14th Annual Conference of the British HIV Association 23-25 April 2008, Belfast

ASSOCIATION BETWEEN ADVERSE EVENTS AND MORTALITY: A VALIDATION ANALYSIS

HIV Med 2008 Apr 23-25 (Suppl 1);14:8 (abstract no. O30)

C Sabin¹, L Bansi¹, M Nelson² and C Leen³, UK CHIC Steering Committee^1
1 Royal Free and University College Medical School, London, UK, ² Chelsea and Westminster Foundation Trust, London, UK, ³ Western General, NHS Lothian, Edinburgh, UK

BACKGROUND: Recent published findings indicate that patients with laboratory abnormalities are at increased risk of mortality. However, these results were based on cross-sectional analyses and did not take account of the fact that toxicities may change in an individual over time. Using data from the UK CHIC Study, we wished to validate these analyses using time-updated laboratory scores.

METHODS: Abnormal values of toxicity markers (haemoglobin, lactate, amylase, creatinine, urate, ALT, AST, bilirubin) were scored according to severity using the Table for Grading Severity of Adult Adverse Experiences. Rates of mortality, stratified by laboratory scores (1 = mild, 2 = moderate, 3 = severe, 4 = serious) were calculated and Poisson regression (adjusted for demographics, CD4 counts, viral loads, HBV/HCV status, HAART regimen and year at start of HAART) was used to identify independent factors associated with mortality.

RESULTS: Ten thousand nine hundred and ninty three patients contributed a total of 39891 person-years (p-yrs) to the analyses. Patients were mostly male (n=8690 (79%)), of white ethnicity (7376 (67%)) and MSM exposure group (6804 (62%)). Patients mainly started HAART with an NNRTI regimen (6119 (56%)) at a median CD4 count and viral load of 228 cells/mm³ and 28,500 copies/mL. Overall, there were 763 deaths, resulting in a crude death rate of 1.9/100 p-yrs. Death rates (95% CI) for laboratory scores 0, 1, 2, 3, >4 were 1.2 (1.0, 1.3), 1.3 (1.1, 1.5), 2.7 (2.3, 3.1), 5.6 (4.5, 6.6) and 15.1 (12.1, 18.2) respectively. In multivariable analyses, laboratory abnormality score was independently associated with mortality (RR = 1.54 (95% CI 1.46, 1.61)).

CONCLUSIONS: In line with recently published findings, we found that patients with laboratory abnormalities were at increased risk of mortality over the short-term.

2008-04-23
O30

Copyright © 2008 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD