Artificial Intelligence and Machine Learning Based Prediction of Viral Load and CD4 Status of People Living with HIV (PLWH) on Anti-Retroviral Treatment in Gedeo Zone Public Hospitals

Int J Gen Med. 2023 Feb 3:16:435-451. doi: 10.2147/IJGM.S397031. eCollection 2023.

Abstract

Background: Despite the success made in scaling up HIV treatment activities, there remains a tremendous unmet demand for the monitoring of the disease progression and treatment success, which threatens HIV/AIDS treatment and control. This research presented the assessments of viral load and CD4 classification of adults enrolled in ART care using machine learning algorithms.

Methods: We trained, validated, and tested eight machine learning (ML) classifier algorithms with historical data, including demographics, clinical, and laboratory data. Data were extracted from the ART registry database of Yirgacheffe Primary Hospital and Dilla University Referral Hospital. ML classifiers were trained to predict virological failure (viral load >1000 copies/mL) and poor CD4 (CD4 cell count <200 cells/mL). The model predictive performances were evaluated using accuracy, sensitivity, specificity, precision, f1-score, F-beta scores, and AUC.

Results: The mean age of the sample participants was 41.6 years (SD = 10.9). The experimental results showed that XGB classifier ranked as the best algorithm for viral load prediction in terms of sensitivity (97%), f1-score (96%), AUC (0.99), accuracy (96%), followed by RF. The GB classifier exhibited a better predictive capability in predicting participants with a CD4 cell count <200 cells/mL.

Conclusion: In this study, the XGB and RF models had the highest accuracy and outperformed on various evaluation metrics among the models examined for viral load classification. In the prediction of participants CD4, GB model had the highest accuracy.

Keywords: AI; ART; CD4 count; HIV; ML; anti-retroviral treatment; artificial intelligence; machine learning; viral load.

Grants and funding

Dilla University provided the financial support to carry out the study.