A model for type I diabetes in an HIV-infected patient under highly active antiretroviral therapy

Abstract

Type 1 diabetes (T1D), previously known as juvenile diabetes or insulin-dependent diabetes, is an autoimmune disease characterized by the insufficient (or lack of) production of insulin by the pancreas. Insulin is crucial to maintain blood sugar at healthy levels. High blood sugar damages the body and causes a variety of symptoms, ranging from severe thirst, fatigue, to urinary infections. The cells responsible for the production of insulin are the β-cells. In T1D, these are killed by an abnormal response of the immune system. Specific clones of cytotoxic T-cells invade the pancreatic islets of Langerhans, and eliminate them.T1D diabetes may develop in human immunodeficiency virus (HIV)-infected patients, though in rare situations. In this paper, we propose a cell model for the development of T1D in these patients, after immune restoration, during highly active antiretroviral therapy (HAART). The study includes the derivation of the qualitative properties of the model, and its comprehensive investigation via path-following methods, using the continuation platform COCO. In this way, the main theoretical predictions are verified in detail. Furthermore, this numerical part establishes accurate parameter thresholds to ensure an effective disease treatment in HIV-infected persons to prevent the development of T1D.