Towards a combined prognostic index for survival in HIV infection: the role of 'non-HIV' biomarkers

AC Justice, KA McGinnis, M Skanderson, CC Chang, CL Gibert, MB Goetz, D Rimland, MC Rodriguez-Barradas, KK Oursler, ST Brown, RS Braithwaite, M May, KE Covinsky, MS Roberts, SL Fultz, KJ Bryant

Research output: Contribution to journalArticle (Academic Journal)peer-review

120 Citations (Scopus)

Abstract

Background As those with HIV infection live longer, ‘non-AIDS’ condition associated with immunodeficiency and chronic inflammation are more common.We ask whether ‘non-HIV’ biomarkers improve differentiation of mortality risk among individuals initiating combination antiretroviral therapy (cART). Methods Using Poisson models, we analysed data from the Veterans Aging Cohort Study (VACS) on HIV-infected veterans initiating cART between 1 January 1997 and 1 August 2002. Measurements included: HIV biomarkers (CD4 cell count, HIV RNA and AIDS-defining conditions); ‘non-HIV’ biomarkers (haemoglobin, transaminases, platelets, creatinine, and hepatitis B and C serology); substance abuse or dependence (alcohol or drug); and age. Outcome was all cause mortality. We tested the discrimination (C statistics) of each biomarker group alone and in combination in development and validation data sets, over a range of survival intervals, and adjusting for missing data. Results Of veterans initiating cART, 9784 (72%) had complete data. Of these, 2566 died. Subjects were middle-aged (median age 45 years), mainly male (98%) and predominantly black (51%). HIV and ‘non-HIV’ markers were associated with each other (P
Translated title of the contributionTowards a combined prognostic index for survival in HIV infection: the role of 'non-HIV' biomarkers
Original languageEnglish
Pages (from-to)143 - 151
Number of pages9
JournalHIV Medicine
Volume11
DOIs
Publication statusPublished - Feb 2010

Bibliographical note

Other: PM:19751364

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