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- Title
Derivation and internal validation of a mortality risk index for aged people living with HIV: The Dat'AIDS score.
- Authors
Hentzien, Maxime; Delpierre, Cyrille; Pugliese, Pascal; Allavena, Clotilde; Jacomet, Christine; Valantin, Marc-Antoine; Cabié, André; Cuzin, Lise; Rey, David; Bani-Sadr, Firouzé; Dramé, Moustapha; null, null
- Abstract
Objective: The objective was to develop a multivariable prognostic index for overall mortality over a five-year span integrating classical HIV biomarkers and comorbidities in people living with HIV (PLHIV) aged 60 or older. Design: Prospective multicenter cohort study from the French Dat’AIDS cohort. Methods: All HIV-1 infected patients aged 60 years or older on 1st January 2008 were included. Sociodemographic data, CD4 cell count, CD4 nadir, HIV viral load, history of comorbidities, hepatitis co-infections and laboratory parameters at baseline were considered as potential prognostic variables. Primary outcome was all-cause mortality. Results: Among 1415 patients included, we derived a score comprising the following predictors: Age (65–74: 1 point; ≥75: 8 points), CD4 cell count (200–349: 3 points; <200: 6 points), non-HIV related cancer (6 points), cardiovascular disease (8 points), estimated glomerular filtration rate (30–59 mL/min/1.73m2: 5 points; <30mL/min/1.73m2: 16 points), cirrhosis (13 points), low body mass index (<18.5 kg/m2, 10 points), anemia (6 points). Mean observed score was 7.0 ± 8.0 and ranged from 0 to 45. Score categories defined 4 risk groups for mortality: low, moderate, high and very high risk (5-year survival probability 0.95 (95%CI[0.93–0.97]), 0.90 (95%CI[0.87–0.92]), 0.77 (95%CI[0.68–0.84]) and 0.54 (95%CI[0.43–0.63]) respectively). The score showed good discrimination (C-statistic = 0.76) and calibration. Conclusions: We propose a multivariable prognostic score for mortality among PLHIV aged 60 or over, who will become the predominant population in future years in western populations. It could be a useful tool for research, for developing preventive and treatment strategies according to risk group, and for risk assessment by clinicians.
- Subjects
HIV infection prognosis; MORTALITY of AIDS patients; OLDER HIV-positive persons; DIAGNOSIS of HIV infections; SOCIODEMOGRAPHIC factors
- Publication
PLoS ONE, 2018, Vol 13, Issue 3, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0195725