Prognostic value of cross-sectional anthropometric indices on short-term risk of mortality in human immunodeficiency virus-infected adults in Abidjan, Cote d'Ivoire

In sub-Saharan Africa where weight loss is very difficult to estimate, cros s-sectional anthropometric indicators could be useful to predict human immu nodeficiency virus (HIV)-associated mortality. The study objective was to l ook for threshold values of baseline body mass index, arm muscle circumfere nce, and fat mass to predict the risk of death in HIV-infected adults inclu ded in a 1996-1998 trial of early cotrimoxazole chemoprophylaxis in Abidjan , Cote d'Ivoire (COTRIMO-CI-ANRS 059 trial). The authors graphically determ ined if consecutive anthropometric categories with the closest hazards rati os of the risk of death could be clustered to obtain a unique threshold tha t distinctly separated two categories. When the threshold values were deter mined, the authors estimated the hazards ratio of mortality of this two-cat egory model. A significant increase of mortality was observed for a body ma ss index of less than or equal to 20.3 in men (hazards ratio = 2.6; 95% con fidence interval (CI): 1.4, 5.0) and of less than or equal to 18.5 in women (hazards ratio = 2.2; 95% CI: 1.05, 4.5) and for a fat mass of less than o r equal to6% in men (hazards ratio = 4.6; 95% CI: 2.3, 9.4) and of less tha n or equal to 18% in women (hazards ratio = 2.4; 95% CI: 1.2, 4.9). No simp le threshold could be identified for arm muscle circumference. in Cote d'Iv oire where chemoprophylaxis of opportunistic infections has recently been r ecommended to be widely initiated on clinical criteria, such thresholds may help to screen patients with higher risks of mortality.