死亡风险指数的验证用于预测西班牙队列 (eVIHa) 艾滋病毒感染者的长期结果
Sophia Pinecki Socias1, Marc Moragues Serra2, Francisca Artigues Serra1,2
1Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain.
Journal of clinical medicine
|December 30, 2025
概括
退伍军人老龄化队列研究 (VACS) 指数1.0准确预测欧洲队列中感染艾滋病毒 (PLHIV) 的人的5年死亡率. 这种艾滋病毒死亡率预测工具的表现优于修改后的查尔森指数.
科学领域:
- 医学研究 医学研究
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 抗逆转录病毒疗法 (ART) 已经将艾滋病毒转化为一种慢性疾病,并增加了预期寿命.
- 退伍军人老龄化队列研究 (VACS) 指数使用与艾滋病毒相关的和非艾滋病毒相关的标志物预测艾滋病毒感染者 (PLHIV) 的5年死亡率.
- 修改后的查尔森指数评估并发症负担,并预测10年死亡率.
研究的目的:
- 为了验证VACS指数1.0和修改的查尔森指数用于当代欧洲PLHIV队列中的死亡率预测.
- 为了比较这两个指数在特定人群中的预测性表现.
主要方法:
- 一项观察性多中心研究,使用eVIHa队列 (西班牙,2000-2023) 的数据.
- 为符合资格的PLHIV计算VACS指数1.0和修改的查尔森指数.
- 使用哈雷尔的C统计和卡普兰-梅尔分析观察到的死亡率对模型歧视的评估.
主要成果:
- VACS指数1.0显示出对5年全因死亡率 (C-统计:0.759) 的良好区别,超过了修改后的查尔森指数 (C-统计:0.729).
- 在VACS指数中,由于肝病 (C:0.875) 和非艾滋病毒相关感染 (C:0.853) 导致的死亡的歧视率最高.
- 由于数据不足,很大一部分符合条件的PLHIV (35.2%) 被排除在外,死亡率更高.
结论:
- VACS指数1.0是研究欧洲PLHIV队列中5年死亡率的准确预测指标.
- 在有较高注射药物使用率和不规则的随访率的人群中,该指数的表现可能较低.
- 临床医生在实践中使用VACS指数时应该考虑这些限制.
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