Establishment of risk nomogram model for Mycobacterium tuberculosis infection in patients with acquired immunodeficiency syndrome
OBJECTIVE To analyze the risk factors for Mycobacterium tuberculosis infection in the patients with ac-quired immunodeficiency syndrome(AIDS),establish the risk prediction model and explore the predictive value.METHODS The clinical data of 758 patients with AIDS who were treated in Yichang Central People's Hospital from Mar 2019 to Mar 2023 were retrospectively analyzed,the patients were divided into the infection group with 54 cases and the no infection group with 704 cases according to the status of complication with M.tuberculosis in-fection.The clinical characteristics of the AIDS patients complicated with M.tuberculosis infection were analyzed,logistic regression analysis was performed for the risk factors for the M.tuberculosis infection in the AIDS pa-tients,the risk nomogram prediction model was established,and the predictive value was analyzed.RESULTS The result of logistic regression analysis showed that smoking history,history of drug abuse,course of human immu-nodeficiency virus(HIV)and baseline CD4+value less than 200/μl were independent risk factors for the M.tuberculosis infection in the AIDS patients(P＜0.05),while the history of Bacillus Calmette-Guerin(BCG)vaccination was the protective factor(P＜0.05).The risk nomogram prediction model was established based on the smoking history,history of drug abuse,history of BCG vaccination,course of HIV and baseline CD4+value,and the result of Hosmer-Lemeshow test of goodness of fit showed that the fitting accuracy of the model was good(x2=7.130,P=0.415).The result of calibration curve indicated that the predicted probability was close to the actual probability.The result of receiver operating characteristic(ROC)curve analysis showed that when the Logit(P)was more than 0.06,the area under curve(AUC)was 0.839,the95％CI was 0.783-0.895,the sensitivity of the model was 77.78％in diagnosis,with the specificity 76.70％.CONCLUSION The incidence of M.tubercu-losis infection is closely associated with smoking history,history of drug abuse,no history of BCG vaccination,course of HIV no less than 5 years and baseline CD4+value less than 200/μl.The risk nomogram prediction mod-el has high predictive value.
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