纵向结果和竞争风险的联合建模:在HIV/AIDS数据中的应用。

IF 1.4 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Khadijeh Najafi Ghobadi, Hossein Mahjub, Jalal Poorolajal, Ebrahim Shakiba, Kaivan Khassi, Ghodratollah Roshanaei
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引用次数: 0

摘要

背景:结核病(TB)和人类免疫缺陷病毒(HIV)是全球主要的公共卫生挑战,由于艾滋病毒/结核病合并感染,结核病感染人数和由艾滋病毒引起的死亡人数很高。另一方面,CD4计数在结核/艾滋病毒合并感染中起着重要作用。我们使用纵向结果和竞争风险的联合模型来确定潜在的危险因素以及CD4细胞对HIV感染患者的结核病感染和由HIV引起的死亡的影响。研究设计:这是一项回顾性队列研究。方法:本研究对1998-2019年期间在克尔曼沙阿省行为疾病咨询中心转诊的1436名HIV阳性患者进行了研究。本研究采用联合建模的方法,确定潜在危险因素和CD4细胞对TB和HIV致死亡的影响。结果:CD4细胞计数下降与死亡风险增加显著相关,而与结核风险无显著相关性。此外,结核病患者的死亡风险更高。结果发现,CD4计数与性别、婚姻状况、教育程度、抗逆转录病毒治疗(ART)、时间以及时间与ART的相互作用存在显著关系。此外,通过性关系感染艾滋病毒的人患结核病的风险较高,而接受抗逆转录病毒治疗或通过药物注射感染艾滋病毒的有监禁史的人患结核病的风险较低。结论:研究结果表明,CD4计数下降与艾滋病毒引起的死亡风险增加有显著关联。然而,它与结核病的风险没有显著相关性。最后,结核病患者死于艾滋病毒的风险更高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Joint Modeling of Longitudinal Outcome and Competing Risks: Application to HIV/AIDS Data.

Background: Tuberculosis (TB) and human immunodeficiency virus (HIV) are major public health challenges globally, and the number of TB infections and death caused by HIV are high because of HIV/ TB co-infection. On the other hand, CD4 count plays a significant role in TB/HIV co-infections. We used a joint model of longitudinal outcomes and competing risks to identify the potential risk factors and the effect of CD4 cells on TB infection and death caused by HIV in HIV-infected patients.

Study design: This was a retrospective cohort study.

Methods: The current study was performed on 1436 HIV+patients referred to Behavioral Diseases Counseling Centers in Kermanshah Province during 1998-2019. In this study, joint modeling was used to identify the effect of potential risk factors and CD4 cells on TB and death caused by HIV.

Results: The results demonstrated that the decreasing CD4 cell count was significantly associated with an increased risk of death, while it had no significant relation with the risk of TB. In addition, patients with TB were at a higher risk of death. Based on the results, a significant relationship was found between CD4 count and sex, marital status, education level, antiretroviral therapy (ART), time, and the interaction between time and ART. Further, people infected with HIV through sexual relationships were at higher risk of TB, while those with a history of imprisonment who received ART or were infected with HIV through drug injection had a lower risk of TB.

Conclusion: The findings revealed that the decreasing CD4 count had a significant association with an increased risk of death caused by HIV. However, it was not significantly related to the risk of TB. Finally, patients with TB were at higher risk of death caused by HIV.

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来源期刊
Journal of research in health sciences
Journal of research in health sciences PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
2.30
自引率
13.30%
发文量
7
期刊介绍: The Journal of Research in Health Sciences (JRHS) is the official journal of the School of Public Health; Hamadan University of Medical Sciences, which is published quarterly. Since 2017, JRHS is published electronically. JRHS is a peer-reviewed, scientific publication which is produced quarterly and is a multidisciplinary journal in the field of public health, publishing contributions from Epidemiology, Biostatistics, Public Health, Occupational Health, Environmental Health, Health Education, and Preventive and Social Medicine. We do not publish clinical trials, nursing studies, animal studies, qualitative studies, nutritional studies, health insurance, and hospital management. In addition, we do not publish the results of laboratory and chemical studies in the field of ergonomics, occupational health, and environmental health
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