed ART had highest predictive mortality value (OR:
2.968; 95% CI 1.236–7.126; p=0.015).
Conclusions: Altered consciousness and no antiretroviral treatment are
mortality predictors in AIDS patients with CNS opportunistic infections.
Keywords: Acquired
immunodeficiency syndrome, CNS opportunistic infection, mortality, predictor
Author: Agustina Lestari,
Sofiati Dian, Chrysanti Murad
Journal Code: jpkedokterangg160290
