HIV Transmission: Statistical Modelling

340 Pages·2020·7.704 MB·English

by  D. M. Basavarajaiah, Bhamidipati Narasimha Murthy

HIV Transmission
Statistical Modelling
D. M. Basavarajaiah
Bhamidipati Narasimha Murthy
123
HIV Transmission
(cid:129)
D. M. Basavarajaiah
Bhamidipati Narasimha Murthy
HIV Transmission
Statistical Modelling
D.M.Basavarajaiah BhamidipatiNarasimhaMurthy
DepartmentofStatisticsandComputer DepartmentofBiostatistics
Science NationalInstituteofEpidemiology,ICMR
VeterinaryAnimalandFisheriesSciences Chennai,TamilNadu,India
University
Bengaluru,Karnataka,India
ISBN978-981-15-0150-0 ISBN978-981-15-0151-7 (eBook)
https://doi.org/10.1007/978-981-15-0151-7
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This book is dedicated to all
HIV-infected children.
Preface
HIVisascourge.Researchofalmost35yearsintohumanimmunodeficiencyvirus
(HIV) has conceivably precipitated more questions than answers. It is widely
understood that unprotected sexual intercourse, intrauterine device (IUD), and
mother to child transmission (MTCT) are the main modes of HIV transmission.
It’sbeenmorethanthreedecadesatgloballevelitisanaddressableissue,thathas
playedasignificantroleofHIVpreventionprogramatnationalandgloballevel.Due
tothepaucityofenquiry-basedstudy,thepolicymakerswereunabletoimplement
new scientific and innovative eradicated programs of HIV MTCT. In this propin-
quityoftheresearchgap,theHIVmodel-basedstudywillhelptoelucidateobserved
patternsofHIVverticaltransmissionrateatglobalscenario.However,themodelling
techniquesareroutinelyusedtoestimatenationalandglobaltrendsofthenumberof
infantsinfectedthroughHIV-MTCT.Suchtypeoffittedmodelsdependontheinput
data sets from individual antiretroviral therapy (ART) centers. The present study
interventionhasdemonstrateddifferentstatisticalandmathematicalmodelsbasedon
the primary and secondary HIV life data sets collected from thrust area (high
prevalence state). The collected HIV massive data sets were demonstrated with
variousmathematicalandstatisticalmodels.Thesefittedmodelsproduceaninsight
analyticalalgorithmstoproveHIV transmissionrateatgreater accuracyandeasily
substituteHIV transmissionwithprior andposterior probabilities (both peripartum
andpostnatal)forestimationofmaximumlikelihood(MLE’s)ofHIVtransmission
rate and algebraic bifurcations (forward/backward). Intervention of maternal
infections (either incident or prevention), timing of infection, comorbidity, and
clinical history have been utilized for the determination of HIV transmission rate
(based on HIV MTCT infection rate). Since the fitted mathematical and statistical
models would clarify the full implications of the research findings and global
population dynamism of the vertical transmission (MTCT), building of this few
cited mathematical models has been used extensively over the past decades to
examinetheepidemicofHIVandacquiredimmunodeficiencysyndrome(AIDS)at
global level. As per the normative results of the HIV vertical transmission,
these fitted models will serve as an important analytical algorithms to recognize
the inherent limitations of massive HIV data sets; impart scientific evidence for
researchers, clinicians, and public health administrators etc. In this present book, a
several important practical and statistical implications and deep illustrations are
discussed, which seem to be simple yet complex, that need to be addressed and
vii
viii Preface
examinedwhileanalyzingHIVMTCTmassivedatasets.Forexample,HIVitselfis
alife-threateningdeadlydisease.However,toomanyquestionsarosefromHIVlife
datasets,andtheresearchers/statisticians/cliniciansarefacingseveralpitfallsforthe
simulationandreductionofHIVmassivedatasetswhilecarryingtrickysituationsof
hypothesistestinganddecision-makingproblemsatlargerpopulationlevel.Major-
ity of the chapters tailored in this book, which can attempt to demonstrate various
techniques of building mathematical and statistical models while analyzing HIV
transmission from mother to child in HIV real-life data sets. The present book
consists of 13 chapters. Chapter 1 describes introduction of HIV transmission,
briefreviewofthepublishedandunpublishedliteraturefrom1997to2019,building
ofmathematicalandstatisticalmodellingtechniquesofHIVMTCT,objectivesand
chapterizationofthebook,real-lifedatasets,methodology,variablesconsideredfor
the study, HIV serological markers, different patterns of HIV, TB co-infection
among children living with HIV (CLHIVs), etc. Chapter 2 discusses the statistical
modelling of HIV transmission. Chapter 3 describes the HIV vertical transmission
DTSMsimulationmodelsfromglobalandnationalperspectivesandthevalidityof
themodelwhichwassimulatedbydifferentvariedparameters.Chapter4describes
largedatamatrices,randomwalkmodel,andapplicationofentropyinHIVmother
to child transmission. This theoretical issue was formulated with suitable
illustrations andvariousexamplesbyusing real-lifeHIV MTCT data setsandalso
fitted models that describe the different techniques of data reduction driven by the
random walk free probability values. Chapter 5 deals with statistical modelling on
postnatal transmission of HIV type I infection from mother to child on global
perspectives and examines the applicability of different statistical models in real-
lifedatasetsofHIVmothertochildtransmissionandantenatalcare(ANCs)women.
