AIDS Weekly Plus
New Research on HIV/AIDS from National Institutes of Health Summarized
Staff Writer
October 1, 2012


2012 OCT 1 (NewsRx) -- By a News Reporter-Staff News Editor at AIDS Weekly -- Data detailed on Immune System Diseases and Conditions have been presented. According to news reporting originating from Bethesda, Maryland, by NewsRx correspondents, research stated, "To evaluate the change in categories of risk of death by adding D-dimer to conventional mortality risk factors. Cohort study. Data on HIV-infected participants receiving standard combination antiretroviral therapy in two clinical trials (Evaluation of Subcutaneous Proleukin in a Randomized International Trial and Strategic Management of antiretroviral therapy), who had baseline D-dimer measured, were randomly split into two equal training and a validation clatasets."

Our news editors obtained a quote from the research from the National Institutes of Health, "A multivariable survival model was built using the training dataset and included only conventional mortality risk factors measured at baseline. D-dimer was added to create the comparison model. The level of reclassification of mortality risk, for those with at least 5-years of follow-up, was then assessed by tabulating mortality risk defined as low (<= 2% predicted rate), moderate (2-5%) or high (>5%). Reclassification analyses were then repeated on the validation dataset. The analysis population at baseline had a mean age of 43 years, median CD4(+) cell count of 535 cells/mu l (IQR: 420-712), and 83% had HIV RNA of at least 500 copies/ml. In the training dataset (n = 1946, 8939 person-years), there were 83 deaths at a rate of 0.93 per 100 person-years. Addition of D-dimer to the reference model resulted in 6% or fewer (P > 0.05) being correctly reassigned, either up or down, to a new risk category, in both, training and validation clatasets. The integrated discrimination improvement in training and validation datasets was 0.60% (P = 0.084) and 0.45% (P = 0.168), respectively. In this relatively well population, at the given risk cutoffs, D-dimer appeared to only modestly improve the discernment of risk."

According to the news editors, the researchers concluded: "Risk reclassification provides a method for assessing the clinical utility of biomarkers in HIV cohort studies."

For more information on this research see: Reclassification of risk of death with the knowledge of D-dimer in a cohort of treated HIV-infected individuals. Aids, 2012;26(13):1707-1717. Aids can be contacted at: Lippincott Williams & Wilkins, 530 Walnut St, Philadelphia, PA 19106-3621, USA. (Lippincott Williams and Wilkins - www.lww.com; Aids - journals.lww.com/aidsonline/pages/default.aspx)

The news editors report that additional information may be obtained by contacting A.C. Achhra, National Institutes of Health, Dept. of Crit Care Med, National Institutes of Health Clin Center, Bethesda, MD 20892, United States (see also Immune System Diseases and Conditions).

Keywords for this news article include: Bethesda, Maryland, HIV/AIDS, RNA Viruses, Retroviridae, United States, HIV Infections, Vertebrate Viruses, Primate Lentiviruses, North and Central America, Viral Sexually Transmitted Diseases, Immune System Diseases and Conditions

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