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Predicting death over 8 years in a prospective cohort of HIV-infected women: the Women’s Interagency HIV Study

OBJECTIVES: Predicting mortality in middle-aged HIV-infected (HIV+) women on antiretroviral therapies (ART) is important for understanding the impact of HIV infection. Several health indices have been used to predict mortality in women with HIV infection. We evaluated: (1) an HIV biological index, V...

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Autores principales: Gustafson, Deborah R, Shi, Qiuhu, Holman, Susan, Minkoff, Howard, Cohen, Mardge H, Plankey, Michael W, Havlik, Richard, Sharma, Anjali, Gange, Stephen, Gandhi, Monica, Milam, Joel, Hoover, Donald R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577878/
https://www.ncbi.nlm.nih.gov/pubmed/28667199
http://dx.doi.org/10.1136/bmjopen-2016-013993
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author Gustafson, Deborah R
Shi, Qiuhu
Holman, Susan
Minkoff, Howard
Cohen, Mardge H
Plankey, Michael W
Havlik, Richard
Sharma, Anjali
Gange, Stephen
Gandhi, Monica
Milam, Joel
Hoover, Donald R
author_facet Gustafson, Deborah R
Shi, Qiuhu
Holman, Susan
Minkoff, Howard
Cohen, Mardge H
Plankey, Michael W
Havlik, Richard
Sharma, Anjali
Gange, Stephen
Gandhi, Monica
Milam, Joel
Hoover, Donald R
author_sort Gustafson, Deborah R
collection PubMed
description OBJECTIVES: Predicting mortality in middle-aged HIV-infected (HIV+) women on antiretroviral therapies (ART) is important for understanding the impact of HIV infection. Several health indices have been used to predict mortality in women with HIV infection. We evaluated: (1) an HIV biological index, Veterans Aging Cohort Study (VACS); (2) a physical index, Fried Frailty Index (FFI); and (3) a mental health index, Center for Epidemiologic Studies-Depression (CES-D). Proportional hazards regression analyses were used to predict death and included relevant covariates. DESIGN: Prospective, observational cohort. SETTING: Multicentre, across six sites in the USA. PARTICIPANTS: 1385 multirace/ethnic ART-experienced HIV+ women in 2005. PRIMARY AND SECONDARY OUTCOMES: All deaths, AIDS deaths and non-AIDS deaths up to ~8 years from baseline. RESULTS: Included together in one model, VACS Index was the dominant, significant independent predictor of all deaths within 3 years (HR=2.20, 95% CI 1.83, 2.65, χ(2)=69.04, p<0.0001), and later than 3 years (HR=1.55, 95% CI 1.30, 1.84, χ(2)=23.88, p<0.0001); followed by FFI within 3 years (HR=2.06, 95% CI 1.19, 3.57, χ(2)=6.73, p=0.01) and later than 3 years (HR=2.43, 95% CI 1.58, 3.75, χ(2)=16.18, p=0.0001). CES-D score was not independently associated with mortality. CONCLUSIONS AND RELEVANCE: This is the first simultaneous evaluation of three common health indices in HIV+ adults. Indices reflecting physical and biological ageing were associated with death.
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spelling pubmed-55778782017-09-08 Predicting death over 8 years in a prospective cohort of HIV-infected women: the Women’s Interagency HIV Study Gustafson, Deborah R Shi, Qiuhu Holman, Susan Minkoff, Howard Cohen, Mardge H Plankey, Michael W Havlik, Richard Sharma, Anjali Gange, Stephen Gandhi, Monica Milam, Joel Hoover, Donald R BMJ Open HIV/AIDS OBJECTIVES: Predicting mortality in middle-aged HIV-infected (HIV+) women on antiretroviral therapies (ART) is important for understanding the impact of HIV infection. Several health indices have been used to predict mortality in women with HIV infection. We evaluated: (1) an HIV biological index, Veterans Aging Cohort Study (VACS); (2) a physical index, Fried Frailty Index (FFI); and (3) a mental health index, Center for Epidemiologic Studies-Depression (CES-D). Proportional hazards regression analyses were used to predict death and included relevant covariates. DESIGN: Prospective, observational cohort. SETTING: Multicentre, across six sites in the USA. PARTICIPANTS: 1385 multirace/ethnic ART-experienced HIV+ women in 2005. PRIMARY AND SECONDARY OUTCOMES: All deaths, AIDS deaths and non-AIDS deaths up to ~8 years from baseline. RESULTS: Included together in one model, VACS Index was the dominant, significant independent predictor of all deaths within 3 years (HR=2.20, 95% CI 1.83, 2.65, χ(2)=69.04, p<0.0001), and later than 3 years (HR=1.55, 95% CI 1.30, 1.84, χ(2)=23.88, p<0.0001); followed by FFI within 3 years (HR=2.06, 95% CI 1.19, 3.57, χ(2)=6.73, p=0.01) and later than 3 years (HR=2.43, 95% CI 1.58, 3.75, χ(2)=16.18, p=0.0001). CES-D score was not independently associated with mortality. CONCLUSIONS AND RELEVANCE: This is the first simultaneous evaluation of three common health indices in HIV+ adults. Indices reflecting physical and biological ageing were associated with death. BMJ Publishing Group 2017-06-30 /pmc/articles/PMC5577878/ /pubmed/28667199 http://dx.doi.org/10.1136/bmjopen-2016-013993 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle HIV/AIDS
Gustafson, Deborah R
Shi, Qiuhu
Holman, Susan
Minkoff, Howard
Cohen, Mardge H
Plankey, Michael W
Havlik, Richard
Sharma, Anjali
Gange, Stephen
Gandhi, Monica
Milam, Joel
Hoover, Donald R
Predicting death over 8 years in a prospective cohort of HIV-infected women: the Women’s Interagency HIV Study
title Predicting death over 8 years in a prospective cohort of HIV-infected women: the Women’s Interagency HIV Study
title_full Predicting death over 8 years in a prospective cohort of HIV-infected women: the Women’s Interagency HIV Study
title_fullStr Predicting death over 8 years in a prospective cohort of HIV-infected women: the Women’s Interagency HIV Study
title_full_unstemmed Predicting death over 8 years in a prospective cohort of HIV-infected women: the Women’s Interagency HIV Study
title_short Predicting death over 8 years in a prospective cohort of HIV-infected women: the Women’s Interagency HIV Study
title_sort predicting death over 8 years in a prospective cohort of hiv-infected women: the women’s interagency hiv study
topic HIV/AIDS
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577878/
https://www.ncbi.nlm.nih.gov/pubmed/28667199
http://dx.doi.org/10.1136/bmjopen-2016-013993
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