Application of case-crossover and case-time-control study designs in analyses of time-varying predictors of T-cell homeostasis failure

Michael F. Schneider, Stephen J. Gange, Joseph B. Margolick, Roger Detels, Joan S. Chmiel, Charles Rinaldo, Haroutune K. Armenian

Research output: Contribution to journalArticlepeer-review

Abstract

To evaluate the association of sexual behavior and recreational drug exposures with T-cell homeostasis failure (TCHF), which corresponds to the onset of a rapid decline in an individual's T lymphocyte count, which occurs on average approximately 1.75 years prior to an initial diagnosis of acquired immunodeficiency syndrome (AIDS). A case-crossover design and a case-time-control design, both nested within the Multicenter AIDS Cohort Study of 4954 homosexual and bisexual men initiated in 1983. In the case-crossover analysis, use of both recreational drugs and hashish were found to be protective against TCHF (odds ratios ≤ 0.41), based on comparisons with four earlier control periods. However, a significant decreasing trend in the prevalence of these exposures was observed over time, thus motivating the implementation of the case-time-control design. Using the latter approach, the associations of drug use (odds ratio = 0.53; 95% confidence interval (CI): 0.22, 1.28) and hashish use (odds ratio = 0.46; 95% CI: 0.20, 1.05) with TCHF were no longer statistically significant. The difference in inferences between these approaches demonstrates the importance of evaluating temporal trends in exposures when using a case-crossover design.

Original languageEnglish (US)
Pages (from-to)137-144
Number of pages8
JournalAnnals of epidemiology
Volume15
Issue number2
DOIs
StatePublished - Feb 2005

Keywords

  • Biological Markers
  • Crossover Studies
  • Epidemiological Methods
  • HIV/AIDS

ASJC Scopus subject areas

  • Epidemiology

Fingerprint Dive into the research topics of 'Application of case-crossover and case-time-control study designs in analyses of time-varying predictors of T-cell homeostasis failure'. Together they form a unique fingerprint.

Cite this