Modeling the trajectory of CD4 cell count and its effect on the risk of AIDS progression and TB infection among HIV-infected patients using a joint model of competing risks and longitudinal ordinal data
Background: This study was conducted to better understand the influence of prognostic factors and the trend of CD4 cell count on the risk of progression to acquired immunodeficiency syndrome (AIDS) and tuberculosis (TB) infection among patients with human immunodeficiency virus (HIV) in a developing...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Milano University Press
2020-01-01
|
| Series: | Epidemiology, Biostatistics and Public Health |
| Online Access: | https://ebph.it/article/view/13223 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850199050512498688 |
|---|---|
| author | Behnaz Alafchi Hossein Mahjub Leili Tapak Jalal Poorolajal Ghodratollah Roshanaei |
| author_facet | Behnaz Alafchi Hossein Mahjub Leili Tapak Jalal Poorolajal Ghodratollah Roshanaei |
| author_sort | Behnaz Alafchi |
| collection | DOAJ |
| description | Background: This study was conducted to better understand the influence of prognostic factors and the trend of CD4 cell count on the risk of progression to acquired immunodeficiency syndrome (AIDS) and tuberculosis (TB) infection among patients with human immunodeficiency virus (HIV) in a developing country.
Methods: The information of 1530 HIV-infected patients admitted in Behavioral Diseases Counseling Centers, Tehran, Iran, (2004-2014) was analyzed in this study. A joint model of ordinal longitudinal outcome and competing events is used to model longitudinal measurements of CD4 cell count and the risk of TB-infection and AIDS-progression among HIV patients, simultaneously.
Results: The results revealed that the trend of CD4 cell count had a significant association with the risk of TB-infection and AIDS-progression (p<0.001). Higher ages (p<0.001), the history of being in prison (p=0.013), receiving antiretroviral therapy (ART) (p<0.001) and isoniazid preventive therapy (IPT) (p<0.001) were associated with the positive trend of CD4 cell count. Higher ages were also associated with higher risks of TB (p<0.001) and AIDS-progression (p<0.001). Furthermore, ART (p=.0009) and IPT (p<0.001) were associated with a lower risk of TB-infection. In addition, ART (p<0.001) was associated with a lower risk of AIDS-progression. Moreover, individuals being imprisoned (p=0.001) and abusing alcohol (p=0.012) were more likely to have TB-co-infection.
Conclusions: The used joint model provided a flexible framework for simultaneous studying of the effects of covariates on the level of CD4 cell count and the risk of progression to TB and AIDS. This model also assessed the effect of CD4 trajectory on the hazards of competing events. |
| format | Article |
| id | doaj-art-1a53c77b6bbe4ce5be1a6fe9fa9e3691 |
| institution | OA Journals |
| issn | 2282-0930 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Milano University Press |
| record_format | Article |
| series | Epidemiology, Biostatistics and Public Health |
| spelling | doaj-art-1a53c77b6bbe4ce5be1a6fe9fa9e36912025-08-20T02:12:42ZengMilano University PressEpidemiology, Biostatistics and Public Health2282-09302020-01-0116410.2427/1322311235Modeling the trajectory of CD4 cell count and its effect on the risk of AIDS progression and TB infection among HIV-infected patients using a joint model of competing risks and longitudinal ordinal dataBehnaz Alafchi0Hossein Mahjub1Leili Tapak2Jalal Poorolajal3Ghodratollah Roshanaei4Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.Research Center for Health Sciences, Department of Biostatistics, Faculty of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.Department of Biostatistics, School of Public Health, Modeling Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan 65175-4171, Iran.Research Center for Health Sciences and Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, 65175-4171, Iran.Modeling Noncommunicable Disease Research Canter, Hamadan University of Medical Sciences, Hamadan, IranBackground: This study was conducted to better understand the influence of prognostic factors and the trend of CD4 cell count on the risk of progression to acquired immunodeficiency syndrome (AIDS) and tuberculosis (TB) infection among patients with human immunodeficiency virus (HIV) in a developing country. Methods: The information of 1530 HIV-infected patients admitted in Behavioral Diseases Counseling Centers, Tehran, Iran, (2004-2014) was analyzed in this study. A joint model of ordinal longitudinal outcome and competing events is used to model longitudinal measurements of CD4 cell count and the risk of TB-infection and AIDS-progression among HIV patients, simultaneously. Results: The results revealed that the trend of CD4 cell count had a significant association with the risk of TB-infection and AIDS-progression (p<0.001). Higher ages (p<0.001), the history of being in prison (p=0.013), receiving antiretroviral therapy (ART) (p<0.001) and isoniazid preventive therapy (IPT) (p<0.001) were associated with the positive trend of CD4 cell count. Higher ages were also associated with higher risks of TB (p<0.001) and AIDS-progression (p<0.001). Furthermore, ART (p=.0009) and IPT (p<0.001) were associated with a lower risk of TB-infection. In addition, ART (p<0.001) was associated with a lower risk of AIDS-progression. Moreover, individuals being imprisoned (p=0.001) and abusing alcohol (p=0.012) were more likely to have TB-co-infection. Conclusions: The used joint model provided a flexible framework for simultaneous studying of the effects of covariates on the level of CD4 cell count and the risk of progression to TB and AIDS. This model also assessed the effect of CD4 trajectory on the hazards of competing events.https://ebph.it/article/view/13223 |
| spellingShingle | Behnaz Alafchi Hossein Mahjub Leili Tapak Jalal Poorolajal Ghodratollah Roshanaei Modeling the trajectory of CD4 cell count and its effect on the risk of AIDS progression and TB infection among HIV-infected patients using a joint model of competing risks and longitudinal ordinal data Epidemiology, Biostatistics and Public Health |
| title | Modeling the trajectory of CD4 cell count and its effect on the risk of AIDS progression and TB infection among HIV-infected patients using a joint model of competing risks and longitudinal ordinal data |
| title_full | Modeling the trajectory of CD4 cell count and its effect on the risk of AIDS progression and TB infection among HIV-infected patients using a joint model of competing risks and longitudinal ordinal data |
| title_fullStr | Modeling the trajectory of CD4 cell count and its effect on the risk of AIDS progression and TB infection among HIV-infected patients using a joint model of competing risks and longitudinal ordinal data |
| title_full_unstemmed | Modeling the trajectory of CD4 cell count and its effect on the risk of AIDS progression and TB infection among HIV-infected patients using a joint model of competing risks and longitudinal ordinal data |
| title_short | Modeling the trajectory of CD4 cell count and its effect on the risk of AIDS progression and TB infection among HIV-infected patients using a joint model of competing risks and longitudinal ordinal data |
| title_sort | modeling the trajectory of cd4 cell count and its effect on the risk of aids progression and tb infection among hiv infected patients using a joint model of competing risks and longitudinal ordinal data |
| url | https://ebph.it/article/view/13223 |
| work_keys_str_mv | AT behnazalafchi modelingthetrajectoryofcd4cellcountanditseffectontheriskofaidsprogressionandtbinfectionamonghivinfectedpatientsusingajointmodelofcompetingrisksandlongitudinalordinaldata AT hosseinmahjub modelingthetrajectoryofcd4cellcountanditseffectontheriskofaidsprogressionandtbinfectionamonghivinfectedpatientsusingajointmodelofcompetingrisksandlongitudinalordinaldata AT leilitapak modelingthetrajectoryofcd4cellcountanditseffectontheriskofaidsprogressionandtbinfectionamonghivinfectedpatientsusingajointmodelofcompetingrisksandlongitudinalordinaldata AT jalalpoorolajal modelingthetrajectoryofcd4cellcountanditseffectontheriskofaidsprogressionandtbinfectionamonghivinfectedpatientsusingajointmodelofcompetingrisksandlongitudinalordinaldata AT ghodratollahroshanaei modelingthetrajectoryofcd4cellcountanditseffectontheriskofaidsprogressionandtbinfectionamonghivinfectedpatientsusingajointmodelofcompetingrisksandlongitudinalordinaldata |