Impact of epidemic and individual heterogeneity on the population distribution of disease progression rates. An example from patient populations in trials of human immunodeficiency virus infection

American Journal of Epidemiology
J P IoannidisJ Lau

Abstract

Patients at the same stage of chronic disease may have had different rates of disease progression. The authors developed a mathematical modeling approach that allows reconstructing and comparing populations in terms of the disease progression rates of their participants when the disease onset and progression rates are unknown for individual patients. Human immunodeficiency virus 1 infection was used as an example. Both published and hypothetical models were used to describe the human immunodeficiency virus 1 epidemic (epidemic heterogeneity) and incubation and survival functions for different disease stages (individual heterogeneity). Reconstructions of populations with late disease (e.g., acquired immunodeficiency syndrome patients) show a marked predominance of rapid progressors, unless the incidence of new infections has been decreasing for a long time. Rapid progressors would also predominate in populations of acute seroconverters, unless diagnosis is based on repeated serologic screening rather than symptoms. Populations of patients who have not progressed beyond an early stage of the disease (e.g., patients with CD4 cell counts > 500/microliter) tend to overrepresent slow progressors, especially if the epidemic has been d...Continue Reading

Citations

Aug 25, 2001·Journal of Clinical Epidemiology·A B Haidich, J P Ioannidis
Nov 22, 1997·Journal of Clinical Epidemiology·J P Ioannidis, J Lau
Nov 14, 1997·Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology : Official Publication of the International Retrovirology Association·J P IoannidisJ Lau
Jun 24, 1998·Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology : Official Publication of the International Retrovirology Association·D G Contopoulos-Ioannidis, J P Ioannidis
Dec 2, 1998·Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology : Official Publication of the International Retrovirology Association·G Santoro-LopesM Schechter
Mar 14, 2012·AIDS·M Arantxa ColcheroSergio Bautista-Arredondo
Dec 21, 2012·Journal of the Royal Society, Interface·Sandra LassSarah E Perkins
Jan 24, 1998·Lancet·J LauC H Schmid
Jan 17, 2009·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Hendrik KoffijbergErik Buskens
Mar 27, 2002·International Journal of Epidemiology·Toshiaki A FurukawaLauren E Griffith
Apr 8, 2003·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Sam M MbulaiteyeEric A Engels
May 6, 2019·Critical Care : the Official Journal of the Critical Care Forum·Shalini SanthakumaranManu Shankar-Hari
Dec 10, 2016·Population Health Metrics·Scott A McDonaldJacco Wallinga

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