2022
Survival analysis of localized prostate cancer with deep learning
Dai X, Park JH, Yoo S, D’Imperio N, McMahon BH, Rentsch CT, Tate JP, Justice AC. Survival analysis of localized prostate cancer with deep learning. Scientific Reports 2022, 12: 17821. PMID: 36280773, PMCID: PMC9592586, DOI: 10.1038/s41598-022-22118-y.Peer-Reviewed Original ResearchMeSH KeywordsCross-Sectional StudiesDeep LearningHumansMaleProstate-Specific AntigenProstatic NeoplasmsSurvival AnalysisUnited StatesConceptsProstate cancer mortalityComposite outcomeCancer mortalityRisk predictionTime-dependent c-statisticsProstate-specific antigen (PSA) testLarge integrated healthcare systemLocalized prostate cancerElectronic health record dataClinical decision-making processProstate cancer patientsIntegrated healthcare systemProstate Cancer Risk PredictionHealth record dataLarge-scale electronic health record dataRisk prediction modelCancer risk predictionAntigen testC-statisticCancer patientsProstate cancerClinical decision systemSurvival analysisVeterans AffairsDeep learningIn with the old, in with the new: machine learning for time to event biomedical research
Danciu I, Agasthya G, Tate JP, Chandra-Shekar M, Goethert I, Ovchinnikova OS, McMahon BH, Justice AC. In with the old, in with the new: machine learning for time to event biomedical research. Journal Of The American Medical Informatics Association 2022, 29: 1737-1743. PMID: 35920306, PMCID: PMC9471708, DOI: 10.1093/jamia/ocac106.Peer-Reviewed Original Research
2020
DNA methylation mediates the effect of cocaine use on HIV severity
Shu C, Justice AC, Zhang X, Wang Z, Hancock DB, Johnson EO, Xu K. DNA methylation mediates the effect of cocaine use on HIV severity. Clinical Epigenetics 2020, 12: 140. PMID: 32928285, PMCID: PMC7491141, DOI: 10.1186/s13148-020-00934-1.Peer-Reviewed Original ResearchConceptsHIV-positive participantsHIV severityVACS IndexCocaine useCocaine effectsVeterans Aging Cohort Study Biomarker CohortVeterans Aging Cohort Study (VACS) IndexEpigenome-wide associationHuman immunodeficiency virus (HIV) progressionHigher VACS indexFrequent cocaine useCandidate CpG sitesPersistent cocaine useMendelian randomization analysisHIV outcomesBiomarker cohortHIV progressionVirus progressionVAC indexVeteran populationAntiviral responseCandidate mediatorsStudy indicesMR analysisSeverity
2019
Emulating a trial of joint dynamic strategies: An application to monitoring and treatment of HIV‐positive individuals
Caniglia EC, Robins JM, Cain LE, Sabin C, Logan R, Abgrall S, Mugavero MJ, Hernández‐Díaz S, Meyer L, Seng R, Drozd DR, Seage G, Bonnet F, Le Marec F, Moore RD, Reiss P, Sighem A, Mathews WC, Jarrín I, Alejos B, Deeks SG, Muga R, Boswell SL, Ferrer E, Eron JJ, Gill J, Pacheco A, Grinsztejn B, Napravnik S, Jose S, Phillips A, Justice A, Tate J, Bucher HC, Egger M, Furrer H, Miro JM, Casabona J, Porter K, Touloumi G, Crane H, Costagliola D, Saag M, Hernán MA. Emulating a trial of joint dynamic strategies: An application to monitoring and treatment of HIV‐positive individuals. Statistics In Medicine 2019, 38: 2428-2446. PMID: 30883859, PMCID: PMC6499640, DOI: 10.1002/sim.8120.Peer-Reviewed Original ResearchConceptsHIV-positive individualsCopies/First-line treatment regimenAIDS Research NetworkAIDS-free survivalCells/Integrated Clinical SystemsHIV-CAUSAL CollaborationOutcomes of interestRisk difference estimatesDirect effectAntiretroviral therapyHIV RNACD4 thresholdTreatment regimenNew regimenTreatment strategiesHIV researchTarget trialsRegimenTherapyResearch NetworkTrialsSurvivalClinical systems
2018
