External validation of the Dat’AIDS score: A risk score for predicting 5-year overall mortality in people living with HIV aged 60 years or older. HIV Medicine
Hentzien et al. aimed to externally validate the Dat’AIDS score’s capacity to predict 5-yearoverall mortality in people with HIV (PWH) aged 60 or older, using data from the Swiss HIV Cohort Study (SHCS).
The Dat’AIDS score comprises the following predictors: age, CD4 cell count, non-HIV related cancer, cardiovascular disease, estimated glomerular filtration rate (eGFR), cirrhosis, low body mass index (BMI) and anaemia. The Dat’AIDS score ranges from 0 to a maximal value of 73. During derivation, the range was divided into four risk groups: low-risk (0–3 points); moderate risk (4–13 points); high-risk (14–19 points); and very high-risk (≥ 20 points).
The authors calculated the Dat’AIDS score in PWH at their first visit between 1 January 2015 and 1 January 2020. The primary endpoint was all-cause mortality.
They included 2’205 participants (82% male) of median [interquartilerange (IQR)] age 62.0 (60.3–67.0) years, mostly with viraemia <50 copies/mL(92.7%). Median follow-up time was 15.9 years and median (IQR) CD4 cell count at enrolment was 586 (420–782) cells/μL. In all, 152 deaths were recorded during a total follow-up period of 7147 patient-years. The median (IQR) observed Dat’AIDS score was 3 (0–8). Discriminative capacities were good as the C-statistic was 0.73 (95% CI: 0.69–0.77) and consistent across all subgroups. Comparison of observed and expected survival probabilities showed good calibration.
In conclusion, this study demonstrates the external validity of the Dat’AIDS score in patients included in the SHCS aged 60 years or more in the late cART era. The score showed a good discrimination capacity as well as good calibration. It may be a useful tool for research, as well as for risk assessment by clinicians, especially as the population of aged PWH is becoming increasingly.