Mathematical Modeling of The Dynamics of

Mathematical modeling of the dynamics of the spread of HIV infection May 21, 2014
Authors monograph
Bassey, B. E.
MINISTRY OF EDUCATION AND SCIENCE OF THE RUSSIAN FEDERATION

The federal state budgetary educational institution
Higher education
"THE KUBAN STATE UNIVERSITY"

(KubSU)
PAPER REVIEW
ON
MATHEMATICAL MODELING OF THE DYNAMICS OF THE

SPREAD OF HIV INFECTION AMONG HETEROGENEOUS
POPULATION
BasseyB, Echeng,
Kuban State University

Department of mathematical and computer methods.Faculty of mathematics and computer sciences
(350040, 149, Ctavrapolskaya street),Krasnodar, Russia

e-mail: awaserex@yandex.com, awaserex@ymail.com
Krasnodar 2014
www.kubsu.ru/2014/pdf
Authors monograph
Bassey, B. E.
Content
INTRODUCTION ........................................................................................... 2
Chapter 1. MathematicalmodellingforHIVTransmission dynamics:

Tools for Social and Behavioural Science Research ........................................................ 4
Chapter 2.Predicting the public health impact of anti-retroviral:

Preventing HIV InDeveloping Countries. ....................................................... 7
Chapter 3. Mathematical models to better combat HIV:Stochastic
analysis of pre-and post-exposure prophylaxis against
HIV infection ................................................................................................... 10
CONCLUSION .............................................................................................. 15
BIBLIOGRAPHY ......................................................................................... 17
Authors monograph
Bassey, B. E.
INTRODUCTION
research widely establishes the usefulness and
A paper review mathematical
how mathematical modeling has contributed
modeling of the dynamics of the spread of
to our understanding of the dynamics and
Human
(HIV)
disparities in the global spread of HIV.
infection among heterogeneous population,
According to the authors, HIV transmission is
is a stratify summary of three major articles,
considered via two main factors: biologic and
all geared on the use of mathematical
social determinant.
Immunodeficiency
Virus
modelling to study the dynamics, predictions
Furthermore, the basic routes of HIV
and prevention strategies of transmission of
transmission between persons could be
HIV. A seemingly motivating factor for the
understood and widely known. But the
explicit use of mathematical modelling in all
determinants of the corresponding disparities
the three research papers is the fact that,
in prevalence and trends among population
mathematical modelling is a real life
remain an area of debate and of intense
studying course and is central to applied
scientific research. It is also obvious that
mathematics.
these disparities have their roots in the
First we consider the mathematical
transmission system which arises from the
models for HIV transmission dynamics: tools
understanding of the system its components
for social and behavioural science research1.
and
This paper focused on attempt to overcome
mathematical models not only provide a way
the needed understanding of social and
to examine the potential effects of proximate
behavioural determinants of HIV related
biologic and behavioural determinant of HIV
risk behaviour. From the authors point of
transmission dynamics alone, but importantly
view, the cumulative impact of individual
serve as a research tool in this endeavours.
its
behaviours on the population level HIV
dynamics.
proper
Said
the
authors,
understanding of
outcome, can be subtle and counterintuitive
transmission
and method of studying these, were rarely
predicting the public health impact of anti-
part of a traditional social science or
retroviral: Preventing HIV in developing
epidemiology
countries2. The authors, using mathematical
training
program.
This
mode
will
pave
HIV
way
to
models, clinically attempted discussing the

1
Susan C., Samuel J. C, and Martina M. Mathematical

models for HIV transmission dynamics: Tools for Social
and Behavioural Science Research. 2008,Published in
the J. Acquir Immune DeficSyndr, 47 (. Suppl 1): s34
s39, doi : 10.1097/QAL, Washington, Seattle, WA.
potential public health impact of anti2
Sally B. and Paul F. Predicting the public health

