Standardized representation, visualization and searchable repository of antiretroviral treatment-change episodes

AIDS Research and Therapy

Robert W Shafer⁶  W Jeffrey Fessel³  Andrea De Luca⁴  Josep Maria Gatell⁸  William Towner¹  Francesca Incardona²  Maurizio Zazzi⁵  Rolf Kaiser⁷  Iñaki Pere⁸  Tommy F Liu⁶  Jose Luis Blanco⁸  Soo-Yon Rhee⁹ 

[1]Department of Infectious Disease, Kaiser Permanente, Los Angeles, CA, USA

[2]Informasrl, EuResist Network GEIE, Rome, Italy

[3]Kaiser Permanente Medical Care Program, South San Francisco, CA, USA

[4]Unit of Infectious Diseases 2, University Hospital of Siena, Siena, Italy

[5]Department of Medical Biotechnologies, EuResist Network GEIE, University of Siena, Siena, Italy

[6]Department of Medicine, Stanford University, Stanford, CA, USA

[7]Institute of Virology, EuResist Network GEIE, University of Cologne, Cologne, Germany

[8]Hospital Clinic Universitari-IDIBAPS, University of Barcelona, Barcelona, Spain

[9]Division of Infectious Diseases, Room S-169, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA, 94305, USA

关键词: Database;    XML schema;    Clinical outcomes;    Drug resistance;    Antiretroviral treatment;    Human immunodeficiency virus;   

Others  :  789665
DOI  :  10.1186/1742-6405-9-13

 received in 2011-10-19, accepted in 2012-03-16,  发布年份 2012

【 摘 要 】

Background

To identify the determinants of successful antiretroviral (ARV) therapy, researchers study the virological responses to treatment-change episodes (TCEs) accompanied by baseline plasma HIV-1 RNA levels, CD4+ T lymphocyte counts, and genotypic resistance data. Such studies, however, often differ in their inclusion and virological response criteria making direct comparisons of study results problematic. Moreover, the absence of a standard method for representing the data comprising a TCE makes it difficult to apply uniform criteria in the analysis of published studies of TCEs.

Results

To facilitate data sharing for TCE analyses, we developed an XML (Extensible Markup Language) Schema that represents the temporal relationship between plasma HIV-1 RNA levels, CD4 counts and genotypic drug resistance data surrounding an ARV treatment change. To demonstrate the adaptability of the TCE XML Schema to different clinical environments, we collaborate with four clinics to create a public repository of about 1,500 TCEs. Despite the nascent state of this TCE XML Repository, we were able to perform an analysis that generated a novel hypothesis pertaining to the optimal use of second-line therapies in resource-limited settings. We also developed an online program (TCE Finder) for searching the TCE XML Repository and another program (TCE Viewer) for generating a graphical depiction of a TCE from a TCE XML Schema document.

Conclusions

The TCE Suite of applications – the XML Schema, Viewer, Finder, and Repository – addresses several major needs in the analysis of the predictors of virological response to ARV therapy. The TCE XML Schema and Viewer facilitate sharing data comprising a TCE. The TCE Repository, the only publicly available collection of TCEs, and the TCE Finder can be used for testing the predictive value of genotypic resistance interpretation systems and potentially for generating and testing novel hypotheses pertaining to the optimal use of salvage ARV therapy.

【 授权许可】

   
2012 Rhee et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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