title: A clinically prognostic scoring system for patients receiving highly active antiretroviral therapy: results from the EuroSIDA study.
abstract: 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.
authors.affiliation: EuroSIDA/Copenhagen HIV Programme Coordinating Centre, Dept. of Infectious Diseases, Hvidovre University Hospital, 2650 Hvidovre, Denmark. jdl@cphiv.dk
authors.forename: Jens D
authors.initials: JD
authors.lastname: Lundgren
authors.forename: Amanda
authors.initials: A
authors.lastname: Mocroft
authors.forename: Jose M
authors.initials: JM
authors.lastname: Gatell
authors.forename: Bruno
authors.initials: B
authors.lastname: Ledergerber
authors.forename: Antonella
authors.initials: A
authors.lastname: D'Arminio Monforte
authors.forename: Philippe
authors.initials: P
authors.lastname: Hermans
authors.forename: Frank-Detlef
authors.initials: FD
authors.lastname: Goebel
authors.forename: Anders
authors.initials: A
authors.lastname: Blaxhult
authors.forename: Ole
authors.initials: O
authors.lastname: Kirk
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Phillips
mesh_terms: 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