Schechter M T, Le N, Craib K J, Le T N, O'Shaughnessy M V, Montaner J S
B.C. Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada.
J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Apr 15;8(5):474-9. doi: 10.1097/00042560-199504120-00007.
Seroconverting men in the Vancouver Lymphadenopathy--Acquired Immune Deficiency Syndrome Study cohort were studied in this analysis to estimate the waiting times in the different stages of the modified World Health Organization (WHO) staging system for human immunodeficiency virus infection. A time-homogeneous staged Markov model was used, and it was assumed that infected individuals progress irreversibly from Stages I to IV and eventually to death. There were 130 individuals who seroconverted during the study (seroincident) and were included in this analysis. With use of the modified WHO staging system, the estimated mean waiting times for progression to Stage IV were 9.5, 6.5, and 2.0 years from stages I, II, and III, respectively. The estimated survival times were 11.2, 8.2, 3.7, and 1.7 years from Stages I to IV, respectively. Waiting times and survival were not significantly different when the lymphocyte count was used instead of the CD4 cell count in application of the staging system. The application of a staged Markov model to the modified WHO staging system suggests that this is a clinically sensible model. Furthermore, our results confirm that in the absence of CD4 cell counts, lymphocyte counts can be used as an alternative without substantial loss of information.
在温哥华淋巴结病——获得性免疫缺陷综合征研究队列中，对血清转化的男性进行了此项分析，以估计人类免疫缺陷病毒感染的改良世界卫生组织（WHO）分期系统不同阶段的等待时间。使用了一个时间齐次的分期马尔可夫模型，并假设感染个体从I期到IV期不可逆地进展，最终死亡。在研究期间有130名个体发生血清转化（血清学发病）并纳入此项分析。使用改良的WHO分期系统，从I期、II期和III期进展到IV期的估计平均等待时间分别为9.5年、6.5年和2.0年。从I期到IV期的估计生存时间分别为11.2年、8.2年、3.7年和1.7年。在应用分期系统时，使用淋巴细胞计数而非CD4细胞计数时，等待时间和生存情况无显著差异。将分期马尔可夫模型应用于改良的WHO分期系统表明这是一个临床上合理的模型。此外，我们的结果证实，在没有CD4细胞计数的情况下，淋巴细胞计数可作为替代指标，而不会有大量信息丢失。
