The HIV Resistance Response Database Initiative (RDI)

The 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, with confidence based on the more than a million patient-years of treatment experience underpinning the system.

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, potentially saving or extending a great many lives.

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.

It is a cause for celebration that this improvement in HIV treatment means the need for sophisticated AI to support HIV treatment decisions has significantly reduced over the past few years. In response, the RDI decided to cease the development of further models and, in March 2024, withdrew the HIV-TRePS system.

The RDI team would like to express their heartfelt thanks to all those individuals and institutions that provided the RDI with the data necessary to train its models and to its funders, all listed below. Particular thanks must go to Dr Cliff Lane and his colleagues at the US National Institutes of Allergy and Infection Diseases for their funding, data, and support throughout the RDI’s history, without which none of this would have been possible.

RDI supporters (data)

Cohorts: Peter Reiss and Ard van Sighem (ATHENA, the Netherlands); Julio Montaner and Richard Harrigan (BC Center for Excellence in HIV & AIDS, Canada); Tobias Rinke de Wit, Raph Hamers and Kim Sigaloff (PASER-M cohort, The Netherlands); Brian Agan, Vincent Marconi and Scott Wegner (US Department of Defense); Wataru Sugiura (National Institute of Health, Japan); Maurizio Zazzi (MASTER, Italy); Rolf Kaiser and Eugen Schuelter (Arevir Cohort, Köln, Germany); Adrian Streinu-Cercel (National Institute of Infectious Diseases Prof. Dr. Matei Balş, Bucharest, Romania); Gerardo Alvarez-Uria (VFHCS, India), Maria-Jesus Perez-Elias (CORIS, Spain); Federico Garcia (Resistance Work Package of the Spanish HIV Resistance Network; RIS, Spain); Tulio de Oliveira, (SATuRN, South Africa).

Clinics: Jose Gatell and Elisa Lazzari (University Hospital, Barcelona, Spain); Brian Gazzard, Mark Nelson, Anton Pozniak and Sundhiya Mandalia (Chelsea and Westminster Hospital, London, UK); Colette Smith (Royal Free Hospital, London, UK); Lidia Ruiz and Bonaventura Clotet (Fundacion Irsi Caixa, Badelona, Spain); Schlomo Staszewski (Hospital of the Johann Wolfgang Goethe-University, Frankfurt, Germany); Carlo Torti (University of Brescia, Italy); Cliff Lane, Julie Metcalf and Catherine A. Rehm (National Institutes of Health Clinic, Rockville, USA); Maria-Jesus Perez-Elias (Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain); Stefano Vella and Gabrielle Dettorre (Sapienza University, Rome, Italy); Andrew Carr, Richard Norris and Karl Hesse (Immunology B Ambulatory Care Service, St. Vincent’s Hospital, Sydney, NSW, Australia); Dr Emanuel Vlahakis (Taylor’s Square Private Clinic, Darlinghurst, NSW, Australia); Hugo Tempelman and Roos Barth (Ndlovu Care Group, Elandsdoorn, South Africa); Robin Wood, Carl Morrow and Dolphina Cogill (Desmond Tutu HIV Centre, University of Cape Town, South Africa); Chris Hoffmann (Aurum Institute, Johannesburg, South Africa and Johns Hopkins University, Boston, USA; Luminita Ene (“Dr. Victor Babes” Hospital for Infectious and Tropical Diseases, Bucharest, Romania); Gordana Dragovic (University of Belgrade, Belgrade, Serbia); Ricardo Diaz and Cecilia Sucupira (Federal University of Sao Paulo, Sao Paulo, Brazil); Omar Sued and Carina Cesar (Fundación Huésped, Buenos Aires, Argentina); Juan Sierra Madero (Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico); Pachamuthu Balakrishnan and Shanmugam Saravanan (YRG Care, Chennai, India).

Clinical trials: Sean Emery and David Cooper (CREST); Carlo Torti (GenPherex); John Baxter (GART, MDR); Laura Monno and Carlo Torti (PhenGen); Jose Gatell and Bonventura Clotet (HAVANA); Gaston Picchio and Marie-Pierre deBethune (DUET 1 & 2 and POWER 3); Maria-Jesus Perez-Elias (RealVirfen); Sean Emery, Paul Khabo and Lotty Ledwaba (PHIDISA).

RDI supporters (funding):

Leidos Biomedical Research, Inc., DC, USA; on behalf of NIAID
The BC Centre for Excellence in HIV/AIDS, Vancouver, Canada
Gilead Sciences Inc. Foster City, Ca, USA
HIV and Hepatitis.com
US Military HIV Research Program
International Health Foundation, Brescia, Italy
Bristol-Myers Squibb