Machine learning to predict virological failure among HIV patients on antiretroviral therapy in the University of Gondar Comprehensive and Specialized Hospital, in Amhara Region, Ethiopia, 2022

Daniel Niguse Mamo, Tesfahun Melese Yilma, Makida Fekadie, Yakub Sebastian, Tilahun Bizuayehu, Mequannent Sharew Melaku, Agmasie Damtew Walle

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    Abstract

    BACKGROUND: Treatment with effective antiretroviral therapy (ART) reduces viral load as well as HIV-related morbidity and mortality in HIV-positive patients. Despite the expanded availability of antiretroviral therapy around the world, virological failure remains a serious problem for HIV-positive patients. Thus, Machine learning predictive algorithms have the potential to improve the quality of care and predict the needs of HIV patients by analyzing huge amounts of data, and enhancing prediction capabilities. This study used different machine learning classification algorithms to predict the features that cause virological failure in HIV-positive patients. METHOD: An institution-based secondary data was used to conduct patients who were on antiretroviral therapy at the University of Gondar Comprehensive and Specialized Hospital from January 2020 to May 2022. Patients' data were extracted from the electronic database using a structured checklist and imported into Python version three software for data pre-processing and analysis. Then, seven supervised classification machine-learning algorithms for model development were trained. The performances of the predictive models were evaluated using accuracy, sensitivity, specificity, precision, f1-score, and AUC. Association rule mining was used to generate the best rule for the association between independent features and the target feature. RESULT: Out of 5264 study participants, 1893 (35.06%) males and 3371 (64.04%) females were included. The random forest classifier (sensitivity = 1.00, precision = 0.987, f1-score = 0.993, AUC = 0.9989) outperformed in predicting virological failure among all selected classifiers. Random forest feature importance and association rules identified the top eight predictors (Male, younger age, longer duration on ART, not taking CPT, not taking TPT, secondary educational status, TDF-3TC-EFV, and low CD4 counts) of virological failure based on the importance ranking, and the CD-4 count was recognized as the most important predictor feature. CONCLUSION: The random forest classifier outperformed in predicting and identifying the relevant predictors of virological failure. The results of this study could be very helpful to health professionals in determining the optimal virological outcome.

    Original languageEnglish
    Article number75
    Pages (from-to)75
    Number of pages1
    JournalBMC Medical Informatics and Decision Making
    Volume23
    Issue number1
    DOIs
    Publication statusPublished - Dec 2023

    Bibliographical note

    Funding Information:
    We would like to thank the University of Gondar, the College of Medicine and Health Science, and the Institution of Public Health for allowing us to undertake this study and the University of Gondar Comprehensive and Specialized Hospital for providing us with data collection to undertake this research study. Our gratitude goes to those who work in the ART service at the University of Gondar Hospital, especially the data clerks who work in the ART clinic for their willingness to support the extraction of data from the database.

    Publisher Copyright:
    © 2023, The Author(s).

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