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The Pediatric AIDS Severity Score (PASS): a multidimensional AIDS-severity adjustment for pediatric HIV infection.
Seage, George R; Buchacz, Kate; Weinberg, Geoffrey A; Patel, Kunjal; McIntosh, Kenneth; Dankner, Wayne M.
Afiliação
  • Seage GR; Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. gseage@hsph.harvard.edu
J Acquir Immune Defic Syndr ; 43(5): 603-10, 2006 Dec 15.
Article em En | MEDLINE | ID: mdl-17003692
ABSTRACT

BACKGROUND:

A severity staging system predictive of mortality for perinatally HIV-infected children is needed for clinical and research purposes.

METHODS:

A pediatric AIDS severity score (PASS) was developed using baseline sociodemographic, clinical, immunologic, and functional measures obtained from 786 perinatally HIV-infected children enrolled into a prospective cohort study (PACTG 219) in the pre-highly active antiretroviral therapy (HAART) era (pre-1996). PASS was then validated among 392 perinatally HIV-infected children randomly sampled from the original source population (n = 1178). Survival estimates and hazard ratios (HRs) were obtained using the Kaplan-Meier method and proportional hazards models, respectively. The most predictive models were determined using Harrell's "C" statistic.

RESULTS:

Overall survival was 95% and 90% at 1 and 2 years of follow-up, respectively. The most comprehensive model for predicting mortality, termed the "Full" PASS, included CD4% <15 (HR = 3.9), CDC category C (HR = 2.6), BMI <10% (HR = 2.4), a low (<70) neuropsychological score (HR = 2.6), a general health rating <5 (HR = 2.4), and an elevated symptoms score (HR = 1.9). These determinants were highly predictive of mortality (C statistic = 0.841).

CONCLUSIONS:

PASS will be helpful in assessing the effectiveness of ART among children with HIV infection, particularly when randomized clinical trials are not possible due to ethical and feasibility concerns.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Índice de Gravidade de Doença / Síndrome da Imunodeficiência Adquirida Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Ethics Limite: Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Acquir Immune Defic Syndr Assunto da revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Ano de publicação: 2006 Tipo de documento: Article País de afiliação: Estados Unidos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Índice de Gravidade de Doença / Síndrome da Imunodeficiência Adquirida Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Ethics Limite: Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Acquir Immune Defic Syndr Assunto da revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Ano de publicação: 2006 Tipo de documento: Article País de afiliação: Estados Unidos