Computational models as predictors of HIV treatment outcomes for the Phidisa cohort in South Africa

Southern African Journal of HIV Medicine

Field Value
Title Computational models as predictors of HIV treatment outcomes for the Phidisa cohort in South Africa
Creator Revell, Andrew Khabo, Paul Ledwaba, Lotty Emery, Sean Wang, Dechao Wood, Robin Morrow, Carl Tempelman, Hugo Hamers, Raph L. Reiss, Peter van Sighem, Ard Pozniak, Anton Montaner, Julio Lane, H. Clifford Larder, Brendan
Subject Medicine; Biomathematics HIV therapy; mathematical modelling; treatment; genotype
Description Background: Selecting the optimal combination of HIV drugs for an individual in resourcelimited settings is challenging because of the limited availability of drugs and genotyping.Objective: The evaluation as a potential treatment support tool of computational models that predict response to therapy without a genotype, using cases from the Phidisa cohort in South Africa.Methods: Cases from Phidisa of treatment change following failure were identified that had the following data available: baseline CD4 count and viral load, details of failing and previous antiretroviral drugs, drugs in new regimen and time to follow-up. The HIV Resistance Response Database Initiative’s (RDI’s) models used these data to predict the probability of a viral load 50 copies/mL at follow-up. The models were also used to identify effective alternative combinations of three locally available drugs.Results: The models achieved accuracy (area under the receiver–operator characteristic curve) of 0.72 when predicting response to therapy, which is less accurate than for an independent global test set (0.80) but at least comparable to that of genotyping with rules-based interpretation. The models were able to identify alternative locally available three-drug regimens that were predicted to be effective in 69% of all cases and 62% of those whose new treatment failed in the clinic.Conclusion: The predictive accuracy of the models for these South African patients together with the results of previous studies suggest that the RDI’s models have the potential to optimise treatment selection and reduce virological failure in different patient populations, without the use of a genotype.Keywords: HIV therapy; mathematical modelling; treatment; genotype
Publisher AOSIS
Contributor The National Institute of Allergy and Infectious Diseases
Date 2016-06-30
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — —
Format text/html application/octet-stream text/xml application/pdf
Identifier 10.4102/sajhivmed.v17i1.450
Source Southern African Journal of HIV Medicine; Vol 17, No 1 (2016); 7 pages 2078-6751 1608-9693
Language eng
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Rights Copyright (c) 2016 Andrew Revell, Paul Khabo, Lotty Ledwaba, Sean Emery, Dechao Wang, Robin Wood, Carl Morrow, Hugo Tempelman, Raph L. Hamers, Peter Reiss, Ard van Sighem, Anton Pozniak, Julio Montaner, H. Clifford Lane, Brendan Larder