Serum Albumin Is a Powerful Predictor of Survival Among HIV-1–Infected Women

Feldman, Joseph; Gange, Stephen J.; Bacchetti, Peter; Cohen, Mardge H.; Young, Mary; Squires, Katheleen E.; Williams, Carolyn; Goldwasser, Philip; Anastos, Kathryn

doi:10.1097/00126334-200305010-00010

Cited by 65 publications

(59 citation statements)

References 29 publications

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“…The difference between the groups was statistically significant. Although no correlation was observed between albumin after 6 months and baseline CD4 count in our study, other investigators have observed a positive correlation between albumin and CD4 in HIV patients initiating ARV [32,34,36,37]. The fact that these patients were initiating ARV, indirectly indicate that they were at an advanced stage of the infection (i.e., CD4 counts below 350 cells/µl).…”

Section: Discussioncontrasting

confidence: 75%

Effects of nutritional education and lifestyle modification on the nutritional status of HIV positive patients: results of a cluster randomized intervention over a period of six months

Nkengfack¹,

Torimiro²,

Ngogang³

et al. 2013

Glob Epidemi Obes

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Background: Effective strategies to improve nutritional status exist, though short-termed and less sustainable for HIV patients in resource limited settings. The aim of this study was to describe the BMI of treatment naïve HIV patients in Yaoundé, Cameroon, and investigate the effects of nutritional education and lifestyle modification on the nutritional status of these patients. Method: A cluster randomized trial was conducted between 2010 and 2012, and included 5 health facilities, randomized either to the intervention (HIV-Care-Program) or control group (usual care). The HIV-Care-Program consisted of counselling lessons for 6 months on: nutrition, hygiene and coping with stigma and discrimination, complemented by practical activities. Primary outcome variable were change in BMI and serum albumin after 6 months, using analysis of covariance. BMI was calculated from weight (kg) and height (m

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Section: Discussioncontrasting

confidence: 75%

Effects of nutritional education and lifestyle modification on the nutritional status of HIV positive patients: results of a cluster randomized intervention over a period of six months

Nkengfack¹,

Torimiro²,

Ngogang³

et al. 2013

Glob Epidemi Obes

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“…The same group went on to study serial albumin measurements prior to HAART initiation and concluded that albumin was a strong independent predictor of mortality, particularly in the short term [25]. The association between albumin and progression to AIDS was not investigated in this study as the number of AIDS events was small.…”

Section: Discussionmentioning

confidence: 98%

Haemoglobin and albumin as markers of HIV disease progression in the highly active antiretrovial therapy era: relationships with gender^*

et al. 2007

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The aims of the study were to describe gender differences in haemoglobin and albumin and to investigate the prognostic value of these measurements in relation to highly active antiretroviral therapy (HAART). MethodsAnaemia was defined as haemoglobin o13.5 g/dL for men and o11.5 g/dL for women. Albumin o35 g/L was defined as hypoalbuminaemia. Proportional hazards models were used to describe relationships between these markers and HIV progression and death. ResultsA total of 291 patients had pre-HAART and 1-year measurements. Mean haemoglobin and albumin levels pre-HAART were lower in women than in men (haemoglobin: 11.2 vs 13.2 g/dL, respectively, Po0.0001; albumin: 37.4 vs 40.2 g/L, respectively, Po0.0001), and a higher proportion of women were anaemic and hypoalbuminaemic compared with men. Despite a rise in both markers in the first year on HAART, mean haemoglobin levels remained lower by 2.08 g/dL (Po0.0001) and albumin by 2.88 g/L (Po0.0001) in women. In the 495 patients included in this analysis, haemoglobin and albumin levels were both significantly related to short-term risk of AIDS and death independently of CD4 count [hazards ratio (HR) 5 0.73/g/dL higher haemoglobin, 95% confidence interval (CI) 0.55-0.82, Po0.0001 and HR 5 0.87/g/L higher albumin, 95% CI 0.83-0.91, Po0.0001]. The prognostic value did not differ by gender. ConclusionsWomen were more likely to be anaemic and/or hypoalbuminaemic pre-HAART, but post-HAART increases were similar to those in men. Both haemoglobin and albumin were strong independent prognostic factors for risk of AIDS and death, regardless of gender.Keywords: albumin, disease progression, gender, haemoglobin, highly active antiretroviral therapy Received: 23 February 2006, accepted 18 September 2006 IntroductionThe management of patients with HIV-1 infection is dependent on the use of markers of disease progression such as the CD4 count and HIV-1 RNA concentration [1,2]. While these remain the main markers in clinical use, they do not fully explain an individual's prognosis [3]. In addition, their measurement requires sophisticated and often expensive laboratory equipment [4,5]. Additional markers of disease progression are therefore required, particularly in resource-poor settings.Many alternative markers have been proposed, including total lymphocyte count, white blood cell count, packed cell *This work has previously been presented as Abstracts at the 10th Anniversary Conference of the British HIV Association (BHIVA), Cardiff, UK, 15-17 April 2004 (The effect of gender on haemoglobin as a marker of HIV disease progression in the HAART era) and at the 3rd International AIDS Society (IAS) conference on HIV pathogenesis and treatment, Rio de Janeiro, Brazil, 24-27 July 2005 (Albumin as a marker of HIV disease progression and prognosis in women and men following initiation of HAART). [4,5,[7][8][9][10][11][12][13][14][15][16][17]. Anaemia is frequently experienced by HIV-positive individuals and has been shown to be a strong independent predictor of disease progression [8,...

