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Title: HIV reservoirs and immune surveillance evasion cause the failure of structured treatment interruptions : a computational study
Authors: Mancini, Emiliano
Castiglione, Filippo
Bernaschi, Massimo
De Luca, Andrea
Sloot, Peter M. A.
Issue Date: 2012
Source: Mancini, E., Castiglione, F., Bernaschi, M., de Luca, A., & Sloot, P. M. A. (2012). HIV Reservoirs and Immune Surveillance Evasion Cause the Failure of Structured Treatment Interruptions: A Computational Study. PLoS ONE, 7(4).
Series/Report no.: PLoS One
Abstract: Continuous antiretroviral therapy is currently the most effective way to treat HIV infection. Unstructured interruptions are quite common due to side effects and toxicity, among others, and cannot be prevented. Several attempts to structure these interruptions failed due to an increased morbidity compared to continuous treatment. The cause of this failure is poorly understood and often attributed to drug resistance. Here we show that structured treatment interruptions would fail regardless of the emergence of drug resistance. Our computational model of the HIV infection dynamics in lymphoid tissue inside lymph nodes, demonstrates that HIV reservoirs and evasion from immune surveillance themselves are sufficient to cause the failure of structured interruptions. We validate our model with data from a clinical trial and show that it is possible to optimize the schedule of interruptions to perform as well as the continuous treatment in the absence of drug resistance. Our methodology enables studying the problem of treatment optimization without having impact on human beings. We anticipate that it is feasible to steer new clinical trials using computational models.
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0036108
Rights: © 2012 The Authors.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:SCSE Journal Articles

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