The current activities of the RDI can be divided into two:
1. The ongoing core activities of:
- Adding data to the database
- Exploring the relationship between changes in the genetic code of HIV (genotype), other clinical and laboratory factors and response to HIV drug therapy
- Developing computational models for helping physicians and their patients to select the best combination of dugs for the individual.
2. Specific research projects.
1. Current status of core activity
As of January 2010, the RDI database contained data from approximately 60,000 patients, having doubled in size in the last three years. The unit of data used for modelling consists of a treatment change episode (TCE). A TCE includes all the relevant data for a patient around when s/he were started on a new antiretroviral drug therapy.
During 2010, the RDI’s computational models will be made available via the RDI web site as an experimental tool to help optimise treatment decision-making
2. Current research projects
Modelling response without using genotype – implications for resource-limited settings
Up until 2008, we always included mutations in the viral genotype as variables in the modelling of response to drug therapy. However, many parts of the world hardest hit by the HIV epidemic have limited resources at their disposal and genotype tests are not generally available. Moreover these settings often have limited drug options and, with patients taking failing regimens for longer than in other settings, the potential for drug resistance to develop and spread is significant.
With this challenge in mind, during 2009 the RDI developed models that were able to predict the response to HIV treatment without the use of a genotype. Some of the results of this modelling can be reviewed in our Scientific Publications section. During 2010, the RDI will develop further its modelling without genotype for potential application in these resource-limited settings.