Development and Validation of a Mortality Risk Prediction Index Score for Adults Living with HIV and Multiple Chronic Comorbidities
Introduction Aging while living with HIV poses new challenges in clinical management, mainly due to the onset of multiple chronic comorbidities. Population-specific risk prediction indices considering comorbidities and other risk factors are essential to comprehensively characterise disease burden...
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Swansea University
2025-06-01
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| Series: | International Journal of Population Data Science |
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| Online Access: | https://ijpds.org/article/view/2926 |
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| author | Viviane Dias Lima Bronhilda Takeh Neil Faught Hasan Nathani Jielin Zhu Scott Emerson Katerina Dolguikh Jason Trigg Kate Salters Rolando Barrios Julio Montaner |
| author_facet | Viviane Dias Lima Bronhilda Takeh Neil Faught Hasan Nathani Jielin Zhu Scott Emerson Katerina Dolguikh Jason Trigg Kate Salters Rolando Barrios Julio Montaner |
| author_sort | Viviane Dias Lima |
| collection | DOAJ |
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Introduction
Aging while living with HIV poses new challenges in clinical management, mainly due to the onset of multiple chronic comorbidities. Population-specific risk prediction indices considering comorbidities and other risk factors are essential to comprehensively characterise disease burden among PLWH. We developed and validated a mortality risk prediction index i to predict the risk of one-year all-cause mortality among people living with HIV (PLWH).
Methods
Participants were ≥18 years and had initiated antiretroviral therapy (ART) between 01/2001 and 12/2018, in British Columbia, Canada. The index date was randomly selected between one-year post-ART initiation and the end of the follow-up. Participants were followed for at least one year from the index date until 12/2019, the last contact date, or the date of death (all-cause), whichever came first. The MRPi included 18 physical/mental comorbidities, demographic and clinical variables, and ranged from 0 (no risk) to 100 (highest risk).
Results
The final model demonstrated the highest discrimination (c-statistic 0.8355, 95% CI: 0.8187-0.8523 in the training dataset and 0.7965, 95% CI: 0.7664-0.8266 in the test dataset). The comorbidities with the highest weights in the MRPi were substance use disorders, metastatic solid tumors and non-AIDs defining cancers. For example, for an MRPi of 30, the predicted one-year all-cause mortality was 0.2%, while an MRPi of 50 had a predicted mortality of 2.3%.
Conclusions
The MRPi provides a promising tool to assess the risk of short-term mortality among PLWH in the modern ART era that can inform clinical practice and health policy decisions.
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| format | Article |
| id | doaj-art-2dac7a76ac7a48ba96a2b838a0ae3da2 |
| institution | DOAJ |
| issn | 2399-4908 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Swansea University |
| record_format | Article |
| series | International Journal of Population Data Science |
| spelling | doaj-art-2dac7a76ac7a48ba96a2b838a0ae3da22025-08-20T03:23:08ZengSwansea UniversityInternational Journal of Population Data Science2399-49082025-06-0110310.23889/ijpds.v10i2.2926Development and Validation of a Mortality Risk Prediction Index Score for Adults Living with HIV and Multiple Chronic ComorbiditiesViviane Dias Lima0Bronhilda Takeh1Neil Faught 2Hasan Nathani 3Jielin Zhu 4Scott Emerson 5Katerina Dolguikh 6Jason Trigg 7Kate Salters 8Rolando Barrios 9Julio Montaner 10British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada; Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada; Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada Introduction Aging while living with HIV poses new challenges in clinical management, mainly due to the onset of multiple chronic comorbidities. Population-specific risk prediction indices considering comorbidities and other risk factors are essential to comprehensively characterise disease burden among PLWH. We developed and validated a mortality risk prediction index i to predict the risk of one-year all-cause mortality among people living with HIV (PLWH). Methods Participants were ≥18 years and had initiated antiretroviral therapy (ART) between 01/2001 and 12/2018, in British Columbia, Canada. The index date was randomly selected between one-year post-ART initiation and the end of the follow-up. Participants were followed for at least one year from the index date until 12/2019, the last contact date, or the date of death (all-cause), whichever came first. The MRPi included 18 physical/mental comorbidities, demographic and clinical variables, and ranged from 0 (no risk) to 100 (highest risk). Results The final model demonstrated the highest discrimination (c-statistic 0.8355, 95% CI: 0.8187-0.8523 in the training dataset and 0.7965, 95% CI: 0.7664-0.8266 in the test dataset). The comorbidities with the highest weights in the MRPi were substance use disorders, metastatic solid tumors and non-AIDs defining cancers. For example, for an MRPi of 30, the predicted one-year all-cause mortality was 0.2%, while an MRPi of 50 had a predicted mortality of 2.3%. Conclusions The MRPi provides a promising tool to assess the risk of short-term mortality among PLWH in the modern ART era that can inform clinical practice and health policy decisions. https://ijpds.org/article/view/2926AgingcomorbidityMortalityburden of diseasemortality risk predictionvalidation |
| spellingShingle | Viviane Dias Lima Bronhilda Takeh Neil Faught Hasan Nathani Jielin Zhu Scott Emerson Katerina Dolguikh Jason Trigg Kate Salters Rolando Barrios Julio Montaner Development and Validation of a Mortality Risk Prediction Index Score for Adults Living with HIV and Multiple Chronic Comorbidities International Journal of Population Data Science Aging comorbidity Mortality burden of disease mortality risk prediction validation |
| title | Development and Validation of a Mortality Risk Prediction Index Score for Adults Living with HIV and Multiple Chronic Comorbidities |
| title_full | Development and Validation of a Mortality Risk Prediction Index Score for Adults Living with HIV and Multiple Chronic Comorbidities |
| title_fullStr | Development and Validation of a Mortality Risk Prediction Index Score for Adults Living with HIV and Multiple Chronic Comorbidities |
| title_full_unstemmed | Development and Validation of a Mortality Risk Prediction Index Score for Adults Living with HIV and Multiple Chronic Comorbidities |
| title_short | Development and Validation of a Mortality Risk Prediction Index Score for Adults Living with HIV and Multiple Chronic Comorbidities |
| title_sort | development and validation of a mortality risk prediction index score for adults living with hiv and multiple chronic comorbidities |
| topic | Aging comorbidity Mortality burden of disease mortality risk prediction validation |
| url | https://ijpds.org/article/view/2926 |
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