Optimal timing and duration of induction therapy for HIV-1 infection

Marcel E. Curlin, Shyamala Iyer, John E. Mittler

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

The tradeoff between the need to suppress drug-resistant viruses and the problem of treatment toxicity has led to the development of various drug-sparing HIV-1 treatment strategies. Here we use a stochastic simulation model for viral dynamics to investigate how the timing and duration of the induction phase of induction-maintenance therapies might be optimized. Our model suggests that under a variety of biologically plausible conditions, 6-10 mo of induction therapy are needed to achieve durable suppression and maximize the probability of eradicating viruses resistant to the maintenance regimen. For induction regimens of more limited duration, a delayed-induction or -intensification period initiated sometime after the start of maintenance therapy appears to be optimal. The optimal delay length depends on the fitness of resistant viruses and the rate at which target-cell populations recover after therapy is initiated. These observations have implications for both the timing and the kinds of drugs selected for induction-maintenance and therapy-intensification strategies.

Original languageEnglish (US)
Pages (from-to)1239-1256
Number of pages18
JournalPLoS computational biology
Volume3
Issue number7
DOIs
StatePublished - Jul 2007

ASJC Scopus subject areas

  • Ecology, Evolution, Behavior and Systematics
  • Modeling and Simulation
  • Ecology
  • Molecular Biology
  • Genetics
  • Cellular and Molecular Neuroscience
  • Computational Theory and Mathematics

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