Reduced Cancer Survival Among Adults With HIV and AIDS-Defining Illnesses Despite No Difference in Cancer Stage at Diagnosis
Grover S, Desir F, Jing Y, Bhatia RK, Trifiletti DM, Swisher-McClure S, Kobie J, Moore RD, Rabkin CS, Silverberg MJ, Salters K, Mathews WC, Gill MJ, Thorne JE, Castilho J, Kitahata MM, Justice A, Horberg MA, Achenbach CJ, Mayor AM, Althoff KN. Reduced Cancer Survival Among Adults With HIV and AIDS-Defining Illnesses Despite No Difference in Cancer Stage at Diagnosis. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2018, 79: 421-429. PMID: 30211722, PMCID: PMC6203623, DOI: 10.1097/qai.0000000000001842.Peer-Reviewed Original ResearchMeSH KeywordsAdultFemaleHIV InfectionsHumansMaleMiddle AgedNeoplasm StagingNeoplasmsSurvival AnalysisConceptsLung cancer diagnosisCancer diagnosisLung cancerCancer stageNorth American AIDS Cohort CollaborationAdjusted mortality rate ratioHodgkin lymphoma diagnosisOnly lung cancerRole of HIVRisk of deathMortality rate ratiosCohort CollaborationImmune dysfunctionCervical cancerImmune suppressionCancer outcomesSignificant immunosuppressionCancer survivalPoor survivalLymphoma diagnosisMortality rateProbability of survivalPWHHigh mortalityCancerBenefits and harms of lung cancer screening in HIV-infected individuals with CD4+ cell count at least 500 cells/&mgr;l
Kong CY, Sigel K, Criss SD, Sheehan DF, Triplette M, Silverberg MJ, Henschke CI, Justice A, Braithwaite RS, Wisnivesky J, Crothers K. Benefits and harms of lung cancer screening in HIV-infected individuals with CD4+ cell count at least 500 cells/&mgr;l. AIDS 2018, 32: 1333-1342. PMID: 29683843, PMCID: PMC5991188, DOI: 10.1097/qad.0000000000001818.Peer-Reviewed Original ResearchConceptsLow-dose computed tomographyLung cancer screeningCD4 cell countMedicaid Services criteriaCancer screeningLung cancerMortality reductionCell countLDCT examinationsAnnual low-dose computed tomographyUninfected individualsLung cancer mortality reductionVeterans Aging Cohort StudyCancer mortality reductionAntiretroviral therapy adherenceAging Cohort StudyLung cancer mortalityCells/Lung Cancer Policy ModelMultiple national organizationsAlternative screening strategiesBase-case analysisHIV cohortCohort studyFormer smokersNonantiretroviral polypharmacy and adverse health outcomes among HIV-infected and uninfected individuals
Justice AC, Gordon KS, Skanderson M, Edelman EJ, Akgün KM, Gibert CL, Re V, Rimland D, Womack JA, Wyatt CM, Tate JP, Team V. Nonantiretroviral polypharmacy and adverse health outcomes among HIV-infected and uninfected individuals. AIDS 2018, 32: 739-749. PMID: 29543653, PMCID: PMC5868488, DOI: 10.1097/qad.0000000000001756.Peer-Reviewed Original ResearchConceptsAdverse health outcomesHIV statusUninfected individualsVACS IndexMedication countUS Veterans Affairs Healthcare SystemHealth outcomesVeterans Affairs Healthcare SystemRisk of hospitalizationSeverity of illnessHIV-1 RNAHIV-positive individualsRisk of mortalityDose responseRace/ethnicityPolypharmacyFiscal year 2009HospitalizationMedicationsMortalityHealthcare systemAntiretroviralsOutcomesAssociationRiskAssociation of Human Immunodeficiency Virus Infection and Risk of Peripheral Artery Disease
