Euresist - Integration of viral genomics with clinical data to predict response to anti-HIV
DISCLAIMER
The system provides an estimate of in vivo efficacy of commonly used antiretroviral drug combinations based on user-defined information of HIV genotype (mandatory) and additional patient information (recommended). The engine is not intended as a replacement for standard of care but can be used by HIV specialists as an additional treatment decision support tool. Although analysis of a large data set of medical records has shown a good performance of the system, there is no warranty that its use will improve patient health. HIV care must rely on a solid knowledge of the complex host-virus interaction and proper consideration of patient status and commitment.
EuResist prediction system
The EuResist project has developed an integrated computational system for clinical management of antiretroviral drug resistance. The system requests HIV genotype and optionally a set of clinical data and returns a prediction of response to common antiretroviral regimens, helping the HIV specialist to choose the most effective drug combinations for her/his patient. The system has been trained and tested on a set of data derived from clinical practice records of more than 18,000 HIV patients collected in Europe. The internal validation showed a prediction accuracy of 76% when treatment success was defined as achieving a decrease of at least 2 log or an undetectable HIV RNA load at week 8 after treatment start. Ongoing analysis indicates that the same performance is obtained with 24-week prediction.
The EuResist system is a linear combination of three statistical learning engines predicting response to treatment. These were designed to work with viral genotype and intended regimen as the only information, as well as with additional measurements (e.g. baseline viral load) and information derived from previous treatments and genotypes to enhance prediction performance. The models combined in the final prediction system include: a Generative Discriminative engine using a Bayesian Network prediction as an additional covariate, a Mixed Effects engine modelling interactions between covariates, and an Evolutionary engine exploiting the genetic barrier to drug resistance as an additional predictor. read more.
EuResist integrated database
The EuResist Integrated DataBase (EIDB) was set up to develop the EuResist prediction system. Currently, it is probably the largest European data set of genotype-response data . The EIDB includes information about patient demographics, drug therapies, AIDS defining events, CD4 and viral load measurements, and HIV sequences. As of June 2008, it contained 18,467 patients, 64,864 therapies, 22,006 HIV sequences, 240,795 viral load and 304,838 CD4 measurements The EIDB integrates biomedical information from the three founding national databases: ARCA (Italy), AREVIR (Germany), Karolinska Institute (Sweden). The original data set is continuously updated with new data in order to improve the results of the prediction system. Following the EIDB setup, data from the Laboratoire de Rétrovirologie of CRP-Santé (Luxembourg) have also been uploaded. read more.
Contribution to the database
The service is and will remain free of charge. Like any data-driven engine, availability of new data is crucial for updating and improving the system. You can contribute genotype-response data to the EuResist initiative under the current regulations. The EuResist data set is available for scientific purposes upon request.