HIV Clin Trials. 2005 Mar-Apr;6(2):81-91.

Evaluation of multiple failure time analyses of observational data in
patients treated for HIV.

Lim HJ, Gordon NH, Justice AC.

Division of Biostatistics, Medical College of Wisconsin, 8701 Water Plank
Road, Milwaukee, WI 53226, USA. hyun@mcw.edu

The development of protease inhibitors and nonnucleoside reverse
transcriptase inhibitors has substantially increased the number of
combinations available for multi-drug therapies in human immunodeficiency
virus (HIV) infection. Unfortunately, all antiretroviral therapies lose
efficacy over time or induce side effects, thus making secondary and
tertiary alternatives necessary. With the multiplicity of multi-drug
combination therapies, the challenge is to determine which multi-drug
combination to use as initial therapy and which to use as subsequent therapy
to maximize survival. No standard methodologic approach has been developed
to answer this question within the context of observational clinical HIV
data. We demonstrate the use of semi-parametric models employing repeated,
multiple failure time analysis to compare the relative efficacy of
treatments containing zidovudine, stavudine, or other multi-drug
combinations for patients in the CHORUS (Collaborations in HIV Outcomes
Research - US) database.

PMID: 15983892 [PubMed - indexed for MEDLINE]