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Construction and validation of a prognostic nomogram for predicting the survival of HIV/AIDS adults who received antiretroviral therapy: a cohort between 2003 and 2019 in Nanjing

BACKGROUND: Great achievements have been achieved by free antiretroviral therapy (ART). A rapid and accurate prediction of survival in people living with HIV/AIDS (PLHIV) is needed for effective management. We aimed to establish an effective prognostic model to forecast the survival of PLHIV after A...

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Autores principales: Jiang, Fangfang, Xu, Yuanyuan, Liu, Li, Wang, Kai, Wang, Lu, Fu, Gengfeng, Wang, Liping, Li, Zhongjie, Xu, Junjie, Xing, Hui, Wang, Ning, Zhu, Zhengping, Peng, Zhihang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8740442/
https://www.ncbi.nlm.nih.gov/pubmed/34991536
http://dx.doi.org/10.1186/s12889-021-12249-8
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author Jiang, Fangfang
Xu, Yuanyuan
Liu, Li
Wang, Kai
Wang, Lu
Fu, Gengfeng
Wang, Liping
Li, Zhongjie
Xu, Junjie
Xing, Hui
Wang, Ning
Zhu, Zhengping
Peng, Zhihang
author_facet Jiang, Fangfang
Xu, Yuanyuan
Liu, Li
Wang, Kai
Wang, Lu
Fu, Gengfeng
Wang, Liping
Li, Zhongjie
Xu, Junjie
Xing, Hui
Wang, Ning
Zhu, Zhengping
Peng, Zhihang
author_sort Jiang, Fangfang
collection PubMed
description BACKGROUND: Great achievements have been achieved by free antiretroviral therapy (ART). A rapid and accurate prediction of survival in people living with HIV/AIDS (PLHIV) is needed for effective management. We aimed to establish an effective prognostic model to forecast the survival of PLHIV after ART. METHODS: The participants were enrolled from a follow-up cohort over 2003-2019 in Nanjing AIDS Prevention and Control Information System. A nested case-control study was employed with HIV-related death, and a propensity-score matching (PSM) approach was applied in a ratio of 1:4 to allocate the patients. Univariable and multivariable Cox proportional hazards analyses were performed based on the training set to determine the risk factors. The discrimination was qualified using the area under the curve (AUC) and concordance index (C-Index). The nomogram was calibrated using the calibration curve. The clinical benefit of prognostic nomogram was assessed by decision curve analysis (DCA). RESULTS: Predictive factors including CD4 cell count (CD4), body mass index (BMI) and hemoglobin (HB) were determined and incorporated into the nomogram. In the training set, AUC and C-index (95% CI) were 0.831 and 0.798 (0.758, 0.839), respectively. The validation set revealed a good discrimination with an AUC of 0.802 and a C-index (95% CI) of 0.786 (0.681, 0.892). The calibration curve also exhibited a high consistency in the predictive power (especially in the first 3 years after ART initiation) of the nomogram. Moreover, DCA demonstrated that the nomogram was clinically beneficial. CONCLUSION: The nomogram is effective and accurate in forecasting the survival of PLHIV, and beneficial for medical workers in health administration. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-12249-8.
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spelling pubmed-87404422022-01-07 Construction and validation of a prognostic nomogram for predicting the survival of HIV/AIDS adults who received antiretroviral therapy: a cohort between 2003 and 2019 in Nanjing Jiang, Fangfang Xu, Yuanyuan Liu, Li Wang, Kai Wang, Lu Fu, Gengfeng Wang, Liping Li, Zhongjie Xu, Junjie Xing, Hui Wang, Ning Zhu, Zhengping Peng, Zhihang BMC Public Health Research BACKGROUND: Great achievements have been achieved by free antiretroviral therapy (ART). A rapid and accurate prediction of survival in people living with HIV/AIDS (PLHIV) is needed for effective management. We aimed to establish an effective prognostic model to forecast the survival of PLHIV after ART. METHODS: The participants were enrolled from a follow-up cohort over 2003-2019 in Nanjing AIDS Prevention and Control Information System. A nested case-control study was employed with HIV-related death, and a propensity-score matching (PSM) approach was applied in a ratio of 1:4 to allocate the patients. Univariable and multivariable Cox proportional hazards analyses were performed based on the training set to determine the risk factors. The discrimination was qualified using the area under the curve (AUC) and concordance index (C-Index). The nomogram was calibrated using the calibration curve. The clinical benefit of prognostic nomogram was assessed by decision curve analysis (DCA). RESULTS: Predictive factors including CD4 cell count (CD4), body mass index (BMI) and hemoglobin (HB) were determined and incorporated into the nomogram. In the training set, AUC and C-index (95% CI) were 0.831 and 0.798 (0.758, 0.839), respectively. The validation set revealed a good discrimination with an AUC of 0.802 and a C-index (95% CI) of 0.786 (0.681, 0.892). The calibration curve also exhibited a high consistency in the predictive power (especially in the first 3 years after ART initiation) of the nomogram. Moreover, DCA demonstrated that the nomogram was clinically beneficial. CONCLUSION: The nomogram is effective and accurate in forecasting the survival of PLHIV, and beneficial for medical workers in health administration. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-12249-8. BioMed Central 2022-01-06 /pmc/articles/PMC8740442/ /pubmed/34991536 http://dx.doi.org/10.1186/s12889-021-12249-8 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Jiang, Fangfang
Xu, Yuanyuan
Liu, Li
Wang, Kai
Wang, Lu
Fu, Gengfeng
Wang, Liping
Li, Zhongjie
Xu, Junjie
Xing, Hui
Wang, Ning
Zhu, Zhengping
Peng, Zhihang
Construction and validation of a prognostic nomogram for predicting the survival of HIV/AIDS adults who received antiretroviral therapy: a cohort between 2003 and 2019 in Nanjing
title Construction and validation of a prognostic nomogram for predicting the survival of HIV/AIDS adults who received antiretroviral therapy: a cohort between 2003 and 2019 in Nanjing
title_full Construction and validation of a prognostic nomogram for predicting the survival of HIV/AIDS adults who received antiretroviral therapy: a cohort between 2003 and 2019 in Nanjing
title_fullStr Construction and validation of a prognostic nomogram for predicting the survival of HIV/AIDS adults who received antiretroviral therapy: a cohort between 2003 and 2019 in Nanjing
title_full_unstemmed Construction and validation of a prognostic nomogram for predicting the survival of HIV/AIDS adults who received antiretroviral therapy: a cohort between 2003 and 2019 in Nanjing
title_short Construction and validation of a prognostic nomogram for predicting the survival of HIV/AIDS adults who received antiretroviral therapy: a cohort between 2003 and 2019 in Nanjing
title_sort construction and validation of a prognostic nomogram for predicting the survival of hiv/aids adults who received antiretroviral therapy: a cohort between 2003 and 2019 in nanjing
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8740442/
https://www.ncbi.nlm.nih.gov/pubmed/34991536
http://dx.doi.org/10.1186/s12889-021-12249-8
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