impact of anti-retroviral: Preventing HIV in developing
countries. Published by AIDScience - Prevention and
Vaccine Research. 2003; vol. 3, No 11, California,
United States.
Page 2
Authors monograph
retroviral
(ARV)
reference
to
drugs
Bassey, B. E.
with
particular
this
countries.
determination of occurrence of HIV in the
Objectively presumed and boosted by the
early stage is of critical importance, but seems
pledged of the U.S. government towards
impossible due to low numbers of viruses and
spending $15 billion in Africa and the
infected cells at the early stage. The only
Caribbean on AIDS prevention and care, in
possible
the use of antiretroviral drugs as effective
dynamics at this stage is through theoretical
prevention tools, as well as therapeutic
mathematical models, which is better used in
source. It is also thought of focusing in
analysing viral dynamics in the early phase
resource poor setting, the potential impact of
and hence, offer insight into therapeutic and
the effective ARV on Acquired immune
prevention strategies from a number of
deficiency
previous studies.
developing
syndrome
or
acquired
research.
means
It
was
of
noted
that
understanding
the
the
immunodeficiency syndrome (AIDS), control
The results of these various findings
effort and transmission from mother to child.
are quite impressing, pointing out that, under
The work is aimed at uncovering the potential
the best of all possible conditions, the
public impact of ARV in developing countries
essential use of mathematical modeling in
in terms of HIV infections prevention and
analysing the dynamics, prevention and
reduction in prevalence as well as the
treatment strategies of the transmission of
treatment with ARVs, taking cognizance, the
HIIV. Also, useful recommendations for
potential target group.
future studies were made.
Understanding and correct prediction

will lead to a prcised formulation of
mathematical
models
to
combat
HIV:
Stochastic Analysis of Pre- and Post-exposure

Prophylaxis against HIV infection3.
The
exponential difficulties in studying and

understanding
human
transmission
and
infection of HIV from the few hours to days

of exposure gave the instinct in carrying out
3
Jessica M. C., Bernard P. K. and Daniel C.

Mathematical models to better combat HIV:
Stochastic analysis of pre-and post-exposure
prophylaxis against HIV infection. Journal of Society
for Industrial and Applied Mathematics (SIAM). 2003;
Vol. 73, No. 2, pp.904 928, Philadelphia, USA.
Page 3
Authors monograph
Bassey, B. E.
and to suggest the possible directions for

future research. The authors clearly impress
Chapter 1.
on us, the fact that mathematical modeling is
MATHEMATICAL MODELING FOR HIV

TRANSMISSIONDYNAMICS: Tools for
Social and Behavioural Science Research
The use of mathematical modeling for
HIV transmission dynamics as tools for social
and behavioural science research widely
establish the usefulness and plays a leading
role in our understanding of the dynamics and
disparities in the global spread of HIV.
According to the authors, HIV transmission is
considered via two main factors: biologic and
social determinants4. Biologic determinants
are clearly an inclusive of characteristics of
the
pathogen,
interventions;
host
while
and
social
biomedical
determinants
used
here
to
essentially
population level
project
the
outcome from
the
individual input. More so, there are many

other
possible
outcomes
with
which
mathematical modeling can be effectively

use, i.e. the incidence of infection, the
prevalence of infection, doubling the time of
epidemic and most specially, the likelihood
of an epidemic occurring. All this (or any) in
an experiment is captioned the reproduction
number of the infection process, denoted by
R0. This quantity R0,can be taken to represent
expected number of secondary infections
generated by the first infected individual from
include the individual level, pairwise and
a susceptible population. Here, it is assumed
community level processes, which affect the
that if R0 1, an epidemic occurs, while if
behaviour,
of
R0 1, the infection is expected to be
transmission network. All this encompasses
eliminated. Therefore, R0,can be accepted to
knowledge, attitude, cultural norms, beliefs,
be a function of biologic and social/or
power differentials, population mobility and
behavioural factors with respect to a single
mixing patterns.
homogeneous population R0 C D.
The
structure
research
and
is
dynamic
aimed
at
demonstrating the value of these analytic

tools on social and behavioural sciences in
HIV prevention research; as well as to
identifying the gap in the current literature
This work in a more explicit manner,

outline two basic dimensionsof constructing
models, which are further classified into four
forms,
all
with
similar
strength
and
limitations. This includes:

