Impact of ART-induced viral suppression on the HIV epidemic in Italy
| Autor: | Papa, F.1, Felici, G.1, Franzetti, M.2, Gandolfi, A.1, Sinisgalli, C.1 |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
viral suppression Time Factors Databases Factual Anti-HIV Agents Art initiation Hiv epidemic antiretroviral therapy HIV Infections Virus Replication Models Biological General Biochemistry Genetics and Molecular Biology Virus 03 medical and health sciences 0302 clinical medicine Acquired immunodeficiency syndrome (AIDS) Antiretroviral Therapy Highly Active medicine Humans Computer Simulation Viremia 030212 general & internal medicine Viral suppression Epidemics General Environmental Science Pharmacology General Immunology and Microbiology business.industry Incidence Applied Mathematics General Neuroscience Incidence (epidemiology) Computational Biology HIV Mathematical Concepts General Medicine Viral Load medicine.disease 030112 virology Antiretroviral therapy stability of equilibrium points Italy HIV epidemic Modeling and Simulation Immunology RNA Viral business Cohort study epidemic ODE model |
| Zdroj: | Mathematical medicine and biology (Online) (2020). doi:10.1093/imammb/dqz010 info:cnr-pdr/source/autori:Papa, F.1, Felici, G.1, Franzetti, M.2, Gandolfi, A.1, Sinisgalli, C.1/titolo:Impact of ART-induced viral suppression on the HIV epidemic in Italy/doi:10.1093%2Fimammb%2Fdqz010/rivista:Mathematical medicine and biology (Online)/anno:2020/pagina_da:/pagina_a:/intervallo_pagine:/volume |
| DOI: | 10.1093/imammb/dqz010 |
| Popis: | The present study aims to clarify the role of the fraction of patients under antiretroviral therapy (ART) achieving viral suppression (VS) (i.e. having plasma viral load below the detectability threshold) on the human immunodeficiency virus (HIV) epidemic in Italy. Based on the hypothesis that VS makes the virus untransmittable, we extend a previous model and we develop a time-varying ordinary differential equation model with immigration and treatment, where the naive and non-naive populations of infected are distinguished, and different compartments account for treated subjects virally suppressed and not suppressed. Moreover, naive and non-naive individuals with acquired immune deficiency syndrome (AIDS) are considered separately. Clinical data stored in the nationwide database Antiviral Response Cohort Analysis are used to reconstruct the history of the fraction of virally suppressed patients since highly active ART introduction, as well as to assess some model parameters. Other parameters are set according to the literature and the final model calibration is obtained by fitting epidemic data over the years 2003–2015. Predictions on the evolution of the HIV epidemic up to the end of 2035 are made assuming different future trends of the fraction of virally suppressed patients and different eligibility criteria for treatment. Increasing the VS fraction is found to reduce the incidence, the new cases of AIDS and the deaths from AIDS per year, especially in combination with early ART initiation. The asymptotic properties of a time-invariant formulation of the model are studied, and the existence and global asymptotic stability of a unique positive equilibrium are proved. |
| Databáze: | OpenAIRE |
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