Estimating the stage-specific numbers of HIV infection using a Markov model and back-calculation.

Abstract:

:The back-calculation method has been used to estimate the number of HIV infections from AIDS incidence data in a particular population. We present an extension of back calculation that provides estimates of the numbers of HIV infectives in different stages of infection. We model the staging process with a time-dependent Markov process that partitions the HIV infectious period into the following progressive stages and/or substages: stage 1, infected but antibody negative; substages 2-3; antibody positive but asymptomatic; substages 4-6, pre-AIDS symptoms and/or abnormal haematologic indicator, stage 7, clinical AIDS. We also model an eight stage, decreased due to AIDS. The model allows for time-dependent treatment effects that slow the rate of progression in substages 4-7. We use the estimated AIDS incubation period distribution for the Markov model in back calculation from AIDS incidence data to estimate the total number of HIV infections and the parameters of the infection probability distribution. We then use these estimates in the Markov model to estimate the stage-specific numbers of HIV infections over the course of the epidemic in the population under study. Example calculations employ data for epidemic in San Francisco City, Clinic Cohort.

journal_name

Stat Med

journal_title

Statistics in medicine

authors

Longini IM Jr,Byers RH,Hessol NA,Tan WY

doi

10.1002/sim.4780110612

subject

Has Abstract

pub_date

1992-04-01 00:00:00

pages

831-43

issue

6

eissn

0277-6715

issn

1097-0258

journal_volume

11

pub_type

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