Objective To establish and verify a nomogram for accurately predicting the mortality risk of human immunodeficency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients receiving antiretroviral therapy (ART).
Methods From China Information System for AIDS Prevention and Control, we extracted the data on HIV/AIDS patients registered during the period from 2006 through 2019 in Xinjiang Uygur Autonomous Region. Univariate and multivariate Cox proportional hazard regression analysis were carried out for the data on 3 272 HIV/AIDS patients of modeling group to determine the factors to be included in the nomogram. The area under the receiver-operating characteristics curve (AUC-ROC) and calibration curve were adopted to assess the prediction accuracy of the established nomogram for the data of modeling group and verifying group (1 636 HIV/AIDS patients). Decision curve analysis (DCA), x-tile analysis and Kaplan-Meier curve were used to evaluate the clinical utility of the established nomogram.
Results Based on the results of multivariate Cox proportional hazard regression analysis, the established nomogram model included following independent factors for predicting the prognosis of HIV/AIDS patients with ART: hemoglobin, body mass index, gender, aspartate aminotransferase, disease staging according to criterions proposed by World Health Organization, delay time between HIV infection and ART, and CD4 cell count. The AUC-ROC of the established nomogram is 0.781 (95% confidence interval 95% CI: 0.703 – 0.861) for the modeling group and that for the verification group is 0.829 (95% CI: 0.758 – 0.896). The calibration curve for the survival of the patients during the 3-year period demonstrated a good consistency between the survival rate predicted by the nomogram and that observed actually. The survival rate was predicted based on the established nomogram for the patients at different (low, moderate and high) risk of mortality assessed according to nomogram scoring resulted from the analysis.
Conclusion The study established a nomogram which could provide accurate and meaningful predictions for the survival of the HIV/AIDS patients with antiretroviral therapy.
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