Beckman JA, Duncan MS, Alcorn CW, So-Armah K, Butt AA, Goetz M, Tindle HA, Sico J, Tracy RP, Justice AC, Freiberg MS. Association of Human Immunodeficiency Virus Infection and Risk of Peripheral Artery Disease. Circulation 2018, 138: 255-265. PMID: 29535090, PMCID: PMC6050082, DOI: 10.1161/circulationaha.117.032647.Peer-Reviewed Original ResearchConceptsRisk of PADIncident PAD eventsPeripheral artery diseaseHuman immunodeficiency virusCD4 cell countTraditional atherosclerotic risk factorsPAD risk factorsAtherosclerotic risk factorsPAD eventsRisk factorsCell countUninfected veteransCD4 cellsArtery diseaseHIV infectionHIV statusViral loadCells/Peripheral artery disease eventsPrior peripheral artery diseaseHuman immunodeficiency virus (HIV) infectionVeterans Aging Cohort StudyHIV-1 ribonucleic acidHIV infection statusHIV viral loadMarkers of chronic obstructive pulmonary disease are associated with mortality in people living with HIV
Triplette M, Justice A, Attia EF, Tate J, Brown ST, Goetz MB, Kim JW, Rodriguez-Barradas MC, Hoo GWS, Wongtrakool C, Akgün K, Crothers K. Markers of chronic obstructive pulmonary disease are associated with mortality in people living with HIV. AIDS 2018, 32: 487-493. PMID: 29135579, PMCID: PMC6366454, DOI: 10.1097/qad.0000000000001701.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseObstructive pulmonary diseaseRisk of deathStudy participantsVACS IndexPulmonary diseaseComputed tomographyImpact of COPDVeterans Aging Cohort Study (VACS) IndexMultivariable Cox regression modelsBurden of comorbiditiesPredictors of mortalityPulmonary function testingCox regression modelMedian followUninfected subjectsAirflow obstructionCohort studyPulmonary functionPulmonary variablesFunction testingMultivariable modelPLWHCT characteristicsMortality rate
2017
Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies
Collaboration T, Trickey A, May M, Vehreschild J, Obel N, Gill M, Crane H, Boesecke C, Patterson S, Grabar S, Cazanave C, Cavassini M, Shepherd L, Monforte A, van Sighem A, Saag M, Lampe F, Hernando V, Montero M, Zangerle R, Justice A, Sterling T, Ingle S, Sterne J. Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies. The Lancet HIV 2017, 4: e349-e356. PMID: 28501495, PMCID: PMC5555438, DOI: 10.1016/s2352-3018(17)30066-8.Peer-Reviewed Original ResearchConceptsInitiation of ARTAntiretroviral therapyART initiationCause mortalityHazard ratioLife expectancyCalendar periodCause-specific mortality hazard ratiosYears of ARTFirst yearHIV-1 cohortToxic antiretroviral drugsCombination antiretroviral therapyHIV-positive patientsCD4 cell countManagement of comorbiditiesMortality hazard ratioUK Medical Research CouncilHealth care plannersMedical Research CouncilEDCTP2 programmeCohort studyViral loadAntiretroviral drugsYear survival
2016
Cause-Specific Mortality in HIV-Positive Patients Who Survived Ten Years after Starting Antiretroviral Therapy
Trickey A, May MT, Vehreschild J, Obel N, Gill MJ, Crane H, Boesecke C, Samji H, Grabar S, Cazanave C, Cavassini M, Shepherd L, Monforte A, Smit C, Saag M, Lampe F, Hernando V, Montero M, Zangerle R, Justice AC, Sterling T, Miro J, Ingle S, Sterne JA, Collaboration A. Cause-Specific Mortality in HIV-Positive Patients Who Survived Ten Years after Starting Antiretroviral Therapy. PLOS ONE 2016, 11: e0160460. PMID: 27525413, PMCID: PMC4985160, DOI: 10.1371/journal.pone.0160460.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAnti-HIV AgentsDemographyFemaleHIV InfectionsHIV-1HumansMaleMiddle AgedRisk FactorsSurvival AnalysisYoung AdultConceptsCombination antiretroviral therapyLow CD4 countHIV-positive patientsAntiretroviral therapyCD4 countDrug useAntiretroviral Therapy Cohort CollaborationFive-year mortality riskAIDS infectionOlder ageCause-specific mortality rate ratiosNon-AIDS cancerLiver-related mortalityHIV Cohort StudyInjection drug useHIV-1 RNAMortality rate ratiosLiver-related diseasesHigh subsequent mortalityCohort CollaborationLow CD4Prior AIDSCardiovascular mortalityCohort studyPrognostic factorsIncidence of AIDS-Defining Opportunistic Infections in a Multicohort Analysis of HIV-infected Persons in the United States and Canada, 2000–2010
