# Dynamic Strategies for the clinical management of HIV disease

> **NIH NIH R37** · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · 2022 · $532,444

## Abstract

PROJECT SUMMARY
Observational cohorts are, and will continue to be, indispensable for the evaluation of strategies for the clinical
management of people living with HIV. The most clinically relevant strategies are dynamic strategies that
incorporate the patients' time-varying clinical history in the clinical decision. Unfortunately, conventional
statistical methods cannot appropriately compare dynamic strategies, so methods specifically designed to deal
with dynamic strategies and time-varying confounders are needed. We propose to continue to develop
analytical methods to enhance the validity of effect estimates from observational HIV cohorts.
We also propose to answer key clinical questions about the management of HIV-positive patients by applying
innovative analytic methods to complex observational data. These questions include 1) the optimal strategy for
viral load monitoring of HIV-positive individuals, 2) the effects of ART simplification on clinical outcomes, and 3)
the effects of ART on the incidence of, and mortality from, non-AIDS outcomes. Our primary data source will
be the HIV-CAUSAL Collaboration, and we will establish collaborations with complementary HIV consortia in
Europe, the U.S., and Africa. We will generate and maintain user-friendly, publicly-available software and
detailed documentation to make these methods available to the HIV research community.
Our work will implement and extend cutting-edge approaches to emulate randomized trials using observational
data, including methods based on the parametric g-formula. One reason for the lack of widespread use of
these methods is their perceived technical complexity, which has made them appear inaccessible to many
practitioners. After more than two decades of methods and software development, our group is now applying
innovative methods to large prospective HIV cohorts, and showing that these methods can be added to the
standard arsenal of HIV researchers. This proposal will strengthen the international role of the HIV-CAUSAL
Collaboration as an incubator for new methodologies in observational HIV research and beyond.

## Key facts

- **NIH application ID:** 10404644
- **Project number:** 5R37AI102634-10
- **Recipient organization:** HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH
- **Principal Investigator:** MIGUEL HERNAN
- **Activity code:** R37 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $532,444
- **Award type:** 5
- **Project period:** 2012-08-09 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10404644

## Citation

> US National Institutes of Health, RePORTER application 10404644, Dynamic Strategies for the clinical management of HIV disease (5R37AI102634-10). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10404644. Licensed CC0.

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