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    Chief Complaint


    Organ System


    Patent Pending

    Veterans Aging Cohort Study (VACS) 1.0 Index

    Estimates risk of 5-year all-cause mortality in patients with HIV and/or HCV.
    When to Use
    Why Use

    Aids in prognostication in patients with HIV or Hepatitis C. Potentially useful with goals of care planning or aggressiveness of therapy.

    • The VACS Index comes from a US VA population, so most patients in both the derivation and validation cohorts were men.
    • Half of patients had started anti-retrovirals prior to 2004, so it is unknown how the newer anti-retrovirals may affect these estimates.
    • <5% of patients in this study were ≥65 years old so this is likely less accurate in older populations.
    • Few patients in the study had significant renal disease: >90% had an eGFR ≥60.

    Traditional mortality estimates using only viral load or CD4 count in HIV or FIB-4 in Hepatitis C are inaccurate; the VACS Index looks adds additional markers to estimate multi-organ system involvement and more-accurately predict mortality.

    < 50 years
    50 - 64 years
    ≥ 65 years
    ≥ 500 cells/mm³
    350 - 499 cells/mm³
    200 - 349 cells/mm³
    100 - 199 cells/mm³
    50 - 100 cells/mm³
    < 50 cells/mm³
    < 500 copies/mL
    500 - 99,999 copies/mL
    ≥ 1x10⁵ copies/mL
    ≥ 14 g/dL
    12 - 13.9 g/dL
    10 - 11.9 g/dL
    <10 g/dL
    < 1.45
    1.45 - 3.25
    > 3.25
    ≥ 60 mL/min
    45 - 59.9 mL/min
    30 - 44.9 mL/min
    < 30 mL/min


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    Creator Insights
    Amy C. Justice, MD, PhD

    About the Creator

    Amy Justice, MD, PhD, is the CNH Long Professor of Medicine and of Public Health at Yale University and a Staff Physician at the VA Connecticut Healthcare System. As principal investigator of the Veterans Aging Cohort Study (VACS), she has more than 20 years of experience developing and validating predictive indices using electronic health record data.

    To view Amy C. Justice, MD, PhD's publications, visit PubMed

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    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    About the Creator
    Amy C. Justice, MD, PhD
    Are you Amy C. Justice, MD, PhD?