The need for reappraisal of AIDS score weight of Charlson comorbidity index

Abstract

Objective To discuss the need for reappraisal of AIDS score weight of the Charlson comorbidity index. Study Design and Setting This article is a comment on Charlson comorbidity index. Results This article shows that the weight assigned for AIDS in the original cohort of Charlson score may be higher considering the dramatic improvement in the prognosis of such patients after the advent of highly active antiretroviral therapy. Only a few exceptions among HIV-related diseases are still strongly associated with high mortality rates within 1 year. This might lead to an inaccurate measurement of the impact of Charlson score on mortality rate, particularly in cohorts with high relative number of AIDS patients. Conclusion Charlson comorbidity index should be reassessed in cohorts with higher proportions of AIDS patients, taking into account the current prognosis of the disease. A stratification of AIDS-related category may be required to improve Charlson score accuracy in predicting mortality or adjusting for confounding.