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M94A2317.TXT
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1994-10-25
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Document 2317
DOCN M94A2317
TI Influence of therapy on HIV incidence estimates in Italy.
DT 9412
AU Mariotti S; Cascioli R; Istituto Superiore di Sanita, Rome, Italy.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):331 (abstract no. PC0257). Unique
Identifier : AIDSLINE ICA10/94370258
AB OBJECTIVE. A back-calculation method relying on a non-stationary
incubation period is used to reconstruct HIV incidence from observed
AIDS cases. Under several hypotheses for the effect of treatment in
modifying the incubation period, the numbers of estimated HIV infections
in Italy are evaluated. METHODS. The method implemented here is a
modification of the two infection stages model proposed originally by
Brookmeyer and Liao, with inclusion of limited length of time in which
therapy is effective. The effect of therapy on estimated HIV infection
is investigated for the first time in a sistematic way, along different
dimensions. Two different estimated progressions for the percentage of
ARC subjects in treatment in different calendar years (Italian vs. USA
estimate), two different values for the effectiveness of the treatment
in reducing the risk (RR reduced to 0.5 vs 0.33), and three different
lengths for the period in which therapy is effective (2 years, 4 yrs,
unlimited), are considered in the simulations. RESULTS. Using data up to
March 1993, cumulative estimated infections at the end of 1991 and
quarterly incidence corresponding to estimated peak of infection are
shown in the Table for each combination of parameters and no therapy. An
estimate with a slower progression of treatment diffusion (USA), smaller
reduction of the risk (0.5), and therapy effective only for two years
yields a cumulative infection estimate of 65,400 as compared to 93,300
for extreme values of the parameters in the opposite direction.
CONCLUSIONS. All factors influencing therapy were shown to have an
important effect in the estimate of HIV incidence. Not taking into
account these factors might severely bias the estimates. TABULAR DATA,
SEE ABSTRACT VOLUME.
DE Acquired Immunodeficiency Syndrome/DRUG THERAPY/*EPIDEMIOLOGY Antiviral
Agents/*THERAPEUTIC USE Comparative Study Cross-Sectional Studies
Human HIV Infections/DRUG THERAPY/*EPIDEMIOLOGY Incidence
Italy/EPIDEMIOLOGY Models, Statistical Treatment Outcome United
States/EPIDEMIOLOGY MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).