Computer models that predict response to treatment

Details of computer models that can predict the chances of a patient responding to their HIV drugs with 80% accuracy are published today in the journal AIDS. The models were developed by the HIV Resistance Response Database Initiative (RDI) using almost half a million pieces of data from approximately 6,000 clinical cases from hundreds of clinics around the world. The models are now available online as part of an experimental treatment support tool, HIV-TRePS.

The random forest models were trained to predict the probability of any combination of HIV drugs reducing the virus in the patient’s blood to an undetectably low level (<50 copies/ml). They use the genetic code of the virus, the patient’s immune status, their treatment history and a measure of the level of HIV in the blood, to make their predictions.

“The publication of these results is an important milestone in the development of expert computer systems to aid clinical practice”, commented Professor Julio Montaner, etc.  “The models harness the experience of hundreds of physicians treating thousands of patients and puts this distilled expertise in the hands of the individual physician via the click of a mouse.”

Currently, when a patient’s treatment fails and the levels of the virus increase, physicians usually run a genotype test, which detects mutations in the genetic code of the virus that can make it resistant to certain drugs.  The physician then selects a combination of drugs that the test indicates will still be effective against the mutated virus. When the results of this test were compared with those of the RDI models they proved significantly less accurate as a predictor of response.

The RDI is an independent, not-for-profit international research collaboration set-up in 2002 with the mission to improve the clinical management of HIV infection through the application of bioinformatics to HIV drug resistance and treatment outcome data. Over the nine years since its inception, the RDI has worked with many of the leading clinicians and scientists in the world to develop the world’s largest database of HIV drug resistance and treatment outcome data, containing information from approximately 85,000 patients in more than 20 countries.

Note: HIV-TRePS is an experimental system intended for research use only. The predictions of the system are not intended to replace professional medical care and attention by a qualified medical practitioner and consequently the RDI does not accept any responsibility for the selection of drugs, the patient's response to treatment or differences between the predictions and patients’ responses.

Reference:  Revell AD, Wang D, Boyd MA et al . The development of an expert system to predict virological response to HIV therapy as part of an online treatment support tool. AIDS 2011; 25(15): 1855-1863.

Link to paper online: http://journals.lww.com/aidsonline/Abstract/2011/09240/The_development_of_an_expert_system_to_predict.6.aspx

Source: http://www.hivrdi.org