-
deterministic or stochastic form;
Analytic

(close
computational
form)
methods
or
(numeric
form).
Page 4
Authors monograph
Bassey, B. E.
The deterministic form involves the
is limited by the fact that the process of
use of mean, as a prediction summary, while
tractability often result to loss of important
the stochastic uses full probability distribution
outcome in the process. Thus, the widely use
of outcome. Analytic, or closed-form,
of computational - deterministic models have
solutions isolate the outcome on the left-hand
become the workhouse of mathematical
side of an equation, with all the determinants
epidemiology. This new approach has led to
on the right-hand side. Thus, it is clear that
substantial knowledge about the population
the outcome depends on the inputs.On the
dynamic
other hand, the outcome of the computational
transmitted
method appears on both sides of the equation
enhance
making the method essentially useful when
stochastic
solutions have a nontrivial feedback loops.
which are more prcised and comprehensive
This model are said to be analytically
in
intractable. Its noted here that in any of this
transmission
models, its population are divided into two
biologic results. This later process serves as
susceptible and the infected. Deterministic
the only means of identifying to accuracy, a
models are usually built on group aggregates
single
or macro-level states, whereas stochastic
(concurrent)
simulation models are usually built to reflect
disadvantages are its requirement for richer
the micro-level states occupied by discrete
inputs and more computational capacity.
individual persons.
of
HIV
and
infections
model
or
is
other
(STDs).
the
sexually
A
computational-
micro-simulation
representation
of
with
models,
heterogeneities
of
behavioural
or
processes,
person
more
multiple
partnerships.
The
ongoing
primary
The authors in their broad view
Clearly, the authors mentioned the
consider the impact of mathematical modeling
essential difference between the two models -
on the parameters which defines R0(the basic
the deterministic models define the dynamics
reproductive number):
using the average rate of transition between
states, while the stochastic models define the
contact;
transmission
probability per
dynamics using the probability that an
c contact rate; and
individual makes the transition from one state
D duration of infectiousness.
to another. From the researchers view, the
The transmission per contact (),

represent
and stochastic) are typically regarded as the
infectivity HIV positive partners and the
ideal because they reveal a process in terms of
susceptibility HIV negative partners. Both
simple cause and effect. However, this model
components depend on either of the following
two
sub-components
analytic models of both sorts (deterministic
the
Page 5
Authors monograph
Bassey, B. E.
factors: demographic, behavioural or biologic
primary stage characterized by initial spike
factors. The is evaluated base on the
of viral load and CD4 cell counts; the
following:
asymptomatic stage (or latent) where the
1) Demographic heterogeneity process
viral load infectiousness remain low for at
which reflects on the asymmetric
least a period of 10 years; and the
transmission and pattern of sexual
symptomatic stage considered as the onset
mixing by age.
of AIDS. Here the viral load rises again for,
2) Stage of disease reflecting to the
which without treatment, the individual is
three main stages of HIV transmission
only allow to live for an average of 3 years,
and infection (i.e. the early stage, the
after which death occurs5.
latent stage and the symptomatic

stage).
3) Connection with other STIs, which are
believed to have strong implications
for infectivity and susceptibility. A
slight increase in STIs, will double the
peak of incidence rate, resulting to
nonlinear variation.
4) Circumcision
of
males
reduces
susceptibility to infection with HIV.

5) Vaccines (sterilizing, leaky, all or
nothing
and
therapeutic)
imperfectness.
The contact rate, c, denotes the rate of
change of sexual contact partners, which
revolves around core partners and selective
mixing (i.e. assortative mixing,Age mixing
and behavioural role patterns among Men
having sex with men -MSM).
The duration of infectiousness D, is
the last component of the basic reproduction
ratio, R0, which is characterized by the three
stages of HIV infection commonly refer to as:

Page 6
Authors monograph
Bassey, B. E.
specified by the relative transmissibility) are

