Serum albumin is a powerful predictor of survival among HIV-1-infected women

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

Research output: Contribution to journalArticlepeer-review

52 Scopus citations


Background: We previously reported that single measurements of albumin strongly predict survival in HIV-1-infected women independent of disease-specific markers. We now extend this to the use of serial measurements and single albumin values prior to initiation of highly active antiretroviral therapy. Design: Prospective cohort study of 1941 women enrolled at six sites in the Women's Interagency HIV Study. Results: Albumin fell 0.44 g/L/y in 1627 women who survived and at a faster rate in 397 who died (1.54 g/L/y; p < .01). In a time-dependent model adjusting for disease markers, the relative hazard (RH) was fivefold higher in patients with serum albumin <35 g/L compared with patients with serum albumin ≥42 g/L. The RH of serum albumin <35 g/L in women with CD4+ lymphocyte counts ≥200 cells/μL was 8.2 [95% CI: 4.2-15.8]) versus only 3.8 [95% CI: 2.4-6.1] in those with counts <200 cells/mm3. In a fixed-covariate Cox analysis of patients who started HAART during the study, albumin prior to HAART was associated with a higher RH (7.0 for albumin <35 g/L versus >42 g/L) than were other factors. Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)66-73
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number1
StatePublished - May 1 2003


  • HIV trends in serum albumin
  • Independent predictor of survival
  • Time-dependent model

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)


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