The use of highly active antiretroviral therapy (HAART) has changed the prognosis for a patient with HIV infection. The EuroSIDA prognostic score uses the most recently measured laboratory values to determine the risk for disease progression. The EuroSIDA study involved multiple academic medical centers in Europe and Israel.
Inclusion criteria:
(1) age >= 16 years at enrollment
(2) on a HAART antiretroviral regimen with >= 3 drugs, with either a protease inhibitor (PI) or non-nucleoside reverse-transcriptase inhibitor (NNRTI) started during the study period
Parameters:
(1) latest CD4 cell count
(2) latest virus load (HIV RNA)
(3) hemoglobin level
(4) clinical status
|
Gender |
Hemoglobin |
Anemia |
|
female |
> 12 g/dL |
normal |
|
|
8 – 12 g/dL |
mild anemia |
|
|
< 8 g/dL |
severe anemia |
|
male |
> 14 g/dL |
normal |
|
|
8 – 14 g/dL |
mild anemia |
|
|
< 8 g/dL |
severe anemia |
|
Parameter |
Finding |
Points |
|
latest CD4 cell count |
> 200 cells per µL |
0 |
|
|
51 – 200 cells per µL |
3 |
|
|
<= 50 cells per µL |
7 |
|
HIV RNA |
< 500 RNA copies/mL |
0 |
|
|
500 – 999 copies/mL |
1 |
|
|
>= 1,000 copies/mL |
2 |
|
anemia |
none |
0 |
|
|
mild |
2 |
|
|
severe |
6 |
|
clinical status |
no previous severe AIDS |
0 |
|
|
severe AIDS ever (non-Hodgkin's lymphoma or PML) |
2 |
prognostic score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 17
• The lower the score the better the prognosis.
• The relative hazard for clinical progression with each point increase is 1.38 (95% CI 1.33 – 1.43).
Purpose: To determine the risk for disease progression in an HIV-positive patient receiving HAART.
Specialty: Infectious Diseases
Objective: severity, prognosis, stage
ICD-10: B24,
