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A Clinically Prognostic Scoring System for Patients Receiving Highly Active Antiretroviral Therapy: Results from the EuroSIDA Study

Lundgren, Jens D. ; Mocroft, Amanda ; Gatell, Jose M. ; Ledergerber, Bruno ; Monforte, Antonella D'Arminio ; Hermans, Philippe ; Goebel, Frank-Detlef ; Blaxhult, Anders ; Kirk, Ole ; Phillips, Andrew N.

In: The Journal of Infectious Diseases, 2002, vol. 185, no. 2, p. 178-187

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    Title
    • A Clinically Prognostic Scoring System for Patients Receiving Highly Active Antiretroviral Therapy: Results from the EuroSIDA Study
    Author
    • Lundgren, Jens D.. Department of Infectious Diseases, Hvidovre Hospital, Copenhagen, Denmark
    • Mocroft, Amanda. Royal Free Centre for HIV Medicine, Royal Free and University College Medical School, London, United Kingdom
    • Gatell, Jose M.. Infectious Disease Unit, Hospital Clinic, University of Barcelona, Spain
    • Ledergerber, Bruno. Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
    • Monforte, Antonella D'Arminio. Institute of Infectious and Tropical Diseases, University of Milan, Milan, Italy
    • Hermans, Philippe. Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre Hospital, Brussels, Belgium
    • Goebel, Frank-Detlef. Medizinische Poliklinik der Univertät München, Munich, Germany
    • Blaxhult, Anders. Department of Infectious Diseases, Karolinska Hospital, Stockholm, Sweden
    • Kirk, Ole. Department of Infectious Diseases, Hvidovre Hospital, Copenhagen, Denmark
    • Phillips, Andrew N.. Royal Free Centre for HIV Medicine, Royal Free and University College Medical School, London, United Kingdom
    Document Type
    • Postprint
    Language
    • English
    Published in
    • The Journal of Infectious Diseases, 2002, vol. 185, no. 2, p. 178-187. The University of Chicago Press
    Other Version
    Classification
    • Health
    OAI-PMH Identifier
    • oai:doc.rero.ch:302363
    Summary
    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