Chapter 6givessurvivabilityandgrowth modelapproachtoCD countsofpeople
4
living with HIV (PLHIVs). This chapter also describes briefly and discusses the
variousissuesofgrowthmodelsanditsapplicationstowardsestimationofsurvival
rateinreal-lifedatasets.Chapter7discussespredictivemodelapproachtoHIVTB
co-infection in vertical transmission. Chapter 8 gives fitted Bayesian modelling
approach to HIV transmission and describes Gaussian emulator approach that was
used to extract the probability values of HIV transmission, models that were
formulatedbynetworkingniche,andalsodescribefrequentistandBayesianmodel
differences. Chapter 9 discusses HIV projection models, while Chap. 10 discusses
thesimulationmodellingtechniquesofHIV/AIDS.Chapter11describesthegenetic
variantsofHIVmothertochildtransmissionanditsmeta-analysis,whichwasdone
for the real historical data sets, and have also extracted HIV subtype B and C env
genes from 190 mother-infant pairs at global level. Chapter 12 deals with the
statistical perspective approach to selection of sample. Chapter 13 describes the
main significance of the entire book for induction of mathematical and statistical
models to prove new formulated models of HIV mother to child transmission at
population level. The prominence of the entire intact of the book traces salient
objectives and practical applicability tolearn what methods are available and most
importantly when they should be applied in real life. Many illustrations accord to
Preface ix
clarifytheuseofmathematicalmodelsandtosubstantiatewhatconclusionscanbe
made at the right time. All the topics are driven purely on the HIV transmission
research gaps and its mechanisms, according to the level of apprehension of the
researchscholars,policymakers,clinicians,andpublichealthadministrators.
Bangaluru,Karnataka,India D.M.Basavarajaiah
Chennai,TamilNadu,India BhamidipatiNarasimhaMurthy
Acknowledgments
Firstandforemost,praisesandthankstotheGod,theAlmighty,forhisshowersof
blessings throughout our research work to complete the research successfully. We
aregratefultoallofthosewithwhomwehavehadthepleasuretoworkwithduring
thisandotherrelatedHIVresearchworks.Thisbookistailorbasedonresearchwork
conductedonchildrenlivingwithHIV(CLHIV)andANCsbetween2009tilldate.
We are grateful to a number of friends and colleagues who have encouraged us to
start the research work, to preserve it, and finally to publish it. We would like to
speciallythankProf.Rajashekaraiah,VijayaPUCollege,forhistechnicalsupports
for proof reading and all the officers of the National AIDS Control Organization,
GovernmentofIndia,forsharingverygoodHIVdataforthisresearchwork.Finally,
wewouldliketoacknowledgewithgratitudethesupportandloveofourfamily–our
parentswhokeptusgoing.Thisbookwouldnothavebeenpossiblewithoutthem.
WefeelimmenselyveryproudforextendingourheartiestthankstotheHIV-infected
childrenwhoparticipatedduringthisstudyperiod.
xi
Contents
1 IntroductionofHIVTransmission. . . . . . . . . . . . . . . . . . . . . . . . . 1
1.1 Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.2 WHOTransmissionThroughBFMakestheFollowing
Recommendation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
1.3 CD CellCountApproachtoHIVTransmission. . . . . . . . . . . 9
4
1.4 RNAPlasmaViralLoadApproachtoHIVTransmission. . . . . 10
1.5 PeriodicVariationofANCCD Counts. . . . . . . . . . . . . . . . . 10
4
1.6 CD PercentageofANCs(μ/dL). . . . . . . . . . . . . . . . . . . . . . 11
4
1.7 ANCViralLoadandSexualTransmission(CopiespermL). . . 11
1.8 SalientFeaturesofHIVMTCTPreventionStrategiesPracticedat
GlobalLevel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
1.9 RoutineHIVTestingDuringPregnancy. . . . . . . . . . . . . . . . . 14
1.10 DetectingofHIVInfectionUsingBloodTests. . . . . . . . . . . . 14
1.11 Opt-InandOpt-OutApproach. . . . . . . . . . . . . . . . . . . . . . . . 14
1.12 CounselingWomanWhoRefusesHIVTesting. . . . . . . . . . . . 15
1.13 DiscussingHIVTestPosttestCounseling. . . . . . . . . . . . . . . . 16
1.14 PosttestCounselingforHIVPregnantWomen. . . . . . . . . . . . 16
1.15 PosttestCounselingforHIV-NegativeWomen. . . . . . . . . . . . 16
1.16 AdditionalCarefortheHIV-PositiveWomanDuringPregnancy. . 17
1.17 TopicalAntiseptic. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
1.18 CaesareanSection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
1.19 Immunoglobulin. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
1.20 AvoidanceofBreastfeeding. . . . . . . . . . . . . . . . . . . . . . . . . . 18
1.21 VitaminA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
1.22 GlobalandNationalEpidemiologicalTrend. . . . . . . . . . . . . . 19
1.23 GlobalTrend. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
1.24 EconomicandDemographicImpactatNationalLevel. . . . . . . 21
1.25 StatisticalImplications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
1.26 ReviewofLiteratureSurvey. . . . . . . . . . . . . . . . . . . . . . . . . 23
1.27 ObjectivesoftheBook. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
1.28 OrganizationofBook. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
1.29 DescriptionofStudyArea. . . . . . . . . . . . . . . . . . . . . . . . . . . 35
1.29.1 SubgroupAnalysisStudySite. . . . . . . . . . . . . . . . . 36
xiii