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The incubation period of acute retroviral syndrome as a multistep process: a parametric survival analysis

Vanhems, Philippe
Voirin, Nicolas
Philippe, Pierre
Brassard, Joelle
Carr, Andrew
Cooper, David
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Published in Journal of Acquired Immune Deficiency Syndromes. 2004, vol. 37, no. 4, p. 1529-1533
Abstract A long duration of acute retroviral syndrome (ARS) and a short incubation of ARS (IncARS) are independent predictors of a fast progression to AIDS. The first objective of this study was to validate previous estimates of IncARS by comparing durations between health care workers (HCWs) accidentally infected by HIV and individuals infected by other routes (non-health care workers [N-HCWs]). The second objective was to use parametric survival models to generate hypotheses on various steps occurring during the IncARS. Data from a prospective cohort of patients with documented ARS and from individuals with ARS as the result of accidental exposure to HIV were analyzed. Nonparametric and parametric survival models were used to describe the incubation of ARS. No differences were found for the median IncARS between 34 HCWs (21.5 days) and 70 N-HCWs (21.5 days) (log-rank test, P = 0.72). According to survival models, IncARS can be modeled with a gamma and/or lognormal model with means of 26.4 days and 26.7 days, respectively. The gamma model suggests that 3 sequential stages are present during the IncARS, which is compatible with basic science investigations identifying crossing of the epithelial barrier by the virus, the virus-host cell interactions, and the viral systemic dissemination.
Keywords Cohort StudiesDisease ProgressionFemaleHIV Infections/ diagnosis/transmissionHumansInfectious Disease Transmission, Patient-to-ProfessionalMalePredictive Value of TestsPrognosisProportional Hazards ModelsSurvival AnalysisSyndromeTime Factors
PMID: 15602132
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VANHEMS, Philippe et al. The incubation period of acute retroviral syndrome as a multistep process: a parametric survival analysis. In: Journal of Acquired Immune Deficiency Syndromes, 2004, vol. 37, n° 4, p. 1529-1533. doi: 10.1097/01.qai.0000131848.20077.eb https://archive-ouverte.unige.ch/unige:7643

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Deposited on : 2010-06-21

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