A clinically prognostic scoring system for patients receiving highly active antiretroviral therapy: results from the EuroSIDA study.
The risk of clinical progression for human immunodeficiency virus (HIV)-infected persons receiving treatment with highly active antiretroviral therapy (HAART) is poorly defined. From an inception cohort of 8457 HIV-infected persons, 2027 patients who started HAART during prospective follow-up were examined. Results were validated in another 2 groups of patients (n=1946 and n=1442). In total, 200 patients (9.9%) experienced clinical progression during 5177 person-years (incidence, 3.9/100 years). The most recently measured CD4 cell count, virus load, and hemoglobin level all were independently related to the risk of clinical progression, as was a diagnosis of severe AIDS before the start of HAART. On the basis of these findings, a scoring system was derived (range, 0-17). A single unit increase in the score was associated with a 38% increased risk of clinical progression (relative hazard, 1.38; 95% confidence interval, 1.33-1.43; P<.0001). The scoring system was validated with remarkably good agreement in the 2 other cohorts. This system can be used in patient and resource management.
Lundgren
Jens D
JD
EuroSIDA/Copenhagen HIV Programme Coordinating Centre, Dept. of Infectious Diseases, Hvidovre University Hospital, 2650 Hvidovre, Denmark. jdl@cphiv.dk
Mocroft
Amanda
A
Gatell
Jose M
JM
Ledergerber
Bruno
B
D'Arminio Monforte
Antonella
A
Hermans
Philippe
P
Goebel
Frank-Detlef
FD
Blaxhult
Anders
A
Kirk
Ole
O
Phillips
Andrew N
AN
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies