Within-host Infection Dynamics Research Articles

Infection dynamics of subtype H9N2 low pathogenic avian influenza a virus in turkeys

While mammals can be infected by influenza A virus either sporadically or with well adapted lineages, aquatic birds are the natural reservoir of the pathogen. So far most of the knowledge on influenza virus dynamics was however gained on mammalian models. In this study, we infected turkeys using a low pathogenic avian influenza virus and determined the infection dynamics with a target-cell limited model. Results showed that turkeys had a different set of infection characteristics, compared with humans and ponies. The viral clearance rates were similar between turkeys and ponies but higher than that in humans. The cell death rates and cell to cell transmission rates were similar between turkeys and humans but higher than those in ponies. Overall, this study indicated the variations of within-host dynamics of influenza infection in avian, humans, and other mammalian systems.

Comparative analysis of within-host dynamics of acute infection and viral rebound dynamics in postnatally SHIV-infected ART-treated infant rhesus macaques.

Viral dynamics of acute HIV infection and HIV rebound following suspension of antiretroviral therapy may be qualitatively similar but must differ given, for one, development of adaptive immune responses. Understanding the differences of acute HIV infection and viral rebound dynamics in pediatric populations may provide insights into the mechanisms of viral control with potential implications for vaccine design and the development of effective targeted therapeutics for infants and children. Mathematical models have been a crucial tool to elucidate the complex processes driving viral infections within the host. Traditionally, acute HIV infection has been modeled with a standard model of viral dynamics initially developed to explore viral decay during treatment, while viral rebound has necessitated extensions of that standard model to incorporate explicit immune responses. Previous efforts to fit these models to viral load data have underscored differences between the two infection stages, such as increased viral clearance rate and increased death rate of infected cells during rebound. However, these findings have been predicated on viral load measurements from disparate adult individuals. In this study, we aim to bridge this gap, in infants, by comparing the dynamics of acute infection and viral rebound within the same individuals by leveraging an infant nonhuman primate Simian/Human Immunodeficiency Virus (SHIV) infection model. Ten infant Rhesus macaques (RMs) orally challenged with SHIV.C.CH505 375H dCT and given ART at 8 weeks post-infection. These infants were then monitored for up to 60 months post-infection with serial viral load and immune measurements. We use the HIV standard viral dynamics model fitted to viral load measurements in a nonlinear mixed effects framework. We find that the primary difference between acute infection and rebound is the increased death rate of infected cells during rebound. We use these findings to generate hypotheses on the effects of adaptive immune responses. We leverage these findings to formulate hypotheses to elucidate the observed results and provide arguments to support the notion that delayed viral rebound is characterized by a stronger CD8+ T cell response.

Mathematical model explains differences in Omicron and Delta SARS-CoV-2 dynamics in Caco-2 and Calu-3 cells.

Within-host infection dynamics of Omicron dramatically differs from previous variants of SARS-CoV-2. However, little is still known about which parameters of virus-cell interplay contribute to the observed attenuated replication and pathogenicity of Omicron. Mathematical models, often expressed as systems of differential equations, are frequently employed to study the infection dynamics of various viruses. Adopting such models for results of in vitro experiments can be beneficial in a number of aspects, such as model simplification (e.g., the absence of adaptive immune response and innate immunity cells), better measurement accuracy, and the possibility to measure additional data types in comparison with in vivo case. In this study, we consider a refinement of our previously developed and validated model based on a system of integro-differential equations. We fit the model to the experimental data of Omicron and Delta infections in Caco-2 (human intestinal epithelium model) and Calu-3 (lung epithelium model) cell lines. The data include known information on initial conditions, infectious virus titers, and intracellular viral RNA measurements at several time points post-infection. The model accurately explains the experimental data for both variants in both cell lines using only three variant- and cell-line-specific parameters. Namely, the cell entry rate is significantly lower for Omicron, and Omicron triggers a stronger cytokine production rate (i.e., innate immune response) in infected cells, ultimately making uninfected cells resistant to the virus. Notably, differences in only a single parameter (e.g., cell entry rate) are insufficient to obtain a reliable model fit for the experimental data.

