Bayesian Joint Modelling of Disease Progression Marker and Time to Death Event of HIV/AIDS Patients under ART Follow-up

2015 ◽  
Vol 5 (8) ◽  
pp. 1034-1043
Author(s):  
Gemeda Buta ◽  
Ayele Goshu ◽  
Hailemichael Worku
Keyword(s):  
Disease Progression ◽  
Aids Patients ◽  
Joint Modelling ◽  
Time To Death ◽  
Progression Marker ◽  
Death Event ◽  
Hiv Aids

scholarly journals Statistical Joint Modeling on Longitudinal Body Weight and CD4 Cell Progression with Survival Time-to-Death Predictors on HIV/AIDS Patients in Mekelle General Hospital, Ethiopia.

2020 ◽  
Author(s):  
Gebru Gebrerufael ◽  
Zeytu Asfaw ◽  
Dessie Melese
Keyword(s):  
Body Weight ◽  
Functional Status ◽  
Survival Time ◽  
Joint Modeling ◽  
Aids Patients ◽  
Cd4 Cell Count ◽  
Time To Death ◽  
Cd4 Cell ◽  
Hiv Aids

Abstract Background This study assessed the impact of repeated biomarker measurements of statistical joint modeling on survival time-to-death and determines potential predictors of HIV/AIDS patients on ART in Mekelle General Hospital Ethiopia. Methods A retrospective cohort study was conducted among HIV/AIDS patients who were under ART follow-up during September 11, 2013 - September 5, 2016 at Mekelle General Hospital, Ethiopia. The two repeated biomarkers of longitudinal measurements and survival outcome with separate univaraite longitudinal modeling approach and statistical joint modeling approach were used to fit simultaneously. A total of 216 HIV/AIDS patients were selected by using systematic random sampling technique from ART follow-up. Results The relationship between the two biomarkers CD4 cell and body weight with risk for survival time-to-death were statistical insignificant. Thus, death is less probable to occur in HIV/AIDS patients with higher value of CD4 cell count and body weight progression. In event process the sub-model, Baseline CD4, Fair and Good Adherence, HIV/TB (yes) and Sex (male) were significant factors of risk to short survival Time-to-Death on HIV/AIDS patients. In the 1st longitudinal process sub-model, Baseline CD4, Ambulatory functional status, HIV/TB (yes), Time*Ambulatory functional status, Time*Working functional status and Time*Baseline CD4 were the significant factors of \sqrt{CD4 cell } count progression. Moreover, In 2nd longitudinal process sub-model, visit Time of follow-up, Age, Sex (male), Baseline weight, Time*Ambulatory and Time*Working functional status were the significant factors of log 10(body weight) progression. Conclusion Both governmental and non-governmental stakeholders should pay special attention for HIV positive adults, especially for those who had developed HIV/TB, male, bedridden functional status, poor adherence and lower Baseline CD4 cell count progression so that mortality due to HIV/AIDS optimally reduced.

Mabthera (Rituximab) Plus CVP Chemotherapy for First-Line Treatment of Stage III/IV Follicular Non-Hodgkin’s Lymphoma (NHL): Confirmed Efficacy with Longer Follow-Up.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 350-350 ◽  
Author(s):  
Philippe Solal-Celigny ◽  
Kevin Imrie ◽  
Andrew Belch ◽  
Katherine Sue Robinson ◽  
David Cunningham ◽  
...  
Keyword(s):  
Risk Factors ◽  
Disease Progression ◽  
Phase Iii ◽  
Stage Iii ◽  
Line Treatment ◽  
First Line ◽  
Time To Death ◽  
Kaplan Meier ◽  
First Line Treatment

Abstract Design/Methods: We recently demonstrated in a phase III trial that the addition of rituximab to each of 8 cycles of CVP (R-CVP) chemotherapy significantly improves the clinical outcome of previously untreated patients with stage III/IV CD20 positive follicular NHL when compared to CVP alone (Marcus et al., Blood2005; 105: 1417–23). A multivariate Cox regression analysis of time to progression or death (TTP) showed a treatment benefit in all patient subgroups according to baseline risk factors, except for patients with a baseline hemoglobin level below normal. We now present an updated analysis of all major trial endpoints with 42 months follow-up (FU). Results: A total of 321 patients (median age 53 years) were recruited (159 CVP, 162 R-CVP). Approximately half of the patients had high-risk disease according to the Follicular Lymphoma International Prognostic Index (FLIPI, score 3–5). The median TTP was more than doubled for patients receiving R-CVP compared to CVP alone (33.6 months vs 14.5 months, p<0.0001). Median time to new lymphoma treatment or death (TNLT) was 12.3 months in the CVP group and nearly quadrupled to 46.3 months in the R-CVP group (p<0.0001). Superior response rates for R-CVP were confirmed (CR+CRu rate 41% vs 11%, p<0.0001) with a median response duration (DR) of 13.5 months in the CVP arm versus 37.7 months in the R-CVP arm. Median disease free survival (DFS) in complete responders was 44.8 months for patients receiving R-CVP and 20.5 months in patients receiving CVP alone (p=0.0005). Thirty-five patients in the CVP arm and 23 patients in the R-CVP arm have died. Kaplan-Meier estimates of 3-year OS rates were 81% in the CVP arm and 89% in the R-CVP (p=0.07). Importantly, significantly more patients receiving CVP died due to lymphoma progression compared to patients receiving R-CVP (25 vs 12 deaths, p=0.02). Subgroup analysis for TTP, ORR, DR and OS according to risk factors at baseline are ongoing and will be presented. Conclusion: With longer FU, the combination of 8 cycles of rituximab with CVP chemotherapy continues to provide a major benefit as first line treatment for patients with advanced stage follicular NHL. Kaplan Meier plot of time to death due to disease progression Kaplan Meier plot of time to death due to disease progression

scholarly journals The effect on survival of a multidimensional intervention project (SEAD) in HIV/AIDS patients with follow-up and adherence (FUP/ADH) barriers

