Application of quantile mixed-effects model in modeling CD4 count from HIV-infected patients in KwaZulu-Natal South Africa.
Background: The CD4 cell count signifies the health of an individual's immune system. The use of data-driven models enables clinicians to accurately interpret potential information, examine the progression of CD4 count, and deal with patient heterogeneity due to patient-specific effects. Quantile-ba...
| Publicado en: | BMC Infectious Diseases Vol. 22; no. 1; pp. 1 - 12 |
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| Autores principales: | , , , |
| Formato: | Journal Article |
| Publicado: |
BioMed Central
1/4/2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=154479837&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 154479837 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712334 1CHU jtl: BMC Infectious Diseases issn: 14712334 maglogo: N pubinfo: dt: 1/4/2022 vid: 22 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 154479837 154479837 NLM34983387 10.1186/s12879-021-06942-7 NLM34983387 154479837 ppf: 1 ppct: 11 formats: tig: atl: Application of quantile mixed-effects model in modeling CD4 count from HIV-infected patients in KwaZulu-Natal South Africa. aug: au: Yirga, Ashenafi A. Melesse, Sileshi F. Mwambi, Henry G. Ayele, Dawit G. affil: School of Mathematics, Statistics, and Computer Science, University of KwaZulu-Natal, Pietermaritzburg, Private Bag X01, 3209, Scottsville, South Africa sug: subj: HIV Infections Drug Therapy South Africa CD4 Lymphocyte Count Viral Load Antiretroviral Therapy, Highly Active ab: Background: The CD4 cell count signifies the health of an individual's immune system. The use of data-driven models enables clinicians to accurately interpret potential information, examine the progression of CD4 count, and deal with patient heterogeneity due to patient-specific effects. Quantile-based regression models can be used to illustrate the entire conditional distribution of an outcome and identify various covariates effects at the respective location.Methods: This study uses the quantile mixed-effects model that assumes an asymmetric Laplace distribution for the error term. The model also incorporated multiple random effects to consider the correlation among observations. The exact maximum likelihood estimation was implemented using the Stochastic Approximation of the Expectation-Maximization algorithm to estimate the parameters. This study used the Centre of the AIDS Programme of Research in South Africa (CAPRISA) 002 Acute Infection Study data. In this study, the response variable is the longitudinal CD4 count from HIV-infected patients who were initiated on Highly Active Antiretroviral Therapy (HAART), and the explanatory variables are relevant baseline characteristics of the patients.Results: The analysis obtained robust parameters estimates at various locations of the conditional distribution. For instance, our result showed that baseline BMI (at [Formula: see text] 0.05: [Formula: see text]), baseline viral load (at [Formula: see text] 0.05: [Formula: see text] [Formula: see text]), and post-HAART initiation (at [Formula: see text] 0.05: [Formula: see text]) were major significant factors of CD4 count across fitted quantiles.Conclusions: CD4 cell recovery in response to post-HAART initiation across all fitted quantile levels was observed. Compared to HIV-infected patients with low viral load levels at baseline, HIV-infected patients enrolled in the treatment with a high viral load level at baseline showed a significant negative effect on CD4 cell counts at upper quantiles. HIV-infected patients registered with high BMI at baseline had improved CD4 cell count after treatment, but physicians should not ignore this group of patients clinically. It is also crucial for physicians to closely monitor patients with a low BMI before and after starting HAART. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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