Early HAART Initiation May Not Reduce Actual Reproduction Number and Prevalence of MSM Infection: Perspectives from Coupled within- and between-Host Modelling Studies of Chinese MSM Populations
Authored by Jianhong Wu, Xiaodan Sun, Yanni Xiao, Sanyi Tang, Zhihang Peng, Ning Wang
Date Published: 2016
DOI: 10.1371/journal.pone.0150513
Sponsors:
Chinese National Natural Science Foundation
National Science and Engineering Research Council of Canada (NSERC)
Platforms:
No platforms listed
Model Documentation:
Other Narrative
Mathematical description
Model Code URLs:
Model code not found
Abstract
Having a thorough understanding of the infectivity of HIV, time of
initiating treatment and emergence of drug resistant virus variants is
crucial in mitigating HIV infection. There are many challenges to
evaluating the long-term effect of the Highly Active Antiretroviral
Therapy (HAART) on disease transmission at the population level. We
proposed an individual based model by coupling within-host dynamics and
between-host dynamics and conduct stochastic simulation in the group of
men who have sex with men (MSM). The mean actual reproduction number is
estimated to be 3.6320 (95\% confidence interval: {[}3.46, 3.80]) for
MSM group without treatment. Stochastic simulations show that given
relatively high (low) level of drug efficacy after emergence of drug
resistant variants, early initiation of treatment leads to a less
(greater) actual reproduction number, lower (higher) prevalence and less
(more) incidences, compared to late initiation of treatment. This
implies early initiation of HAART may not always lower the actual
reproduction number and prevalence of infection, depending on the level
of treatment efficacy after emergence of drug resistant virus variants, frequency of high-risk behaviors and etc. This finding strongly suggests
early initiation of HAART should be implemented with great care
especially in the settings where the effective drugs are limited.
Coupling within-host dynamics with between-host dynamics can provide
critical information about impact of HAART on disease transmission and
thus help to assist treatment strategy design and HIV/AIDS prevention
and control.
Tags
Life Expectancy
Drug-resistance
Viral load
Dynamics in-vivo
Within-host
Immunodeficiency-virus type-1
Combination antiretroviral therapy
Amplified hiv transmission
Income
countries
Jiangsu province