HIV-1 dynamics after transient antiretroviral therapy: Implications for pathogenesis and clinical management

• Published in: Journal of medical virology Vol. 53; no. 3; pp. 261 - 265
• Main Authors: Phillips, Andrew N., McLean, Angela, Johnson, Margaret A., Tyrer, Mervyn, Emery, Vince, Griffiths, Paul, Bofill, Margarita, Janossy, George, Loveday, Clive
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 01.11.1997; Wiley-Liss
• Subjects: AIDS/HIV; Anti-HIV Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; antiretroviral therapy; Antiviral agents; Biological and medical sciences; CD4 counts; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes - immunology; CD4-Positive T-Lymphocytes - virology; HIV infection; HIV Infections - drug therapy; HIV Infections - immunology; HIV Infections - virology; HIV-1 - physiology; Human viral diseases; Humans; Infectious diseases; Mathematical Computing; Medical sciences; Models, Biological; Pharmacology. Drug treatments; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Virus Replication; Human; Immunopathology; Prognosis; HIV-1 virus; Retroviridae; AIDS; Statistical simulation; Immune deficiency; Lentivirus; Cell subpopulation; Infection; Virus; Chemotherapy; Treatment; Viral disease; T-Lymphocyte; Antiviral; Human immunodeficiency virus; Mathematical model; Quantitative analysis
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/(SICI)1096-9071(199711)53:3<261::AID-JMV14>3.0.CO;2-K

Simple models of CD4 lymphocyte interactions with human immunodeficiency virus (HIV) lead to the hypothesis that progression of HIV infection involves an increase in viral replicative capacity, due either to changes in the virus or in the host environment, or both. In order to consider how changes in plasma virus load after transient, potent antiretroviral therapy can be used to test the above hypothesis—a simple mathematical model that encompasses the processes of (1) arrival of new CD4 lymphocytes, (2) death/removal of these cells by HIV‐independent mechanisms, (3) infection of susceptible CD4 lymphocytes by HIV, and (4) death/removal of infected cells was investigated. This showed that the in vivo rate of increase in plasma virus load immediately after transient therapy provides a measure of the viral replicative capacity. Thus, the hypothesis that progression of HIV infection involves an increase in viral replicative capacity can be tested by measuring this viral growth rate in patients with high CD4 counts and in patients with low CD4 counts. Studies should thus investigate dynamics of changes in virus levels after stopping antiretroviral therapy and, in particular, measure rates of increase in virus in patients at high and low CD4 counts. In practice, such data may assist in therapeutic management of patients with HIV infection. J. Med. Virol. 53:261–265, 1997. © 1997 Wiley‐Liss, Inc.