Chapter 2
PREDICTING THE PUBLIC HEALTH
IMPACT OF ANTI-RETROVIRAL:
Preventing HIV in Developing Countries.
said to be only imprecisely known, making

the entire model working with practically
uncertain analysis. Basically, the authors
made use of Multivariate sensitivity analysis -
Overcoming the spread of the deadly
the Monte Carlos methods for the analysis of
disease via the usage of anti-retroviral drugs,
the model leading to the identification of the
lead to formulation of a model for predicting
key factors in decreasing transmissionand
the public health impact of anti-retroviral as a
increasing the transmission and prevalence of
means of Preventing HIV in Developing
drug-resistance.
Countries6.
From the authors point of view, the
The model deployed here, is the
advantage of the anti-retroviral usage in
mathematical model used as health policy
developing countries is in the provision of
tools for quantification and predictions of
direct and obvious therapeutic benefits for
epidemic level effect of ARVs, in terms of
infected individuals, as it will increase the
both the beneficial and detrimental epidemic -
length and quality of their lives. This leads to
level. The interesting aspect of this model as
more active group in the work force and care
in use is the simultaneous tracking of the
for families. The study also indicates that a
transmission dynamics of both drugs
high usage of ARVs in the developing
susceptible and drugs - resistance strains.
countries
The only parameter needed here is the
substantial number of new HIV infections.
will
definitely
prevent
definition of upper and lower bound of the
Further revealed by this study, is the
parameter range. This of course, is an added
complexity of the ARVs on HIV epidemics
advantage as it enables the transmission
resulting from the two ways outcome the
model to be used as predictive tools, with the
beneficial and detrimental effect at the
predictions presented with uncertainty bars.
epidemic-level. Stated are the viral load
The values of many of the parameters in these
deductions on parents on the therapy which
transmission models (for example, the fitness
are associated with decrease in the rate of
of drug-resistance strains relative to the
transmission. Mentioned as other benefit of
fitness of the drugs-sensitive strains as
the therapy, is the enhancement of preventive
effect via increase utilization and uptake of

United States.
voluntary counselling and testing. Of course,

this approach has been considered a prime
Page 7
Authors monograph
Bassey, B. E.
method in the current prevention efforts. The
strains plus the transmission of drugs -
study
resistant strains; a high usage rate of ARVs
observed
considerable
de-
stigmatization of infected individuals.
increases the transmission of drug resistance
The authors perseverance on this
strains, the overall transmission decreases .
research was further been informed by the
The implication is that the higher the usage of
positive results obtained in the usage of anti-
ARVs, the lower the result of incidence rates,
retroviral drugs in the developed countries.
and substantial number of HIV infection
For example, the case of HIV epidemic in
would be averted and preventing HIV
Sam Francisco, where 50 90% of HIV
infections would increase over time.
infected individuals received ARVs. It was
On the contrary, the consequences of
observed that both the incidence of resistance
risky behaviour in the developing countries
(number of cases of transmitted resistance per
are undefined but presumed to be on the
year) and the prevalence of resistance have
decrease if the rate of contact between
been correctly predicted. The result indicates
patients receiving ARVs and their health care
initial increase in transmitted resistance and
providers (secondary prevention) is on the
then fairly quickly stability at a relatively low
increase. This research revealed that there are
level. Analysis from Sam Francisco also
three epidemiological outcomes which are
shows that substantial usage of the ARVs,
possible if risky behaviour increases when
altars the competitive dynamics between the
ARVs are made available: incidence and
drug susceptible and the drug resistant
prevalence can 1) increase, 2) decrease, or 3)
strains of HIV. The higher the usage of
remain stable. The eventual outcome taken on
ARVs, the greater the reduction in the
any of these three largely depends on upon
prevalence of drug susceptible strains, but
the magnitude of increase in risky behaviour
the greater the increase in the prevalence of
which in turn depends on the efficacy of
the drug resistance strains.
secondary
prevention
massages,
the
The authors viewed the overall impact
proportion of HIV infected patients on
of ARVs on transmission of HIV in the
ARVs, and the degree to which these patients
developed
mathematical
are rendered less infectious through viral load
models - the evaluation of the effect of a high
suppression. Thus, implying that decrease or
rate (50% 90% of HIV infection treated)
stability in incidence rate depends on the level
of anti-retroviral usage indicates that the
of risky behaviour of infected group. For
overall transmission defined as incidence
example, the study from Brazil, as a
rate, is the transmission of drug susceptible
developing
countries
using
country
with
comprehensive
Page 8
Authors monograph
Bassey, B. E.
AIDS prevention and care program, indicates
preventing infections and increasing the
the high usage of ARVs, which clearly
burden of drug-resistant strains which is
suggest a declined in incidence rate and
required in designing the epidemic control
subsequently resulting in the contraction of
strategies. This, according to the authors is
HIV epidemic in that country.
obvious as to avoid conflicting interest in the