A mathematical model for the within-host (re)infection dynamics of SARS-CoV-2

Interactions between SARS-CoV-2 and the immune system during infection are complex. However, understanding the within-host SARS-CoV-2 dynamics is of enormous importance for clinical and public health outcomes. Current mathematical models focus on describing the within-host SARS-CoV-2 dynamics during the acute infection phase. Thereby they ignore important long-term post-acute infection effects. We present a mathematical model, which not only describes the SARS-CoV-2 infection dynamics during the acute infection phase, but extends current approaches by also recapitulating clinically observed long-term post-acute infection effects, such as the recovery of the number of susceptible epithelial cells to an initial pre-infection homeostatic level, a permanent and full clearance of the infection within the individual, immune waning, and the formation of long-term immune capacity levels after infection. Finally, we used our model and its description of the long-term post-acute infection dynamics to explore reinfection scenarios differentiating between distinct variant-specific properties of the reinfecting virus. Together, the model’s ability to describe not only the acute but also the long-term post-acute infection dynamics provides a more realistic description of key outcomes and allows for its application in clinical and public health scenarios.

A cell-level dynamical model for malaria parasite infection with antimalarial drug treatment

Malaria is an infectious disease caused by intracellular parasites of the genus Plasmodium. It is a major health problem around the world. In this study, a cell-level mathematical model of malaria parasites with antimalarial drug treatments is formulated and analyzed. The model consists of seven compartments for cell populations. We analyzed the qualitative behavior of the model using various techniques. The stability analysis of the parasite-free equilibrium is obtained, whereas it is locally and globally stable if the basic reproduction number R0<1. The parasite persistence equilibrium point exists, and it is locally asymptotically stable if R0>1. The sensitivity analysis of the basic reproduction number is computed, and the results show that the infection rate of the erythrocyte by merozoites, the average number of merozoites per ruptured infected erythrocyte cells, the natural death rate of merozoites, and the requirement rate of the uninfected erythrocyte are the most influential parameters within-host dynamics of malaria infection. Different numerical simulations are performed to supplement our analytical findings. The effect of primary tissue schizontocides, blood schizontocides, and gametocytocides on infected hepatocytes, infected erythrocytes, and gametocytes have been investigated, respectively. Finally, some counterplots are presented in order to investigate the impact of parameters on the basic reproduction number. The in-host basic reproduction number decreases as the antimalarial treatment administration increases. Therefore, increasing antimalarial treatment administration is the best way to mitigate the in-host malaria infection.

A fractional-order nonlinear model for a within-host chikungunya virus dynamics with adaptive immunity using Caputo derivative operator

The study of within-host dynamics of viral infection is a vital process of understanding how healthy cells in the body are affected by viral foreign bodies and how body immunity responds to such changes. This paper presents and analyses the dynamics of a within-host Chikungunya virus transmission with adaptive immune responses using a fractional-order derivative operator of the Caputo type. The formulated model describes the interaction of uninfected cells, infected cells and viral particles in the presence of Cytotoxic T-Lymphocytes and antibody immune responses. Several analytical methods are employed to analyse the fractional-order within-host model. Positivity and boundedness theory are used to investigate the properties of solutions of the model via the generalized mean value theorem approach. The existence and uniqueness of solutions are examined using the Banach fixed point method. The normalized forward sensitivity method determines how different model parameters affect the fractional-order system. It was shown that transmission rate and parameters representing adaptive immune responses played a significant role in the Chikungunya virus model’s dynamics. Further, the time-dependent optimal control fractional-order model is analysed to optimize the performance of adaptive immune responses using the optimal control theory approach made popular by Pontryagin’s maximum principle. Simulations are performed to visualize the theoretical results and show the influence of memory on the trajectories of concentrations of uninfected cells, infected cells, viral particles, Cytotoxic T-Lymphocytes and antibodies.

Virulence decomposition for bifurcating infections.

