criticality of timing for anti-hiv therapy initiation临界抗艾滋病病毒治疗开始的时间.pdfVIP

Criticality of Timing for Anti-HIV Therapy Initiation 1 1,2 Filippo Castiglione , Paola Paci * 1 Institute for Computing Applications ‘‘Mauro Picone’’, National Research Council of Italy, Rome, Italy, 2 Biomedical University Campus, Rome, Italy Abstract The time of initiation of antiretroviral therapy in HIV-1 infected patients has a determinant effect on the viral dynamics. The question is, how far can the therapy be delayed? Is sooner always better? We resort to clinical data and to microsimulations to forecast the dynamics of the viral load at therapy interruption after prolonged antiretroviral treatment. A computational model previously evaluated, produces results that are statistically adherent to clinical data. In addition, it allows a finer grain analysis of the impact of the therapy initiation point to the disease course. We find a swift increase of the viral density as a function of the time of initiation of the therapy measured when the therapy is stopped. In particular there is a critical time delay with respect to the infection instant beyond which the therapy does not affect the viral rebound. Initiation of the treatment is beneficial because it can down-regulate the immune activation, hence limiting viral replication and spread. Citation: Castiglione F, Paci P (2010) Criticality of Timing for Anti-HIV Therapy Initiation. PLoS ONE 5(12): e15294. doi:10.1371/journal.pone.0015294 Editor: Vladimir Brusic, Dana-Farber Cancer Institute, United States of America Received July 30, 2010; Accepted November 5, 2010; Published December 23, 2010 Copyright: 2010 Castiglione, Paci. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.