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HIV-1: Optimizing treatment protocols when diagnostics are costly

Date:
April 30, 2015
Source:
PLOS
Summary:
HIV-1 continues to spread globally. While neither a cure, nor an effective vaccine are available, recent focus has been put on 'treatment-for-prevention', which is a method by which treatment is used to reduce the contagiousness of an infected person. A new study challenges current treatment paradigms in the context of 'treatment for prevention' against HIV-1.
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Optimal treatment strategies in the context of 'treatment for prevention' against HIV-1. Without medical treatment (upper panel) HIV-1 infected individuals have a high viral titer, which is related to a high probability to infect a sero-discordant partner after sexual contact. In contrast, diagnostic-guided (middle panel) and pro-active treatment switching strategies (lower panel) can durably suppress the virus in an HIV-1 infected individual, thus reducing the probability that the individual spreads the infection.
Credit: Sulav Duwal

HIV-1 continues to spread globally. While neither a cure, nor an effective vaccine are available, recent focus has been put on 'treatment-for-prevention', which is a method by which treatment is used to reduce the contagiousness of an infected person. A study published this week in PLOS Computational Biology challenges current treatment paradigms in the context of 'treatment for prevention' against HIV-1.

Sulav Duwal, Max von Kleist and their collaborators develop and employ optimal control theory to compute and assess diagnostic-guided vs. pro-active treatment strategies in terms of their expected costs, treatment benefit and reduction of onwards transmission.

In the study published this week in PLOS Computational Biology, the authors provide a mathematical platform that can be used to compute optimal diagnostic-guided vs. pro-active treatment strategies under consideration of available resources. They apply this framework to a stochastic model of viral intra-host dynamics and drug resistance development. When applied to resource-constrained settings, they show that pro-active strategies may be worthwhile.


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Journal Reference:

  1. Sulav Duwal, Stefanie Winkelmann, Christof Schütte, Max von Kleist. Optimal Treatment Strategies in the Context of ‘Treatment for Prevention’ against HIV-1 in Resource-Poor Settings. PLOS Computational Biology, 2015; 11 (4): e1004200 DOI: 10.1371/journal.pcbi.1004200

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PLOS. "HIV-1: Optimizing treatment protocols when diagnostics are costly." ScienceDaily. ScienceDaily, 30 April 2015. <www.sciencedaily.com/releases/2015/04/150430144953.htm>.
PLOS. (2015, April 30). HIV-1: Optimizing treatment protocols when diagnostics are costly. ScienceDaily. Retrieved May 23, 2017 from www.sciencedaily.com/releases/2015/04/150430144953.htm
PLOS. "HIV-1: Optimizing treatment protocols when diagnostics are costly." ScienceDaily. www.sciencedaily.com/releases/2015/04/150430144953.htm (accessed May 23, 2017).

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