The human immunodeficiency virus (HIV) is a viral infection that destroys the human immune system, resulting in the acquired immunodeficiency syndrome (AIDS). The management and care of patients on antiretroviral therapy (ART) consumes a large portion of the health budget of many countries. ART improves the lives of the HIV patients. However, benefiting from the treatment remains to be low due to the nonadherence, adverse events, and treatment failure associated with the transmitted drug resistance mutations (TDRMs). Extra care is therefore required in prescribing switch of ART regimens for HIV-naive patients. We propose a disease monitoring system, which depends on how the HIV-naive patients respond to the ART regimen. We model cluster of differentiation 4 (CD4) counts data measured at every 3 months in a period of 48 weeks on a cohort of 87 HIV-naive patients on ART, from Zambia. We demonstrate how to apply the Bayesian Wishart distribution to model CD4 counts, leading to an informative HIV progression monitoring system. We found a steady increase in the average of the CD4 counts (from 219 to 315) for HIV-naive patients on the ART regimen. The average was still below the expected 500 CD4 counts for a normal person. The derived precision matrix shows an increase in probability of potency of the ART regimen, which ranges from 0.1261 to 0.8678. An early detection is crucial as it allows for timely switch of regimen from first to second line or to the third line. The proposed HIV disease progression monitoring system for HIV-naive patients on ART regimen that is based on CD4 counts could enable physicians make informed decisions on the management and care of the patients.

中文翻译：

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基于CD4计数和Wishart分布的HIV感染进展监测系统

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症（AIDS）。抗逆转录病毒疗法 (ART) 患者的管理和护理消耗了许多国家卫生预算的很大一部分。ART 改善了 HIV 患者的生活。然而，由于与传播耐药突变 (TDRM) 相关的不依从性、不良事件和治疗失败，从治疗中获益仍然很低。因此，在为未感染 HIV 的患者开具 ART 方案转换时需要格外小心。我们提出了一种疾病监测系统，该系统取决于未感染 HIV 的患者对 ART 方案的反应。我们对来自赞比亚的 87 名接受 ART 的 87 名未感染 HIV 患者的队列进行了分化簇 4 (CD4) 计数数据建模，这些数据在 48 周的时间内每 3 个月测量一次。我们演示了如何将贝叶斯 Wishart 分布应用于 CD4 计数模型，从而形成一个信息丰富的 HIV 进展监测系统。我们发现接受 ART 方案的 HIV 初治患者的 CD4 计数平均值稳步增加（从 219 增加到 315）。该平均值仍低于正常人预期的 500 CD4 计数。派生的精度矩阵显示 ART 方案的效力概率增加，范围从 0.1261 到 0.8678。早期检测至关重要，因为它可以及时将方案从一线切换到二线或三线。