Document Detail


Distinct effects of protease and reverse transcriptase inhibition in an immunological model of HIV-1 infection with impulsive drug effects.
MedLine Citation:
PMID:  15294425     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We present an immunological model that considers the dynamics of CD4+ T cells interacting with free virions, reverse transcriptase inhibiting drugs and protease inhibiting drugs. We divide the T cells into multiple classes and use impulsive differential equations to describe the drug activity. As expected, we find that insufficient dosing of either drug corresponds to high viral load and a large population of infectious T cells. The model further predicts that, in the absence of physiological limits on tolerable drug concentrations, sufficiently frequent dosing with the reverse transcriptase inhibitor alone could theoretically maintain the CD4+ T cell count arbitrarily close to the T cell count in the uninfected immune system. However, for frequent dosing of the protease inhibitor alone, the limiting T cell populations may not be enough to maintain the immune system. Furthermore, frequent dosing of both drugs has the same net effect on the T cell population as frequent dosing of the reverse transcriptase inhibitor only. Thus, the two drug classes can have fundamentally different effects on the long-term dynamics and the reverse transcriptase inhibitor, in particular, plays a crucial role in maintaining the immune system. We also provide estimates for the dosing intervals of each drug that could theoretically sustain the T cell population at a desired level.
Authors:
R J Smith; L M Wahl
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Bulletin of mathematical biology     Volume:  66     ISSN:  0092-8240     ISO Abbreviation:  Bull. Math. Biol.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-08-05     Completed Date:  2005-06-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401404     Medline TA:  Bull Math Biol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1259-83     Citation Subset:  IM    
Affiliation:
Department of Applied Mathematics, University of Western Ontario, London, ON, N6A 5B7, Canada.
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MeSH Terms
Descriptor/Qualifier:
CD4 Lymphocyte Count
CD4-Positive T-Lymphocytes / drug effects,  immunology,  virology
Computer Simulation
Drug Therapy, Combination
HIV Infections / drug therapy*,  immunology*
HIV Protease Inhibitors / therapeutic use*
HIV-1 / immunology*
Humans
Models, Immunological*
Reverse Transcriptase Inhibitors / therapeutic use*
Chemical
Reg. No./Substance:
0/HIV Protease Inhibitors; 0/Reverse Transcriptase Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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