HIV Resistance Response Database Initiative (RDI) was formed in 2002 to use artificial intelligence (AI) to predict how patients will respond to HIV drugs using data from more 250,000 patients from around 50 countries around the world. The RDI used its models to power its HIV Treatment Response Prediction System (HIV-TRePS). Launched in 2010, this free online tool enabled healthcare professionals to upload their patient’s data and obtain highly accurate predictions of how they would respond to different combinations of the 30 or more drugs available. The tool enabled physicians to individualize their patients’ treatment, using these predictions based on more than a million patient-years of treatment experience. HIV-TRePS was possibly the first ever AI-based system for medical decision-making to be developed, successfully tested, and used in clinical practice. It has since been used by thousands of healthcare professionals to optimise the treatment of tens of thousands of patients. Since the RDI’s inception the treatment of

HIV The human immunodeficiency viruses (HIV) are two species of '' Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the im ...

infection has progressed enormously, with more effective and better tolerated drugs available in ever more convenient combination formulations. In most countries HIV is now considered a chronic, manageable condition. Moreover, the success of the drugs in reducing the amount of

virus A virus is a submicroscopic infectious agent that replicates only inside the living Cell (biology), cells of an organism. Viruses infect all life forms, from animals and plants to microorganisms, including bacteria and archaea. Viruses are ...

is substantially reducing the onward transmission of the virus and cases of new infections are falling in many settings. This improvement in HIV treatment means the need for sophisticated AI to support HIV treatment decisions has significantly reduced. In response, the RDI ceased development of further models and, in March 2024, withdrew its HIV-TRePS system.

Background

Human immunodeficiency virus (HIV) is the

that causes

acquired immunodeficiency syndrome The human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. Without treatment, it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS). It is a preventable disease. It can ...

(

AIDS The HIV, human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. Without treatment, it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS). It is a Preventive healthcare, pr ...

), a condition in which the immune system begins to fail, leading to life-threatening opportunistic infections. There are approximately 30 HIV

antiretroviral The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs as a strategy to control HIV infection. There are several classes of antiretroviral agents that act on different stages of the HIV life-cycle. The use of mu ...

drugs that have been approved for the treatment of HIV infection, from six different classes, based on the point in the HIV life-cycle at which they act. They are used in combination; typically 3 or more drugs from 2 or more different classes, a form of therapy known as highly active antiretroviral therapy or

HAART The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs as a strategy to control HIV infection. There are several classes of antiretroviral agents that act on different stages of the HIV life-cycle. The use of mu ...

. The aim of therapy is to suppress the virus to very low, ideally undetectable, levels in the blood. This prevents the virus from depleting the

immune cells White blood cells (scientific name leukocytes), also called immune cells or immunocytes, are cells of the immune system that are involved in protecting the body against both infectious disease and foreign entities. White blood cells are genera ...

that it preferentially attacks (

CD4 In molecular biology, CD4 (cluster of differentiation 4) is a glycoprotein that serves as a co-receptor for the T-cell receptor (TCR). CD4 is found on the surface of immune cells such as helper T cells, monocytes, macrophages, and dendritic c ...

cells) and prevents or delays illness and death. Despite the expanding availability of these drugs and the impact of their use, treatments continue to fail, often involving to the development of resistance. During drug therapy, low-level virus replication may still occur, particularly when a patient misses a dose. HIV makes errors in copying its genetic material and, if a

mutation In biology, a mutation is an alteration in the nucleic acid sequence of the genome of an organism, virus, or extrachromosomal DNA. Viral genomes contain either DNA or RNA. Mutations result from errors during DNA or viral replication, ...

makes the virus resistant to one or more of the drugs in the patient's treatment, it may begin to replicate more successfully in the presence of that drug and undermine the effect of the treatment. If this happens, the treatment needs to be changed to re-establish control over the virus.

RDI's Approach

The RDI’s approach was to use

artificial intelligence Artificial intelligence (AI) is the capability of computer, computational systems to perform tasks typically associated with human intelligence, such as learning, reasoning, problem-solving, perception, and decision-making. It is a field of re ...

(including

neural network A neural network is a group of interconnected units called neurons that send signals to one another. Neurons can be either biological cells or signal pathways. While individual neurons are simple, many of them together in a network can perfor ...

and

random forest Random forests or random decision forests is an ensemble learning method for statistical classification, classification, regression analysis, regression and other tasks that works by creating a multitude of decision tree learning, decision trees ...

models), trained with data from hundreds of thousands of patients, treated with different drugs in a variety of clinical settings all over the world, to predict how an individual patient will respond to any new combination of HIV drugs. The models were tested with independent data sets and consistently achieved accuracy of approximately 80%. {{cite journal, vauthors=((Larder B. A., Wang, D., Revell, A. D., Montaner J, Harrigan, R., Hamers, R. L., de Wolf, F., et al.)), year=2007, title=The development of artificial neural networks to predict virological response to combination HIV therapy, journal=

Antiviral Therapy Antiviral drugs are a class of medication used for treating viral infections. Most antivirals target specific viruses, while a broad-spectrum antiviral is effective against a wide range of viruses. Antiviral drugs are a class of antimicrobials ...

, issue=12, pages=15–24, volume=12, doi=10.1177/135965350701200112 , pmid=17503743, s2cid=6947981 , doi-access=free

References

External links

RDI official site
Health informatics organizations Medical databases Applications of artificial intelligence HIV/AIDS organisations in the United Kingdom Database companies