Featured Research

from universities, journals, and other organizations

Computer models predict how patients will respond to HIV drugs without the need for resistance testing

Date:
March 14, 2013
Source:
Oxford University Press (OUP)
Summary:
Computer models can predict how HIV patients whose drug therapy is failing will respond to a new treatment. Crucially for patients in poorer countries, the models do not require the results of expensive drug resistance tests to make their predictions. The study also showed that the models were able to identify alternative drug combinations that were predicted to work in cases where the treatment used in the clinic had failed, suggesting that their use could avoid treatment failure.

Results of a study published online in the Journal of Antimicrobial Chemotherapy March 14, demonstrate that computer models can predict how HIV patients whose drug therapy is failing will respond to a new treatment. Crucially for patients in poorer countries, the models do not require the results of expensive drug resistance tests to make their predictions. The study also showed that the models were able to identify alternative drug combinations that were predicted to work in cases where the treatment used in the clinic had failed, suggesting that their use could avoid treatment failure.

When a patient's HIV drugs begin to fail in well-resourced countries a genotypic resistance test is performed to identify mutations that cause the virus to become resistant to certain drugs. The results are used to predict whether the patient will respond to different drugs in a new treatment. These tests are generally not available in resource-limited settings. Today's study shows that computer models can predict how such a patent will respond, with comparable accuracy, without the need for such tests.

"This is the first time this approach has been tried with real cases of treatment failure from resource-limited settings," commented Julio Montaner, former President of the International AIDS Society, Director of the BC Centre for Excellence in HIV & AIDS, based in Vancouver, Canada and an author on the paper. "The results show that using sophisticated computer based algorithms we can effectively put the experience of treating thousands of patients into the hands of the under-resourced physician with potentially huge benefits."

The models were developed by The HIV Resistance Response Database Initiative (RDI), using information gathered from many thousands of patients in hundreds of clinics around the world. They make their predictions of the probability of the drugs reducing the level of virus below a low limit from the patient's treatment history, the CD4 count(i) and the viral load. The models were most accurate (over 70%) when they were used to make predictions for new cases from the clinics that provided the data used in their training. However they were 60-64% accurate when tested with cases from southern Africa, 57% for India and 67% for Romania where resources are very limited. This compares favourably with accuracy of around 60-65% for genotyping, with interpretation using standard algorithms.

The models were also able to identify alternative, three-drug regimens, comprising locally available drugs that were predicted to produce a virological response for a substantial proportion of the treatment failures observed. This proportion ranged from 75% in Southern Africa, where the number of drugs available was highly restricted, to 93% in Romania and 99% in India. In all cases from the resource-limited countries, the models were able to identify regimens with a higher predicted probability of success than the regimen that failed.

"These results suggest that use of the system could help to avoid significant numbers of treatment failures," commented lead author Andrew Revell of the RDI. "The superiority of the models with cases from 'familiar' settings indicates that the full potential of this system to aid treatment decision-making could be realised by the collection of data from resource-limited settings and the use of these data to train the next generation of models."

The models are now available free of charge on the RDI web site at http://www.hivrdi.org.

It should be noted that, as the study was retrospective, no firm claims can be made for the clinical benefit that use of the system as a treatment support tool could provide. Nevertheless, the results were positive for clinics and cohorts in many different countries across five disparate regions of the world, which is very encouraging in terms of generalizability. The results also suggest that this approach has the potential to reduce virological failure and improve patient outcomes in less well-resourced countries.

[i] CD4 (cluster of differentiation 4) is a glycoprotein found on the surface of immune cells such as T helper cells, monocytes, macrophages, and dendritic cells.


Story Source:

The above story is based on materials provided by Oxford University Press (OUP). Note: Materials may be edited for content and length.


Journal Reference:

  1. Andrew D. Revell, Dechao Wang, Robin Wood, Carl Morrow, Hugo Tempelman, Raph Hamers, Gerardo Alcarez-Uria, Adrian Streinu-Cercel, Luminita Ene, Annemarie Wensing, Frank De Wolf, Mark Nelson, Julio Montaner, H. Lane, and Brendan Larder. Computational models can predict response to HIV therapy without a genotype and may reduce treatment failure in different resource-limited settings. Journal of Antimicrobial Chemotherapy, 2013 DOI: 10.1093/jac/dkt041

Cite This Page:

Oxford University Press (OUP). "Computer models predict how patients will respond to HIV drugs without the need for resistance testing." ScienceDaily. ScienceDaily, 14 March 2013. <www.sciencedaily.com/releases/2013/03/130313214015.htm>.
Oxford University Press (OUP). (2013, March 14). Computer models predict how patients will respond to HIV drugs without the need for resistance testing. ScienceDaily. Retrieved September 2, 2014 from www.sciencedaily.com/releases/2013/03/130313214015.htm
Oxford University Press (OUP). "Computer models predict how patients will respond to HIV drugs without the need for resistance testing." ScienceDaily. www.sciencedaily.com/releases/2013/03/130313214015.htm (accessed September 2, 2014).

Share This




More Health & Medicine News

Tuesday, September 2, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Get on Your Bike! London Cycling Popularity Soars Despite Danger

Get on Your Bike! London Cycling Popularity Soars Despite Danger

AFP (Sep. 1, 2014) Wedged between buses, lorries and cars, cycling in London isn't for the faint hearted. Nevertheless the number of people choosing to bike in the British capital has doubled over the past 15 years. Duration: 02:27 Video provided by AFP
Powered by NewsLook.com
Can You Train Your Brain To Eat Healthy?

Can You Train Your Brain To Eat Healthy?

Newsy (Sep. 1, 2014) New research says if you condition yourself to eat healthy foods, eventually you'll crave them instead of junk food. Video provided by Newsy
Powered by NewsLook.com
We've Got Mites Living In Our Faces And So Do You

We've Got Mites Living In Our Faces And So Do You

Newsy (Aug. 30, 2014) A new study suggests 100 percent of adult humans (those over 18 years of age) have Demodex mites living in their faces. Video provided by Newsy
Powered by NewsLook.com
Liberia Continues Fight Against Ebola

Liberia Continues Fight Against Ebola

AFP (Aug. 30, 2014) Authorities in Liberia try to stem the spread of the Ebola epidemic by raising awareness and setting up sanitation units for people to wash their hands. Duration: 00:41 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins