Abstract: Objective To establish a scoring model for the clinical diagnosis of active pulmonary tuberculosis in patients with AIDS using common clinical indicators and to evaluate the predictive performance of the model. Method A total of 229 patients admitted to the Department of Infectious Diseases, Liuzhou People's Hospital, from October 1, 2014, to September 30, 2021, were included in the study. Among them, there were 104 cases of AIDS combined with active pulmonary tuberculosis and 125 cases of AIDS combined with other non-tuberculous pulmonary diseases. Univariate analysis and binary logistic regression analysis were used to select variables favorable for diagnosing active pulmonary tuberculosis in AIDS patients. A clinical scoring model for the diagnosis of active pulmonary tuberculosis in AIDS was established, and the predictive ability of the model was assessed. Result In this clinical diagnostic scoring model, six variables were analyzed: cough and sputum symptoms (7 points), CD4⁺T lymphocyte count (12 points), upper lobe lung lesions (6 points), multi-segment lung lesions (7 points), lung lesions with mediastinal lymphadenopathy (7 points), and unilateral pleural effusion (6 points). When the score was greater than 24 points, the area under the curve for clinical diagnosis of active pulmonary tuberculosis in AIDS patients was 0.911 (95%CI 0.864-0.958) (P<0.05). The sensitivity and specificity were 82.2% and 92.0%, respectively. The positive predictive value and negative predictive value were 89.6% and 86.9%, respectively. The results obtained from the validation group achieved an accuracy of 88.2% (60/68). Conclusion The clinical diagnostic scoring model for active pulmonary tuberculosis in AIDS patients established in this study is simple to use in clinical practice and has good predictive and pre-judgment efficacy for evaluating whether HIV-infected individuals with a CD4⁺T lymphocyte count ≤200/μl are combined with active pulmonary tuberculosis.

Key words: Acquired immune deficiency syndrome, Active pulmonary tuberculosis, Opportunistic infection, Clinical diagnostic score, CD4⁺T lymphocyte