medical decision support medical decision support
Sign In

Risk Score of Robbins et al for Predicting Virologic Failure for an HIV Outpatient

Purpose: To identify an HIV-positive outpatient who is at risk for virologic failure using the risk score of Robbins et al.

Description

Robbins et al develop a simple score to identify an HIV-positive outpatient who is likely to experience virologic failure. This can helpt to identify a patient who may require more aggressive management. The authors are from Massachusetts General Hospital and Brigham and Women's Hospital in Boston.


Parameters:

(1) adherence

(2) CD4 cell count

(3) drug and/or alcohol abuse

(4) experience with HAART (highly-active antiretroviral therapy)

(5) number of appointments missed within the past year

(6) history of virologic failure

(7) duration of HIV suppression

 

Parameter

Finding

Points

adherence

optimum

0

 

suboptimum (< 85%)

1

CD4 cell count

>= 100 per µL

0

 

< 100 per µL

1

drug and/or alcohol abuse

no

0

 

yes

1

experienced with HAART

no

0

 

yes

1

number of appointments missed

0

0

 

>= 1

1

history of virologic failure

no

0

 

yes

1

duration of viral suppression

>= 12 months

0

 

< 12 months

1

 

where:

• Experenced with HAART: (treatment with NRTI, non-NRTI and protease inhibitor prior to current regimen) OR (current antiretroviral therapy regimen containing enfuvirtide or an investigational antiretroviral drug)

• The abstract uses <= 12 months for duration of viral suppression while Table 3 uses < 12 months.

 

total score =

= SUM(points for all 7 paramters)

 

Interpretation:

• minimum score: 0

• maximum score: 7

• The higher the score the greater the risk of virologic failure.

 

Total Score

Risk for Virologic Failure

0 or 1

low

2 or 3

intermediate

4 to 7

high

 


To read more or access our algorithms and calculators, please log in or register.

Specialty

Objective

ICD-10