title: A mathematical model for HIV and hepatitis C co-infection and its assessment from a statistical perspective.
abstract: The hepatitis C virus (HCV) and the human immunodeficiency virus (HIV) are a clear threat for public health, with high prevalences especially in high risk groups such as injecting drug users. People with HIV infection who are also infected by HCV suffer from a more rapid progression to HCV-related liver disease and have an increased risk for cirrhosis and liver cancer. Quantifying the impact of HIV and HCV co-infection is therefore of great importance. We propose a new joint mathematical model accounting for co-infection with the two viruses in the context of injecting drug users (IDUs). Statistical concepts and methods are used to assess the model from a statistical perspective, in order to get further insights in: (i) the comparison and selection of optional model components, (ii) the unknown values of the numerous model parameters, (iii) the parameters to which the model is most 'sensitive' and (iv) the combinations or patterns of values in the high-dimensional parameter space which are most supported by the data. Data from a longitudinal study of heroin users in Italy are used to illustrate the application of the proposed joint model and its statistical assessment. The parameters associated with contact rates (sharing syringes) and the transmission rates per syringe-sharing event are shown to play a major role.
authors: Interuniversity Institute for Biostatistics and statistical Bioinformatics, Hasselt University, Agoralaan 1, B3590 Diepenbeek, Belgium. amparo.castrosanchez@uhasselt.be
authors: Amparo Yovanna
authors: AY
authors: Castro Sanchez
authors: Marc
authors: M
authors: Aerts
authors: Ziv
authors: Z
authors: Shkedy
authors: Peter
authors: P
authors: Vickerman
authors: Fabrizio
authors: F
authors: Faggiano
authors: Guiseppe
authors: G
authors: Salamina
authors: Niel
authors: N
authors: Hens
mesh_terms: D060085:Coinfection / Q000453:epidemiology; D003198:Computer Simulation; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology* / Q000635:transmission*; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000453:epidemiology; D008113:Liver Neoplasms / Q000453:epidemiology; D008962:Models, Theoretical; D016485:Needle Sharing / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology