The Veterans Aging Cohort Study (VACS) risk index uses both HIV-related and non-HIV-related biomarkers to predict mortality in patients with HIV. A restricted index is based on a subset of these factors, using only age and HIV-related factors.
Patient selection: HIV-positive adult
Parameters:
(1) age in years
(2) CD4 lymphocyte count per µL
(3) HIV-1 RNA in copies per mL
|
Parameter |
Finding |
Points |
|
age in years |
< 50 years of age |
0 |
|
|
50 to 64 years |
23 |
|
|
>= 65 years |
44 |
|
CD4 lymphocyte count |
>= 500 per µL |
0 |
|
|
200 to 499 per µL |
10 |
|
|
100 to 199 per µL |
19 |
|
|
50 to 99 per µL |
40 |
|
|
< 50 per µL |
46 |
|
HIV-1 RNA copies |
< 500 copies per mL |
0 |
|
|
500 to 100,000 copies per mL |
11 |
|
|
> 100,000 (10^5) copies per mL |
25 |
total iindex =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 115
• The higher the score the all-cause mortality.
In the study of Brown et al (from the OPTIMA trial) mortality at 216 weeks (4.15 years) can be expressed as:
|
Score |
Percent Mortality |
|
20 to 80 |
(0.01125 * ((score)^2)) - (0.225 * (score)) + 12 |
|
60 to 120 |
(-0.01125 * ((score)^2)) + (3.065 * (score)) - 105.1 |
|
> 120 |
100% |
Specialty: Infectious Diseases
ICD-10: ,
