Dataset Information

Incomplete immune reconstitution and its predictors in people living with HIV in Wuhan, China.

ABSTRACT:

Objective

This study aimed to build and validate a nomogram model to predict the risk of incomplete immune reconstitution in people living with HIV (PLWH).

Methods

Totally 3783 individuals with a confirmed diagnosis of HIV/AIDS were included. A predictive model was developed based on a retrospective set (N = 2678) and was validated using the remaining cases (N = 1105). Univariate and multivariate logistic regression analyses were performed to determine valuable predictors among the collected clinical and laboratory variables. The predictive model is presented in the form of a nomogram, which is internally and externally validated with two independent datasets. The discrimination of nomograms was assessed by calculating the area under the curve (AUC). Besides, calibration curve and decision curve (DCA) analyses were performed in the training and validation sets.

Results

The final model comprised 5 predictors, including baseline CD4, age at ART initiation, BMI, HZ and TBIL. The AUC of the nomogram model was 0.902, 0.926, 0.851 in the training cohort, internal validation and external cohorts. The calibration accuracy and diagnostic performance were satisfactory in both the training and validation sets.

Conclusions

This predictive model based on a retrospective study was externally validated using 5 readily available clinical indicators. It showed high performance in predicting the risk of incomplete immune reconstitution in people living with HIV.

SUBMITTER: Zhang W

PROVIDER: S-EPMC10505310 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Publications

Incomplete immune reconstitution and its predictors in people living with HIV in Wuhan, China.

Zhang Wenyuan W Yan Jisong J Luo Hong H Wang Xianguang X Ruan Lianguo L

BMC public health 20230916 1

<h4>Objective</h4>This study aimed to build and validate a nomogram model to predict the risk of incomplete immune reconstitution in people living with HIV (PLWH).<h4>Methods</h4>Totally 3783 individuals with a confirmed diagnosis of HIV/AIDS were included. A predictive model was developed based on a retrospective set (N = 2678) and was validated using the remaining cases (N = 1105). Univariate and multivariate logistic regression analyses were performed to determine valuable predictors among th ...[more]

PMID: 37716975

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Project description:BackgroundAchieving complete immune reconstitution (CIR) in people living with human immunodeficiency virus (PLWH) following antiretroviral therapy (ART) is essential for preventing acquired immunodeficiency syndrome (AIDS) progression and improving survival. However, there is a paucity of robust prediction models for determining the likelihood of CIR in PLWH after ART. We aimed to develop and validate a CIR prediction model utilizing baseline data.MethodsBaseline data including demographic information, immunological profiles, and routine laboratory test results, were collected from PLWH in Yunnan, China. Baseline referred to the first recorded results after HIV diagnosis but before initiating ART, and these initial measurements served as the baseline data for analysis. The participants were divided into training and validation sets (7:3 ratio). To construct the model and accompanying nomogram, univariable and multivariable Cox regression analyses were performed. The model was evaluated using the C-index, time-dependent receiver operating characteristic (ROC) curves, calibration curves, and clinical decision curves to assess discrimination, calibration, and clinical applicability.ResultsFive thousand four hundred eight PLWH were included, with a CIR of 38.52%. Cox regression analysis revealed various independent factors associated with CIR, including infection route, baseline CD4+T cell count, baseline CD4/CD8 ratio, interval from HIV diagnosis to ART initiation, and the level of PLT, Glu, Crea, HGB, ALT. A nomogram was formulated to predict the probability of achieving CIR at years 4, 5, and 6. The model demonstrated good performance, as evidenced by an AUC of 0.8 for both sets. Calibration curve analysis demonstrated a high level of agreement, and decision curve analysis revealed a significant positive yield.ConclusionsThis study successfully developed a prediction model with robust performance. This model has considerable potential to aid clinicians in tailoring treatment strategies, which could enhance outcomes and quality of life for PLWH.

Dataset Information

Incomplete immune reconstitution and its predictors in people living with HIV in Wuhan, China.

Objective

Methods

Results

Conclusions

Publications

Incomplete immune reconstitution and its predictors in people living with HIV in Wuhan, China.

Similar Datasets

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