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American Journal of Epidemiology Vol. 126, No. 1: 14-24
Copyright © 1987 by The Johns Hopkins University School of Hygiene and Public Health

research-article

THE PREVALENT COHORT STUDY AND THE ACQUIRED IMMUNODEFICIENCY SYNDROME

RON BROOKMEYER1,2,3,, MITCHELL H. GAIL2 and FRANK POLK3

1Department of Biostatistics, Johns Hopkins University School of Hygiene and Public Health 615 N. Wolfe Street, Baltimore, MD 21205
2Epidemiologic Methods Section, Biostatistics Branch, National Cancer Institute Bethesda, MD
3Department of Epidemiology, Johns Hopkins University, School of Hygiene and Public Health Baltimore, MD

Reprint requests to Dr. Ron Brookmeyer at that address

The acquired Immunodeficiency syndrome (AIDS) Is caused by a retrovirus, the human immunodeficiency virus (HIV). A rapid and convenient method to Identify additional cofactors or risk modifiers and markers of disease progression is to study a cohort prevalent with HIV antibody. However, because the time of viral infection is usually unknown in the cohort, there are several potential sources of bias. Three sources of bias in a prevalent cohort study are identified assuming a proportional hazards model: onset confounding, differential length-biased sampling, and frailty selection. A number of problems In the interpretation of results on markers from a prevalent cohort also are considered. It is concluded that risk estimates derived from a prevalent cohort are not directly comparable to risk estimates derived from an Incident cohort.

acquired immunodeficiency syndrome; biometry; epidemiologic methods; follow-up studies; human immunodeficiency viruses; prevalence studies


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