2012 ◽  
Vol 15 (6(Suppl 4)) ◽  
Author(s):  
M Pérez Elías ◽  
L Elías Casado ◽  
M Pumares ◽  
A Moreno ◽  
F Dronda ◽  
...  
Keyword(s):  
Aids Patients ◽  
Hiv Aids

scholarly journals The role of SEAD project intervention in viral suppression of HIV/AIDS patients with follow-up and adherence barriers

2012 ◽  
Vol 15 (6(Suppl 4)) ◽  
Author(s):  
L Elías Casado ◽  
M Pérez Elías ◽  
D López Pérez ◽  
M Pumares Álvarez ◽  
M Martinez-Colubi ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Aids Patients ◽  
Project Intervention ◽  
Hiv Aids

scholarly journals Semi-Markov Modelling of HIV/AIDS Disease Progression

2021 ◽  
Author(s):  
Tilahun Asena ◽  
Ayele Goshu ◽  
Mebratu Senbeta ◽  
Derbachew Teni
Keyword(s):  
Body Mass Index ◽  
Disease Progression ◽  
Body Mass ◽  
Waiting Time ◽  
Time Distribution ◽  
The Body ◽  
Waiting Time Distribution ◽  
Body Mass Index Increase ◽  
Hiv Aids

Abstract Background: HIV/AIDS epidemic continues to be the main challenge in the world. According to United Nations Program on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) reports of 2013, 35 million people were living with HIV worldwide, with 2.1 million new infections and with 1.5 million deaths occurred each year. Among these, 24.7 million lived in sub-Saharan Africa with 1.5 million new infections and 1.1 million AIDS deaths.Method: The main objective of this study is finding factors affecting HIV/AIDS disease progression. This study was conducted to investigate the effect of factors on HIV/AIDS disease progression. Patient follow-up data is obtained at Yirgalim General Hospital. A sample of 370 Patient data from a follow-up cohort is obtained at Yirgalim General Hospital. Multivariate generalized hazard regression model was employed to investigate the disease progression using both time independent and time dependent covariates. Result: The study revealed that the risk of transition differs by patient's body mass index. Increase in the body mass index reduces the risk of transiting into the next worst states. The effects of sex, weight, age and body mass index of patients are significantly associated with AIDS disease progression. The risk of transition differs by patient's body mass index. Increase in the body mass index reduces the risk of transiting into the next worst states. The effect of sex, weight, age and body mass index of patients are significantly associated with AIDS disease progression. The results further revealed that the semi-Markov model with Weibull waiting time distribution has smaller log likelihood and AIC values compared to a semi-Markov model with exponential waiting time distribution.Conclusion: Transition probabilities are highly dependent on the choice of waiting times. We recommend that while choosing waiting time distributions for semi-Marko models one should consider appropriate distributions as waiting time distribution effect have a significant change on the estimated model parameters. In addition, this study recommends that concerned bodies should look at deferent contributing factors of AIDS diseases progression in addition to the ART services administered for slowing the current level of high diseased population in the country.

scholarly journals Eliminating Perceived Stigma and Burnout among Nurses Treating HIV/AIDS Patients Implementing Integrated Intervention

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Ilakkiya. L ◽  
Dr S. Subramanian
Keyword(s):  
Burnout Syndrome ◽  
Perceived Stigma ◽  
Aids Patients ◽  
Government Hospitals ◽  
Integrated Intervention ◽  
Post Test ◽  
Experimental Group ◽  
Three Phases ◽  
Hiv Aids

Stigma is essentially one of the most important barriers to public action, disease disclosure and treatment adherence, worse even it gets exacerbated when those who provide treatment hold stigmatizing attitudes or at the receiving end of stigma. Stigma is of global concern and it requires an intensive integrated approach across all levels to eliminate it from healthcare settings for the betterment of patients and nurses. Objective: The present study intended to explore whether there were significant association between Perceived Stigma and Burnout Syndrome among nurses treating cancer patients and nurses treating HIV/AIDS patients and the extent to which the Integrated Intervention facilitates eliminating Perceived Stigma and Burnout. Methods: Around 120 nurses treating HIV/AIDS patients were selected from a sample of 240 nurses working in government hospitals in Chennai. Later, the Nurses were classified into two groups – as Experimental Group (N=30) and Control Group (N=30) treating HIV/AIDS patients in Government Hospitals. Their level of Perceived Stigma was measured using the HASI-N developed by Uys and others and burnout level was assessed using questionnaire developed by Maslach. The comprehensive Integrated Intervention covering cognitive restructuring, Jacobson’s Progressive Muscle Relaxation, yoga and mindfulness meditation, etc was administered exclusively to the Experimental Group of Nurses for the duration of three months. The required data on Perceived Stigma and Burnout levels were measure at three phases of time period – pre and post period of the administration of Integrated Intervention. Results: In this study, these two categories of nurses were tested at three points of time (pre-test, post-test and follow-up). The within-subjects factor was the three phases of testing (pre-test, post-test, and follow-up) of the variables under investigation or time and the between-subjects factor was the two Category of nurses. Therefore, a mixed model factorial ANOVA was used to analyse differences over time and between the two categories of nurses Conclusions: There were significant differences among nurses treating HIV/AIDS patients with regard to stigma and burnout.

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