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 Gange, Monica Gandhi, Joel Milam, Donald R. Hoover

Research output: Contribution to journalArticle

5 Citations (Scopus)

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; 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, S, 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 ; 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.
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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.",
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AU - Minkoff, Howard

AU - Cohen, Mardge H.

AU - Plankey, Michael W.

AU - Havlik, Richard

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AU - Gandhi, Monica

AU - Milam, Joel

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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.

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