TY - JOUR
T1 - Clinical Evaluation of Rega 8
T2 - An Updated Genotypic Interpretation System That Significantly Predicts HIV-Therapy Response
AU - Vercauteren, Jurgen
AU - Beheydt, Gertjan
AU - Prosperi, Mattia
AU - Libin, Pieter
AU - Imbrechts, Stijn
AU - Camacho, Ricardo
AU - Clotet, Bonaventura
AU - De Luca, Andrea
AU - Grossman, Zehava
AU - Kaiser, Rolf
AU - Sönnerborg, Anders
AU - Torti, Carlo
AU - Van Wijngaerden, Eric
AU - Schmit, Jean Claude
AU - Zazzi, Maurizio
AU - Geretti, Anna Maria
AU - Vandamme, Anne Mieke
AU - Van Laethem, Kristel
PY - 2013/4/17
Y1 - 2013/4/17
N2 - Introduction:Clinically evaluating genotypic interpretation systems is essential to provide optimal guidance in designing potent individualized HIV-regimens. This study aimed at investigating the ability of the latest Rega algorithm to predict virological response on a short and longer period.Materials & Methods:9231 treatment changes episodes were extracted from an integrated patient database. The virological response after 8, 24 and 48 weeks was dichotomized to success and failure. Success was defined as a viral load below 50 copies/ml or alternatively, a 2 log decrease from the baseline viral load at 8 weeks. The predictive ability of Rega version 8 was analysed in comparison with that of previous evaluated version Rega 5 and two other algorithms (ANRS v2011.05 and Stanford HIVdb v6.0.11). A logistic model based on the genotypic susceptibility score was used to predict virological response, and additionally, confounding factors were added to the model. Performance of the models was compared using the area under the ROC curve (AUC) and a Wilcoxon signed-rank test.Results:Per unit increase of the GSS reported by Rega 8, the odds on having a successful therapy response on week 8 increased significantly by 81% (OR = 1.81, CI = [1.76-1.86]), on week 24 by 73% (OR = 1.73, CI = [1.69-1.78]) and on week 48 by 85% (OR = 1.85, CI = [1.80-1.91]). No significant differences in AUC were found between the performance of Rega 8 and Rega 5, ANRS v2011.05 and Stanford HIVdb v6.0.11, however Rega 8 had the highest sensitivity: 76.9%, 76.5% and 77.2% on 8, 24 and 48 weeks respectively. Inclusion of additional factors increased the performance significantly.Conclusion:Rega 8 is a significant predictor for virological response with a better sensitivity than previously, and with rules for recently approved drugs. Additional variables should be taken into account to ensure an effective regimen.
AB - Introduction:Clinically evaluating genotypic interpretation systems is essential to provide optimal guidance in designing potent individualized HIV-regimens. This study aimed at investigating the ability of the latest Rega algorithm to predict virological response on a short and longer period.Materials & Methods:9231 treatment changes episodes were extracted from an integrated patient database. The virological response after 8, 24 and 48 weeks was dichotomized to success and failure. Success was defined as a viral load below 50 copies/ml or alternatively, a 2 log decrease from the baseline viral load at 8 weeks. The predictive ability of Rega version 8 was analysed in comparison with that of previous evaluated version Rega 5 and two other algorithms (ANRS v2011.05 and Stanford HIVdb v6.0.11). A logistic model based on the genotypic susceptibility score was used to predict virological response, and additionally, confounding factors were added to the model. Performance of the models was compared using the area under the ROC curve (AUC) and a Wilcoxon signed-rank test.Results:Per unit increase of the GSS reported by Rega 8, the odds on having a successful therapy response on week 8 increased significantly by 81% (OR = 1.81, CI = [1.76-1.86]), on week 24 by 73% (OR = 1.73, CI = [1.69-1.78]) and on week 48 by 85% (OR = 1.85, CI = [1.80-1.91]). No significant differences in AUC were found between the performance of Rega 8 and Rega 5, ANRS v2011.05 and Stanford HIVdb v6.0.11, however Rega 8 had the highest sensitivity: 76.9%, 76.5% and 77.2% on 8, 24 and 48 weeks respectively. Inclusion of additional factors increased the performance significantly.Conclusion:Rega 8 is a significant predictor for virological response with a better sensitivity than previously, and with rules for recently approved drugs. Additional variables should be taken into account to ensure an effective regimen.
UR - http://www.scopus.com/inward/record.url?scp=84876273802&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0061436
DO - 10.1371/journal.pone.0061436
M3 - Article
C2 - 23613852
AN - SCOPUS:84876273802
SN - 1932-6203
VL - 8
JO - PLoS ONE
JF - PLoS ONE
IS - 4
M1 - e61436
ER -