Time from HIV seroconversion to death: a collaborative analysis of eight studies in six low and middle-income countries before highly active antiretroviral therapy

Todd, Jim; Glynn,; Marston, Milly; Lutalo, Tom; Biraro, Sam; Wambura, Mwita; Suriyanon,; Rangsin, Ram; Ke, Nelson; Sonnenberg, Pam; Fitzgerald, Daniel W.; Karita, Etienne; Żaba, Basia

doi:10.1097/01.aids.0000299411.75269.e8

Cited by 147 publications

(155 citation statements)

References 30 publications

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“…These data are only from sub-Saharan Africa with 51% of the person-years of exposure coming from the ZVITAMBO trial in Zimbabwe. 8 Regional differentials between sub-Saharan Africa and Thailand were seen in adults; 19 therefore, adding data from other regions would help confirm whether such differences exist for the mortality of HIV-positive children, although we acknowledge that fewer HIV-exposed children are breastfed in Asia or South America than in sub-Saharan Africa.…”

Section: Discussionmentioning

confidence: 99%

“…External constraints were introduced to extend the curve beyond the follow-up time provided by the studies, and these data were used until 20 subjects were remaining, which was deemed as a point at which the results could not be seen as reliable due to small numbers. Recently, a pooled study has been published 5,19 showing survival post infection in adults by age of infection using data from low-and middle-income countries. This showed a more favourable survival for those adults infected at a younger age, and similar results were found in studies from higher-income countries in the pre-ART era.…”

Section: Calculating Net Survivalmentioning

confidence: 99%

See 1 more Smart Citation

Net survival of perinatally and postnatally HIV-infected children: a pooled analysis of individual data from sub-Saharan Africa

Marston

Becquet

Żaba

et al. 2011

International Journal of Epidemiology

149

122

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Section: Discussionmentioning

confidence: 99%

Section: Calculating Net Survivalmentioning

confidence: 99%

Net survival of perinatally and postnatally HIV-infected children: a pooled analysis of individual data from sub-Saharan Africa

Marston

Becquet

Żaba

et al. 2011

International Journal of Epidemiology

149

122

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“…Older age at infection pre-ART is associated with a shorter survival time [24] independent of current age [25]. We investigated whether this could also have an effect on subfertility classified by duration of infection (model not shown).…”

Section: Fertility Rate Ratio By Duration Of Infectionmentioning

confidence: 99%

The effects of HIV on fertility by infection duration

Marston

Nakiyingi‐Miiro

Kusemererwa

et al. 2017

Aids

Self Cite

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on behalf of the ALPHA network 1 Objectives: To estimate the relationship between HIV natural history and fertility by duration of infection in east and southern Africa before the availability of antiretroviral therapy and assess potential biases in estimates of age-specific subfertility when using retrospective birth histories in cross-sectional studies.Design: Pooled analysis of prospective population-based HIV cohort studies in Masaka (Uganda), Kisesa (Tanzania) and Manicaland (Zimbabwe).Methods: Women aged 15-49 years who had ever tested for HIV were included. Analyses were censored at antiretroviral treatment roll-out. Fertility rate ratios were calculated to see the relationship of duration of HIV infection on fertility, adjusting for background characteristics. Survivorship and misclassification biases on age-specific subfertility estimates from cross-sectional surveys were estimated by reclassifying person-time from the cohort data to simulate cross-sectional surveys and comparing fertility rate ratios with true cohort results.Results: HIV-negative and HIV-positive women contributed 15 440 births and 86 320 person-years; and 1236 births and 11 240 000 person-years, respectively, to the final dataset. Adjusting for age, study site and calendar year, each additional year since HIV seroconversion was associated with a 0.02 (95% confidence interval 0.01-0.03) relative decrease in fertility for HIV-positive women. Survivorship and misclassification biases in simulated retrospective birth histories resulted in modest underestimates of subfertility by 2-5% for age groups 20-39 years.Conclusion: Longer duration of infection is associated with greater relative fertility reduction for HIV-positive women. This should be considered when creating estimates for HIV prevalence among pregnant women and prevention of mother-to-child transmission need over the course of the HIV epidemic and antiretroviral treatment scale up.

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“…The pattern of progression from infection to AIDS was initially based on a Weibull distribution with a median survival of 7, 9 or 11 years, then updated to 9 years from infection to AIDS death based on the Masaka cohort in 2003 [45], then updated to a median of 11 years’ survival based on data from the ALPHA network starting in 2007 [27]. In 2012 Spectrum implemented the CD4 compartment approach for adults where the HIV-positive population is tracked by CD4 count based on annual rates of CD4 count decline and mortality by CD4 category [42].…”

Section: Resultsmentioning

confidence: 99%

Producing HIV estimates: from global advocacy to country planning and impact measurement

Mahy

Brown

Stover

et al. 2017

Global Health Action

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Background: The development of global HIV estimates has been critical for understanding, advocating for and funding the HIV response. The process of generating HIV estimates has been cited as the gold standard for public health estimates. Objective: This paper provides important lessons from an international scientific collaboration and provides a useful model for those producing public health estimates in other fields. Design: Through the compilation and review of published journal articles, United Nations reports, other documents and personal experience we compiled historical information about the estimates and identified potential lessons for other public health estimation efforts. Results: Through the development of core partnerships with country teams, implementers, demographers, mathematicians, epidemiologists and international organizations, UNAIDS has led a process to develop the capacity of country teams to produce internationally comparable HIV estimates. The guidance provided by these experts has led to refinements in the estimated numbers of people living with HIV, new HIV infections and AIDS-related deaths over the past 20 years.A number of important updates to the methods since 1997 resulted in fluctuations in the estimated levels, trends and impact of HIV. The largest correction occurred between the 2005 and 2007 rounds with the additions of household survey data into the models. In 2001 the UNAIDS models at that time estimated there were 40 million people living with HIV. In 2016, improved models estimate there were 30 million (27.6–32.7 million) people living with HIV in 2001. Conclusions: Country ownership of the estimation tools has allowed for additional uses of the results than had the results been produced by researchers or a team in Geneva. Guidance from a reference group and input from country teams have led to critical improvements in the models over time. Those changes have improved countries’ and stakeholders’ understanding of the HIV epidemic.

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Time from HIV seroconversion to death: a collaborative analysis of eight studies in six low and middle-income countries before highly active antiretroviral therapy

Cited by 147 publications

References 30 publications

Net survival of perinatally and postnatally HIV-infected children: a pooled analysis of individual data from sub-Saharan Africa

Net survival of perinatally and postnatally HIV-infected children: a pooled analysis of individual data from sub-Saharan Africa

The effects of HIV on fertility by infection duration

Producing HIV estimates: from global advocacy to country planning and impact measurement

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