A fundamental goal in infection biology is to understand the emergence of variation in pathogen virulence-here defined as the decrease in host fitness caused by a pathogen. To uncover the sources of such variation, virulence can be decomposed into both host- and pathogen-associated components. However, decomposing virulence can be challenging owing to complex within-host pathogen dynamics such as bifurcating infections, which recently received increased empirical and theoretical attention. Bifurcating infections are characterized by the emergence of two distinct infection types: (i) terminal infections with high pathogen loads resulting in rapid host death, and (ii) persistent infections with lower loads and delayed host death. Here, we propose to use discrete mixture models to perform separate virulence decompositions for each infection type. Using this approach, we reanalysed a recently published experimental dataset on bacterial load and survival in Drosophila melanogaster. This analysis revealed several advantages of the new approach, most importantly the generation of a more comprehensive picture of the varying sources of virulence in different bacterial species. Beyond this application, our approach could provide valuable information for ground-truthing and improving theoretical models of within-host infection dynamics, which are developed to predict variation in infection outcome and pathogen virulence.

Severe acute respiratory syndrome-coronavirus-2 (SARS-COV-2) infection of pneumocytes with vaccination and drug therapy: Mathematical analysis and optimal control

We propose a mathematical model studying a within-host infection dynamics of SARS-CoV-2 in pneumocytes. This model incorporates immune response, vaccination and antiviral drugs. The crucial properties of the model — the existence, positivity and boundary of solutions — are established. Equilibrium points and the basic reproduction number are calculated. The stability of each equilibrium point is analyzed. Optimal control is applied to the model by adding three control variables: vaccination, treatment by Favipiravir and treatment by Molnupiravir. Numerical results show that each individual control could reduce SARS-CoV-2 infection in some aspects; however, with a combination of three controls, we obtain the best results in reducing SARS-CoV-2 infection. This study has emphasized the importance of prevention by vaccine and the antiviral treatments.

Relationship between the inclusion/exclusion criteria and sample size in randomized controlled trials for SARS-CoV-2 entry inhibitors

The coronavirus disease 2019 (COVID-19) pandemic that has been ongoing since 2019 is still ongoing and how to control it is one of the international issues to be addressed. Antiviral drugs that reduce the viral load in terms of reducing the risk of secondary infection are important. For the general control of emerging infectious diseases, establishing an efficient method to evaluate candidate therapeutic agents will lead to a rapid response. We evaluated clinical trial designs for viral entry inhibitors that have the potential to be effective pre-exposure prophylactic drugs in addition to reducing viral load after infection. We used a previously developed simulation of clinical trials based on a mathematical model of within-host viral infection dynamics to evaluate sample sizes in clinical trials of viral entry inhibitors against COVID-19. We assumed four measures as outcomes, namely change in log10-transformed viral load from symptom onset, PCR positive ratio, log10-transformed viral load, and cumulative viral load, and then sample sizes were calculated for drugs with 99 % and 95 % antiviral efficacy. Consistent with previous results, we found that sample sizes could be dramatically reduced for all outcomes used in an analysis by adopting inclusion/exclusion criteria such that only patients in the early post-infection period would be included in a clinical trial. A comparison of sample sizes across outcomes demonstrated an optimal measurement schedule associated with the nature of the outcome measured for the evaluation of drug efficacy. In particular, the sample sizes calculated from the change in viral load and from viral load tended to be small when measurements were taken at earlier time points after treatment initiation. For the cumulative viral load, the sample size was lower than that from the other outcomes when the stricter inclusion/exclusion criteria to include patients whose time since onset is earlier than 2 days was used. We concluded that the design of efficient clinical trials should consider the inclusion/exclusion criteria and measurement schedules, as well as outcome selection based on sample size, personnel and budget needed to conduct the trial, and the importance of the outcome regarding the medical and societal requirements. This study provides insights into clinical trial design for a variety of situations, especially addressing infectious disease prevalence and feasible trial sizes. This manuscript was submitted as part of a theme issue on “Modelling COVID-19 and Preparedness for Future Pandemics”.

Host density has limited effects on pathogen invasion, disease-induced declines and within-host infection dynamics across a landscape of disease.

1. Host density is hypothesized to be a major driver of variability in the responses and outcomes of wildlife populations following pathogen invasion. While the effects of host density on pathogen transmission have been extensively studied, these studies are dominated by theoretical analyses and small-scale experiments. This focus leads to an incomplete picture regarding how host density drives observed variability in disease outcomes in the field. 2. Here, we leveraged a dataset of hundreds of replicate amphibian populations that varied by orders of magnitude in host density. We used these data to test the effects of host density on three outcomes following the arrival of the amphibian-killing fungal pathogen Batrachochytrium dendrobatidis (Bd): the probability that Bd successfully invaded a host population and led to a pathogen outbreak, the magnitude of the host population-level decline following an outbreak and within-host infection dynamics that drive population-level outcomes in amphibian-pathogen systems. 3. Based on previous small-scale transmission experiments, we expected that populations with higher densities would be more likely to experience Bd outbreaks and would suffer larger proportional declines following outbreaks. To test these predictions, we developed and fitted a Hidden Markov Model that accounted for imperfectly observed disease outbreak states in the amphibian populations we surveyed. 4. Contrary to our predictions, we found minimal effects of host density on the probability of successful Bd invasion, the magnitude of population decline following Bd invasion and the dynamics of within-host infection intensity. Environmental conditions, such as summer temperature, winter severity and the presence of pathogen reservoirs, were more predictive of variability in disease outcomes. 5. Our results highlight the limitations of extrapolating findings from small-scale transmission experiments to observed disease trajectories in the field and provide strong evidence that variability in host density does not necessarily drive variability in host population responses following pathogen arrival. In an applied context, we show that feedbacks between host density and disease will not necessarily affect the success of reintroduction efforts in amphibian-Bd systems of conservation concern.

Stochastic Modeling of Within-Host Dynamics of Plasmodium Falciparum

Malaria remains a major public health burden in South-East Asia and Africa. Mathematical models of within-host infection dynamics and drug action, developed in support of malaria elimination initiatives, have significantly advanced our understanding of the dynamics of infection and supported development of effective drug-treatment regimens. However, the mathematical models supporting these initiatives are predominately based on deterministic dynamics and therefore cannot capture stochastic phenomena such as extinction (no parasitized red blood cells) following treatment, with potential consequences for our interpretation of data sets in which recrudescence is observed. Here we develop a stochastic within-host infection model to study the growth, decline and possible stochastic extinction of parasitized red blood cells in malaria-infected human volunteers. We show that stochastic extinction can occur when the inoculation size is small or when the number of parasitized red blood cells reduces significantly after an antimalarial treatment. We further show that the drug related parameters, such as the maximum killing rate and half-maximum effective concentration, are the primary factors determining the probability of stochastic extinction following treatment, highlighting the importance of highly-efficacious antimalarials in increasing the probability of cure for the treatment of malaria patients.

Understanding dynamics of Plasmodium falciparum gametocytes production: Insights from an age-structured model

Many models of within-host malaria infection dynamics have been formulated since the pioneering work of Anderson et al. in 1989. Biologically, the goal of these models is to understand what governs the severity of infections, the patterns of infectiousness, and the variation thereof across individual hosts. Mathematically, these models are based on dynamical systems, with standard approaches ranging from K-compartments ordinary differential equations (ODEs) to delay differential equations (DDEs), to capture the relatively constant duration of replication and bursting once a parasite infects a host red blood cell. Using malariatherapy data, which offers fine-scale resolution on the dynamics of infection across a number of individual hosts, we compare the fit and robustness of one of these standard approaches (K-compartments ODE) with a partial differential equations (PDEs) model, which explicitly tracks the “age” of an infected cell. While both models perform quite similarly in terms of goodness-of-fit for suitably chosen K, the K-compartments ODE model particularly overestimates parasite densities early on in infections when the number of repeated compartments is not large enough. Finally, the K-compartments ODE model (for suitably chosen K) and the PDE model highlight a strong qualitative connection between the density of transmissible parasite stages (i.e., gametocytes) and the density of host-damaging (and asexually-replicating) parasite stages. This finding provides a simple tool for predicting which hosts are most infectious to mosquitoes —vectors of Plasmodium parasites— which is a crucial component of global efforts to control and eliminate malaria.

