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

Abstract

IntroductionHIV-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. MethodsWe 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. ResultsSeventy-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). ConclusionsIn 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.