Study On Influencing Factors Of Immunology And Growth Of HIV/AIDS Children Antiviral Therapy Based On Mixed Effect Model And Machine Learning

Objective:To explore the efficacy of Antiretroviral therapy（ART）immunology（CD₄⁺Tcells,）in HIV/AIDS children,the characteristic of hygiene（growth and development）effect when treatment time changes,and the factors which affect CD4 cell,growth and development,the studycan provide a quantitative basis for improving the therapeutic effect of children with HIV/AIDS.Methods:This study collected 631 cases of HIV/AIDS children aged from less than 15 years old who were diagnosed with antiviral therapy in Xinjiang from January 2007 to June 2016.They were divided into two groups according to age:<5 years old and≥5 years old.（1）Follow-up data of 271 HIV/AIDS children treated with ART treatment time≤3 years in June 2008-June 2016 describe the dynamic trend of short-term efficacy immunology and compare with normal children,Meanwhile,the study analyse main factors affecting the efficacy of immunology,using modeled by generalized linear mixed-effects model.（2）To analyze the growth and development of Xinjiang 601 HIV/AIDS children from January 2007 to June 2016,and use propensity score matching method（PSM）,according to age and sex ratio of 1:1,this study select 601 cases from normal children and see as the control group,contrasting the height and weight of normal children and HIV/AIDS children.At the same time,the Z-score method was used to contrast the nutritional changes of HIV/AIDS children at different ages（namely,age-specific body weight（WAZ）and age-specific height（HAZ））.The generalized linear mixed-effects model was used to model HAZ and WAZ and determine the relationships between WAZ and HAZ results.（3）Five kinds of machine learning algorithms were used to model the immunology and growth of HIV/AIDS children’s antiviral therapy,compared with the results of the（generalized）linear mixed effect model and selected the optimal model.Result:（1）For CD4,including 271HIV/AIDS children,The age of<5 years old and≥5 years old were 71 and 200,respectively.The median CD4 cells were 654 and 400,respectively.After treatment,CD4cells of HIV/AIDS children of different age groups were lower than those of normal children,but CD4 cells of HIV/AIDS children showed an upward trend with treatment time,which were all higher than baseline CD4 cells group.In the factor analysis,the risk factors for immunological treatment failure is baseline immunological inhibition,baseline WHO clinical stage,and the last 7 days of missed medication[odds ratio（OR）>1],all of which increased the incidence of immunological failure.But treatment time reduced the incidence of immunological failure[OR=0.9715,95%（CI）:0.971 4⁰.9715].（2）In terms of growth and development,the study include 601 HIV/AIDS children.After different time treatment,the growth and development trajectory of HIV/AIDS children was not significantly different from that of normal children,and the average level was improved.In factor analysis,HAZ changes were mainly related to starting ART age,treatment time,normative follow-up,recent 7-day missed medication,and baseline WHO clinical stage（P<0.05）,and immunosuppression and starting ART age are related（Interactions（P<0.05））;low immunosuppression and significant increase in height of HIV/AIDS children with early ART age;WAZ changes were mainly related to gender and treatment time（P<0.05）,including treatment time and starting ART that was an interaction in the age group（P<0.001）,and the weight of HIV/AIDS children who started ART early and treated for a long time was significantly increased.（3）Using five kinds of machine learning algorithms to model CD4 and long development,and comparing with the mixed effect model,it is concluded that the machine learning algorithm is better than the mixed effect model.Conclusion:After treatment with ART,CD4 levels and growth and development indicators are significantly improved,and long-term treatment is more effective than short-term treatment.Therefore,the promotion of early diagnosis and early treatment of HIV/AIDS children should be strengthened,and follow-up management should be strengthened to improve compliance,in order to further improve the quality of life of HIV/AIDS children in the long time.