开发和验证一种临床风险评分，以预测 HIV 感染者 PISCIS 队列中的损失。

Developing and validating a clinical risk score to predict losses in the PISCIS cohort of people with HIV.

机构信息

Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, Badalona, Spain.

CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain.

出版信息

Int J STD AIDS. 2024 Oct;35(12):952-962. doi: 10.1177/09564624241270967. Epub 2024 Aug 15.

DOI:10.1177/09564624241270967

PMID:39148144

Abstract

BACKGROUND

People lost to follow-up (LTFU) from HIV care have an increased risk of worse health. The objective of this study is to create and validate a risk score to predict LTFU among PLWH in Catalonia and the Balearic Islands.

METHODS

6661 PLWH were included. LTFU were those without contact with HIV care for 12 months or more. Logistic regression models were used to assess the role of independent factors on LTFU. The validation included a 10-fold iteration to predict the performance of the regression model and the Area under the ROC Curve (AUC). Regression coefficients were rounded and summed to construct the score.

RESULTS

Determinants of LTFU included being younger than 34 years (OR: 1.80, CI, 1.44-2.23), not having been born in Spain (OR: 1.32, 1.11-1.58), men who inject drugs (OR: 2.10, 1.38-3.19), having a detectable viral load (OR: 3.14, 2.47-3.99), and ≤2.5 years since HIV diagnosis (OR: 3.84, 3.10-4.75). The validation of determinants resulted in a mean AUC of 0.69 and the risk-score revealed that 28.8% had a medium and 3.4% a high risk of LTFU respectively.

CONCLUSIONS

Findings can be used to prevent LTFU in HIV care.

摘要

背景

从艾滋病护理中失访（LTFU）的人健康状况恶化的风险增加。本研究的目的是建立和验证一个风险评分，以预测加泰罗尼亚和巴利阿里群岛的艾滋病毒感染者（PLWH）的 LTFU。

方法

共纳入 6661 名 PLWH。LTFU 是指与 HIV 护理无接触 12 个月或以上的人。使用逻辑回归模型评估独立因素对 LTFU 的作用。验证包括 10 倍迭代，以预测回归模型的性能和 ROC 曲线下面积（AUC）。回归系数四舍五入并相加，以构建评分。

结果

LTFU 的决定因素包括年龄小于 34 岁（OR：1.80，CI，1.44-2.23）、非西班牙出生（OR：1.32，1.11-1.58）、男性注射毒品（OR：2.10，1.38-3.19）、病毒载量可检测（OR：3.14，2.47-3.99）和 HIV 诊断后≤2.5 年（OR：3.84，3.10-4.75）。对决定因素的验证导致平均 AUC 为 0.69，风险评分显示分别有 28.8%和 3.4%的人存在中危和高危 LTFU 风险。