在多中心艾滋病队列研究中,抑郁改善了所有原因死亡率的VACS指数2.0的预测准确度
Yuhang Qian1,2, Warren S Comulada3,4, Marco A Hidalgo5
1Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
Journal of acquired immune deficiency syndromes (1999)
|August 26, 2025
概括
将抑郁症添加到退伍军人老龄化队列研究 (VACS) 索引2.0显著改善了艾滋病毒感染的性少数男性 (SMM) 的死亡率预测. 抑郁症查可以改善患者的健康状况并降低死亡率.
科学领域:
- 公共卫生
- 流行病学
- 临床医学
背景情况:
- 使用临床数据预测退伍军人老龄化队列研究 (VACS) 指数2.
- 艾滋病毒感染的性少数群体男性 (SMM) 通常会经历诸如抑郁症之类的行为和心理社会因素,这可能会影响死亡率.
- 通过这些因素增强VACS指数2.0可以提高SMM的预测准确性.
研究的目的:
- 评估是否结合行为和心理社会因素,特别是抑郁症,可以改善艾滋病感染者死亡率的预测.
- 评估抑郁症查在该群体VACS指数2.0中的附加值.
主要方法:
- 分析了从多中心艾滋病队列研究 (MACS) 开始高活性抗逆转录病毒治疗 (HAART) 的1438名SMM队列.
- 考克斯比例危险模型和韦布尔生存模型用于开发和验证新的指数,将抑郁症纳入VACS指数2.0.
- 在开发和验证组中使用C统计和校准曲线进行了模型准确性比较,包括子组分析.
主要成果:
- 抑郁症是5年死亡率的重要预测因素,在艾滋病毒感染的SMM中增加了70%的风险 (aHR=1. 70).
- 在发展组中,包括抑郁症改善了VACS指数2. 0的C统计值,从0. 818提高到0. 851.
- 这些发现在各种子组中一致,包括年龄,种族,CD4计数和病毒抑制.
结论:
- 将抑郁症纳入VACS指数2.0提高了它预测艾滋病毒感染者死亡率的能力.
- 建议对抑郁症进行常规查和治疗,以改善这一脆弱群体的健康状况并降低死亡率.
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