{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T10:30:57Z","timestamp":1787999457495,"version":"build-2784847793"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T00:00:00Z","timestamp":1738886400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Pneumocystis pneumonia (PCP) is a common and serious complication of HIV\/AIDS, with a higher prevalence in patients not receiving antiretroviral therapy. Due to the high mortality rate of PCP, accurate prediction of its case fatality rate is very important for clinical treatment. We aimed to develop a risk model for the near-term prognosis of people with HIV\/AIDS and PCP and verify its effectiveness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This single-center, retrospective observational study was conducted at Beijing Youan Hospital from January 2012 to October 2022. 972 AIDS patients with Pneumocystis pneumonia met our criteria were recruited. The patients were divided into death group and survival group according to clinical outcome during hospitalization. Data of the two groups were collected including general information and laboratory test results. 53 medical characteristics of the two groups were collected. Prediction variables were screened with Multivariate logistic regression analysis and Lasso regression model. We used ROC curve to identify the discrimination of training and testing data sets. The Shapley Additive exPlanation (SHAP) method was applied to explain the final model and the weights of features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall mortality rate among hospitalized patients was 17.8%. We found that the best prediction effect can be obtained when ALB, PO<jats:sub>2<\/jats:sub>, TBIL, LDH, CD4<jats:sup>+<\/jats:sup> T lymphocyte counts are incorporated into the PCP risk prediction model. The model had a perfect discrimination with AUC of 0.994 and 0.947 in training and validation cohorts. The prognosis risk grade was divided into three grades: low-risk group (0-25 points with mortality of 5.9%), moderate-risk group (25-50 points with mortality of 45.1%) and high-risk group (above 50 points with mortality of 80%). There is a statistically significant difference in mortality among these three grades (\u03c7<jats:sup>2<\/jats:sup> = 419.271, P&amp;lt;0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We developed and validated a model of the prognostic risk level of PCP in patients of AIDS with the results of blood tests reviewed by patients at routine visits. The model is more convenient to use, allowing clinicians to obtain a determined probability value of PCP mortality with simple calculations within the first 72 hours of the patient\u2019s admission.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2024.1485231","type":"journal-article","created":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T06:52:24Z","timestamp":1738911144000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Mortality risk prediction model in AIDS patients with pneumocystis pneumonia in China"],"prefix":"10.3389","volume":"14","author":[{"given":"Xi","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letian","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhangli","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianwei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanqun","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijun","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aixin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"203","DOI":"10.12290\/xhyxzz.2022-0097","article-title":"Chinese guidelines for diagnosis and treatment of human immunodeficiency virus infection\/acquired immunodeficiency syndrome(2021 edition)","volume":"13","year":"2022","journal-title":"Med. J. Peking Union Med. Coll. Hosp."},{"key":"B2","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1097\/CM9.0000000000003383","article-title":"Chinese expert consensus on diagnosis and treatment of pneumocystis pneumonia in AIDS patients (2024 edition)","volume":"17","year":"2024","journal-title":"Chin. J. Clin. Infect. Dis."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1097\/00003246-199906000-00030","article-title":"Pneumocystis carinii pneumonia requiring intensive care management: survival and prognostic study in 110 patients with human immunodeficiency virus","volume":"27","author":"B\u00e9dos","year":"1999","journal-title":"Crit. Care Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1503","DOI":"10.1164\/ajrccm.150.6.7952607","article-title":"A rapid preadmission method for predicting inpatient course of disease for patients with HIV-related Pneumocystis carinii pneumonia","volume":"150","author":"Bennett","year":"1994","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1164\/ajrccm\/144.2.319","article-title":"Combined APACHE II score and serum lactate dehydrogenase as predictors of in-hospital mortality caused by first episode Pneumocystis carinii pneumonia in patients with acquired immunodeficiency syndrome","volume":"144","author":"Benson","year":"1991","journal-title":"Am. Rev. Respir. Dis."},{"key":"B6","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1378\/chest.107.2.506","article-title":"Outcome of intensive care in patients with HIV infection","volume":"107","author":"De Palo","year":"1995","journal-title":"Chest."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1070","DOI":"10.1136\/thx.2009.117846","article-title":"Predicting mortality from HIV-associated Pneumocystis pneumonia at illness presentation: an observational cohort study","volume":"64","author":"Fei","year":"2009","journal-title":"Thorax."},{"key":"B8","doi-asserted-by":"publisher","first-page":"3055","DOI":"10.2147\/IJGM.S349786","article-title":"Nomograms for death from pneumocystis jirovecii pneumonia in HIV-uninfected and HIV-infected patients","volume":"15","author":"Feng","year":"2022","journal-title":"Int. J. Gen. Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"155","DOI":"10.19296\/j.cnki.1008-2409.2020-03-044","article-title":"Clinical analysis of 144 cases of AIDS complicated with pneumocystis pneumonia","volume":"33","author":"Huang","year":"2020","journal-title":"Acta Medicinae Sin."},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0241955","article-title":"Prognostic factors for severity and mortality in patients infected with COVID-19: A systematic review","volume":"15","author":"Izcovich","year":"2020","journal-title":"PloS One"},{"key":"B11","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/j.jinf.2021.06.027","article-title":"Risk factors for IRIS in HIV-associated Pneumocystis-pneumonia following ART initiation","volume":"83","author":"Kann","year":"2021","journal-title":"J. Infect."},{"key":"B12","first-page":"4768","author":"Lundberg","year":"2017"},{"key":"B13","volume-title":"Retrospective analysis of risk factors for severe pneumocystis yerbii pneumonia","author":"Nie","year":"2023"},{"key":"B14","doi-asserted-by":"publisher","first-page":"891","DOI":"10.3201\/eid0809.020096","article-title":"A new name (Pneumocystis jiroveci) for Pneumocystis from humans","volume":"8","author":"Stringer","year":"2002","journal-title":"Emerg. Infect. Dis."},{"key":"B15","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1089\/aid.2020.0057","article-title":"Admission C-reactive protein-to-albumin ratio predicts the 180-day mortality of AIDS-related pneumocystis pneumonia","volume":"36","author":"Wang","year":"2020","journal-title":"AIDS Res. Hum. Retroviruses"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1495","DOI":"10.14188\/j.1671-8852.2022.0935","article-title":"Analysis of risk factors for the short-term prognosis of patients with Pneumocystis jiroveci pneumonia","volume":"44","author":"Wang","year":"2023","journal-title":"Med. J. Wuhan Univ."},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.680108","article-title":"Risk factors of mortality from pneumocystis pneumonia in non-HIV patients: A meta-analysis","volume":"9","author":"Wang","year":"2021","journal-title":"Front. Public Health"},{"key":"B18","doi-asserted-by":"publisher","first-page":"447","DOI":"10.3892\/etm.2022.11374","article-title":"Evaluation of qSOFA score, and conjugated bilirubin and creatinine levels for predicting 28-day mortality in patients with sepsis","volume":"24","author":"Xiao","year":"2022","journal-title":"Exp. Ther. Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"208","DOI":"10.3969\/j.issn.2096-3718.2023.20.033","article-title":"Clinical features and prognostic risk factors in AIDS patients with Pneumocustis carinii pneumonia","volume":"30","author":"Zhou","year":"2023","journal-title":"Pract. Prev. Med."}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2024.1485231\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T06:52:31Z","timestamp":1738911151000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2024.1485231\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,7]]},"references-count":19,"alternative-id":["10.3389\/fcimb.2024.1485231"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2024.1485231","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,7]]},"article-number":"1485231"}}