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Analysis of HIV-associated sensory neuropathic pain: GLMM versus survival analysis
Malvar, Jemily Santero
People infected with human immunodeficiency virus (HIV) are now living decadeslonger as a result of effective combination anti-retroviral therapy (CART). Unfortunately, CART is also associated with adverse side effects, which include diabetes and neuropathy. Due to the high prevalence of HIV-associated sensory neuropathy, research on sensory neuropathy and distal sensory neuropathic pain (DSNP) will benefit many of those who are infected with HIV. The CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) study is a multi-center cohort study that aims to investigate the effects of CART history and regimen on HIV-associated central and peripheral neurologic complications. Mixed effects logistic regression and frailty Cox proportional hazards regression were both employed on the analysis of the CHARTER longitudinal cohort data. Additionally, the cohort was divided into subgroups, based on the subjects' pain status at baseline, which allowed us to examine DSNP incidence and retention separately. The analysis will be utilized to identify risk factors associated with DSNP incidence and retention. The results from the two techniques were mostly consistent for the overall cohort and the subgroup without DSNP at baseline, but some differences were apparent for the subgroup with baseline DSNP pain. More predictors were significant in the mixed effects logistic regression than the frailty Cox proportional hazards regression. The results confirm that old age, exposure to toxic substances, anti-retroviral therapy (ART), and current depressed mood were highly associated with DSNP. ART and current depressed mood were also found to play a major role in DSNP. Old age, ART exposure, and current depressed mood were significant risk factors for DSNP incidence.
Mathematics and Statistics
Master of Science (M.S.) San Diego State University, 2010
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