Resistance, Remission, and Qualitative Differences in HIV Chemotherapy

To understand the role of qualitative differences in multidrug chemotherapy for human immunodeficiency virus (HIV) infection in virus remission and drug resistance, we designed a mathematical system that models HIV multidrug chemotherapy including uninfected CD4+ T cells, infected CD4+ T cells, and...

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Main Authors: Denise E. Kirschner, G.F. Webb
Format: Article
Language:English
Published: Centers for Disease Control and Prevention 1997-09-01
Series:Emerging Infectious Diseases
Subjects:
Online Access:https://wwwnc.cdc.gov/eid/article/3/3/97-0303_article
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author Denise E. Kirschner
G.F. Webb
author_facet Denise E. Kirschner
G.F. Webb
author_sort Denise E. Kirschner
collection DOAJ
description To understand the role of qualitative differences in multidrug chemotherapy for human immunodeficiency virus (HIV) infection in virus remission and drug resistance, we designed a mathematical system that models HIV multidrug chemotherapy including uninfected CD4+ T cells, infected CD4+ T cells, and virus populations. The model, which includes the latent and progressive stages of the disease and introduces chemotherapy, is a system of differential equations describing the interaction of two distinct classes of HIV (drug-sensitive [wild type] and drug-resistant [mutant]) with lymphocytes in the peripheral blood; the external lymphoid system contributes to the viral load. The simulations indicate that to preclude resistance, antiviral drugs must be strong enough and act fast enough to drive the viral population below a threshold level. The threshold depends upon the capacity of the virus to mutate to strains resistant to the drugs. Above the threshold, mutant strains rapidly replace wild-type strains. Below the threshold, resistant strains do not become established, and remission occurs. An important distinction between resistance and remission is the reduction of viral production in the external lymphoid system. Also the virus population rapidly rebounds when treatment is stopped even after extended periods of remission.
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spelling doaj.art-38bcfc01ab884f50a865e7de5f1482692022-12-22T01:40:34ZengCenters for Disease Control and PreventionEmerging Infectious Diseases1080-60401080-60591997-09-013327328310.3201/eid0303.970303Resistance, Remission, and Qualitative Differences in HIV ChemotherapyDenise E. KirschnerG.F. WebbTo understand the role of qualitative differences in multidrug chemotherapy for human immunodeficiency virus (HIV) infection in virus remission and drug resistance, we designed a mathematical system that models HIV multidrug chemotherapy including uninfected CD4+ T cells, infected CD4+ T cells, and virus populations. The model, which includes the latent and progressive stages of the disease and introduces chemotherapy, is a system of differential equations describing the interaction of two distinct classes of HIV (drug-sensitive [wild type] and drug-resistant [mutant]) with lymphocytes in the peripheral blood; the external lymphoid system contributes to the viral load. The simulations indicate that to preclude resistance, antiviral drugs must be strong enough and act fast enough to drive the viral population below a threshold level. The threshold depends upon the capacity of the virus to mutate to strains resistant to the drugs. Above the threshold, mutant strains rapidly replace wild-type strains. Below the threshold, resistant strains do not become established, and remission occurs. An important distinction between resistance and remission is the reduction of viral production in the external lymphoid system. Also the virus population rapidly rebounds when treatment is stopped even after extended periods of remission.https://wwwnc.cdc.gov/eid/article/3/3/97-0303_articleUnited States
spellingShingle Denise E. Kirschner
G.F. Webb
Resistance, Remission, and Qualitative Differences in HIV Chemotherapy
Emerging Infectious Diseases
United States
title Resistance, Remission, and Qualitative Differences in HIV Chemotherapy
title_full Resistance, Remission, and Qualitative Differences in HIV Chemotherapy
title_fullStr Resistance, Remission, and Qualitative Differences in HIV Chemotherapy
title_full_unstemmed Resistance, Remission, and Qualitative Differences in HIV Chemotherapy
title_short Resistance, Remission, and Qualitative Differences in HIV Chemotherapy
title_sort resistance remission and qualitative differences in hiv chemotherapy
topic United States
url https://wwwnc.cdc.gov/eid/article/3/3/97-0303_article
work_keys_str_mv AT deniseekirschner resistanceremissionandqualitativedifferencesinhivchemotherapy
AT gfwebb resistanceremissionandqualitativedifferencesinhivchemotherapy