Buchacz K, Lau B, Jing Y, Bosch R, Abraham A, Gill M, Silverberg M, Goedert J, Sterling T, Althoff K, Martin J, Burkholder G, Gandhi N, Samji H, Patel P, Rachlis A, Thorne J, Napravnik S, Henry K, Mayor A, Gebo K, Gange S, Moore R, Brooks J, Research and Design of IeDEA F, Kirk G, Benson C, Bosch R, Boswell S, Mayer K, Grasso C, Hogg R, Harrigan P, Montaner J, Cescon A, Samji H, Brooks J, Buchacz K, Gebo K, Moore R, Moore R, Carey J, Rodriguez B, Horberg M, Silverberg M, Thorne J, Goedert J, Jacobson L, D'Souza G, Klein M, Rourke S, Burchell A, Rachlis A, Hunter-Mellado R, Mayor A, Gill M, Deeks S, Martin J, Patel P, Brooks J, Saag M, Mugavero M, Willig J, Eron J, Napravnik S, Kitahata M, Crane H, Drozd D, Sterling T, Rebeiro P, Haas D, Bebawy S, Turner M, Justice A, Dubrow R, Fiellin D, Gange S, Anastos K. Incidence of AIDS-Defining Opportunistic Infections in a Multicohort Analysis of HIV-infected Persons in the United States and Canada, 2000–2010. The Journal Of Infectious Diseases 2016, 214: 862-872. PMID: 27559122, PMCID: PMC4996145, DOI: 10.1093/infdis/jiw085.Peer-Reviewed Original ResearchMeSH KeywordsAdultAIDS-Related Opportunistic InfectionsCanadaCohort StudiesFemaleHumansIncidenceMaleMiddle AgedSurvival AnalysisUnited StatesConceptsFirst opportunistic infectionOpportunistic infectionsIncidence rateNorth American AIDS Cohort CollaborationIncident opportunistic infectionsPneumocystis jiroveci pneumoniaMycobacterium kansasii infectionRates of AIDSHuman immunodeficiency virusConfidence intervalsIncidence of AIDSMycobacterium avium complexCohort CollaborationAntiretroviral therapyJiroveci pneumoniaEsophageal candidiasisMulticohort analysisImmunodeficiency virusClinical eventsAvium complexHIVObservation periodInfectionAIDSRecent data
2015
Using observational data to emulate a randomized trial of dynamic treatment-switching strategies: an application to antiretroviral therapy
Cain LE, Saag MS, Petersen M, May MT, Ingle SM, Logan R, Robins JM, Abgrall S, Shepherd BE, Deeks SG, Gill M, Touloumi G, Vourli G, Dabis F, Vandenhende MA, Reiss P, van Sighem A, Samji H, Hogg RS, Rybniker J, Sabin CA, Jose S, del Amo J, Moreno S, Rodríguez B, Cozzi-Lepri A, Boswell SL, Stephan C, Pérez-Hoyos S, Jarrin I, Guest JL, Monforte A, Antinori A, Moore R, Campbell CN, Casabona J, Meyer L, Seng R, Phillips AN, Bucher HC, Egger M, Mugavero MJ, Haubrich R, Geng EH, Olson A, Eron JJ, Napravnik S, Kitahata MM, Van Rompaey SE, Teira R, Justice AC, Tate JP, Costagliola D, Sterne JA, Hernán MA, Systems A. Using observational data to emulate a randomized trial of dynamic treatment-switching strategies: an application to antiretroviral therapy. International Journal Of Epidemiology 2015, 45: 2038-2049. PMID: 26721599, PMCID: PMC5841611, DOI: 10.1093/ije/dyv295.Peer-Reviewed Original ResearchConceptsAntiretroviral therapyCopies/Antiretroviral Therapy Cohort CollaborationTime-varying covariatesTight control groupAdjusted hazard ratioAntiretroviral therapy regimenAIDS Research NetworkIntegrated Clinical SystemsHIV-CAUSAL CollaborationDeath eventsCohort CollaborationHazard ratioTherapy regimenRandomized trialsInverse probability weightingInclusion criteriaMortality analysisClinical treatmentAIDSTherapyDeath analysisDeathTrialsComparative effectsQuality of HIV Care and Mortality Rates in HIV-Infected Patients
