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

Author:

Palacio-Vieira Jorge123ORCID,Díaz Yesika123,Moreno-Fornés Sergio123,Bruguera Andreu123,Nomah Daniel K.13,Llibre Josep M.4,Knobel Hernando5,Chivite Iván6,Miró José M.67,Suanzes Paula8,Fanjul Francisco9,Navarro Gemma10,Macorigh Lizza11,Homar Borràs Francesc12,Vilaró López Ingrid13,Orti Llaveria Amat Joaquim14,Casabona Jordi123,Imaz Arkaitz15,Reyes-Urueña Juliana123,

Affiliation:

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

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

3. Institut d'Investigació Germans Trias i Pujol (IGTP), Barcelona, Spain

4. Hospital Universitari Germans Trias i Pujol, Badalona, Spain

5. Hospital del Mar, Barcelona, Spain

6. Hospital Clínic-Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain

7. CIBERINFEC. Instituto de Salud Carlos III, Madrid, Spain

8. Hospital de la Vall d'Hebron, Barcelona, Spain

9. Hospital Son Espases, Palma de Mallorca, Spain

10. Hospital Parc Taulí, Sabadell, Spain

11. Hospital de Granollers, Granollers, Spain

12. Hospital Son Llàtzer, Palma, Spain

13. Hospital Universitari de Vic, Barcelona, Spain

14. Hospital Verge de la Cinta, Tarragona, Spain

15. Department of Infectious Diseases, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain

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.

Funder

“la Caixa” Banking Foundation

La Marató de TV3 Foundation

Institut d’Investigacions Biomèdiques August Pi i Sunyer

Publisher

SAGE Publications

Reference48 articles.

1. UNAIDS. Fast-track: ending the AIDS epidemic by 2030, https://www.unaids.org/sites/default/files/media_asset/JC2686_WAD2014report_en.pdf (2014).

2. UNAIDS. Global HIV statistics, Fact sheet, https://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf (2021).

3. Características clinicoepidemiológicas y tendencias en el tratamiento antirretroviral de una cohorte de pacientes con infección por el virus de la inmunodeficiencia humana. Cohorte PISCIS

4. Missed Visits and Mortality among Patients Establishing Initial Outpatient HIV Treatment

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