HIV treatment strategies utilizing virologic and immunologic markers as criteria for changing treatments

Stat Med. 1996 Nov;15(21-22):2425-43; discussion 2455-8. doi: 10.1002/(sici)1097-0258(19961130)15:22<2425::aid-sim461>3.0.co;2-d.

Abstract

Currently available antiviral drugs used in the treatment of AIDS patients are effective for a limited time. Therapy consisting of different drugs given in sequence thus has the potential to yield the greatest possible benefit to patients, yet it is not known in what order the drugs should be administered, or for how long. Can patient-specific information, such as viral load or determination of mutation status, be used to make these decisions on a patient by patient basis? We propose a general model for the relationship between treatment, virologic or immunologic markers, and clinical disease progression that can provide answers to these questions. We develop guidelines for optimizing progression under several settings. Optimal survival is derived for full, partial, or no interim information.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acquired Immunodeficiency Syndrome / drug therapy*
  • Acquired Immunodeficiency Syndrome / immunology
  • Acquired Immunodeficiency Syndrome / virology
  • Anti-HIV Agents / therapeutic use*
  • Biomarkers
  • Disease Progression
  • Drug Therapy, Combination
  • Humans
  • Models, Biological*
  • Prognosis
  • Proportional Hazards Models
  • Survival Analysis
  • Treatment Outcome

Substances

  • Anti-HIV Agents
  • Biomarkers