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Serum Albumin as a Prognostic Marker for Serious Non-AIDS Endpoints in the Strategic Timing of Antiretroviral Treatment (START) Study

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  1. Pulmonary Arterial Enlargement in Well-Treated Persons With Human Immunodeficiency Virus

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. A Systematic Review of Clinical Practice Guidelines for the Diagnosis and Management of Bronchiolitis

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Biomarkers for Disease Severity in Children Infected With Respiratory Syncytial Virus: A Systematic Literature Review

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Andreas Ronit
  • Shweta Sharma
  • Jason V Baker
  • Rosie Mngqibisa
  • Tristan Delory
  • Luis Caldeira
  • Nicaise Ndembi
  • Jens D Lundgren
  • Andrew N Phillips
  • International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) Strategic Timing of Antiretroviral Treatment (START) Study Group
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Background: Serum albumin may be used to stratify human immunodeficiency virus (HIV)-infected persons with high CD4 count according to their risk of serious non-AIDS endpoints.

Methods: Cox proportional hazards models were used to analyze the risk of serious non-AIDS events in the Strategic Timing of Antiretroviral Treatment (START) study (NCT00867048) with serum albumin as a fixed and time-updated predictor. Models with exclusion of events during initial follow-up years were built to assess the ability of serum albumin to predict beyond shorter periods of time. Secondarily, we considered hospitalizations and AIDS events.

Results: Among 4576 participants, 71 developed a serious non-AIDS event, 788 were hospitalized, and 63 experienced an AIDS event. After adjusting for a range of variables associated with hypoalbuminemia, higher baseline serum albumin (per 1 g/dL) was associated with a decreased risk of serious non-AIDS events (hazard ratio, 0.37 [95% confidence interval, .20-.71]; P = .002). Similar results were obtained in a time-updated model, after controlling for interleukin 6, and after excluding initial follow-up years. Serum albumin was independently associated with hospitalization but not with risk of AIDS.

Conclusions: A low serum albumin level is a predictor for short- and long-term serious non-AIDS events, and may be a useful marker of risk of noncommunicable diseases, particularly in resource-limited settings.

Original languageEnglish
JournalThe Journal of infectious diseases
Volume217
Issue number3
Pages (from-to)405-12
ISSN0022-1899
DOIs
Publication statusPublished - Jan 2018

    Research areas

  • Journal Article

ID: 52183719