Modeling Within-Host Dynamics of SARS-CoV-2 Infection: A Case Study in Ferrets.

The pre-clinical development of antiviral agents involves experimental trials in animals and ferrets as an animal model for the study of SARS-CoV-2. Here, we used mathematical models and experimental data to characterize the within-host infection dynamics of SARS-CoV-2 in ferrets. We also performed a global sensitivity analysis of model parameters impacting the characteristics of the viral infection. We provide estimates of the viral dynamic parameters in ferrets, such as the infection rate, the virus production rate, the infectious virus proportion, the infected cell death rate, the virus clearance rate, as well as other related characteristics, including the basic reproduction number, pre-peak infectious viral growth rate, post-peak infectious viral decay rate, pre-peak infectious viral doubling time, post-peak infectious virus half-life, and the target cell loss in the respiratory tract. These parameters and indices are not significantly different between animals infected with viral strains isolated from the environment and isolated from human hosts, indicating a potential for transmission from fomites. While the infection period in ferrets is relatively short, the similarity observed between our results and previous results in humans supports that ferrets can be an appropriate animal model for SARS-CoV-2 dynamics-related studies, and our estimates provide helpful information for such studies.

Comparing antiviral strategies against COVID-19 via multiscale within-host modelling.

Within-host models of COVID-19 infection dynamics enable the merits of different forms of antiviral therapy to be assessed in individual patients. A stochastic agent-based model of COVID-19 intracellular dynamics is introduced here, that incorporates essential steps of the viral life cycle targeted by treatment options. Integration of model predictions with an intercellular ODE model of within-host infection dynamics, fitted to patient data, generates a generic profile of disease progression in patients that have recovered in the absence of treatment. This is contrasted with the profiles obtained after variation of model parameters pertinent to the immune response, such as effector cell and antibody proliferation rates, mimicking disease progression in immunocompromised patients. These profiles are then compared with disease progression in the presence of antiviral and convalescent plasma therapy against COVID-19 infections. The model reveals that using both therapies in combination can be very effective in reducing the length of infection, but these synergistic effects decline with a delayed treatment start. Conversely, early treatment with either therapy alone can actually increase the duration of infection, with infectious virions still present after the decline of other markers of infection. This suggests that usage of these treatments should remain carefully controlled in a clinical environment.

Size-asymmetric competition among snails disrupts production of human-infectious Schistosoma mansoni cercariae.

Parasites can harm hosts and influence populations, communities, and ecosystems. However, parasites are reciprocally affected by population- and community-level dynamics. Understanding feedbacks between infection dynamics and larger-scale epidemiological and ecological processes could improve predictions and reveal novel control methods. We evaluated how exploitative resource competition among hosts, a fundamental aspect of population biology, influences within-host infection dynamics of the widespread human parasite Schistosoma mansoni in its intermediate host, Biomphalaria glabrata. We added size-dependent consumption of shared resources to a parameterized bioenergetics model to predict a priori the growth, parasite production, and survival of an infected focal host coexisting with an uninfected conspecific competitor in an experiment that varied competitor size. The model quantitatively anticipated that competitors disrupt growth and parasite production and that these effects increase with competitor size. Fitting the model to these data improved its match to host survivorship. Thus, resource competition alters infection dynamics, there are strong size asymmetries in these effects, and size-asymmetric resource competition effects on infection dynamics can be accurately predicted by bioenergetics theory. More broadly, this framework can assess parasite transmission and control in other contexts, such as in resource competitive host communities, or in response to eutrophication, food supplementation, or culling.

Differential drivers of intraspecific and interspecific competition during malaria-helminth co-infection.

