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Faculty
Alvaro Munoz
Professor
Academic Degrees
PhD
Departmental Affiliation
Epidemiology
Joint Departmental Affiliations
Environmental Health Sciences, Biostatistics
Departmental Address
615 N. Wolfe Street, E7648
Baltimore, MD 21205
Phone: 410-955-2792
Fax: 410-955-7587
Research and Professional Experience

Dr. Muñoz received his MS (1977) and PhD (1980) degrees in statistics from Stanford University. From 1980-1985, he was an instructor at the Channing Laboratory at Harvard Medical School. In 1986 Dr. Muñoz was appointed to the post of assistant professor in the Department of Epidemiology, with a joint appointment in the Department of Biostatistics at the Johns Hopkins School of Public Health. He was promoted to associate professor in 1987 and to full professor in 1993. He was awarded an additional joint appointment in the Department of Environmental Health Sciences in 1994.

Dr. Muñoz has been intimately involved in large cohort studies of the epidemiology of HIV/AIDS and since 2003, in a nation-wide cohort study of children with chronic renal insufficiency. His research interest is in statistical methods in epidemiology, particularly survival and longitudinal data analysis.

In the late 1980s, Dr. Muñoz contributed methods to combine seroprevalent and incident cohorts for the characterization of the incubation period of AIDS. In the early 90s, Dr. Muñoz and collaborators documented the prognostic information of CD4 cell count on the development of PCP, and their work was instrumental in the issuing of Public Health Services guidelines regarding individuals who should receive prophylaxis for PCP.

In the mid 1990s, Dr. Muñoz' work served to describe the occurrence and characteristics of long-term non-progressors with HIV infection. In addition, Dr. Muñoz directed the analysis to characterize the joint prognostic information provided by HIV-RNA and CD4 cell count. This collaboration provided the basis for the establishment of guidelines for the treatment of HIV-infected individuals with highly active antiretroviral therapies. In the latter part of the 1990s, Dr. Muñoz concentrated his efforts on the treated as opposed to the natural history of HIV infection. In this context, he and his collaborators characterized the frequency of therapy usage; who is more likely to receive therapy; and the impact of therapy on the incidence of clinical outcomes and in the trajectories of markers of disease progression.

Recent pivotal collaborations include linking to public health by providing methods for cohort studies to asess treatment effectiveness at the individual and population levels.

Dr. Muñoz continues to provide leadership in the design of new studies, data analysis, and methodological research in collaboration with faculty and staff of the Department of Epidemiology. The methodological developments achieved by Dr. Muñoz and his collaborators in the context of cohorts of HIV infected individuals have been presented in Epidemiologic Review (1998;20:1-14) dedicated to cohort studies, co-edited by John Samet and A. Muñoz. Experience and methods derived from research initiatives are part of two courses taught by Dr. Muñoz and collaborators: Advanced Methods for the Design and Analysis of Cohort Studies; and Cohort Studies: Design, Analysis and Application.

In 2003, Dr. Muñoz and collaborators obtained funding from NIDDK to become the data coordinating center of a cohort study on children with chronic renal insufficiency. Web-based data management systems and analytical methods for biomarkers in HIV/AIDS are expected to be applicable to the elucidation of the natural history of chronic kidney disease.

Since 1994, Dr. Muñoz has been the leader of the Biostatistics Epidemiology Core of the Program Project "Molecular Biomarkers for Environmental Carcinogens," in collaboration with faculty in the Department of Environmental Health Sciences. In parallel, Drs. Muñoz, Gange, and Jacobson have been the data coordinating center for several clinical trails conducted in China on putative chemopreventive agents against liver cancer. In addition, Dr. Muñoz has directed, since 1995, Epidemiological/Biostatistical Centers for postmarketing surveillance programs to monitor prescription drug abuse in the United States.

Keywords

Statistics in Epidemiology, Cohort Studies, Infectious Diseases, Biomarkers, Kidney Disease, Post marketing surveillance, Human Immunodeficiency Virus (HIV), Acquired Immunodeficiency Syndrome (AIDS), Survival Analysis, Analysis of Longitudinal Data

Honors and Awards

Member, Delta Omega-Alpha Chapter, Honorary Public Health Society, Johns Hopkins School of Public Health, 1995

Advising, Mentoring and Teaching Award (AMTRA) from Student Assembly, Johns Hopkins School of Public Health, 1995, 1996, 1998

Fellow, American College of Epidemiology, 1997

Fellow, American Statistical Association, 1999

Golden Apple for Excellence in Teaching, 2003, 2006

Selected Publications

Muñoz A, Wang MC, Bass S, Taylor J, Kingsley LA, Chmiel JS, Polk BF. AIDS-free time after HIV-1 seroconversion in homosexual men. Am J Epidemiol 1989;130:530-39.

Muñoz A, Carey V, Schouten JP, Segal M, Rosner B. A parametric family of correlation structures for the analysis of longitudinal data. Biometrics 1992;48:733-42.

Muñoz A, Carey V, Taylor JMG, Chmiel JS, Kingsley L, VanRaden M, Hoover DR. Estimation of time since exposure for a prevalent cohort. Stat Med 1992; 11:939-52

Muñoz A, Hoover D. The role of observational cohort studies for evaluating the effectiveness and implementationof treatments. In: AIDS Clinical Trials, D. Finkelstein, D. Schoenfeld, (Eds). New York, NY: Wiley, 1995.

