The human immunodeficiency virus (HIV) is a viral infection that destroys the human immune system resulting in acquired immunodeficiency syndrome (AIDS). The Zambia HIV prevalence rate (11.3%) remains among the highest in the sub-Saharan Africa. In the treatment of HIV-naive patients, a problem that relates to the transmitted drug resistance mutation strains (TDRMs) occurs in the administration of antiretroviral (ARV) drugs. To address this problem, we propose the use of transition probabilities when prescribing a switch from the first-line to the second-line or to the third-line regimen on the ARV drugs combination. We formulate a statistical technique to determine an optimal ARV drugs combination. To compute a transition probability matrix chart on ARV drugs combinations of the first-line and second-line regimens, we apply a beta-binomial hierarchical model on HIV data. The transition probability matrices corresponding to the ARV drugs combinations TDF+ETC+NVP, TDF+FTC+EFV, AZT+3TC+NVP, AZT+3TC+EFV, D4T+3TC+NVP, and D4T+3TC+EFV provide an upper triangular matrix of probabilities. We observe a higher probability of remaining in the same regimen state than moving to another state. A transition probability chart provides information on the most effective combination to prescribe to a patient in the presence of transmitted drug resistance mutation (TDRM) test results. The transmission probabilities play a major role in aiding the physicians make an informed decision to prescribe an optimal ARV drugs combination. We suggest a TDRM test to be carried out to all newly diagnosed HIV individuals before prescribing any of the ARV drugs combination.

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使用 Beta-二项式模型估计 HIV 治疗中传播耐药突变株的概率

人类免疫缺陷病毒 (HIV) 是一种破坏人体免疫系统的病毒感染，导致获得性免疫缺陷综合征 (AIDS)。赞比亚的艾滋病毒流行率（11.3%）仍然是撒哈拉以南非洲地区最高的。在治疗未感染 HIV 的患者时，在使用抗逆转录病毒 (ARV) 药物时会出现与传播的耐药突变株 (TDRM) 相关的问题。为了解决这个问题，我们建议在 ARV 药物组合上从一线切换到二线或三线方案时使用转换概率。我们制定了一种统计技术来确定最佳 ARV 药物组合。为了计算一线和二线方案的 ARV 药物组合的转移概率矩阵图，我们对 HIV 数据应用 Beta 二项式分层模型。ARV药物组合TDF+ETC+NVP、TDF+FTC+EFV、AZT+3TC+NVP、AZT+3TC+EFV、D4T+3TC+NVP、D4T+3TC+EFV对应的转移概率矩阵提供了上三角概率矩阵。我们观察到保持相同养生状态的概率比转移到另一个状态的概率更高。转移概率图提供有关在存在传播耐药突变 (TDRM) 测试结果的情况下向患者开出的最有效组合的信息。传播概率在帮助医生做出明智决定以开出最佳 ARV 药物组合方面发挥着重要作用。我们建议在开任何 ARV 药物组合之前对所有新诊断的 HIV 个体进行 TDRM 测试。