Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2018 Apr 19;13(4):e0195725.
doi: 10.1371/journal.pone.0195725. eCollection 2018.

Derivation and internal validation of a mortality risk index for aged people living with HIV: The Dat'AIDS score

Maxime Hentzien  1   2 , Cyrille Delpierre  3 , Pascal Pugliese  4 , Clotilde Allavena  5 , Christine Jacomet  6 , Marc-Antoine Valantin  7 , André Cabié  8 , Lise Cuzin  3   9 , David Rey  10 , Firouzé Bani-Sadr  1 , Moustapha Dramé  2   11 ; Dat’Aids Study Group
Affiliations
Multicenter Study

Derivation and internal validation of a mortality risk index for aged people living with HIV: The Dat'AIDS score

Maxime Hentzien et al. PLoS One. .

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.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Five-year Kaplan-Meier survival probabilities among each risk group.
Fig 2
Fig 2. Assessment of model calibration: Observed (Kaplan Meier, black) versus predicted (Cox, gray) survival curves.
See this image and copyright information in PMC

References

    1. Morlat P, Roussillon C, Henard S, Salmon D, Bonnet F, Cacoub P, et al. Causes of death among HIV-infected patients in France in 2010 (national survey): trends since 2000. AIDS. 2014;28: 1181–1191. doi: 10.1097/QAD.0000000000000222 - DOI - PubMed
    1. Costagliola D. Demographics of HIV and aging. Curr Opin HIV AIDS. 2014;9: 294–301. doi: 10.1097/COH.0000000000000076 - DOI - PubMed
    1. Sabin CA. Do people with HIV infection have a normal life expectancy in the era of combination antiretroviral therapy? BMC Medicine. 2013;11: 251 doi: 10.1186/1741-7015-11-251 - DOI - PMC - PubMed
    1. Thompson MA, Aberg JA, Cahn P, Montaner JSG, Rizzardini G, Telenti A, et al. Antiretroviral treatment of adult HIV infection: 2010 recommendations of the International AIDS Society-USA panel. JAMA. 2010;304: 321–333. doi: 10.1001/jama.2010.1004 - DOI - PubMed
    1. Guaraldi G, Orlando G, Zona S, Menozzi M, Carli F, Garlassi E, et al. Premature age-related comorbidities among HIV-infected persons compared with the general population. Clin Infect Dis. 2011;53: 1120–1126. doi: 10.1093/cid/cir627 - DOI - PubMed