Functions of oral candidiasis episodes that are highly prognostic for AIDS.
Although oral candidiasis lesions are widely recognized as markers for AIDS, the relative prognostic significance of functions of these episodes has not been examined. We compare the associations with time to AIDS of one fixed and six time-dependent metrics of oral candidiasis lesions, including proximity of a lesion to seroconversion, any candidiasis history, and recency of a lesion. We show in Cox regression models that two metrics are clinically and statistically far more significant than the others, alone or in combination: any history of candidiasis since HIV seroconversion, and recency of a candidiasis episode. The latter metric indicates that the risk of an AIDS diagnosis is high during a candidiasis episode. The results hold for two cohorts of male seroconverters, 627 haemophiliacs and 196 men who have sex with men. Identification of highly prognostic functions of a patient's oral candidiasis history allows clinicians and researchers to focus on these aspects of the history and to omit extraneous information from data collection. Our method extends well beyond candidiasis and AIDS, and may shed light on associations of covariates with outcomes in a variety of settings.
Hilton
J F
JF
Department of Epidemiology and Biostatistics, University of California, San Francisco, California 94143-0560, USA. joan@biostat.ucsf.edu
D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology; D000328:Adult; D002180:Candidiasis, Oral / Q000150:complications* / Q000276:immunology; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D018450:Disease Progression; D015658:HIV Infections / Q000150:complications*; D006467:Hemophilia A / Q000150:complications; D018451:Homosexuality, Male; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D015337:Multicenter Studies as Topic; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors