Andreas Ronit1, Shweta Sharma2, Jason V Baker3, Rosie Mngqibisa4, Tristan Delory5, Luis Caldeira6, Nicaise Ndembi7, Jens D Lundgren8, Andrew N Phillips9. 1. Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark. 2. Division of Biostatistics, School of Public Health, University of Minnesota. 3. Infectious Diseases and Department of Medicine, Hennepin County Medical Center, Minneapolis, Minnesota. 4. Enhancing Care Foundation, Durban University of Technology, South Africa. 5. Department of Infectious Diseases, Hospital Saint Louis, Assistance Publique-Hôpitaux de Paris, France. 6. Clínica Universitária de Doenças Infecciosas, Faculty of Medicine, Santa Maria University Hospital, University of Lisbon, Portugal. 7. Institute of Human Virology Nigeria, Abuja. 8. CHIP, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark. 9. Research Department of Infection and Population Health, University College London Medical School, United Kingdom.
Abstract
Background: Serum albumin may be used to stratify human immunodeficiency virus (HIV)-infected persons with high CD4 count according to their risk of serious non-AIDS endpoints. Methods: Cox proportional hazards models were used to analyze the risk of serious non-AIDS events in the Strategic Timing of Antiretroviral Treatment (START) study (NCT00867048) with serum albumin as a fixed and time-updated predictor. Models with exclusion of events during initial follow-up years were built to assess the ability of serum albumin to predict beyond shorter periods of time. Secondarily, we considered hospitalizations and AIDS events. Results: Among 4576 participants, 71 developed a serious non-AIDS event, 788 were hospitalized, and 63 experienced an AIDS event. After adjusting for a range of variables associated with hypoalbuminemia, higher baseline serum albumin (per 1 g/dL) was associated with a decreased risk of serious non-AIDS events (hazard ratio, 0.37 [95% confidence interval, .20-.71]; P = .002). Similar results were obtained in a time-updated model, after controlling for interleukin 6, and after excluding initial follow-up years. Serum albumin was independently associated with hospitalization but not with risk of AIDS. Conclusions: A low serum albumin level is a predictor for short- and long-term serious non-AIDS events, and may be a useful marker of risk of noncommunicable diseases, particularly in resource-limited settings.
RCT Entities:
Background: Serum albumin may be used to stratify human immunodeficiency virus (HIV)-infectedpersons with high CD4 count according to their risk of serious non-AIDS endpoints. Methods: Cox proportional hazards models were used to analyze the risk of serious non-AIDS events in the Strategic Timing of Antiretroviral Treatment (START) study (NCT00867048) with serum albumin as a fixed and time-updated predictor. Models with exclusion of events during initial follow-up years were built to assess the ability of serum albumin to predict beyond shorter periods of time. Secondarily, we considered hospitalizations and AIDS events. Results: Among 4576 participants, 71 developed a serious non-AIDS event, 788 were hospitalized, and 63 experienced an AIDS event. After adjusting for a range of variables associated with hypoalbuminemia, higher baseline serum albumin (per 1 g/dL) was associated with a decreased risk of serious non-AIDS events (hazard ratio, 0.37 [95% confidence interval, .20-.71]; P = .002). Similar results were obtained in a time-updated model, after controlling for interleukin 6, and after excluding initial follow-up years. Serum albumin was independently associated with hospitalization but not with risk of AIDS. Conclusions: A low serum albumin level is a predictor for short- and long-term serious non-AIDS events, and may be a useful marker of risk of noncommunicable diseases, particularly in resource-limited settings.
Authors: Shruti H Mehta; Jacquie Astemborski; Timothy R Sterling; David L Thomas; David Vlahov Journal: AIDS Res Hum Retroviruses Date: 2006-01 Impact factor: 2.205
Authors: Jens D Lundgren; Abdel G Babiker; Fred Gordin; Sean Emery; Birgit Grund; Shweta Sharma; Anchalee Avihingsanon; David A Cooper; Gerd Fätkenheuer; Josep M Llibre; Jean-Michel Molina; Paula Munderi; Mauro Schechter; Robin Wood; Karin L Klingman; Simon Collins; H Clifford Lane; Andrew N Phillips; James D Neaton Journal: N Engl J Med Date: 2015-07-20 Impact factor: 91.245