Statistical Joint Modeling for Predicting the Association of CD4 Measurement and Time to Death of People Living with HIV Who Enrolled in ART, Southwest Ethiopia

Firew Tiruneh,1 Lalisa Chewaka,2 Dinaol Abdissa1,3 1Department of Midwifery, College of Health Science, Mizan Tepi University, Mizan Teferi, SNNPR, Ethiopia; 2Department of Nursing, College of Health Science, Mizan Tepi University, Mizan Teferi, SNNPR, Ethiopia; 3Department of Nutrition and Reproduc...

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Autores principales:	Tiruneh F, Chewaka L, Abdissa D
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	hiv survival joint modeling cd4 prediction Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/cfdc8b45121a448291552d1c545dcb46
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spelling	oai:doaj.org-article:cfdc8b45121a448291552d1c545dcb462021-12-02T10:55:25ZStatistical Joint Modeling for Predicting the Association of CD4 Measurement and Time to Death of People Living with HIV Who Enrolled in ART, Southwest Ethiopia1179-1373https://doaj.org/article/cfdc8b45121a448291552d1c545dcb462021-01-01T00:00:00Zhttps://www.dovepress.com/statistical-joint-modeling-for-predicting-the-association-of-cd4-measu-peer-reviewed-article-HIVhttps://doaj.org/toc/1179-1373Firew Tiruneh,1 Lalisa Chewaka,2 Dinaol Abdissa1,3 1Department of Midwifery, College of Health Science, Mizan Tepi University, Mizan Teferi, SNNPR, Ethiopia; 2Department of Nursing, College of Health Science, Mizan Tepi University, Mizan Teferi, SNNPR, Ethiopia; 3Department of Nutrition and Reproductive Health, School of Public Health, College of Health Science, Mizan Tepi University, Mizan Teferi, SNNPR, EthiopiaCorrespondence: Firew TirunehMizan Tepi University, PO Box 260, Mizan Teferi, EthiopiaTel +251-917-83-0101Email mtu2012x@gmail.comBackground: In much epidemiological HIV research, patients are often followed over a period of time to predict their survival on the basis of repeatedly measured CD4 status. To predict survival, statistical models of the association between mortality and longitudinal CD4 measurement have been conducted widely using time-varying Cox models. However, in the presence of repeated measure, this approach leads to biased estimates. In view of the limitation of time-varying Cox models, in the present study, we considered joint modeling to predict the association of longitudinal CD4 measurement and time to death among patients initiated on ART.Methods: A retrospective cohort study was employed for five years from 2009 to 2014 on a randomly selected 358 samples. Data were collected from patients’ ART and pre-ART follow-up registration book, database and other clinical records. Data were analyzed using joint latent class modeling of repeated CD4 measurement and time-to-event (HIV death).Results: We have studied a total of 358 HIV-positive patients. The median and interquartile ranges of the age of patients were 30.31 years and 13.82, respectively. Males constitute the larger proportion, 51.68%. The square root of CD4 count has declined on average over time. This has been indicated with the negative sign of the coefficient for the time effect. The deterioration of health of individuals is severe in class 1, it has been observed with a worse decline in CD4 cell counts over time in this class than other classes (β= − 0.488). Women had a larger risk rate than men (β=− 2.475, p-value=0.013). Besides, the CD4 counts measurement of patients has been revealed to decrease as age increases (β= − 0.016, p=0.008).Conclusion: The finding indicated that the square root CD4 cell measurement dropped over time in the three classes. This clearly suggested deterioration in the health of individuals. Women were found to have a higher hazard rate than men.Keywords: HIV, survival, joint modeling, CD4, predictionTiruneh FChewaka LAbdissa DDove Medical Pressarticlehivsurvivaljoint modelingcd4predictionImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol Volume 13, Pp 73-79 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	hiv survival joint modeling cd4 prediction Immunologic diseases. Allergy RC581-607
