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Even with the use of antiretroviral
therapy (ART), which can lead to viral suppression and reductions in
AIDS-related deaths, researchers maintain that people with HIV infection have a
higher mortality rate because chronic HIV infection intensifies age-related
organ system injury.
The Veterans Aging Cohort Study
(VACS) Index funded by the National Institutes of Health used older indices
that measured HIV biomarkers, including CD4 cell count, HIV-1 RNA levels, and
patient age, to ascertain mortality risk. The newer VACS Index uses other
critical factors, including the increasing role of multi-organ system injury
and hepatitis C infection as well as the decreasing role of other factors such
as CD4 count.
In a collaborative study by Yale
University, the VA Healthcare System, and the North American Cohort
Collaboration, the researchers compared the accuracy of the VACS Index with
that of the newer VACS. Data reviewed were from more than 5,000 veterans and
more than 10,000 non-veterans, representing 14 separate cohorts of HIV-infected
persons from around the country who had at least one year of ART. The
researchers followed up with patients for a little more than three years.
Researchers found the new VACS Index
was much more accurate and effective than the previous index, which used CD 4
count, HIV-1 RNA, and age. Dr. Amy Justice, professor of internal medicine at
Yale School of Medicine, stated that the VACS Index accurately estimated risk
of mortality among persons aging with HIV infection whether they live in Canada
or the United States. She also found that the index was accurate among men and
women, older or younger individuals, and white people or people of color. The
team has created an app for use by patients and their providers. It is
available at: http://www.vacs.med.yale.edu/.
The study, “Predictive Accuracy of
the Veterans Aging Cohort Study Index for Mortality with HIV Infection: A North
American Cross Cohort Analysis,” was published in the Journal of Acquired
Immune Deficiency Syndromes (2013; 62 (2):149–163).
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
TOGETHER WE REMAIN STRONG!
