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Statistical models and methods for m...

Gupte, Nikhil Anil.

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Statistical models and methods for mother to infant HIV transmission studies.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Statistical models and methods for mother to infant HIV transmission studies./
Author:	Gupte, Nikhil Anil.
Description:	143 p.
Notes:	Source: Dissertation Abstracts International, Volume: 64-10, Section: B, page: 5021.
Contained By:	Dissertation Abstracts International64-10B.
Subject:	Statistics. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3107513

Statistical models and methods for mother to infant HIV transmission studies.
Gupte, Nikhil Anil.

Statistical models and methods for mother to infant HIV transmission studies. - 143 p.

Source: Dissertation Abstracts International, Volume: 64-10, Section: B, page: 5021.

Thesis (Ph.D.)--The Johns Hopkins University, 2004.

The overall objective of this thesis was to develop statistical models and methods for mother-to-infant HIV transmission studies. We address two specific issues in this work, first, based on the periodic viral assays, we propose a statistical model that estimates the mother-to-infant HIV transmission probabilities depending on the tinning of transmission. We do this by assuming time (age of the infant) dependent sensitivity function which also depends on the timing of vertical HIV transmission. In the second part, we propose statistical techniques to combine multiple HIV diagnostic tests so that the resulting decision rule would be highly sensitive and specific. For identifying pregnant women with HIV disease, we propose decision rules that have desired levels of sensitivity and specificity, and which would incur minimum expenses.Subjects--Topical Terms:

517247
Statistics.

Statistical models and methods for mother to infant HIV transmission studies.
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035 $a (UnM)AAI3107513
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100 1 $a Gupte, Nikhil Anil. $3 1949826
245 1 0 $a Statistical models and methods for mother to infant HIV transmission studies.
300 $a 143 p.
500 $a Source: Dissertation Abstracts International, Volume: 64-10, Section: B, page: 5021.
500 $a Adviser: Ronald Brookmeyer.
502 $a Thesis (Ph.D.)--The Johns Hopkins University, 2004.
520 $a The overall objective of this thesis was to develop statistical models and methods for mother-to-infant HIV transmission studies. We address two specific issues in this work, first, based on the periodic viral assays, we propose a statistical model that estimates the mother-to-infant HIV transmission probabilities depending on the tinning of transmission. We do this by assuming time (age of the infant) dependent sensitivity function which also depends on the timing of vertical HIV transmission. In the second part, we propose statistical techniques to combine multiple HIV diagnostic tests so that the resulting decision rule would be highly sensitive and specific. For identifying pregnant women with HIV disease, we propose decision rules that have desired levels of sensitivity and specificity, and which would incur minimum expenses.
520 $a As an application to the perinatal HIV transmission model we used data from South African and Indian mother-to-infant HIV transmission studies. The South African study was a randomized clinical trial to assess the role of post-exposure prophylaxis in reducing mother-to-child transmission of HIV-1 in infants born to infected mothers without access to antiretroviral therapy. The Indian data were from a pilot study for a clinical trial to reduce mother-to-infant HIV transmission. This clinical trial would enroll pregnant women who are HIV positive, and who intend to breastfeed their infants. A study was conducted to evaluate rapid HIV tests in a tertiary care hospital in Pune, India. These tests would be used to diagnose HIV infection in women so that they could be enrolled in the clinical trail. These data were used as an application to statistical methods for combining multiple diagnostic tests.
520 $a The analysis of South African data using our model estimated the overall mother-to-infant transmission rate of 18.86% with probability of transmission, intrauterine, 0.0696 (95% CI: 0.0264--0.1127), intrapartum, 0.0806, (95% CI: 0.0274--0.1338) and a risk of infection postpartum when breastfed for up to six months, is 0.0077 (probability of breastfeeding transmission, 0.0384) with a 95% CI for elambda: (0.9938, 1.0216). An estimated 79.6% of the transmissions occurred intrauterine and intrapartum. Modifying the model for non-breastfeeding infants, we analyzed data from the Indian clinical trial. The estimate of the overall perinatal HIV transmission probability is 0.1186 with a standard error of 0.0907. These data suggest that, 65.5% of the transmissions occurred intrauterine and 34.5% were infected intrapartum. (Abstract shortened by UMI.)
590 $a School code: 0098.
650 4 $a Statistics. $3 517247
650 4 $a Biology, Biostatistics. $3 1018416
650 4 $a Health Sciences, Public Health. $3 1017659
690 $a 0463
690 $a 0308
690 $a 0573
710 2 0 $a The Johns Hopkins University. $3 1017431
773 0 $t Dissertation Abstracts International $g 64-10B.
790 1 0 $a Brookmeyer, Ronald, $e advisor
790 $a 0098
791 $a Ph.D.
792 $a 2004
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3107513