Abstract
About 22.9 million people living with HIV/AIDS reside in sub-Saharan Africa, many of
whom have progressed to AIDS over time. Kenya has high numbers of new infections;
a total of 104,000 in the general population with paediatrics at 13,000 and adults at
91,000. Risk scores constructed using prognostic factors may be valuable in the early
identication and intervention to patients at risk of progression to AIDS. There was
therefore a necessity to come up with robust risk models that use a limited number of
easily available factors. The main objective was to come up with a risk score utilizing
routine care data which can be easily applicable in a clinical setting to asses for risk
of AIDS among HIV infected patients. It was a prospective cohort study done using 2
year follow-up (initiated on Highly Active Antiretroviral Therapy (HAART)) between
1st of June, 2010 and 30th of May, 2011) data from 1454 HIV/AIDS on ART care and
treatment. Age, sex, marital status, CD4 cell count, haemoglobin level, BMI, prior TB
medication and whether or not patients were currently receiving any ART was modelled
to describe the short term risk of new AIDS event. Flexible parametric survival regression
analysis (Royston Parmar) was used instead of Cox-PH regression. Strong predictors of
progression were Body Mass Index, haemoglobin, World Health Organization staging and
Tuberculosis treatment prior to HAART initiation. The study was able to develop a two
group risk categorization based on the risk model developed. The discriminative ability
of the model was moderately strong (Harrell's c-index of 0.69). The rate of progression
to AIDS between the high and low risk groups was well dened. The rate of progression
was 0.38 and 0.93 per thousand person-years of followup for the low risk and high risk
groups respectively which was more than twofold risk of progression to AIDS among high
risk group, (HR= 2.47 95% CI: 1.66 - 3.69; p
OWUOR, K (2021). Flexible Parametric Prognostic Risk Score Models For Short-Term Risk Of Aids On Patients Newly Initiated On Highly Active Antiretroviral Therapy (Haart) In Nyanza, Kenya. Afribary. Retrieved from https://tracking.afribary.com/works/flexible-parametric-prognostic-risk-score-models-for-short-term-risk-of-aids-on-patients-newly-initiated-on-highly-active-antiretroviral-therapy-haart-in-nyanza-kenya
OWUOR, KEVIN "Flexible Parametric Prognostic Risk Score Models For Short-Term Risk Of Aids On Patients Newly Initiated On Highly Active Antiretroviral Therapy (Haart) In Nyanza, Kenya" Afribary. Afribary, 06 May. 2021, https://tracking.afribary.com/works/flexible-parametric-prognostic-risk-score-models-for-short-term-risk-of-aids-on-patients-newly-initiated-on-highly-active-antiretroviral-therapy-haart-in-nyanza-kenya. Accessed 18 Dec. 2024.
OWUOR, KEVIN . "Flexible Parametric Prognostic Risk Score Models For Short-Term Risk Of Aids On Patients Newly Initiated On Highly Active Antiretroviral Therapy (Haart) In Nyanza, Kenya". Afribary, Afribary, 06 May. 2021. Web. 18 Dec. 2024. < https://tracking.afribary.com/works/flexible-parametric-prognostic-risk-score-models-for-short-term-risk-of-aids-on-patients-newly-initiated-on-highly-active-antiretroviral-therapy-haart-in-nyanza-kenya >.
OWUOR, KEVIN . "Flexible Parametric Prognostic Risk Score Models For Short-Term Risk Of Aids On Patients Newly Initiated On Highly Active Antiretroviral Therapy (Haart) In Nyanza, Kenya" Afribary (2021). Accessed December 18, 2024. https://tracking.afribary.com/works/flexible-parametric-prognostic-risk-score-models-for-short-term-risk-of-aids-on-patients-newly-initiated-on-highly-active-antiretroviral-therapy-haart-in-nyanza-kenya