FORECASTING METHODS FOR HIV AIDS AND AGING

Recent treatment advances suggest that AIDS may be changing from a rap idly lethal, acute disease into a chronic disease process with lengthy periods of remission. Stochastic compartment models can describe AIDS progression, remission, and overall survival. Such models can combine multiple data sources to estimate transitions through intermediate, u nobserved disease states. Age/time AIDS mortality may be combined with age/time AIDS incidence to generate an ''observed'' health event dist ribution, using maximum likelihood estimation. The models can project the future behavior of AIDS in an aging population. Transitions among intermediate disease states (i.e., components of the disease's ''natur al'' and ''treatment-altered'' history) can be evaluated as time-varyi ng functions that reflect treatment efficacy For example, the introduc tion of protease inhibitors to therapy with two nucleoside analogues s ignificantly slows transitions between disease states. Persons infecte d, but successfully treated, may develop organ damage, neurological di sorders, or cancer.