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首页> 外文期刊>AIDS Research and Human Retroviruses >Modified Kigali combined staging predicts risk of mortality in HIV-infected adults in Lusaka, Zambia.
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Modified Kigali combined staging predicts risk of mortality in HIV-infected adults in Lusaka, Zambia.

机译：改良的Kigali联合分期法可预测赞比亚卢萨卡的HIV感染成年人死亡风险。

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摘要

We assessed the utility of the modified Kigali combined (MKC) staging system for predicting survival in HIV-infected Zambian adults in a prospective, longitudinal, open cohort. From 1995 to 2004, HIV-discordant couples (one HIV-infected partner and one HIV-negative partner) were recruited from couples' voluntary counseling and testing centers in Lusaka, Zambia and followed at 3-month intervals. MKC stage, which incorporates clinical stage with erythrocyte sedimentation rate (ESR), hematocrit, and body mass index (BMI), was determined at enrollment. Kaplan-Meier survival and Cox proportional hazard methods were used to calculate median survival and relative hazards. We enrolled 1479 HIV-discordant couples with a combined 7305 person-years of follow-up. Among HIV-infected participants over the 9-year study period, there were 333 confirmed deaths. The time to 50% mortality was 8.5 years with MKC stage 1 and 2 disease compared to 3.7 years with MKC stage 4 disease at enrollment. Survival rates at 3 years were 85% with MKC stage 1 and 2 disease, 74% with MKC stage 3 disease, and 51% with MKC stage 4 disease. A total of 275 HIV-negative partners seroconverted during follow-up. In comparison, survival rates at 3 years were 94% for HIV-negative participants and 92% for participants who seroconverted during follow-up. In multivariate analysis, MKC stage 4 disease (HR = 3.7, 95% CI = 2.7-5.0) remained a strong predictor of mortality. Incorporating ESR, hematocrit, and BMI with clinical staging is a powerful, low-cost tool to identify HIV-infected adults at high risk for mortality.
机译：我们评估了改良的基加利联合（MKC）分期系统在前瞻性，纵向，开放性队列中预测HIV感染的赞比亚成年人存活率的效用。从1995年到2004年，从赞比亚卢萨卡的夫妻自愿咨询和检测中心招募了艾滋病毒不相容的夫妻（一对HIV感染者和一个HIV阴性者），每3个月进行一次随访。在入组时确定MKC阶段，该阶段将临床阶段与红细胞沉降率（ESR），血细胞比容和体重指数（BMI）结合在一起。 Kaplan-Meier生存率和Cox比例风险方法用于计算中值生存率和相对危害。我们纳入了1479例HIV不一致的夫妇，并进行了7305人年的随访。在为期9年的研究期内，被HIV感染的参与者中，有333例确诊死亡。在入组时，MKC 1和2期疾病达到50％死亡率的时间为8.5年，而MKC 4期疾病则为3.7年。 MKC 1期和2期疾病3年生存率分别为85％，MKC 3期疾病74％和MKC 4期疾病51％。在随访过程中，共有275名HIV阴性伴侣被血清转化。相比之下，HIV阴性参与者在3年生存率是94％，在随访期间进行血清转化的参与者在92％。在多变量分析中，MKC 4期疾病（HR = 3.7，95％CI = 2.7-5.0）仍然是死亡率的重要预测指标。将ESR，血细胞比容和BMI与临床分期相结合是一种功能强大的低成本工具，可用于识别处于高死亡风险的HIV感染成年人。

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