Prediction of clinical outcomes of human immunodeficiency virus infection in the era of highly active anti-retroviral therapy : use of repeated measures of HIV viral load and CD4 cell count

Objective. To compare the prognostic ability of first available measurements of CD4 cell count and viral load with that of the most recent measurements and to assess the additional prognostic ability of the values of past measurements of these markers. / Methods. Demographic and clinical information on 965 HIV-1 infected adults followed at a university-based HIV clinic in Montreal, Quebec were extracted from a clinical database. The prognostic ability of initial and most recent CD4 cell count and viral load measurements were assessed in a series of Cox models. The added prognostic ability of past values of measurements of these markers was explored by calculating; (i) the unweighted mean values of all previous measurements and (ii) a time-weighted mean. The differences between these mean levels and the most recent values were included as time-dependent covariates in Cox models adjusted for the value of the most recent measurements. / Conclusion. The most recent measurements of CD4 cell count and viral load are more powerful predictors of clinical disease progression than initial measurements. (Abstract shortened by UMI.)

Identiferoai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.33842
Date January 2001
CreatorsSmith, Graham H. R.
ContributorsAbrahamowicz, M. (advisor)
PublisherMcGill University
Source SetsLibrary and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada
LanguageEnglish
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation
Formatapplication/pdf
CoverageMaster of Science (Department of Epidemiology and Biostatistics.)
RightsAll items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated.
Relationalephsysno: 001862484, proquestno: MQ78960, Theses scanned by UMI/ProQuest.

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