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A Stochastic Model for HIV-TB Coinfection and Applications on Young Adults |
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PP: 1515-1531 |
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doi:10.18576/jsap/130508
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Author(s) |
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Claris Shoko,
Wilford Molefe,
Pascal O. Bessong,
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Abstract |
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| In this study, we investigate the progression of HIV/AIDS in patients with TB co-infection. Approximately one in three people living with HIV die due to TB. This hinders progress towards the achievement of the 2030 Sustainable Development Goal of ending the HIV and TB pandemic. We model the progression of HIV in patients with TB coinfection using multi-state modeling using data from HIV-TB co-infected young adults (15 to 34 years) from South Africa. HIV progression for this cohort is divided into 4 states (state 1: Undetectable viral load below 50 HIV RNA per mL; state-2: HIV ribonucleic acid (RNA) ranging from 50 to below 10 000 copies/mL; state-3: at least 10 000 HIV RNA copies/mL); and state-4: Death). Results from the analysis show that TB increases the log odds of an unsuppressed viral load. This is quite notable for patients in state 2 where the log-linear effect of having TB during treatment is approximately 5.776 for the transition from state-2 to state-3. At state-2 of HIV progression, the rate of virologic failure accelerates transitions to death from state-1 (3.806). This study is unique because it presents the interaction effects of viral load baseline and TB-coinfection as crucial in analyzing HIV progression among young adults. |
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