cliot (version 1.0.0)

vacs_1_0_index: Veterans Aging Cohort Study (VACS) 1.0 Index

Description

Calculates the VACS Index 1.0 score to estimate the risk of all-cause mortality in patients with HIV. The score integrates age, HIV-specific biomarkers (CD4, Viral Load), and general organ system injury markers (Hemoglobin, FIB-4 for liver fibrosis, eGFR for renal function, and Hepatitis C status).

Usage

vacs_1_0_index(age, cd4_count, hiv_rna, hemoglobin, platelets, ast, alt,
               creatinine, hepatitis_c_positive, sex = "male", race = "other")

Value

A list containing:

VACS_Index_Score

The calculated total score (Range 0 to ~164).

Calculated_Values

Derived FIB-4 and eGFR values used in the score.

Arguments

age

Numeric. Patient age in years.

cd4_count

Numeric. CD4 T-cell count (cells/mm^3).

hiv_rna

Numeric. HIV-1 RNA viral load (copies/mL).

hemoglobin

Numeric. Hemoglobin level (g/dL).

platelets

Numeric. Platelet count (x10^3/uL or x10^9/L).

ast

Numeric. Aspartate Aminotransferase (AST) level (U/L).

alt

Numeric. Alanine Aminotransferase (ALT) level (U/L).

creatinine

Numeric. Serum Creatinine level (mg/dL).

hepatitis_c_positive

Numeric (0 or 1). Hepatitis C virus (HCV) status (1 = Positive).

sex

String. Patient sex ("male" or "female"). Used for eGFR calculation.

race

String. Patient race ("black", "african american", "other"). Used for eGFR calculation (MDRD).

References

Justice AC, Modur SP, Tate JP, et al. Predictive accuracy of the Veterans Aging Cohort Study (VACS) Index for mortality with HIV infection: a North American cross cohort analysis. J Acquir Immune Defic Syndr. 2013;62(2):149-163. doi:10.1097/QAI.0b013e31827df36c

Examples

# Example 1: Low Risk
# 40yo, CD4 600, VL <500, Hgb 15, Plt 250, AST 20, ALT 20, Cr 0.9, HCV-
vacs_1_0_index(40, 600, 400, 15, 250, 20, 20, 0.9, 0)

# Example 2: High Risk
# 55yo (+12), CD4 150 (+10), VL 50k (+7), Hgb 11 (+22), FIB-4 >3.25 (+25), eGFR <30 (+26), HCV+ (+5)
# Approx calculation: 55y, CD4 150, VL 50000, Hgb 11, Plt 100, AST 100, ALT 40, Cr 3.0, HCV+
vacs_1_0_index(55, 150, 50000, 11, 100, 100, 40, 3.0, 1, "male", "black")