Viral load testing and HIV-TRePS to optimise response to therapy
LONDON, UK; 6th December 2013. The RDI and the Load Zero Foundation have entered into partnership to bring HIV viral load testing and treatment response prediction to resource-limited countries, where there is the most need to improve HIV management. Viral load testing will enable physicians to detect HIV treatment failure early, avoiding drug resistance or clinical progression of the disease. It will also enable the physician to use the RDI's free online HIV Treatment Response Prediction System (HIV-TRePS) to select the optimal next combination of drugs for the patient."With these diagnostics, physicians can switch to the right drugs at the right time, which was previously not possible in resource-limited countries", commented Professor Julio Montaner, Past President of the International AIDS Society and Director of the BC Centre for Excellence in HIV/AIDS, based in Vancouver, Canada. "This collaboration is putting the tools and the treatment experience of thousands of HIV physicians at the fingertips of the healthcare professional in resource-limited countries."
In rich countries the standard of care is for the amount of HIV in the bloodstream, the viral load to be tested every few months, enabling the drugs to be switched as soon as they stop suppressing the virus. Viral load tests have been unaffordable in may low-income countries so doctors have had to wait until the patient showed clinical or immunological signs of disease progression before switching: a strategy which has been shown to lead to poorer outcomes. The World Health Organisation has recently recommended the adoption of HIV Treatment as Prevention with viral load monitoring in low to middle income countries and The Load Zero Foundation is funding the provision of tests developed specifically for such settings, to support the shift to viral load monitoring.
Following treatment failure, physicians in rich countries usually use a genotypic resistance test to help select the best drugs to use next. This identifies where the genetic code of HIV has mutated and to which drugs it may be resistant and which sensitive. Genotyping is also unaffordable in most low/middle income countries. HIV-TRePS uses computer models that have been trained with treatment outcome data from tens of thousands of patients treated in hospitals all over the world. The system is freely available over the Internet and predicts how the patient will respond to all the available combinations of HIV drugs, enabling the physician to select the combination most likely to be effective. Studies have shown the system to be significantly more predictive of treatment response than genotyping, with the potential to reduce the failure rate and costs of HIV treatment.
"We are really excited to be working with the Load Zero Foundation," commented Dr Andrew Revell, Executive Director of the RDI. "The viral load is the only direct way to tell if a patient's HIV therapy is no longer working, before damage to the immune system or clinical disease develops. It enables timely and necessary treatment changes to be made and also means that HIV-TRePS can be used to select the best salvage regimen."
Under the terms of the agreement the two groups will be collaborating to improve access to viral load testing and awareness of the availability and potential benefits of the HIV-TRePS system. The two groups will be sharing contacts and information, and undertaking joint fund-raising, communications research activities.
"We are thrilled to be collaborating with the RDI. We see the HIV Treatment Prediction System (HIV-TRePS) as a total game changer", said Tony Kuhn, Executive Director of the Load Zero Foundation. "With a simple viral load test and CD4 test, this free system can accurately predict how an individual who is virologically failing, will respond to any given combination of HIV drugs without the use of genotypic testing. Together we plan to improve the lives of millions of HIV patients."
The RDI is an independent, not-for-profit research group set-up in 2002 with the mission to improve the clinical management of HIV infection through the application of bioinformatics to HIV drug resistance and treatment outcome data. Over the 11 years since its inception, the RDI has worked with many of the leading clinicians and scientists in the world to develop the worldaEUR(TM)s largest database of HIV drug resistance and treatment outcome data, containing information from approximately 110,000 patients in more than 30 countries.
The Load Zero Foundation (LZF) is the world's only philanthropic organization specifically dedicated to viral load testing for over 28 million HIV patients in Africa, India, and Southeast Asia. The foundation funds viral load tests designed for low technology laboratories to measure all HIV types and subtypes active in these regions through donations.
Note: HIV-TRePS is an experimental system intended for research use only. The predictions of the system are not intended to replace professional medical care and attention by a qualified medical practitioner and consequently the RDI does not accept any responsibility for the selection of drugs, the patient's response to treatment or differences between the predictions and patientsaEUR(TM) responses.
More information can be found at: http://www.hivrdi.org and http://www.loadzerofoundation.org
For further information contact:
Andrew Revell (Executive Director, RDI) on +44 207 226 7314, +44 7067 126498 (mobile) or andrewrevell@hivrdi.org
Tony Kuhn (Executive Director, LZF) on +1 914-902-3139, +1 248-854-1272 (cell) or tk@loadzerofoundation.org
Date published: 6th December 2013