Korthuis PT, McGinnis KA, Kraemer KL, Gordon AJ, Skanderson M, Justice AC, Crystal S, Goetz MB, Gibert CL, Rimland D, Fiellin LE, Gaither JR, Wang K, Asch SM, McInnes DK, Ohl ME, Bryant K, Tate JP, Duggal M, Fiellin DA. Quality of HIV Care and Mortality Rates in HIV-Infected Patients. Clinical Infectious Diseases 2015, 62: 233-239. PMID: 26338783, PMCID: PMC4690479, DOI: 10.1093/cid/civ762.Peer-Reviewed Original ResearchMeSH KeywordsFemaleHIV InfectionsHumansLongitudinal StudiesMaleMiddle AgedMortalityQuality of Health CareSurvival AnalysisVeteransConceptsMortality rateIllicit drug useDrug useSurvival analysisDisease severityNational Death Index recordsVeterans Aging Cohort StudyKaplan-Meier survival analysisCox proportional hazards modelAge-adjusted mortality ratesPast-year illicit drug useAging Cohort StudyOverall mortality rateHuman immunodeficiency virusVeterans Health AdministrationUnhealthy alcohol useProportional hazards modelLower age-adjusted mortality ratesHigh-quality careLongitudinal survival analysisHIV qualityUnhealthy alcoholHIV careCohort studyImproved survivalInjection Drug Use and Hepatitis C as Risk Factors for Mortality in HIV-Infected Individuals
May MT, Justice AC, Birnie K, Ingle SM, Smit C, Smith C, Neau D, Guiguet M, Schwarze-Zander C, Moreno S, Guest JL, Monforte A, Tural C, Gill MJ, Bregenzer A, Kirk O, Saag M, Sterling TR, Crane HM, Sterne JA. Injection Drug Use and Hepatitis C as Risk Factors for Mortality in HIV-Infected Individuals. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2015, 69: 348-354. PMID: 25848927, PMCID: PMC4506784, DOI: 10.1097/qai.0000000000000603.Peer-Reviewed Original ResearchConceptsInjection drug useDrug useLiver-related mortalityHepatitis C infectionEffect of HCVMortality hazard ratioNorth American cohortHCV coinfectionHCV statusAntiretroviral therapyC infectionHepatitis CHazard ratioSurvival differencesRisk factorsExcess mortalityPoor survivalRisk groupsHCVAmerican cohortHIVNew treatmentsMortalitySubstantial proportionComplete dataLong-term Prescription of Opioids and/or Benzodiazepines and Mortality Among HIV-Infected and Uninfected Patients
Weisberg DF, Gordon KS, Barry DT, Becker WC, Crystal S, Edelman EJ, Gaither J, Gordon AJ, Goulet J, Kerns RD, Moore BA, Tate J, Justice AC, Fiellin DA. Long-term Prescription of Opioids and/or Benzodiazepines and Mortality Among HIV-Infected and Uninfected Patients. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2015, 69: 223-233. PMID: 26009831, PMCID: PMC4446730, DOI: 10.1097/qai.0000000000000591.Peer-Reviewed Original ResearchConceptsLong-term opioidsMorphine equivalent daily doseOpioid receiptRisk of deathLong-term prescriptionUninfected patientsOpioid dosesAntiretroviral therapyHazard ratioDaily dosePropensity scoreHigher opioid dosesCause mortalityHIV statusAvailable patientsMortality riskOpioidsHIVPatientsProspective analysisMortalityBenzodiazepinesDosesDeathRiskComparing clinical outcomes in HIV‐infected and uninfected older men hospitalized with community‐acquired pneumonia
Barakat LA, Juthani-Mehta M, Allore H, Trentalange M, Tate J, Rimland D, Pisani M, Akgün KM, Goetz MB, Butt AA, Rodriguez-Barradas M, Duggal M, Crothers K, Justice AC, Quagliarello VJ. Comparing clinical outcomes in HIV‐infected and uninfected older men hospitalized with community‐acquired pneumonia. HIV Medicine 2015, 16: 421-430. PMID: 25959543, PMCID: PMC5015437, DOI: 10.1111/hiv.12244.Peer-Reviewed Original ResearchConceptsCommunity-acquired pneumoniaVeterans Aging Cohort StudyVACS IndexCAP outcomesAntiretroviral therapyOlder adultsHigher VACS indexDays of dischargeAging Cohort StudyUninfected participantsCohort studyMean LOSHIV infectionLonger LOSClinical outcomesUnadjusted analysesUninfected groupMultivariable modelEligibility criteriaHIVMale veteransMortality rateART useMortalityOutcomesSex Differences in Overall and Cause-Specific Mortality among HIV-Infected Adults on Antiretroviral Therapy in Europe, Canada and the US
