Forecasting Methods for HIV/AIDS and Aging

Abstract

Recent treatment advances suggest that AIDS may be changing from a rapidly lethal,acute disease into a chronic disease process with lengthy periods of remission.Stochastic compartment models can describe AIDS progression, remission, andoverall survival. Such models can combine multiple data sources to estimate transitions through intermediate, unobserved disease states. Age/time AIDS mortality maybe combined with age/time AIDS incidence to generate an "observed" health eventdistribution, using maximum likelihood estimation. The models can project the futurebehavior of AIDS in an aging population. Transitions among intermediate diseasestates (i.e., components of the disease's "natural" and "treatment-altered" history) canbe evaluated as time-varying functions that reflect treatment efficacy. For example,the introduction of protease inhibitors to therapy with two nucleoside analoguessignificantly slows transitions between disease states. Persons infected, but success-fully treated, may develop organ damage, neurological disorders, or cancer.

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