The need for reappraisal of AIDS score weight of Charlson comorbidity index.
OBJECTIVE
To discuss the need for reappraisal of AIDS score weight of the Charlson comorbidity index.


METHODS
This article is a comment on Charlson comorbidity index.


RESULTS
This article shows that the weight assigned for AIDS in the original cohort of Charlson score may be higher considering the dramatic improvement in the prognosis of such patients after the advent of highly active antiretroviral therapy. Only a few exceptions among HIV-related diseases are still strongly associated with high mortality rates within 1 year. This might lead to an inaccurate measurement of the impact of Charlson score on mortality rate, particularly in cohorts with high relative number of AIDS patients.


CONCLUSIONS
Charlson comorbidity index should be reassessed in cohorts with higher proportions of AIDS patients, taking into account the current prognosis of the disease. A stratification of AIDS-related category may be required to improve Charlson score accuracy in predicting mortality or adjusting for confounding.
Zavascki
Alexandre Prehn
AP
Medical Sciences Post-graduate Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. apzavascki@terra.com.br
Fuchs
Sandra Costa
SC
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000401:mortality*; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D006305:Health Status Indicators; D006801:Humans; D011379:Prognosis; D016016:Proportional Hazards Models; D015996:Survival Rate
D044966:Anti-Retroviral Agents