Discussion and revision of the mathematical modeling tool described in the previously published article "Modeling HIV Transmission risk among Mozambicans prior to their initiating highly active antiretroviral therapy".
Discussion and revision of the mathematical modeling tool described in the previously published article "Modeling HIV Transmission risk among Mozambicans prior to their initiating highly active antiretroviral therapy".
复制标题
DOI：
10.1080/09540120802626204
复制
发表时间：
2009-07
期刊：
影响因子：
1.7
通讯作者：
Gloyd S
中科院分区：
文献类型：
--
作者：
Cassels S;Pearson CR;Kurth AE;Martin DP;Simoni JM;Matediana E;Gloyd S
数学模型越来越多地用于艾滋病毒传播的社会和行为研究;然而，模型结构必须仔细选择，以最好地回答手头的问题，结论必须谨慎解释。在中，我们提出了一个简单的分析处理确定性模型，以估计艾滋病毒阳性莫桑比克人继发性艾滋病毒感染的数量，并评估在不同的治疗和行为情景下估计值将如何变化。在随后对不同数据集的模型应用中，我们观察到该模型对新的HIV-1感染人数的估计过于保守。在这份简短的报告中，我们的第一个目标是描述模型的修订，以纠正这种低估。具体而言，我们建议调整人口层面的性传播感染（STI）参数，以适用于个人层面的模型规格占未感染STI的个人的比例。在将修订后的模型应用于原始数据时，我们注意到每年每1000名艾滋病毒阳性者中估计有40例感染（而最初的每年每1000名艾滋病毒阳性者中有23例感染）。此外，修订后的模型估计，高效抗逆转录病毒疗法（HAART）沿着梅毒和单纯疱疹病毒2型（HSV-2）治疗相结合，可以减少72%的HIV-1传播（根据原始模型为86%）。本报告的第二个目的是讨论数学模型在该领域的优点和缺点以及模型解释的影响。我们警告说，简单的模型应仅用于启发式目的。由于这些模型没有考虑到人口的异质性，并大大简化了艾滋病毒的传播动力学，它们应该用来描述流行病的一般特征，并证明模型中参数的重要性或敏感性。
Mathematical models are increasingly used in social and behavioral studies of HIV transmission; however, model structures must be chosen carefully to best answer the question at hand and conclusions must be interpreted cautiously. In, we presented a simple analytically tractable deterministic model to estimate the number of secondary HIV infections stemming from a population of HIV-positive Mozambicans and to evaluate how the estimate would change under different treatment and behavioral scenarios. In a subsequent application of the model with a different data set, we observed that the model produced an unduly conservative estimate of the number of new HIV-1 infections. In this brief report, our first aim is to describe a revision of the model to correct for this underestimation. Specifically, we recommend adjusting the population-level sexually transmitted infection (STI) parameters to be applicable to the individual-level model specification by accounting for the proportion of individuals uninfected with an STI. In applying the revised model to the original data, we noted an estimated 40 infections/1000 HIV-positive persons per year (versus the original 23 infections/1000 HIV-positive persons per year). In addition, the revised model estimated that highly active antiretroviral therapy (HAART) along with syphilis and herpes simplex virus type 2 (HSV-2) treatments combined could reduce HIV-1 transmission by 72% (versus 86% according to the original model). The second aim of this report is to discuss the advantages and disadvantages of mathematical models in the field and the implications of model interpretation. We caution that simple models should be used for heuristic purposes only. Since these models do not account for heterogeneity in the population and significantly simplify HIV transmission dynamics, they should be used to describe general characteristics of the epidemic and demonstrate the importance or sensitivity of parameters in the model.
登录
查看更多内容
影响因子：
3.7
作者：
Abu-Raddad LJ;Magaret AS;Celum C;Wald A;Longini IM Jr;Self SG;Corey L
通讯作者：
Corey L
影响因子：
3.8
作者：
Chakraborty, H;Sen, PK;Cohen, MS
通讯作者：
Cohen, MS
影响因子：
3.8
作者：
Gray, RH;Li, XB;Quinn, TC
通讯作者：
Quinn, TC
影响因子：
6.4
作者：
Korenromp, EL;White, RG;Hayes, RJ
通讯作者：
Hayes, RJ
影响因子：
3.8
作者：
Auvert, B;Buvé, A;Akam, E
通讯作者：
Akam, E