Balasubramanian R, Lagakos S W
Department of Biostatistics, Harvard University School of Public Health, Boston, Massachusetts 02115, USA.
Biometrics. 2001 Dec;57(4):1048-58. doi: 10.1111/j.0006-341x.2001.01048.x.
Knowledge of the timing of perinatal transmission of HIV would be valuable for the determination and evaluation of preventive treatments and would shed light on the mechanism of transmission. Estimation of the distribution of the time of perinatal transmission is difficult, however, because tests of infection status can only be undertaken after birth. DNA and RNA polymerase chain reaction (PCR) assays and HIV culture have been the most commonly used diagnostic tests for perinatal HIV infection. Such tests have high sensitivity and specificity, except when they are given shortly after infection. In this paper we use the time-dependent sensitivity of these diagnostic tests to make nonparametric and semiparametric inferences about the distribution of the time of perinatal HIV transmission as well as the cumulative probability of perinatal transmission. The methods are illustrated with data from a clinical trial conducted by the AIDS Clinical Trials group.
了解围产期艾滋病毒传播的时间对于确定和评估预防性治疗具有重要价值，并且有助于阐明传播机制。然而，围产期传播时间分布的估计很困难，因为感染状况测试只能在出生后进行。DNA和RNA聚合酶链反应（PCR）检测以及艾滋病毒培养一直是围产期艾滋病毒感染最常用的诊断测试。这些测试具有很高的灵敏度和特异性，除非在感染后不久进行检测。在本文中，我们利用这些诊断测试的时间依赖性灵敏度，对围产期艾滋病毒传播时间的分布以及围产期传播的累积概率进行非参数和半参数推断。通过艾滋病临床试验组进行的一项临床试验的数据对这些方法进行了说明。
