Incomplete immune reconstitution and its predictors in people living with HIV in Wuhan, China

Abstract

Objective This study aimed to build and validate a nomogram model to predict the risk of incomplete immune reconstitution in people living with HIV (PLWH).Methods Totally 3783 individuals with a confirmed diagnosis of HIV/AIDS were included. A predictive model was developed based on a retrospective set (N = 2678) and was validated using the remaining cases (N = 1105). Univariable and multivariable logistic regression analyses were performed to determine valuable predictors among the collected clinical and laboratory variables. The predictive model was presented as a nomogram, and internally validated using another independent dataset. The predictive value of the model was evaluated by determining the area under the curve (AUC). Besides, calibration curve and decision curve (DCA) analyses were performed in both the training and test sets.Results The final model comprised 5 predictors, including baseline CD4, age at ART initiation, BMI, HZ and TBIL. The AUC of the nomogram model was 0.902 in the training cohort, versus 0.926 in the validation cohort. The calibration accuracy and diagnostic performance were satisfactory in both the training and test sets.Conclusions This predictive model based on a retrospective study was internally validated using 5 readily available clinical indicators. It showed high performance in predicting the risk of incomplete immune reconstitution.