{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T22:48:25Z","timestamp":1785192505656,"version":"3.55.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01AI162181"],"award-info":[{"award-number":["R01AI162181"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["T32GM156735"],"award-info":[{"award-number":["T32GM156735"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007249","name":"University of Minnesota","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007249","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["K23NS137968"],"award-info":[{"award-number":["K23NS137968"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2TR002492"],"award-info":[{"award-number":["KL2TR002492"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People with advanced human immunodeficiency virus (HIV) disease (CD4 \u2264 200 cells\/\u00b5L) remain at high risk for opportunistic infections, hospitalization, and death, despite access to antiretroviral therapy (ART). We evaluated serum C-reactive protein (CRP) as a predictor of 30-day hospitalization or death among outpatients with advanced HIV disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively enrolled 1388 outpatient Ugandan adults with CD4 \u2264 200 cells\/\u00b5L from May 2022 to February 2025, of whom 1378 had serum CRP measured at enrollment. Participants were ART-na\u00efve or experienced, and people with known virologic suppression were excluded. Participants received tuberculosis and cryptococcosis screening and therapy per World Health Organization (WHO) recommendations. We examined CRP as a continuous and dichotomized predictor (\u226510\u2005mg\/L) of 30-day hospitalization or death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1378 participants, 41.6% had CRP \u226510\u2005mg\/L. Participants with CRP \u226510\u2005mg\/L were more likely to be hospitalized (relative risk = 4.2, 95% CI: 2.3\u20137.8) or die (relative risk = 9.8, 95% CI: 2.9\u201332.8) within 30 days. In a multivariable Cox model adjusted for weight, CD4 count, ART status, and age, each 2-fold increase in CRP was associated with a 36.9% higher hazard of 30-day hospitalization or death (hazard ratio = 1.4, 95% CI: 1.2\u20131.5). Including CRP in the multivariable model significantly improved prediction of 30-day hospitalization or death (AUC 0.80 with CRP vs 0.72 without, DeLong's P = .009).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CRP \u226510\u2005mg\/L is associated with increased risk of 30-day hospitalization or death among outpatients with advanced HIV disease receiving the WHO-recommended package of care. Prospective studies should evaluate whether point-of-care CRP testing can enable real-time risk stratification to reduce AIDS-related deaths.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf560","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T11:36:57Z","timestamp":1759750617000},"page":"745-752","source":"Crossref","is-referenced-by-count":1,"title":["Predictive Value of C-reactive Protein for Hospitalization and Mortality Among People With Advanced HIV Disease in Uganda Receiving the World Health Organization-recommended Package of Care"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9550-0635","authenticated-orcid":false,"given":"Elizabeth L","family":"Schwartz","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota , Minneapolis, Minnesota ,","place":["USA"]},{"name":"Division of Epidemiology 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,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann M","family":"Fieberg","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota , Minneapolis, Minnesota ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olive L","family":"Namakula","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, Makerere University , Kampala ,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4747-3687","authenticated-orcid":false,"given":"Biyue","family":"Dai","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota , Minneapolis, Minnesota 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