The prevalent cohort study and the acquired immunodeficiency syndrome.
The acquired immunodeficiency syndrome (AIDS) is caused by a retrovirus, the human immunodeficiency virus (HIV). A rapid and convenient method to identify additional cofactors or risk modifiers and markers of disease progression is to study a cohort prevalent with HIV antibody. However, because the time of viral infection is usually unknown in the cohort, there are several potential sources of bias. Three sources of bias in a prevalent cohort study are identified assuming a proportional hazards model: onset confounding, differential length-biased sampling, and frailty selection. A number of problems in the interpretation of results on markers from a prevalent cohort also are considered. It is concluded that risk estimates derived from a prevalent cohort are not directly comparable to risk estimates derived from an incident cohort.
D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D004812:Epidemiologic Methods; D005500:Follow-Up Studies; D006678:HIV / Q000302:isolation & purification*; D006801:Humans; D013223:Statistics as Topic; D014481:United States