Serum albumin as a predictor of survival in HIV-infected women in the Women's Interagency HIV Study

Joseph G. Feldman, David N. Burns, Stephen J Gange, Peter Bacchetti, Mardge Cohen, Kathryn Anastos, Marek Nowicki, Robert Delapena, Paolo Miotti

Research output: Contribution to journalArticle

Abstract

Background: The level of serum albumin is associated with mortality in a wide variety of chronic diseases. However, few studies have examined the relationship between serum albumin and survival in HIV-1 infection. Objectives: To determine whether the serum albumin level is associated with survival in HIV-1 infected women. Design: Prospective cohort study. Patients were interviewed and examined at 6 month intervals. Setting: A North American multi-institutional cohort of HIV-infected women from five geographical areas. Participants: A total of 2056 HIV-infected women at various stages of disease. Measurements: Mortality during the first 3 years of follow-up. The relative risk of death by serum albumin level was estimated using a proportional hazards ratio adjusted for CD4 cell count, HIV-1-RNA level and other relevant covariates. Result: Three year mortality for women in the lowest serum albumin category (<35/l) was 48% compared with 11% in the highest category (≥ 42 g/l; P <0.001). The adjusted relative hazard (RH) of death was 3.1 times greater for those in the lowest albumin category (P <0.01). The excess risk associated with lower serum albumin levels remained when subjects with moderate to severe immunosuppression and abnormal kidney and liver function were excluded (P <0.01). Conclusion: The baseline serum albumin level is an independent predictor of mortality in HIV-1-infected women. The serum albumin level may be a useful additional marker of HIV-1 disease progression, particularly among asymptomatic women with little or no evidence of immunosuppression. (C) 2000 Lippincott Williams and Wilkins.

Original languageEnglish (US)
Pages (from-to)863-870
Number of pages8
JournalAIDS
Volume14
Issue number7
DOIs
StatePublished - 2000

Fingerprint

Serum Albumin
HIV
Survival
HIV-1
Mortality
Immunosuppression
CD4 Lymphocyte Count
HIV Infections
Disease Progression
Albumins
Chronic Disease
Cohort Studies
Prospective Studies
RNA
Kidney
Liver

Keywords

  • Proportional hazards
  • Serum albumin
  • Survival

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Feldman, J. G., Burns, D. N., Gange, S. J., Bacchetti, P., Cohen, M., Anastos, K., ... Miotti, P. (2000). Serum albumin as a predictor of survival in HIV-infected women in the Women's Interagency HIV Study. AIDS, 14(7), 863-870. https://doi.org/10.1097/00002030-200005050-00013

Serum albumin as a predictor of survival in HIV-infected women in the Women's Interagency HIV Study. / Feldman, Joseph G.; Burns, David N.; Gange, Stephen J; Bacchetti, Peter; Cohen, Mardge; Anastos, Kathryn; Nowicki, Marek; Delapena, Robert; Miotti, Paolo.

In: AIDS, Vol. 14, No. 7, 2000, p. 863-870.

Research output: Contribution to journalArticle

Feldman, JG, Burns, DN, Gange, SJ, Bacchetti, P, Cohen, M, Anastos, K, Nowicki, M, Delapena, R & Miotti, P 2000, 'Serum albumin as a predictor of survival in HIV-infected women in the Women's Interagency HIV Study', AIDS, vol. 14, no. 7, pp. 863-870. https://doi.org/10.1097/00002030-200005050-00013
Feldman, Joseph G. ; Burns, David N. ; Gange, Stephen J ; Bacchetti, Peter ; Cohen, Mardge ; Anastos, Kathryn ; Nowicki, Marek ; Delapena, Robert ; Miotti, Paolo. / Serum albumin as a predictor of survival in HIV-infected women in the Women's Interagency HIV Study. In: AIDS. 2000 ; Vol. 14, No. 7. pp. 863-870.
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AU - Feldman, Joseph G.

AU - Burns, David N.

AU - Gange, Stephen J

AU - Bacchetti, Peter

AU - Cohen, Mardge

AU - Anastos, Kathryn

AU - Nowicki, Marek

AU - Delapena, Robert

AU - Miotti, Paolo

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N2 - Background: The level of serum albumin is associated with mortality in a wide variety of chronic diseases. However, few studies have examined the relationship between serum albumin and survival in HIV-1 infection. Objectives: To determine whether the serum albumin level is associated with survival in HIV-1 infected women. Design: Prospective cohort study. Patients were interviewed and examined at 6 month intervals. Setting: A North American multi-institutional cohort of HIV-infected women from five geographical areas. Participants: A total of 2056 HIV-infected women at various stages of disease. Measurements: Mortality during the first 3 years of follow-up. The relative risk of death by serum albumin level was estimated using a proportional hazards ratio adjusted for CD4 cell count, HIV-1-RNA level and other relevant covariates. Result: Three year mortality for women in the lowest serum albumin category (<35/l) was 48% compared with 11% in the highest category (≥ 42 g/l; P <0.001). The adjusted relative hazard (RH) of death was 3.1 times greater for those in the lowest albumin category (P <0.01). The excess risk associated with lower serum albumin levels remained when subjects with moderate to severe immunosuppression and abnormal kidney and liver function were excluded (P <0.01). Conclusion: The baseline serum albumin level is an independent predictor of mortality in HIV-1-infected women. The serum albumin level may be a useful additional marker of HIV-1 disease progression, particularly among asymptomatic women with little or no evidence of immunosuppression. (C) 2000 Lippincott Williams and Wilkins.

AB - Background: The level of serum albumin is associated with mortality in a wide variety of chronic diseases. However, few studies have examined the relationship between serum albumin and survival in HIV-1 infection. Objectives: To determine whether the serum albumin level is associated with survival in HIV-1 infected women. Design: Prospective cohort study. Patients were interviewed and examined at 6 month intervals. Setting: A North American multi-institutional cohort of HIV-infected women from five geographical areas. Participants: A total of 2056 HIV-infected women at various stages of disease. Measurements: Mortality during the first 3 years of follow-up. The relative risk of death by serum albumin level was estimated using a proportional hazards ratio adjusted for CD4 cell count, HIV-1-RNA level and other relevant covariates. Result: Three year mortality for women in the lowest serum albumin category (<35/l) was 48% compared with 11% in the highest category (≥ 42 g/l; P <0.001). The adjusted relative hazard (RH) of death was 3.1 times greater for those in the lowest albumin category (P <0.01). The excess risk associated with lower serum albumin levels remained when subjects with moderate to severe immunosuppression and abnormal kidney and liver function were excluded (P <0.01). Conclusion: The baseline serum albumin level is an independent predictor of mortality in HIV-1-infected women. The serum albumin level may be a useful additional marker of HIV-1 disease progression, particularly among asymptomatic women with little or no evidence of immunosuppression. (C) 2000 Lippincott Williams and Wilkins.

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