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“…Different hypotheses have been proposed to explain the low levels of albumin seen in HIV infection [15]. Some studies have demonstrated that HIV co-infection with HCV accelerates the progression of liver disease while other studies have found albumin to be a significant predictor of HIV disease progression even among those not infected with HCV [16]. It is also possible that low that low albumin levels may reflect the effects of anorexia, poor nutritional status or chronic inflammation (albumin is a negative acute phase reactive protein whose levels can possibly be depressed by elevated levels of TNF and IL-1 during chronic inflammation) [15].…”

Section: Discussionmentioning

confidence: 99%

Levels of Immunoglobulin Classes Are Not Associated with Severity of HIV Infection in Nigerian Patients

Akinpelu¹,

Aken'Ova²,

Arinola³

2012

WJA

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The serum concentrations of immunoglobulin G (IgG), immunoglobulin A (IgA), immunoglobulin M (IgM), total protein and albumin were measured in 35 Human Immunodeficiency Virus-positive, HAART (highly active antiretroviral therapy) naïve subjects attending the PEPFAR (President's Emergency Plan for AIDS relief) clinic, University College Hospital, Ibadan and in 30 apparently healthy control subjects to assess the relationship between serum protein, immunoglobulin concentrations and laboratory indices of HIV disease (CD4 cell counts and viral load). Serum IgG (1008.6 ± 530.7 mg/dL), IgA (170.4 ± 69 mg/dL) and total protein (9.9 ± 1.7 g/dL) levels were higher among HIV positive subjects compared with mean values in healthy subjects (549.8 ± 193.8 mg/dL, 106.8 ± 26.4 mg/dL and 7.8 ± 0.5 g/dL respectively). The median serum IgM concentration (131 mg/dl) was significantly higher in HIV positive subjects compared with 35 mg/dL in healthy controls (p < 0.001). Mean serum albumin concentration was significantly lower among HIV positive subjects (3.7 ± 0.7 g/dL), compared with 4.3 ± 0.3 g/dL in healthy subjects (p < 0.001). There were no significant differences observed in the levels of the immunoglobulin classes when HIV subjects with CD4 counts of <200 cell/µL were compared with subjects with CD4 counts > 200 cells/µL. There was also no statistically significant correlation observed between viral load and serum immunoglobulin levels.

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Serum Albumin Is a Powerful Predictor of Survival Among HIV-1–Infected Women

Abstract: Serum albumin is a strong independent predictor of mortality in HIV-1-infected women after adjustment for known disease markers and may be useful for clinical monitoring.

Cited by 65 publications

References 29 publications

Effects of nutritional education and lifestyle modification on the nutritional status of HIV positive patients: results of a cluster randomized intervention over a period of six months

Effects of nutritional education and lifestyle modification on the nutritional status of HIV positive patients: results of a cluster randomized intervention over a period of six months

Haemoglobin and albumin as markers of HIV disease progression in the highly active antiretrovial therapy era: relationships with gender^*

Levels of Immunoglobulin Classes Are Not Associated with Severity of HIV Infection in Nigerian Patients

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Serum Albumin Is a Powerful Predictor of Survival Among HIV-1–Infected Women

Abstract: Serum albumin is a strong independent predictor of mortality in HIV-1-infected women after adjustment for known disease markers and may be useful for clinical monitoring.

Cited by 65 publications

References 29 publications

Effects of nutritional education and lifestyle modification on the nutritional status of HIV positive patients: results of a cluster randomized intervention over a period of six months

Effects of nutritional education and lifestyle modification on the nutritional status of HIV positive patients: results of a cluster randomized intervention over a period of six months

Haemoglobin and albumin as markers of HIV disease progression in the highly active antiretrovial therapy era: relationships with gender*

Levels of Immunoglobulin Classes Are Not Associated with Severity of HIV Infection in Nigerian Patients

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Haemoglobin and albumin as markers of HIV disease progression in the highly active antiretrovial therapy era: relationships with gender^*