Inferring the Timing of Antiretroviral Therapy by Zero-Inflated Random Change Point Models Using Longitudinal Data Subject to Left-Censoring

• Published in: Algorithms Vol. 18; no. 6; p. 346
• Main Authors: Zhang, Hongbin, Robertson, McKaylee, Braunstein, Sarah L., Hanna, David B., Felsen, Uriel R., Waldron, Levi, Nash, Denis
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 01.06.2025
• Subjects: Algorithms; Analysis; Antiretroviral drugs; Antiviral agents; censored data; Drug therapy; Gibbs sampler; Highly active antiretroviral therapy; HIV; HIV patients; Human immunodeficiency virus; nonlinear mixed-effects model; Normal distribution; Probability distribution functions; random change point model; Random variables; Samplers; Stochastic EM; Surveillance; zero-inflated exponential distribution; New York; United States
• ISSN: 1999-4893; 1999-4893
• DOI: 10.3390/a18060346

We propose a new random change point model that utilizes routinely recorded individual-level HIV viral load data to estimate the timing of antiretroviral therapy (ART) initiation in people living with HIV. The change point distribution is assumed to follow a zero-inflated exponential distribution for the longitudinal data, which is also subject to left-censoring, and the underlying data-generating mechanism is a nonlinear mixed-effects model. We extend the Stochastic EM (StEM) algorithm by combining a Gibbs sampler with a Metropolis–Hastings sampling. We apply the method to real HIV data to infer the timing of ART initiation since diagnosis. Additionally, we conduct simulation studies to assess the performance of our proposed method.