| Titre : | Methods to assess population effectiveness of therapies in human immunodeficiency virus incident and prevalent cohorts. (2001) |
| Auteurs : | Patrick-M TARWATER ; Roger Detels ; Mary-E GORE ; Joseph-B MARGOLICK ; John MELLORS ; Alvaro MUNOZ ; John PHAIR ; Bloomberg School of Public Health. Johns Hopkins University. Baltimore. MD. USA |
| Type de document : | Article |
| Dans : | American journal of epidemiology (vol. 154, n° 7, 2001) |
| Pagination : | 675-681 |
| Langues: | Anglais |
| Mots-clés : | Sida ; Virose ; Infection ; Thérapeutique médicamenteuse ; Chimiothérapie ; Thérapeutique ; Pronostic ; Epidémiologie ; Méthodologie ; Prévalence ; Homme ; Immunopathologie |
| Résumé : | [BDSP. Notice produite par INIST-CNRS R0xVCe34. Diffusion soumise à autorisation]. Two methods are presented for measuring population effectiveness (i.e., reduction of disease in a population in which only some receive treatment) of antiretroviral therapy among human immunodeficiency virus (HIV) - infected men at risk for acquired immunodeficiency syndrome (AIDS) and followed between January 1,1986, and June 30,1999, in the Multicenter AIDS Cohort Study. Method I, requiring use of a seroincident cohort, estimates relative hazards of AIDS for persons at equal duration of infection. Method II, allowing use of a seroprevalent cohort, estimates relative hazards since the beginning of therapy eras for persons starting at equal levels of prognostic markers of disease stage (CD4 cell count and HIV type 1 RNA). The follow-up interval was divided into four calendar periods to characterize different eras of antiretroviral therapy. For method I, the relative hazards were 1.52 (95% confidence interval (Cl) : 0.93,2.49), 0.91 (95% Cl : 0.66,1.26), and 0.30 (95% CI : 0.18,0.51) for the eras of no therapy, dual nucleoside therapy, and potent combination antiretroviral therapy, respectively (monotherapy was the reference era). For method II, the corresponding relative hazards were 1.52 (95% Cl : 1.10,2.09), 1.03 (95% Cl : 0.77,1.38), and 0.31 (95% Cl : 0.21,0.45). These results extend the measurement of population effectiveness from incident to prevalent cohorts and demonstrate the ability of cohort studies to complement information provided by clinical trials. |
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