Abstract
BackgroundThe progression of Human Immunodeficiency Virus (HIV) within host includes typical stages and the Antiretroviral Therapy (ART) is shown to be effective in slowing down this progression. There are great challenges in describing the entire HIV disease progression and evaluating comprehensive effects of ART on life expectancy for HIV infected individuals on ART.MethodsWe develop a novel summative treatment benefit index (TBI), based on an HIV viral dynamics model and linking the infection and viral production rates to the Weibull function. This index summarizes the integrated effect of ART on the life expectancy (LE) of a patient, and more importantly, can be reconstructed from the individual clinic data.ResultsThe proposed model, faithfully mimicking the entire HIV disease progression, enables us to predict life expectancy and trace back the timing of infection. We fit the model to the longitudinal data in a cohort study in China to reconstruct the treatment benefit index, and we describe the dependence of individual life expectancy on key ART treatment specifics including the timing of ART initiation, timing of emergence of drug resistant virus variants and ART adherence.ConclusionsWe show that combining model predictions with monitored CD4 counts and viral loads can provide critical information about the disease progression, to assist the design of ART regimen for maximizing the treatment benefits.
Highlights
The progression of Human Immunodeficiency Virus (HIV) within host includes typical stages and the Antiretroviral Therapy (ART) is shown to be effective in slowing down this progression
We show that parametrizing the infection rate and viral reproduction rate through three key parameters in the Weibull function [22, 23] permits us to extend the classical viral dynamics model in such a way that accurate description of the viral dynamics during the entire HIV disease progression within a host is possible
We demonstrate, using a longitudinal cohort study in China, how parameters of the relevant Weibul functions can be estimated by fitting the viral dynamics model prediction to patient data, and how these parameterized Weibul functions in combination with the viral dynamics model yields important information about the comprehensive effects of ART on the life expectancy (LE)
Summary
The progression of Human Immunodeficiency Virus (HIV) within host includes typical stages and the Antiretroviral Therapy (ART) is shown to be effective in slowing down this progression. Typical stages of HIV infection are well documented [6, 8], and the antiretroviral therapy (ART) is shown to be effective in slowing down the progression to AIDS and improving the life quality of HIV patients [9,10,11]. One purpose of this study is to propose a novel viral dynamic model which can describe a typical disease progression including acute infection, chronic latency and AIDS stage on the basis of the classic viral dynamic model frame [8, 19,20,21]. We demonstrate, using a longitudinal cohort study in China, how parameters of the relevant Weibul functions can be estimated by fitting the viral dynamics model prediction to patient data, and how these parameterized Weibul functions in combination with the viral dynamics model yields important information about the comprehensive effects of ART on the life expectancy (LE)
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