Predicting death over 8 years in a prospective cohort of HIV-infected women

The Women's Interagency HIV Study

Deborah R. Gustafson, Qiuhu Shi, Susan Holman, Howard Minkoff, Mardge H. Cohen, Michael W. Plankey, Richard Havlik, Anjali Sharma, Stephen J Gange, Monica Gandhi, Joel Milam, Donald R. Hoover

Research output: Contribution to journalArticle

Abstract

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, X2 =69.04, p<0.0001), and later than 3 years (HR=1.55, 95% CI 1.30, 1.84, X2 =23.88, p<0.0001); followed by FFI within 3 years (HR=2.06, 95% CI 1.19, 3.57, X2 =6.73, p=0.01) and later than 3 years (HR=2.43, 95% CI 1.58, 3.75, X2 =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.

Original languageEnglish (US)
Article numbere013993
JournalBMJ Open
Volume7
Issue number6
DOIs
StatePublished - Jun 1 2017

Fingerprint

HIV
Veterans
HIV Infections
Mortality
Epidemiologic Studies
Cohort Studies
Depression
Health
HIV-1
Mental Health
Acquired Immunodeficiency Syndrome
Regression Analysis
Therapeutics

Keywords

  • Ageing
  • Frailty
  • HCV
  • HIV

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Gustafson, D. R., Shi, Q., Holman, S., Minkoff, H., Cohen, M. H., Plankey, M. W., ... Hoover, D. R. (2017). Predicting death over 8 years in a prospective cohort of HIV-infected women: The Women's Interagency HIV Study. BMJ Open, 7(6), [e013993]. https://doi.org/10.1136/bmjopen-2016-013993

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 J; Gandhi, Monica; Milam, Joel; Hoover, Donald R.

In: BMJ Open, Vol. 7, No. 6, e013993, 01.06.2017.

Research output: Contribution to journalArticle

Gustafson, DR, Shi, Q, Holman, S, Minkoff, H, Cohen, MH, Plankey, MW, Havlik, R, Sharma, A, Gange, SJ, Gandhi, M, Milam, J & Hoover, DR 2017, 'Predicting death over 8 years in a prospective cohort of HIV-infected women: The Women's Interagency HIV Study', BMJ Open, vol. 7, no. 6, e013993. https://doi.org/10.1136/bmjopen-2016-013993
Gustafson, Deborah R. ; Shi, Qiuhu ; Holman, Susan ; Minkoff, Howard ; Cohen, Mardge H. ; Plankey, Michael W. ; Havlik, Richard ; Sharma, Anjali ; Gange, Stephen J ; 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. In: BMJ Open. 2017 ; Vol. 7, No. 6.
@article{92a53f6398684ba5884a8158b2560107,
title = "Predicting death over 8 years in a prospective cohort of HIV-infected women: The Women's Interagency HIV Study",
abstract = "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, X2 =69.04, p<0.0001), and later than 3 years (HR=1.55, 95{\%} CI 1.30, 1.84, X2 =23.88, p<0.0001); followed by FFI within 3 years (HR=2.06, 95{\%} CI 1.19, 3.57, X2 =6.73, p=0.01) and later than 3 years (HR=2.43, 95{\%} CI 1.58, 3.75, X2 =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.",
keywords = "Ageing, Frailty, HCV, HIV",
author = "Gustafson, {Deborah R.} and Qiuhu Shi and Susan Holman and Howard Minkoff and Cohen, {Mardge H.} and Plankey, {Michael W.} and Richard Havlik and Anjali Sharma and Gange, {Stephen J} and Monica Gandhi and Joel Milam and Hoover, {Donald R.}",
year = "2017",
month = "6",
day = "1",
doi = "10.1136/bmjopen-2016-013993",
language = "English (US)",
volume = "7",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "6",

}

TY - JOUR

T1 - Predicting death over 8 years in a prospective cohort of HIV-infected women

T2 - The Women's Interagency HIV Study

AU - Gustafson, Deborah R.

AU - Shi, Qiuhu

AU - Holman, Susan

AU - Minkoff, Howard

AU - Cohen, Mardge H.

AU - Plankey, Michael W.

AU - Havlik, Richard

AU - Sharma, Anjali

AU - Gange, Stephen J

AU - Gandhi, Monica

AU - Milam, Joel

AU - Hoover, Donald R.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - 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, X2 =69.04, p<0.0001), and later than 3 years (HR=1.55, 95% CI 1.30, 1.84, X2 =23.88, p<0.0001); followed by FFI within 3 years (HR=2.06, 95% CI 1.19, 3.57, X2 =6.73, p=0.01) and later than 3 years (HR=2.43, 95% CI 1.58, 3.75, X2 =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.

AB - 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, X2 =69.04, p<0.0001), and later than 3 years (HR=1.55, 95% CI 1.30, 1.84, X2 =23.88, p<0.0001); followed by FFI within 3 years (HR=2.06, 95% CI 1.19, 3.57, X2 =6.73, p=0.01) and later than 3 years (HR=2.43, 95% CI 1.58, 3.75, X2 =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.

KW - Ageing

KW - Frailty

KW - HCV

KW - HIV

UR - http://www.scopus.com/inward/record.url?scp=85021713270&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021713270&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2016-013993

DO - 10.1136/bmjopen-2016-013993

M3 - Article

VL - 7

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 6

M1 - e013993

ER -