Modeling the incidence of Acquired Immunodeficiency Syndrome (AIDS) in San Francisco, Los Angeles, and New York
Modeling the incidence of Acquired Immunodeficiency Syndrome (AIDS) in San Francisco, Los Angeles, and New York
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对旧金山、洛杉矶和纽约的获得性免疫缺陷综合症 (AIDS) 发病率进行建模
DOI：
10.1016/0270-0255(86)90127-2
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发表时间：
1986
期刊：
影响因子：
--
通讯作者：
Juliette C. Walker
中科院分区：
文献类型：
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作者：
J. Pickering;J. Wiley;N. Padian;L. Lieb;D. Echenberg;Juliette C. Walker
到1985年11月，纽约、弗朗西斯科和洛杉矶报告的艾滋病病例分别超过4980、1403和1315例。尽管在1984年7月之前的10-11个月里，这些城市的累计确诊病例数翻了一番，但艾滋病发病率不一定会继续以这种速度增长。一个离散的，非线性模型，并用于探索潜在的生物学和社会学特征的艾滋病爆发，并预测新的病例数。该模型的结构假设艾滋病是性传播的，其他形式的传播类似于性传播。它的参数反映了（1）艾滋病从暴露到诊断需要多长时间，（2）在这个发展过程中，个体何时具有传染性，以及（3）性行为和性饱和度的变化-通过感染去除易感个体-如何影响艾滋病的发病率。作为行为变化的指标，该模型使用在旧金山弗朗西斯科诊所诊断的淋病趋势，其中肛门/直肠病例从1979-1981年的月平均411例下降到1985年的59例，尿道病例也从863例下降到248例。肛门/直肠淋病的下降比尿道淋病的下降更好地反映了有艾滋病风险的旧金山弗朗西斯科人群中性接触率的下降。此外，将模型与来自洛杉矶、纽约和旧金山弗朗西斯科的发病率数据最佳拟合的参数值目前一般表明，艾滋病从暴露到诊断需要35-47个月的时间，个体在三个阶段中传染性最强尽管对这三个城市的预测表明，艾滋病的发病率可能会在16个月内上升，从1987年以前的水平来看，这一模式显示，目前可能没有足够的数据可供使用平方和标准在完全不同的预测之间作出选择。例如，通过将洛杉矶艾滋病发病率与肛门/直肠淋病的下降联系起来，将模型拟合到艾滋病发病率的两个参数集给出了相似的残差平方和806和808，但对1987年之前洛杉矶确诊的3271和2230例总病例的预测不同。这些结果表明，需要更多的数据才能选择决定性的参数值。尽管如此，该模型与来自旧金山弗朗西斯科的肛门/直肠淋病率结合使用，以产生艾滋病发病率的初步预测。到1986年底，它预测洛杉矶的累计确诊病例总数为2200-3300例，纽约为6800-8900例，弗朗西斯科为2100-4200例，模型与观察到的发病率的最佳拟合表明，这些城市的累计病例数至少为2400、7200和2500例。分别
By November, 1985, reported AIDS cases in New York, San Francisco, and Los Angeles totaled over 4980, 1403, and 1315, respectively. Although the cumulative number of cases diagnosed doubled in these cities in the 10–11 months before July, 1984, the incidence of AIDS will not necessarily continue to increase at this rate. A discrete, nonlinear model is presented and used to explore underlying biological and sociological characteristics of the AIDS outbreak and to forecast the number of new cases. The model's structure assumes that AIDS is sexually transmitted and that other forms of transmission mimic sexual transmission. Its parameters reflect (1) how long AIDS takes to develop from exposure to diagnosis, (2) when during this development individuals are contagious, and (3) how changes in sexual behavior and saturation— the removal of susceptible individuals through infection—affect the incidence of AIDS. As indices of behavioral changes, the model uses trends in gonorrhea diagnosed at a San Francisco clinic, where anal/rectal cases have dropped from a monthly average of 411 in 1979–1981 to 59 in 1985, and, urethral cases, similarly, from 863 to 248.Judged by the least residual sum of squares of the model's fit to observations, the drop in anal/rectal gonorrhea better reflects the decline in sexual contact rates in the San Francisco population at risk to AIDS than does the drop in urethral gonorrhea. Furthermore, the parameter values that best fit the model to the incidence data from Los Angeles, New York, and San Francisco currently suggest in general that AIDS takes 35–47 months to develop from exposure to diagnosis, and, that individuals are most infectious in the 3–16 months immediately following exposure to the agent.Although forecasts for each of these three cities suggest that the incidence of AIDS could level off or even decline from present levels before 1987, the model shows that there may currently be insufficient data to choose, using the sum of squares criterion, between radically different forecasts. Two parameter sets that fit the model to Los Angeles AIDS incidence by linking it to the drop in anal/rectal gonorrhea, for example, give similar residual sum of squares of 806 and 808 but different forecasts of 3271 and 2230 total cases diagnosed in Los Angeles before 1987. These results suggest that more data are needed before conclusive parameter values can be chosen. Nevertheless, the model is used in conjunction with anal/rectal gonorrhea rates from San Francisco to generate preliminary forecasts of AIDS incidence. By the end of 1986, it forecasts a range for the total cumulative number of diagnosed cases in Los Angeles of 2200–3300, in New York of 6800–8900, and in San Francisco of 2100–4200, with the model's best fits to observed incidence suggesting that there will be at least 2400, 7200, and 2500 cummulative cases in these cities, respectively.
患有艾滋病相关综合症的人和有艾滋病风险的健康男同性恋者唾液中的 HTLV-III。
DOI：
10.1126/science.6093247
发表时间：
1984
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Groopman,JE;Salahuddin,SZ;Sarngadharan,MG;Markham,PD;Gonda,M;Sliski,A;Gallo,RC
通讯作者：
Gallo,RC