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Activity Number: 338
Type: Topic Contributed
Date/Time: Tuesday, August 6, 2013 : 10:30 AM to 12:20 PM
Sponsor: Section on Statistics in Epidemiology
Abstract - #308881
Title: Determining the Predictors for Negative HIV Outcomes Under a Suppressive ART Regime
Author(s): Mireille Schnitzer*+ and Judith J. Lok and Ronald J. Bosch
Companies: Harvard School of Public Health and Harvard School of Public Health and Harvard School of Public Health
Keywords: longitudinal ; causal inference ; double-robust ; targeted maximum likelihood estimation ; HIV ; biostatistics
Abstract:

The current clinical gold standard in HIV treatment is to continuously administer Anti-Retroviral Treatment (ART) to HIV-positive subjects after initiation. With full adherence, this regime is expected to fully suppress immune activation and viral load. Clinical interest lies in improving patient outcomes under continuous treatment and successful immune suppression. In this study, we will present an analysis of the ALLRT database to determine the predictors of long-term negative outcomes under the counterfactual setting of continuous treatment (and virologic suppression), and no censoring. A marginal structural logistic model will be introduced to model AIDS and non-AIDS defining events, including mortality. We will present data analyses using using two doubly-robust, semiparametrically efficient methods for longitudinal data, namely the Bang and Robins estimator and Targeted Maximum Likelihood Estimation.


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