Exploring the Impact of Factors Affecting the Lifespan of HIVs/AIDS Patient’s Survival: An Investigation Using Advanced Statistical Techniques
- 1 Department of Statistics, Nnamdi Azikiwe University, Awka, Nigeria
- 2 Department of Statistics, Nnamdi Azikiwe University, Awka, Nigeria
- 3 College of Business, Missouri State University, Springfield, USA
- 4 Department of Statistics, Nnamdi Azikiwe University, Awka, Nigeria
Abstract
This study investigates the impact of various factors on the lifespan and diagnostic time of HIV/AIDS patients using advanced statistical techniques. The Power Chris-Jerry (PCJ) distribution is applied to model CD4 counts of patients, and the goodness-of-fit test confirms a strong fit with a p-value of 0.6196. The PCJ distribution is found to be the best fit based on information criteria (AIC and BIC) with the smallest negative log-likelihood, AIC, and BIC values. The study uses datasets from St. Luke hospital Uyo, Nigeria, containing HIV/AIDS diagnosis date, age, CD4 count, gender, and opportunistic infection dates. Multiple linear regression is employed to analyze the relationship between these variables and HIV/AIDS diagnostic time. The results indicate that age, CD4 count, and opportunistic infection significantly impact the diagnostic time, while gender shows a nonsignificant relationship. The F-test confirms the model's overall significance, indicating the factors are good predictors of HIV/AIDS diagnostic time. The R-squared value of approximately 72% suggests that administering antiretroviral therapy (ART) can improve diagnostic time by suppressing the virus and protecting the immune system. Cox proportional hazard modeling is used to examine the effects of predictor variables on patient survival time. Age and CD4 count are not significant factors in the hazard of HIV/AIDS diagnostic time, while opportunistic infection is a significant predictor with a decreasing effect on the hazard rate. Gender shows a strong but nonsignificant relationship with decreased risk of death. To address the violation of the assumption of proportional hazard, the study employs an assumption-free alternative, Aalen ’ s model. In the Aalen model, all predictor variables except age and gender are statistically significant in relation to HIV/AIDS diagnostic time. The findings provide valuable insights into the factors influencing diagnostic time and survival of HIV/AIDS patients, which can inform interventions aimed at reducing transmission and improving early diagnosis and treatment. The Power Chris-Jerry distribution proves to be a suitable fit for modeling CD4 counts, while multiple linear regression and survival analysis techniques provide insights into the relationships between predictor variables and diagnostic time. These results contribute to the understanding of HIV/AIDS patient outcomes and can guide public health interventions to enhance early detection, treatment, and care.
- Marks, G., Crepaz, N. and Janssen, R.S. (2006) Estimating Sexual Transmission of HIV from Persons Aware and Unaware That They Are Infected with the Virus in the USA. AIDS, 20, 1447-1450. https://doi.org/10.1097/01.aids.0000233579.79714.8d
- Mugavero, M.J., Amico, K.R., Horn, T. and Thompson, M.A. (2013) The State of Engagement in HIV Care in the United States: From Cascade to Continuum to Control. Clinical Infectious Diseases, 57, 1164-1171. https://doi.org/10.1093/cid/cit420
- May, M., Gompels, M. and Delpech, V. (2011) Impact of Late Diagnosis and Treatment on Life Expectancy in People with HIV-1: UK Collaborative HIV Cohort (UK CHIC) Study. The BMJ, 343, d6016. https://doi.org/10.1136/bmj.d6016
- Sobrino-Vegas, P., Rodríguez-Urrego, J. and Berenguer, J. (2001) Delayed Diagnosis of HIV Infection in Spain: Missed Opportunities for Optimal Intervention. Journal of Acquired Immune Deficiency Syndromes, 26, 513-520.
- Palella Jr, F.J., Deloria-Knoll, M. and Chmiel, J.S. (2003) Survival Benefit of Initiating Antiretroviral Therapy in HIV-Infected Persons in Different CD4+ Cell Strata. Annals of Internal Medicine, 138, 620-626. https://doi.org/10.7326/0003-4819-138-8-200304150-00007
- Pathai, S., Bajillan, H., Landay, A.L. and High, K.P. (2014) Is HIV a Model of Accelerated or Accentuated Aging? The Journals of Gerontology: Series A, 69, 833-842. https://doi.org/10.1093/gerona/glt168
- Lawn, S.D., Butera, S.T. and Folks, T.M. (2001) Contribution of Immune Activation to the Pathogenesis and Transmission of Human Immunodeficiency Virus Type 1 Infection. Clinical Microbiology Reviews, 14, 753-777. https://doi.org/10.1128/CMR.14.4.753-777.2001
- Kuller, L.H., Tracy, R. and Belloso, W. (2008) Inflammatory and Coagulation Biomarkers and Mortality in Patients with HIV Infection. PLOS Medicine, 5, e203. https://doi.org/10.1371/journal.pmed.0050203
- Nacher, M., Huber, F., Adriouch, L., Djossou, F., Adenis, A. and Couppie, P. (2018) Temporal Trend of the Proportion of Patients Presenting with Advanced HIV in French Guiana: Stuck on the Asymptote? BMC Research Notes, 11, Article No. 831.
- Coffin, J.M. (1999) Molecular Biology of HIV. In: Crandall, K.A., Ed., The Evolution of HIV, Johns Hopkins University Press, Baltimore, 3-40.
- Udofia, E.M., Umeh, E.U. and Onyekwere, C.K. (2021) Modeling of Survival of HIV Patients by Stages of Immune Suppression and Opportunisic Infections. American Journal of Theoretical and Applied Statistics, 10, 233-242. https://doi.org/10.11648/j.ajtas.20211006.12