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
AU - Gandhi, Monica
AU - Milam, Joel
AU - Hoover, Donald R.
N1 - Publisher Copyright:
© Article author(s) 2017.
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
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U2 - 10.1136/bmjopen-2016-013993
DO - 10.1136/bmjopen-2016-013993
M3 - Article
C2 - 28667199
AN - SCOPUS:85021713270
SN - 2044-6055
VL - 7
JO - BMJ open
JF - BMJ open
IS - 6
M1 - e013993
ER -