心理健康症状,物质使用和艾滋病毒感染者的病毒抑制模式:一个集群分析
Y Joseph Hwang1, Catherine R Lesko2, Jarratt D Pytell3
1Department of Medicine, Johns Hopkins University School of Medicine, 2024 E. Monument Street 2-300, Baltimore, MD, 21287, USA. yhwang19@jhmi.edu.
AIDS and behavior
|June 10, 2025
概括
患有艾滋病毒的人经历心理健康问题和物质使用,病毒抑制率较低. 机器学习识别了不同的患者群体,突出了需要针对性干预的子群体,以获得更好的治疗结果.
科学领域:
- 公共卫生 公共卫生
- 临床医学 临床医学
- 医疗保健中的机器学习
背景情况:
- 精神健康状况和物质使用在艾滋病毒感染者中很常见.
- 这些情况独立地与较差的HIV病毒抑制有关.
- 由于数据有限,对病毒抑制的综合影响可能未得到充分研究.
研究的目的:
- 使用机器学习来根据心理健康症状和物质使用来识别不同类型的PWH.
- 分析这些已识别的群体与HIV病毒抑制状态的关系.
- 为改善抗逆转录病毒治疗结果提供有针对性的干预信息.
主要方法:
- 在约翰霍普金斯艾滋病毒临床队列 (2013-2023) 的患者报告数据上进行了基于机器学习的集群分析.
- 一个随机的森林模型使用心理健康症状 (抑郁,焦虑,PTSD) 和物质使用 (酒精,可卡因,胺,阿片类药物,大麻) 预测病毒抑制状态.
- 从随机森林模型中得出的相似度测量被用来将参与者分成三个不同的集群.
主要成果:
- 根据心理健康和物质使用概况,确定了三种具有临床意义的PWH集群.
- 病毒抑制率最低的群体 (74.5%) 呈现出最高的抑郁和焦虑得分,以及高的可卡因和阿片类药物使用率.
- 病毒抑制率最高的群体 (81.1%) 的抑郁和焦虑得分最低,可卡因和阿片类药物使用最小.
结论:
- 机器学习有效地识别了具有不同心理健康和物质使用特征的PWH不同的子组.
- 这些子组显示了与HIV病毒抑制的差异关联.
- 同时出现心理健康症状和物质使用的PWH代表了旨在提高抗逆转录病毒疗法坚持和结果的干预措施的关键人群.
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