public health goals of reducing the overall
The authors, based on predictions

from developed countries, predicting the
potential impact of ARVs in developing
countries which are likely not clear as the
proportion of HIV- infected individuals who
receive the ARVs could be considerably low.
For instance, in South Africa, with an
assumed non-increasing drug-resistant, if 25%
of infected individuals received ARVs, then
19%, of projected new HIV infections would
transmission of drug-resistance HIV. The

level of pan-susceptible HIV is paramount to
the public health policy officials. This leads to
the agitation for the usage of ARVs as a
prevention
tool
as
they
reduce
the
transmission rate. The same use is not made

when compared with other conventional
prevention tools for Sexually transmitted
diseases
(STDs),
such as
condoms
or
educational interventions.
be prevented . On the other hand, the only

magnitude by which reduction of new HIV
This research revealed the impact of
infection in developing countries are viewed,
ARVs in developing countries provided the
is by the number of lives saved, since
measure is targeted on the behavioural core
incidence rate are extremely high.
group i.e. the sex workers which exhibit a
Therefore, the overall implication is
high level of risky activities. Therefore
that, although ARVs could serve as a fairly
according to the authors, the ARVs should be
effective preventive strategy in developing
viewed as a non-conventional prevention
countries, the magnitude of the prevention
tools since it is used as both preventive and
effect will be substantially underestimated if
therapeutic effectives and are given to the
it is only evaluated by increasing incidence
infected (rather than uninfected) individuals.
rate. The authors viewed the situation in

developing countries will be similar to that of
developed countries in terms of accessibility
to ARVs but with varying increase in drugsresistant .
The study however cautioned for the
creation of acceptable balance between
The advantage of the anti-retroviral

usage in the developing countries is the
therapeutic enhancement to the HIV
infected individuals who received it as
treatment and yet act as preventive benefits to
the uninfected. The children of adult whose
Page 9
Authors monograph
Bassey, B. E.
lives are prolonged by ARVs are also
prevention messages and harm reduction
considered direct beneficiaries.
strategies. Also, the issues of brain drain
The disadvantage of the ARVs is the

expanded
access
of
ARVs
leading
to
substantial increase in the evaluation and

transmission of drug-resistant strains of HIV.
Furthermore, an epidemic control strategy
that utilizes ARVs simply as a conversional
tool and targets behavioural core groups is an
and burn out will be reduced to the barest

minimal. Mathematical models need to move
beyond transmission models and traditional
economic analyses in order to model the full
biosocial complexity of the HIV epidemic and
to assess the full impact of ARVs in
developing countries7.
explicit decision to provide therapeutic

benefit preferentially to the core groups;
thus the non-core group suffers a substantial
loss from such a targeted prevention strategy.
This particular approach, remarked by the
authors
seems
unethical
and
totally
impractical.
From the authors findings, a number
of suggestions and recommendations were put
forward: - if targeted treatment needed to be
considered due to limited resources, then an
alternative strategy would be to target the
sickest AIDS patients, as has been the case in
Haiti.
Additional
benefit
of
ARVs
recommended for future modeling analysis

include intensive voluntary counselling and
testing, lessen AIDS- related stigma and
decrease the high dropout documents among
health care workers in the most heavily
burdened areas. Frequently and regular
contact between patients and health workers
is highly recommended. This will afford the
later, the chance to reinforce the secondary

United States.
Page 10
Authors monograph
Bassey, B. E.
difference between the efficacies of different

Chapter 3.
drugs at this phase.
Mathematical models to better combat

HIV: Stochastic analysis of
pre-and post-exposure
prophylaxis against HIV
infection
We therefore needed a model which
could
enhance
previous
models.
This ample situation inferred the

authors into formulating a stochastic model to
analyze viral dynamics and to understand how
protective or preventive drug treatment prior
to or immediately following exposure, can act
The
to reduce risk of infection under various
mathematical models to better combat HIV-
scenarios. Also, this article came at the prime
period following the ongoing discussion in
prophylaxis against HIV infection , is one
public health circles over the application of
much
pre and post exposure prophylaxis
more
preferred
among
other
mathematical models.
(PrEP* and PEP* respectively), against HIV.

