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 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 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) 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 immune ...

is the virus that causes acquired immunodeficiency syndrome (

AIDS Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual m ...

), 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 multipl ...

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 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 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 T helper cells, monocytes, macrophages, and dendritic ...

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 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 (including

neural network A neural network is a network or circuit of biological neurons, or, in a modern sense, an artificial neural network, composed of artificial neurons or nodes. Thus, a neural network is either a biological neural network, made up of biological ...

and

random forest Random forests or random decision forests is an ensemble learning method for classification, regression and other tasks that operates by constructing a multitude of decision trees at training time. For classification tasks, the output of th ...

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. Unlike most antibiotics, antiviral drugs do no ...

, 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