Table 2.
Independent Predictors of Mortality in the First 48 Weeks on Antiretroviral Therapy Initiated With CD4 Count <100 Cells/µL
| Factor | Univariable Effects of Factors Selected for Multivariable Model in REALITY Trial Participants | Final Multivariable Model in REALITY Trial Participants | Multivariable Model From Bisson et al [10], Fitted to REALITY Trial Participants | ||||||
|---|---|---|---|---|---|---|---|---|---|
| HR | (95% CI) | P Value | HR | (95% CI) | P Value | HR | (95% CI) | P Value | |
| Age (per 5 y older) | 1.09 | (1.03–1.16) | .005 | 1.12 | (1.04–1.20) | .002 | 1.13 | (1.06–1.21) | <.001 |
| CD4 (per 10 cells/µL higher) | 0.89 | (.85–.94) | <.001 | 0.90 | (.85–.95) | <.001 | 0.87 | (.82–.92) | <.001 |
| Hemoglobin (per g/dL higher) | 0.77 | (.72–.82) | <.001 | 0.90 | (.83–.99) | .01 | 0.87 | (.80–.94) | <.001 |
| Albumin (per g/L higher) | 0.92 | (.90–.93) | <.001 | 0.96 | (.94–.98) | .001 | 0.94 | (.92–.97) | <.001 |
| WBC count (per 109/L higher) | 1.17 | (1.08–1.26) | <.001 | 1.08 | (1.00–1.17) | .054 | 1.16 | (1.06–1.25) | .001 |
| Grip strength (per kg higher) | 0.93 | (.91–.95) | <.001 | 0.98 | (.96–1.00) | .03 | … | ||
| Previous healthcare contact | 1.16 | (.75–1.79) | .50 | 0.63 | (.39–1.03) | .067 | … | ||
| WHO stage 3/4 weight loss | 1.90 | (1.42–2.53) | <.001 | 1.43 | (1.01–2.03) | .04 | … | ||
| Patient-reported fever | 3.37 | (2.54–4.47) | <.001 | 1.67 | (1.19–2.35) | .003 | … | ||
| Patient-reported vomiting | 3.72 | (2.64–5.26) | <.001 | 1.55 | (1.00–2.39) | .048 | … | ||
| EQ-5D Mobility: some problems vs no problems | 4.42 | (3.36–5.81) | <.001 | 1.88 | (1.21–2.93) | .005 | … | ||
| Confined to bed vs no problems | 11.87 | (7.00–20.12) | <.001 | 2.47 | (1.00–6.08) | .050 | … | ||
| EQ-5D Self-care: some problems vs no problems | 3.73 | (2.78–5.02) | <.001 | 1.32 | (.82–2.13) | .26 | … | ||
| Unable to wash/dress vs no problems | 8.59 | (5.91–12.47) | <.001 | 2.78 | (1.42–5.43) | .003 | … | ||
| Enhanced prophylaxis | 0.75 | (.57–.97) | .03 | 0.72 | (.54–.96) | .02 | … | ||
| Sex (female vs male) | 1.23 | (.95–1.60) | .12 | … | 1.19 | (.89–1.60) | .23 | ||
| BMI <18.5 vs >25 kg/m2 | 2.41 | (1.30–4.48) | .005 | … | 0.90 | (.52–1.55) | .70 | ||
| BMI 18.5–25 vs >25 kg/m2 | 1.38 | (.74–2.58) | .32 | … | 0.70 | (.41–1.19) | .19 | ||
| HIV VL (per log10 higher) | 1.52 | (1.22–1.89) | <.001 | … | 1.37 | (1.09–1.74) | .008 | ||
| Neutrophil % (per 5% higher) | 1.07 | (1.02–1.12) | .003 | … | 0.99 | (.95–1.04) | .64 | ||
Final multivariable model in REALITY trial participants also adjusted for center. Backwards elimination (exit P < .1) on factors in Table 1, refitting final model to all observations with complete data for chosen factors. Factors with P > .05 are included to adjust for confounding. All continuous factors were selected in final models with linear effects, ie, each unit increase had the same impact on mortality at all levels of the factor.
Abbreviations: BMI, body mass index; CI, confidence interval; EQ-5D, EuroQol 5 Dimensions (score); HIV, human immunodeficiency virus; HR, hazard ratio; REALITY, Reduction in EArly MortaLITY (trial); VL, viral load; WBC, white blood cell; WHO, World Health Organization.