The clinical practice for PEP have
The varying viral life cycles informed

the different classes if HIV drugs targeted at
different phases of the viral cycle. For
example,
the
author,
Daniel
Coombs,
explained that drugs may prevent the viral

genetic material from being integrated into
the host cell or disrupt the formation of new
viral particles, compare to the outcome of the
models of chronic infection. The situation
seems different during the early infection,
where every step of the life cycle is critical
often been based on empirical findings with

less effective drugs and PrEP, a very new and
still under development have shown varying
success, making it pretty difficult to predict
their level of effectiveness. Prior to this
constrains and the curiosity to overcome it,
this paper proposes a simple and a more
complex model to investigate different choice
of treatments strategies for both PEP and
PrEP.
The simple one-compartment model of
for the small virus population to persist in the

host, and therefore, leads to an interesting
HIV infection uses a mathematical formula

that
incorporate
the
replication-competent
dynamics
and
between
-incompetent
viruses, as well as infected cells in the eclipse

8

*PreP - Pre-exposure Prophylaxis.
*PEP Post-exposure Prophylaxis
phase (not producing virus) and in the

productive phase (producing virus). The
formula also includes the rate of infection of
new cells, the rate of viral clearance (due to
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Authors monograph
Bassey, B. E.
removal or inactivation), as well as the
The method used here essentially
interaction of different types of drugs. The
involves presentation of two models (one
complex (two-compartment) model is similar,
simple and one more complex), aimed at
but additionally incorporates different cell
describing early HIV infection. The models
types and transport dynamicstwo factors
are expressed as a continuous time
that are also important in the initiation of HIV
branching process, making it comfortable to
infection.
calculate the probability of infection by a
The research potentially revealed that,
single founder virus. Also, the model
unlike the protease inhibitors, the reverse
adequately defined the needed parameters for
transcriptase inhibitor (RTIs), which inhibits
which the probability are obtained and
the process of transcription of the main
explaining the effect of any drug treatment.
viruss RNA (ribonucleic acid) into DNA
The single model which essentially
(Deoxyribonucleic acid), in the host cell, are
captures several features of the early infection
somewhat more effective. Other factors for
reduces the probability of infection to a
which the transcriptase inhibitors could be
simple analytic expression. It is composed of
more preferred to the protease inhibitors
four compartments - replication competent
include the toxic side-effects or drug cost.
and incompetent virus, designated by V and
The PrEP models and trial predictably have
W respectively. Other components were as
shown faster initiation of the therapy. The
well initialized and parameters defined.
authors model indicate that risk reduction
Among other parameters defined in this
falls to below 15% after a three-day delay of
paper,
treatment, and a two-week treatment regimen
probabilities q" , - an important function of
is shown to work essentially as against the
the model and the main focus of the research.
current recommendation of four weeks.
is
the
infection
clearance
Like every other modeling research,
The models presented in the paper
appropriate measures (assumptions) were
deal with HIV infection following blood
taken into account. The paper pointed out as a
exposure,
on
lack of better information for the one-
occupational exposure. According to the
compartment model, due to extreme low
authors,
complicated
numbers of viruses and the number of
mechanism leading to infection by sexual
infected cell at the early stage, most estimated
exposure, the general framework of the model
values of
can be applied to cases of sexual infection.
models are the same with exception for the
hence
in
spite
focusing
of
the
mainly
both the simple and complex
later, in the infection rate of target cells. The