Jarrin I, Moreno S, Ingle S, May M, Sterling T, Justice A, Bickel M, Crane H, Mugavero M, De Wolf F, Jung N, Cescon A, Garcia I, Elzi L, Arminio A, Krause M, Smith C, Guest J, Hessamfar M, Gill J, Sterne J, del Amo J. Sex Differences in Overall and Cause-Specific Mortality among HIV-Infected Adults on Antiretroviral Therapy in Europe, Canada and the US. Antiviral Therapy 2015, 20: 21-28. PMID: 24675571, DOI: 10.3851/imp2768.Peer-Reviewed Original ResearchConceptsNon-AIDS mortalityInjection drug useAll-causeAntiretroviral therapyAIDS-mortality rateNon-AIDS-related mortalityCause-specific mortalityCD4(+) T-cell countsNon-AIDS infectionsRates of all-causeNon-AIDS malignanciesART Cohort CollaborationT-cell countsHIV-infected adultsHIV-positive patientsHIV-1 RNAAll-cause mortalityCox proportional hazards modelsCohort of individualsHIV-positive menProportional hazards modelART-CCSex differencesCART initiationCause-specific
2014
HIV Infection and Cardiovascular Disease in Women
Womack JA, Chang C, So‐Armah K, Alcorn C, Baker JV, Brown ST, Budoff M, Butt AA, Gibert C, Goetz MB, Gottdiener J, Gottlieb S, Justice AC, Leaf D, McGinnis K, Rimland D, Rodriguez‐Barradas M, Sico J, Skanderson M, Tindle H, Tracy RP, Warner A, Freiberg MS. HIV Infection and Cardiovascular Disease in Women. Journal Of The American Heart Association 2014, 3: e001035. PMID: 25324353, PMCID: PMC4323817, DOI: 10.1161/jaha.114.001035.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge DistributionAgedCardiovascular DiseasesCase-Control StudiesComorbidityConfidence IntervalsFemaleHIV InfectionsHumansLongitudinal StudiesMiddle AgedPrevalenceProportional Hazards ModelsProspective StudiesRisk AssessmentSeverity of Illness IndexSurvival AnalysisUnited StatesUser-Computer InterfaceVeteransConceptsRisk of CVDCVD eventsCardiovascular diseaseHIV infectionVeterans Aging Cohort StudyCox proportional hazards modelHIV uninfected womenIncident CVD eventsIncident cardiovascular diseaseIndependent risk factorAging Cohort StudyClinical Modification codesFirst clinical encounterDeath certificate dataProportional hazards modelSubstance use/abuseUse/abuseRace/ethnicityUninfected womenHepatitis CHIV- womenLast followCohort studyIschemic strokeUnstable anginaThe VACS Index Predicts Mortality in a Young, Healthy HIV Population Starting Highly Active Antiretroviral Therapy
Bebu I, Tate J, Rimland D, Mesner O, Macalino GE, Ganesan A, Okulicz JF, Bavaro M, Weintrob AC, Justice AC, Agan BK. The VACS Index Predicts Mortality in a Young, Healthy HIV Population Starting Highly Active Antiretroviral Therapy. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2014, 65: 226-230. PMID: 24226058, PMCID: PMC4091811, DOI: 10.1097/qai.0000000000000045.Peer-Reviewed Original ResearchConceptsVACS IndexActive antiretroviral therapyCause mortalityAntiretroviral therapyHIV populationVeterans Aging Cohort Study (VACS) IndexActive antiretroviral therapy (HAART) initiationAntiretroviral therapy initiationPrediction of mortalityGood discriminationNHS subjectsTherapy initiationDifferent time pointsStudy cohortSimilar patientsClinical variablesEarly risk assessmentMedical historyVAC indexHealthy populationMortalityStudy indicesOutcome predictionTime pointsLaboratory data