A graph neural network-based model with out-of-distribution robustness for enhancing antiretroviral therapy outcome prediction for HIV-1.

Journal: Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society
PMID:

Abstract

Predicting the outcome of antiretroviral therapies (ART) for HIV-1 is a pressing clinical challenge, especially when the ART includes drugs with limited effectiveness data. This scarcity of data can arise either due to the introduction of a new drug to the market or due to limited use in clinical settings, resulting in clinical dataset with highly unbalanced therapy representation. To tackle this issue, we introduce a novel joint fusion model, which combines features from a Fully Connected (FC) Neural Network and a Graph Neural Network (GNN) in a multi-modality fashion. Our model uses both tabular data about genetic sequences and a knowledge base derived from Stanford drug-resistance mutation tables, which serve as benchmark references for deducing in-vivo treatment efficacy based on the viral genetic sequence. By leveraging this knowledge base structured as a graph, the GNN component enables our model to adapt to imbalanced data distributions and account for Out-of-Distribution (OoD) drugs. We evaluated these models' robustness against OoD drugs in the test set. Our comprehensive analysis demonstrates that the proposed model consistently outperforms the FC model. These results underscore the advantage of integrating Stanford scores in the model, thereby enhancing its generalizability and robustness, but also extending its utility in contributing in more informed clinical decisions with limited data availability. The source code is available at https://github.com/federicosiciliano/graph-ood-hiv.

Authors

  • Giulia Di Teodoro
    Sapienza University of Rome, Department of Computer Control and Management Engineering Antonio Ruberti, 00185, Rome, Italy; EuResist Network, 00152, Rome, Italy. Electronic address: diteodoro@diag.uniroma1.it.
  • Federico Siciliano
    Sapienza University of Rome, Department of Computer Control and Management Engineering Antonio Ruberti, 00185, Rome, Italy. Electronic address: siciliano@diag.uniroma1.it.
  • Valerio Guarrasi
    Unit of Computer Systems and Bioinformatics, Department of Engineering, University Campus Bio-Medico of Rome, Italy; Department of Computer, Control, and Management Engineering, Sapienza University of Rome, Italy. Electronic address: valerio.guarrasi@unicampus.it.
  • Anne-Mieke Vandamme
    KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Clinical and Epidemiological Virology, Leuven, Belgium; Center for Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, 1349-008, Lisbon, Portugal. Electronic address: annemie.vandamme@kuleuven.be.
  • Valeria Ghisetti
    Molecular Biology and Microbiology Unit, Amedeo di Savoia Hospital, ASL Città di Torino, 10128, Turin, Italy. Electronic address: valeria.ghisetti@unito.it.
  • Anders Sönnerborg
    Karolinska Institutet, Stockholm, Sweden.
  • Maurizio Zazzi
  • Fabrizio Silvestri
    DIAG, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy. Electronic address: fsilvestri@diag.uniroma1.it.
  • Laura Palagi
    Department of Computer, Control and Management Engineering Antonio Ruberti, Sapienza University, Piazzale Aldo Moro 5, 00185 Rome, Italy.