Various host and parasite factors interact to determine the outcome of infection. We investigated the effects of two factors on the within-host dynamics of malaria in mice: initial infectious dose and co-infection with a helminth that limits the availability of red blood cells (RBCs). Using a statistical, time-series approach to model the within-host ‘epidemiology’ of malaria, we found that increasing initial dose reduced the time to peak cell-to-cell parasite propagation, but also reduced its magnitude, while helminth co-infection delayed peak cell-to-cell propagation, except at the highest malaria doses. Using a mechanistic model of within-host infection dynamics, we identified dose-dependence in parameters describing host responses to malaria infection and uncovered a plausible explanation of the observed differences in single vs co-infections. Specifically, in co-infections, our model predicted a higher background death rate of RBCs. However, at the highest dose, when intraspecific competition between malaria parasites would be highest, these effects of co-infection were not observed. Such interactions between initial dose and co-infection, although difficult to predict a priori, are key to understanding variation in the severity of disease experienced by hosts and could inform studies of malaria transmission dynamics in nature, where co-infection and low doses are the norm.

Challenges in forming inferences from limited data: a case study of malaria parasite maturation.

Inferring biological processes from population dynamics is a common challenge in ecology, particularly when faced with incomplete data. This challenge extends to inferring parasite traits from within-host infection dynamics. We focus on rodent malaria infections (Plasmodium berghei), a system for which previous work inferred an immune-mediated extension in the length of the parasite development cycle within red blood cells. By developing a system of delay-differential equations to describe within-host infection dynamics and simulating data, we demonstrate the potential to obtain biased estimates of parasite (and host) traits when key biological processes are not considered. Despite generating infection dynamics using a fixed parasite developmental cycle length, we find that known sources of measurement bias in parasite stage and abundance data can affect estimates of parasite developmental duration, with stage misclassification driving inferences about extended cycle length. We discuss alternative protocols and statistical methods that can mitigate such misestimation.

Host age alters disease life history. A case study in zooplankton and a castrating pathogen

Host age alters disease life history. A case study in zooplankton and a castrating pathogen

Global analysis of a reaction–diffusion blood-stage malaria model with immune response

Malaria is one of the most dangerous diseases that threatens people’s lives around the world. In this paper, we study a reaction-diffusion model for the within-host dynamics of malaria infection with an antibody immune response. The model is given by a system of partial differential equations (PDEs) to describe the blood-stage of malaria life cycle. It addresses the interactions between uninfected red blood cells, antibodies, and three types of infected red blood cells, namely ring-infected red blood cells, trophozoite-infected red blood cells and schizont-infected red blood cells. Moreover, the model contains a parameter to measure the efficacy of isoleucine starvation and its effect on the growth of malaria parasites. We show the basic properties of the model. We compute all equilibria and derive the thresholds from the conditions of existence of malaria equilibrium points. We prove the global stability of all equilibrium points based on choosing suitable Lyapunov functionals. We use the characteristic equations to verify the local instability of equilibrium points. We finally execute numerical simulations to validate the theoretical results and highlight some important observations. The results indicate that isoleucine starvation can have a critical impact on the stability of equilibrium points. When the efficacy of isoleucine starvation is high, it switches the system from the infection state to the malaria-free state. The presence of an antibody immune response does not lead to the elimination of malaria infection, but it suppresses the growth of malaria parasites and increases the amount of healthy red blood cells.

Global Analysis of a Reaction-Diffusion Within-Host Malaria Infection Model with Adaptive Immune Response

Malaria is one of the most dangerous global diseases. This paper studies a reaction-diffusion model for the within-host dynamics of malaria infection with both antibody and cell-mediated immune responses. The model explores the interactions between uninfected red blood cells (erythrocytes), three types of infected red blood cells, free merozoites, CTLs and antibodies. It contains some parameters to measure the effect of antimalarial drugs and isoleucine starvation on the blood cycle of malaria infection. The basic properties of the model are discussed. All possible equilibrium points and the threshold conditions required for their existence are addressed. The global stability of all equilibria are proved by selecting suitable Lyapunov functionals and using LaSalle’s invariance principle. The characteristic equations are used to study the local instability conditions of the equilibria. Some numerical simulations are conducted to support the theoretical results. The results indicate that antimalarial drugs with high efficacy can clear the infection and take the system towards the disease-free state. Increasing the efficacy of isoleucine starvation has a similar effect as antimalarial drugs and can eliminate the disease. The presence of immune responses with low efficacy of treatments does not provide a complete protection against the disease. However, the immune responses reduce the concentrations of all types of infected cells and limit the production of malaria parasites.