Reader Comments
Post a new comment on this article
Post Your Discussion Comment
Please follow our guidelines for comments and review our competing interests policy. Comments that do not conform to our guidelines will be promptly removed and the user account disabled. The following must be avoided:
- Remarks that could be interpreted as allegations of misconduct
- Unsupported assertions or statements
- Inflammatory or insulting language
Thank You!
Thank you for taking the time to flag this posting; we review flagged postings on a regular basis.
closeStrenghts and limitations of the modelling technique
Posted by jjmiranda on 18 Jan 2007 at 05:47 GMT
Here we develop a mathematical model that can be used to make short-term predictions for the emergence and stochastic evolution of transmitted resistance in a resource-poor country. We use our model to determine when the WHO's 5% threshold is likely to be exceeded in Botswana.
http://plosone.org/article/info:doi/10.1371/journal.pone.0000152#article1.body1.sec1.p1
The paper addresses, using modelling techniques, the need to evaluate and monitor properly the roll-out of ARVs in a resource poor setting, where most of the patients are treatment naïve for HIV. The evaluation has been made on the basis of a short term approach -the beginning of HIV treatment in this population.
As the authors point out in the discussion, careful interpretation of the analysis made is required when using these results for other contexts -even in the same setting- such as a more advanced stage of epidemic and a different stage of patient’s treatments. Factors such as primary infection, vertical transmission and ARV resistance have not been part of the model developed and reported in this paper.
RE: Strenghts and limitations of the modelling technique
sblower replied to jjmiranda on 19 Jan 2007 at 21:39 GMT
We would like to clarify the observation that is made in this
annotation. We are not suggesting that our results should be widely applied to other settings. Instead we are suggesting that the methodology that we develop in our article could be extremely useful for predicting the evolution of ARV resistance in other resource-constrained settings that are just beginning the ARV roll-out.
Also, we explain – in our discussion – why we have not included primary infection and the development of resistance to ARV when used to prevent vertical transmission. We refer the interested reader to both the discussion & Supplementary Material sections of our article.
Sally Blower & Raffaele Vardavas