Anthropometric indices as predictors of survival in AIDS adults. Aquitaine Cohort, France, 1985-1997. Groupe d'Epidémiologie Clinique du Sida en Aquitaine (GECSA)

Abstract

The aim of the study was to assess the performance of weight related nutritional markers [reported involuntary weight loss (WL) greater than 10%, measured WL and body mass index (BMI)] in predicting survival at AIDS stage. The three anthropometric indices were used as time dependent variables in Cox models to predict survival at AIDS stage. The studied sample included 630 HIV1-infected individuals of a prospective cohort of those 421 died (median survival at AIDS stage: 19.9 months). After adjustment for usual prognostic factors of survival, the reported WL greater than 10% was a pejorative predictor of survival (hazard ratio (HR) 2.4; 95% confidence interval (CI): 1.9-3.0). For measured WL < 5%, between 5 and 10% and > or = 10% of baseline weight compared with no WL, HR were respectively, 1.9 (CI: 1.4-2.6), 3.3 (CI: 2.4-4.4) and 6.7 (CI: 5.2-8.6). The HR of death were 2.2 (CI: 1.6-3.0) for BMI between 16 and 18.4 kg/m2 and 4.4 (CI: 3.1-6.3) for BMI < 16 compared to normal BMI (> or = 18.5). Even a limited WL measured at a given point in time during follow up increases the risk of death at the AIDS stage. Simple cross-sectional measures of BMI have a good predictive value of survival.