HIV-TRePS is an innovative and important

HIV-TRePS is an innovative and important tool to improve the health of people living with HIV, and the BC Centre for Excellence in HIV/AIDS (BC-CfE) is proud to contribute to its development,” commented Dr. Julio Montaner, Past President of the International AIDS Society and Director of the BC-CfE, based in Vancouver, Canada. “These promising results are the first to be published from a clinical evaluation of such a system. I would encourage people to try the system and enter follow-up data and evaluations to help the RDI to continue to refine and improve the system.”

Selecting and changing treatments for patients with HIV and AIDS in order to keep the virus suppressed is complex and challenging. There are approximately 25 HIV drugs available, from which physicians normally choose a combination of three or more to suppress the virus. However, mutations occurring in the viral genetic code can cause resistance to the drugs used against it. The physician then has to select a new combination of drugs to overcome this resistant strain.

The computational models within HIV-TRePS, called “Random Forests,” base their predictions on a range of more than 80 different variables including mutations in the viral genetic code, the drugs used to treat the patient in the past, CD4 cell counts (a type of white blood cell that is attacked by HIV) and the amount of virus in the bloodstream. The models estimate the probability of each combination of drugs reducing the amount of virus to below the limit of detection in the blood (50 copies HIV RNA/ml) based on what the system has ‘learnt’ during its training with thousands of real clinical cases. The system’s overall accuracy during development and testing was approximately 80%.

“We are very pleased to see the results of these studies published,” said Dr Brendan Larder, Scientific Chair of the HIV Resistance Response Database Initiative (RDI). “It is gratifying to see evidence that the years of technical development have resulted in a system that is likely to produce clinical benefits and that physicians are keen to use.”

The RDI is already working on a version of HIV-TRePS for use in resource-limited settings where there are fewer treatment options and health care workers do not have access to all the information that this initial system requires. The RDI’s approach could also have potential benefit in other diseases, most obviously where drug resistance can be a problem such as Hepatitis.

The RDI is an independent, not-for-profit research group 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 eight 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 70,000 patients in more than 15 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.