Comparison of Methods to Correct Survival Estimates and Survival Regression Analysis on a Large HIV African Cohort - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue PLoS ONE Année : 2012

Comparison of Methods to Correct Survival Estimates and Survival Regression Analysis on a Large HIV African Cohort

J. Henriques
  • Fonction : Auteur
M. Pujades-Rodriguez
  • Fonction : Auteur
M. Mcguire
  • Fonction : Auteur
E. Szumilin
  • Fonction : Auteur
J. Iwaz
  • Fonction : Auteur
J.F. Etard
  • Fonction : Auteur
R. Ecochard

Résumé

Objective: The evaluation of HIV treatment programs is generally based on an estimation of survival among patients receiving antiretroviral treatment (ART). In large HIV programs, loss to follow-up (LFU) rates remain high despite active patient tracing, which is likely to bias survival estimates and survival regression analyses. Methods: We compared uncorrected survival estimates derived from routine program data with estimates obtained by applying six correction methods that use updated outcome data by a field survey targeting LFU patients in a rural HIV program in Malawi. These methods were based on double-sampling and differed according to the weights given to survival estimates in LFU and non-LFU subpopulations. We then proposed a correction of the survival regression analysis. Results: Among 6,727 HIV-infected adults receiving ART, 9% were LFU after one year. The uncorrected survival estimates from routine data were 91% in women and 84% in men. According to increasing sophistication of the correction methods, the corrected survival estimates ranged from 89% to 85% in women and 82% to 77% in men. The estimates derived from uncorrected regression analyses were highly biased for initial tuberculosis mortality ratios (RR; 95% CI: 1.07; 0.76-1.50 vs. 2.06 to 2.28 with different correction weights), Kaposi sarcoma diagnosis (2.11; 1.61-2.76 vs. 2.64 to 3.9), and year of ART initiation (1.40; 1.17-1.66 vs. 1.29 to 1.34). Conclusions: In HIV programs with high LFU rates, the use of correction methods based on non-exhaustive double-sampling data are necessary to minimise the bias in survival estimates and survival regressions.

Domaines

Autre [q-bio.OT]

Dates et versions

hal-00697952 , version 1 (16-05-2012)

Identifiants

Citer

J. Henriques, M. Pujades-Rodriguez, M. Mcguire, E. Szumilin, J. Iwaz, et al.. Comparison of Methods to Correct Survival Estimates and Survival Regression Analysis on a Large HIV African Cohort. PLoS ONE, 2012, 7 (2), pp.1-7. ⟨10.1371/journal.pone.0031706⟩. ⟨hal-00697952⟩
106 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Mastodon Facebook X LinkedIn More