The use of artificial intelligence (AI) in life sciences, or "Life Tech", has increased at a rapid pace. According to World Intellectual Property Organization (WIPO), there has been "a shift from theoretical research to the use of AI technologies in commercial products and services," as reflected in the change in ratio of scientific papers to patent applications over the past decade.1 Indeed, while research into AI began in earnest in the 1950s, more than 1.6 million scientific papers have been published on AI, with more than half of identified AI inventions in the last six years alone.2,3 A review article in Nature Medicine reported last year that despite few peer-reviewed publications on use of machine learning technologies in medical devices, FDA approvals of AI as medical devices have been accelerating.4 Many of these FDA approvals relate to image analysis for diagnostic purposes, such as QuantX, the first AI platform to evaluate breast abnormalities; Aidoc, which detects acute intracranial hemorrhages in head CT scans, assisting radiologists to prioritize patient injuries; and IDx-DR, which analyzes retinal images to detect diabetic retinopathy.

We describe an AI system (CTSHIV) that connects the scientific AIDS literature describing specific human immunodeficiency virus (HIV) drug resistances directly to the customized treatment strategy of a specific HIV patient. Rules in the CTSHIV knowledge base encode knowledge about sequence mutations in the HIV genome that have been found to result in drug resistance to the HIV virus. Rules are applied to the actual HIV sequences of the virus strains infecting the specific patient undergoing clinical treatment to infer current drug resistance. A rule-directed search through mutation sequence space identifies nearby drug-resistant mutant strains that might arise. The possible combination drug-treatment regimens currently approved by the U.S. Food and Drug Administration are considered and ranked by their estimated ability to avoid identified current and nearby drug-resistant mutants. The highest-ranked treatments are recommended to the attending physician. The result is more precise treatment of individual HIV patients and a decreased tendency to select for drug-resistant genes in the global HIV gene pool. Initial results from a small human clinical trial are encouraging, and further clinical trials are planned. From an AI viewpoint, the case study demonstrates the extensibility of knowledge-based systems because it illustrates how existing encoded knowledge can be used to support new knowledge-based applications that were unanticipated when the original knowledge was encoded.