New Tool Predicts One-Year Mortality Risk for People Living with HIV and Other Chronic Illnesses
As people living with HIV grow older, many are also managing other serious health problems like cancer, heart disease, and diabetes. To support their care, researchers at the British Columbia Centre for Excellence, Canada, have developed a new tool that predicts the risk of dying within one year for adults with HIV and multiple chronic conditions. This Mortality Risk Prediction Index (MRPi), built using real-world health data and published in the International Journal of Population Data Science (IJPDS), was designed to help clinicians make faster, more personalised decisions and better support patients as they age.
Over the last three decades, antiretroviral therapy has transformed HIV from a life-threatening illness into a chronic, manageable condition. Today, most people with HIV live long lives, but that longevity brings new health challenges. In British Columbia, nearly two-thirds of people living with HIV are now aged 50 or older and increasingly face age-related illnesses.
The new Mortality Risk Prediction Index (MRPi) was developed by researchers using data from over 4,000 adults living with HIV in British Columbia. It incorporates 18 common comorbidities, like heart disease, diabetes, chronic lung disease, and non-AIDS cancers, alongside age, sex, CD4 count (a marker of immune health), viral suppression status, years on antiretroviral therapy, and socioeconomic factors.
Here’s an example: a 46-year-old man on treatment for four years, with a healthy immune system (CD4 of 500 cells/mm³), no comorbidities, and a suppressed viral load, would have an MRPi score of 41, corresponding to a 0.8% risk of dying within a year. But if the same individual had substance use disorder and chronic liver disease, was receiving income assistance, had an unsuppressed viral load, and a CD4 count of 150 cells/mm³, his score would rise to 63, translating into an 11% one-year mortality risk.
The MRPi is already available as a free online calculator and can be used in routine clinical care. It offers a simple but powerful way for doctors, researchers, and policymakers to identify patients at higher risk and coordinate more responsive care. By capturing the complex interactions between HIV and other chronic illnesses, it supports a more holistic approach to health in an aging population.
“We’ve built a tool that turns complex medical histories into clear, actionable scores,” says Dr. Viviane Dias Lima, lead author of the study. “It helps shift HIV care from one-size-fits-all to something far more precise and timely.”
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Viviane Dias Lima, Senior Scientist & Head of Modelling and Forecasting, British Columbia Centre for Excellence in HIV/AIDS/ Professor, University of British Columbia