Natural variation in HIV infection: Monte Carlo estimates that include CD8 effector cells |
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Authors: | Heffernan Jane M Wahl Lindi M |
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Affiliation: | Department of Applied Mathematics, University of Western Ontario, Western Rd, London, Ont., Canada N6A 5B7. jheffer2@uwo.ca |
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Abstract: | Viral load and CD4 T-cell counts in patients infected with the human immunodeficiency virus (HIV) are commonly used to guide clinical decisions regarding drug therapy or to assess therapeutic outcomes in clinical trials. However, random fluctuations in these markers of infection can obscure clinically significant change. We employ a Monte Carlo simulation to investigate contributing factors in the expected variability in CD4 T-cell count and viral load due solely to the stochastic nature of HIV infection. The simulation includes processes that contribute to the variability in HIV infection including CD4 and CD8 T-cell population dynamics as well as T-cell activation and proliferation. The simulation results may reconcile the wide range of variabilities in viral load observed in clinical studies, by quantifying correlations between viral load measurements taken days or weeks apart. The sensitivity of variability in T-cell count and viral load to changes in the lifetimes of CD4 and CD8 T-cells is investigated, as well as the effects of drug therapy. |
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Keywords: | Monte Carlo simulation HIV CD4 T-cell count CD8 T-cell count Viral load Variability Effector cell Stochastic model Mathematical model Activation Proliferation |
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