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A clinically prognostic scoring system for patients receiving highly active antiretroviral therapy: Results from the EuroSIDA study

par Lundgren, Jens D;Phillips, Andrew N.;Mocroft, Amanda;Gatell, Jose;Ledergerber, Bruno;d'Arminio Monforte, Antonella;Hermans, Philippe ;Goebel, Frank Detlef;Blaxhult, Anders;Kirk, Ole
Référence The Journal of infectious diseases, 185, 2, page (178-187)
Publication Publié, 2002-01

Article révisé par les pairs

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Résumé :

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.