Risk Score for Predicting Nevirapine-Associated Rash in HIV-Infected Patient

 

Patient selection: HIV-positive patient with low CD4 count treated with nevirapine in a resource limited setting

 

Parameters:

(1) history of drug allergy

(2) body weight in kilograms

(3) dose escalation regimen

(4) number of concomitant drugs (type not defined)

 

Parameter	Finding	Points
history of drug allergy	no	0
	yes	14
body weight in kilograms	<= 55 kg	7
	> 55 k	0
dose escalation	slow	0
	not slow	7
number of concomitant drugs	0	9
	1 or more	0

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score 37

• A score >= 21 identifies a patient at high risk for developing a rash (odds ratio 4).

• A positive score is achieved with history of drug allergy and at least one other risk factor OR the 3 risk factors other than history of drug allergy.

 

Perfromance:

• The specificity of a positve score was 99% with a positive predictive value of 69%. The sensitivity was not given but it is very low if read from Figure 1.

• The area under the ROC curve was 0.71 which is mediocre.