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 journalArticlepeer-review

59 Scopus citations


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
Issue number7
StatePublished - 2000
Externally publishedYes


  • Proportional hazards
  • Serum albumin
  • Survival

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases


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