American Journal of Epidemiology Vol. 154, No. 1 : 75-84
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Prognostic Value of Cross-sectional Anthropometric Indices on Short-term Risk of Mortality in Human Immunodeficiency Virus-infected Adults in Abidjan, Côte d'Ivoire
1 INSERM U.330, Université Victor Segalen Bordeaux 2, Bordeaux, France.
2 Centre IRD de Petit-Bassam, Abidjan, Côte d'Ivoire.
3 Programme PAC-CI, Abidjan, Côte d'Ivoire.
4 Centre de Diagnostic et de Recherche sur le SIDA et les Infections Opportunistes, CHU de Treichville, Abidjan, Côte d'Ivoire.
5 Service de Gastro-Entérologie, CHU de Yopougon, Abidjan, Côte d'Ivoire.
6 Centre René Labusquière, Université Victor Segalen Bordeaux 2, Bordeaux, France.
In sub-Saharan Africa where weight loss is very difficult to estimate, cross-sectional anthropometric indicators could be useful to predict human immunodeficiency virus (HIV)-associated mortality. The study objective was to look for threshold values of baseline body mass index, arm muscle circumference, and fat mass to predict the risk of death in HIV-infected adults included in a 1996–1998 trial of early cotrimoxazole chemoprophylaxis in Abidjan, Côte d'Ivoire (COTRIMO-CI–ANRS 059 trial). The authors graphically determined if consecutive anthropometric categories with the closest hazards ratios of the risk of death could be clustered to obtain a unique threshold that distinctly separated two categories. When the threshold values were determined, the authors estimated the hazards ratio of mortality of this two-category model. A significant increase of mortality was observed for a body mass index of 
20.3 in men (hazards ratio = 2.6; 95% confidence interval (CI): 1.4, 5.0) and of 18.5 in women (hazards ratio = 2.2; 95% CI: 1.05, 4.5) and for a fat mass of 6% in men (hazards ratio = 4.6; 95% CI: 2.3, 9.4) and of 18% in women (hazards ratio = 2.4; 95% CI: 1.2, 4.9). No simple threshold could be identified for arm muscle circumference. In Côte d'Ivoire where chemoprophylaxis of opportunistic infections has recently been recommended to be widely initiated on clinical criteria, such thresholds may help to screen patients with higher risks of mortality.
body mass index; HIV infections; survival; weight loss
Abbreviations: CI, confidence interval; COTRIMO-CI, cotrimoxazole chemoprophylaxis in Abidjan, Côte d'Ivoire; HIV, human immunodeficiency virus; HIV+, HIV infected.