Impact of Antiretrovirals on the Spread of HIV

抗逆转录病毒药物对艾滋病毒传播的影响

• 批准号: 7140594
• 负责人: UME L ABBAS
• 金额: $ 18.13万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-06-15 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7140594
• 关键词: AIDS education /prevention; HIV infections; antiAIDS agent; antiviral agents; behavioral /social science research tag; chemoprevention; communicable disease control; communicable disease transmission; computer simulation; disease outbreaks; drug adverse effect; health care model; helper T lymphocyte; high risk behavior /lifestyle; human data; human immunodeficiency virus 1; human mortality; mathematical model; public health; safe sex /sex abstinence; statistics /biometry; therapy compliance; virus load

DESCRIPTION (provided by applicant): The potential impact of antiretroviral therapy of HIV-infected individuals and antiretroviral chemoprophylaxis of HIV susceptible individuals on the global spread of human immunodeficiency virus (HIV) is unknown and has not been adequately modeled. This proposal will investigate the effects of antiretroviral therapy and chemoprophylaxis on heterosexual spread of HIV using a new generation of mathematical and computational models that represent realistic biological and behavioral heterogeneities that underlie heterosexual spread of HIV. These innovative models: i) incorporate variation in plasma viremia, CD4 cell decline, HIV disease progression, infectiousness, risk behavior and response to antiretroviral therapy, both within and among individuals; ii) simulate different strategies of antiretroviral use; and iii) predict HIV epidemic outcomes at the population level. Our long-term goal is to use modeling and simulation to design public health interventions that will help control the global HIV epidemic. The central hypothesis is that targeting specific subpopulations of persons at highest risk for transmitting and acquiring HIV infection can maximize the impact of antiretrovirals on the HIV epidemic. The specific aims proposed are: 1) to develop and analyze a set of analogous yet increasingly accurate models of the heterosexual HIV epidemic in resource-limited settings, using three different modeling methods - differential equations, discrete event systems and exponential random graphs; 2) to identify which HIV-infected persons should receive antiretroviral therapy to maximize the effect of antiretroviral therapy on heterosexual transmission of HIV; and 3) to compare the effectiveness of antiretroviral therapy of infected individuals with antiretroviral chemoprophylaxis of HIV-susceptible persons. The proposed research is innovative in that we will use newly developed mathematical and computational models to simulate the effectiveness of different HIV prevention strategies in resource-limited settings. Our findings should help identify maximally effective antiretroviral strategies to curb the global spread of HIV.

描述（由申请人提供）：艾滋病毒感染个体的抗逆转录病毒治疗和HIV易感个体对人免疫缺陷病毒（HIV）全球扩散的抗逆转录病毒预防症的潜在影响是未知的，尚未充分建模。该提案将使用新一代的数学和计算模型来研究抗逆转录病毒疗法和化学预防对HIV的异性恋传播的影响，这些数学和计算模型代表了现实的生物学和行为异质性，这些生物学和行为异质性基于HIV的异性恋传播。这些创新的模型：i）纳入血浆病毒血症，CD4细胞下降，HIV疾病进展，传染性，风险行为和对抗逆转录病毒疗法的反应的变化； ii）模拟抗逆转录病毒使用的不同策略； iii）预测人口水平上的HIV流行预后。我们的长期目标是使用建模和模拟来设计公共卫生干预措施，以帮助控制全球艾滋病毒流行。中心假设是，针对传播和获取HIV感染风险最高的人的特定亚群可以最大程度地提高抗逆转录病毒对HIV流行的影响。提出的具体目的是：1）使用三种不同的建模方法 - 微分方程，离散事件系统和指数随机图，开发和分析了在资源受限的设置中，在资源受限的设置中开发和分析异性恋HIV流行的一组类似但越来越准确的模型； 2）确定哪些HIV感染者应接受抗逆转录病毒疗法，以最大程度地提高抗逆转录病毒疗法对HIV异性传播的影响； 3）比较受HIV敏感人的抗逆转录病毒化学预防症的抗逆转录病毒治疗的有效性。拟议的研究具有创新性，因为我们将使用新开发的数学和计算模型来模拟不同HIV预防策略在资源有限的环境中的有效性。我们的发现应有助于确定具有最大有效的抗逆转录病毒策略，以遏制HIV的全球传播。