spellingShingle	hiv survival joint modeling cd4 prediction Immunologic diseases. Allergy RC581-607 Tiruneh F Chewaka L Abdissa D Statistical Joint Modeling for Predicting the Association of CD4 Measurement and Time to Death of People Living with HIV Who Enrolled in ART, Southwest Ethiopia
description	Firew Tiruneh,1 Lalisa Chewaka,2 Dinaol Abdissa1,3 1Department of Midwifery, College of Health Science, Mizan Tepi University, Mizan Teferi, SNNPR, Ethiopia; 2Department of Nursing, College of Health Science, Mizan Tepi University, Mizan Teferi, SNNPR, Ethiopia; 3Department of Nutrition and Reproductive Health, School of Public Health, College of Health Science, Mizan Tepi University, Mizan Teferi, SNNPR, EthiopiaCorrespondence: Firew TirunehMizan Tepi University, PO Box 260, Mizan Teferi, EthiopiaTel +251-917-83-0101Email mtu2012x@gmail.comBackground: In much epidemiological HIV research, patients are often followed over a period of time to predict their survival on the basis of repeatedly measured CD4 status. To predict survival, statistical models of the association between mortality and longitudinal CD4 measurement have been conducted widely using time-varying Cox models. However, in the presence of repeated measure, this approach leads to biased estimates. In view of the limitation of time-varying Cox models, in the present study, we considered joint modeling to predict the association of longitudinal CD4 measurement and time to death among patients initiated on ART.Methods: A retrospective cohort study was employed for five years from 2009 to 2014 on a randomly selected 358 samples. Data were collected from patients’ ART and pre-ART follow-up registration book, database and other clinical records. Data were analyzed using joint latent class modeling of repeated CD4 measurement and time-to-event (HIV death).Results: We have studied a total of 358 HIV-positive patients. The median and interquartile ranges of the age of patients were 30.31 years and 13.82, respectively. Males constitute the larger proportion, 51.68%. The square root of CD4 count has declined on average over time. This has been indicated with the negative sign of the coefficient for the time effect. The deterioration of health of individuals is severe in class 1, it has been observed with a worse decline in CD4 cell counts over time in this class than other classes (β= − 0.488). Women had a larger risk rate than men (β=− 2.475, p-value=0.013). Besides, the CD4 counts measurement of patients has been revealed to decrease as age increases (β= − 0.016, p=0.008).Conclusion: The finding indicated that the square root CD4 cell measurement dropped over time in the three classes. This clearly suggested deterioration in the health of individuals. Women were found to have a higher hazard rate than men.Keywords: HIV, survival, joint modeling, CD4, prediction
format	article
author	Tiruneh F Chewaka L Abdissa D
author_facet	Tiruneh F Chewaka L Abdissa D
author_sort	Tiruneh F
title	Statistical Joint Modeling for Predicting the Association of CD4 Measurement and Time to Death of People Living with HIV Who Enrolled in ART, Southwest Ethiopia
title_short	Statistical Joint Modeling for Predicting the Association of CD4 Measurement and Time to Death of People Living with HIV Who Enrolled in ART, Southwest Ethiopia
title_full	Statistical Joint Modeling for Predicting the Association of CD4 Measurement and Time to Death of People Living with HIV Who Enrolled in ART, Southwest Ethiopia
title_fullStr	Statistical Joint Modeling for Predicting the Association of CD4 Measurement and Time to Death of People Living with HIV Who Enrolled in ART, Southwest Ethiopia
title_full_unstemmed	Statistical Joint Modeling for Predicting the Association of CD4 Measurement and Time to Death of People Living with HIV Who Enrolled in ART, Southwest Ethiopia
title_sort	statistical joint modeling for predicting the association of cd4 measurement and time to death of people living with hiv who enrolled in art, southwest ethiopia
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/cfdc8b45121a448291552d1c545dcb46
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Statistical Joint Modeling for Predicting the Association of CD4 Measurement and Time to Death of People Living with HIV Who Enrolled in ART, Southwest Ethiopia

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