Muñoz A, Xu J. Models for the incubation period of AIDS and variations according to age and period. Stat Med 1996;15:2459-73.

Muñoz A, Sunyer J. Comparison of semiparametric and parametric survival models for the analysis of bronchial responsiveness. Am J Respir and Critical Care Medicine 1996;154:S234-S239.

Muñoz A, Sabin C, Phillips AN. The incubation period of AIDS. AIDS 1997;11:(Suppl 1):S69-S76.

Mellors JW, Muñoz A, Giorgi JV, et al. Plasma viral load and CD4+ T-lymphocytes as prognostic markers of HIV-1 infection. Ann Intern Med 1997;126:946-54.

Detels R, Muñoz A, McFarlane G, et al. Effectiveness of highly active antiretroviral therapy on time to AIDS and death in men with known HIV infection duration. JAMA 1998;280:1497-1503.

Gange SJ, Muñoz A, et al. Identification of inflections in T-cell counts among HIV-1 infected individuals and relationship with progression to clinical AIDS. Proc Natl Acad Sci (USA) 1998;95:10848-10853.

Muñoz A, Gange SJ. Biomarkers and intermediate markers in cohort studies. Epidemiol Rev 1998;20(1):29-42.

Samet J, Muñoz A. The evolution of the cohort study. Epidemiol Rev 1998;20(1):1-14.

Lamarca R, Alonso J, Gomez G, Muñoz A. Left-truncated data with age as time scale: an alternative for survival analysis in the elderly. J Gerontology: Medical Sciences 1998;53:M337-43.

Cicero TJ, Adams EH, Geller A, Inciardi JA, Muñoz A, Schnoll SH, Senay EC, Woody GE. A postmarketing surveillance program to monitor Ultram® (tramadol hydrochloride) abuse in the United States. Drug and Alcohol Dependence 1999;57:7-22.

Muñoz A, Gange SJ, Jacobson LP. Distinguishing efficacy, individual effectiveness and population effectiveness of therapies. AIDS 2000;14:754-56.

Tarwater PM, Mellors J, Gore ME, Margolick JB, Phair J, Detels R, Muñoz A. Methods to assess population effectiveness of therapies in human immunodeficiency virus incident and prevalent cohorts. Am J Epidemiol 2001:154:675-81.

Jacobson LP, Li R, Phair J, Margolick JB, Rinaldo CR, Detels R, Muñoz A. Evaluation of effectiveness of highly active antiretroviral therapy (HAART) using biomarker-based equivalence of disease progression. Am J Epidemiol 2002;155:760-70.

Li X, Buechner JM, Tarwater PM, Muñoz A. A diamond-shaped equiponderant graphical display of the effects of two categorical predictors on continuous outcomes. The American Statistician 2003;57:193-99.

Kuang S-Y, Jackson PE, Wang J-B, Lu P-X, Muñoz A, Qian G-S, Kensler TW, Groopman JD. Specific mutations of hepatitis B virus in plasma predict liver cancer development. Proc Natl Acad Sci 2004;101:3575-80.

Cole SR, Li R, Anastos K, Detels R, Young M, Chmiel JS, Muñoz A. Accounting for leadtime in cohort studies: evaluating when to initiate HIV therapies. Stat Med 2004;23:3351-63.

Cicero TJ, Inciardi JA, Muñoz A. Trends in abuse of OxyContin® and other opioid analgesics in the United States: 2002-2004. J Pain 2005;6:662-72.

Schneider MF, Gange SJ, Williams CM, Anastos K, Greenblatt RM, Kingsley L, Detels R, Muñoz, A.

Patterns of the hazard of death after AIDS through the evolution of antiretroviral therapy: 1984-2004. AIDS 2005;19:2009-18.

Cicero TJ, Inciardi JA, Adams EH, Geller A, Senay EC, Woody GE, Muñoz A. Rates of abuse of tramadol remain unchanged with the introduction of new branded and generic products: results of an abuse monitoring system, 1994-2004. Pharmacoepidemiol Drug Saf 2005;14:251-59.

Schwartz GJ, Furth S, Cole SR, Warady B, Muñoz A. Glomerular filtration rate via plasma iohexol disappearance: pilot study for chronic kidney disease in children. Kidney International 2006; 69:2070-77.

Furth SL, Cole SR, Moxey-Mims M, Kaskel F, Mak R, Schwartz G, Wong C, Muñoz A, Warady BA. Design and methods of the chronic kidney disease in children (CKiD) prospective cohort study. Clin J Am Soc Nephrology 2006;1:1006-15.

Mellors JW, Margolick JB, Phair JP, Rinaldo CR, Detels R, Jacobson LP, Muñoz A:Prognostic value of HIV-1 RNA, CD4 Cell count slope for progression to AIDS and death in untreated HIV-1 infection. JAMA 2007;297:2349-50.

Cox C, Chu H, Schneider M, Muñoz A. Parametric Survival Analysis and Taxonomy of Hazard Functions for the Generalized Gamma Distribution. Stat Med 2007;26:4352-4374.

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