cliot (version 1.0.0)

vacs_2_0_index: Veterans Aging Cohort Study (VACS) 2.0 Index

Description

Calculates the VACS Index 2.0 score to estimate the risk of 5-year all-cause mortality in patients with HIV. This updated model incorporates additional variables (albumin, WBC, BMI) and uses continuous functions for laboratory values to improve predictive accuracy over the original VACS Index 1.0.

Usage

vacs_2_0_index(age, cd4_count, hiv_rna, hemoglobin, fib4_index, egfr,
               hepatitis_c_positive, albumin, wbc_count, bmi,
               sex = "male", race = "other")

Value

A list containing:

VACS_2_0_Index

The calculated risk score (higher scores indicate greater mortality risk).

Est_5_Year_Mortality

Estimated probability of 5-year all-cause mortality.

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).

fib4_index

Numeric. FIB-4 Index for Liver Fibrosis.

egfr

Numeric. Estimated Glomerular Filtration Rate (mL/min/1.73m^2).

hepatitis_c_positive

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

albumin

Numeric. Serum Albumin level (g/dL).

wbc_count

Numeric. White Blood Cell count (x10^3/uL).

bmi

Numeric. Body Mass Index (kg/m^2).

sex

String. Patient sex ("male" or "female"). (Not explicitly weighted in published general model but typically collected).

race

String. Patient race ("black", "other"). (Not explicitly weighted in published general model but typically collected).

References

Tate JP, et al. An internationally generalizable risk index for mortality after one year of antiretroviral therapy. AIDS. 2013;27(4):563-572. Justice AC, et al. A prognostic index for HIV-associated mortality.

Examples

# Example 1: Low Risk
# 40yo, CD4 600, VL 50, Hgb 15, FIB4 1.0, eGFR 100, HCV-, Alb 4.2, WBC 6.0, BMI 26
vacs_2_0_index(40, 600, 50, 15, 1.0, 100, 0, 4.2, 6.0, 26)

# Example 2: High Risk
# 60yo, CD4 200, VL 50000, Hgb 11, FIB4 3.5, eGFR 45, HCV+, Alb 3.0, WBC 4.0, BMI 22
vacs_2_0_index(60, 200, 50000, 11, 3.5, 45, 1, 3.0, 4.0, 22)