Page 12
Authors monograph
Bassey, B. E.
infection rate are taken to be multiple of the
work also took into account the infection and
peripheral rate (KT), reflecting the increase in
production rate of DCs, which are modulated
density of CD4 T cells.
by antiretroviral drugs and as well, examine
The second model the complex

model is essentially a two compartment
with viral transport. Its basically similar to
the implications of reduced drugs efficacy in

the lymphoid compartment.
Like
the
parameters
of
one
the single model in two phases. But takes
compartment model, the baseline parameters
account the progress and transmission of the
are the same with slight variation in the
infection cycle neglected by the simple
compartment of the chronic HIV infection.
model. These include the different cells types
Two key parameters in our model are the
and transport dynamics thought to be
inoculum size N0and the rate of infection of
important in the initiation of HIV infection. It
target cells during early infection, kT.The
also capture the hypothesis that successful
authors also pointed out that no clear estimate
HIV infection is promoted by dendritic cells
of rate of infection provided in the literature.
(DCs) of the periphery, via infection (cis
The occupational exposure, as the key
infection) or adhesion to the DC surface and
finding of this paper, is defined as the range
assimilation into endosomes (trans-infection)
from accidental exposure from possible
as well as carriage of HIV to the lymphoid
needle-sticks
tissues with high density T cells. The
chronically infected patients whose viral
interaction of the dendritic cells and the T
loads may vary by order of magnitude. For
cells (DC/T cells) are thought to facilitate
conformity, the authors have assumed the
rapid infection.
inoculum size is uniformly distributed, given
The
complex
model
therefore
represents an extended model which explicitly
to
blood
splashes,
from
between zero and Nmax.

The authors in this research, also took
tissues
into account, previous assumptions made by
compartment. In this model, the target cell
Vaidya et al and Pearson et al, about the
viral dynamics of the peripheral compartment,
higher presence of KT (rate of infection of
which are taken to be the same as in the
target cells in the early stage ) compare to its
simple modelis coupled to the lymphoid
chronic
tissue by mobile DCs. The peripheral
procedure for calculations of the basic
compartment could represent the blood (e.g.,
reproduction
for needle-stick exposure) or the genital
outlined, and necessary equations derived.
mucosa (in the case of sexual exposure). The
These predominantly lead to the calculation
includes
DCs
and
lymphoid
infection
compartment.
parameters
were
The
clearly
Page 13
Authors monograph
Bassey, B. E.
of the risk of infection probability for which a
by a one- compartment model while the
patient becomes infected with HIV upon
efficacy of PEP depends critically on the
exposed inoculum of size No, and the
treatment initiation.
infection clearance probabilitiesq, as the
As a control measure, alternative viral
efficacy of the drugs is time dependent.
production model were in use under the
On the bases of the above analysis and

calculation proceedings,, the authors obtained
following factors:
-
Number of viruses produce under
a number of results which for purposes
different assumptions, where burst
clarity, were sub-sectioned. For example, the
viral production were released;
result of estimating a reasonable scale for the
number of viruses in the initial inoculum.

This sub-section ends with sure observations
Estimating inoculum size and cell

infection rate;
PrEP effectiveness were said to
about the difference between the one and
assume burst viral production. Here it
two compartment models.
is seen that similar risk reduction with
The major results obtained from the
both
simple compartment were:
compartment
inoculum
size,
model,
different
viral
No,
as
propagation of infection more easily
having
the
key
parameter;
controlled;
-
PEP effectiveness indicates similar

result under the two viral production
2) Number of viral strains initiating HIV

infection, i.e. the number of founder
strains;
models.
The authors elaborating on the various
results, affirmed impressive reduction of
3) Impact of infection i.e. examining the

probability
under
production were attained. This made
1) Estimating inoculum size from the one
drugs
of
infection
incidence in at-risk population from recent
changes
PrEP trials. It was however noted that the
between one - and two compartment
only impediment in the implementation, is the
models.
cost of low adherence. The authors therefore
The risk reduction estimates for PrEP with
recommended the implementation of further
RTIs drugs was compared with estimates for
research model in this direction. Also,
protease inhibitors (PIs). Here, calculations
suggested, was the use of post-exposure
were based on estimate, since no clear
prophylaxis as a treatment possibly within the
literature obtained; infections were initiated
first three days of exposure to HIV, with
by a single virus; and the PrEP were obtained
duration
of
at
least,
one
month.
By
Page 14
Authors monograph
Bassey, B. E.
theirprediction, this process will yielda risk
examine the potential effect of the proximate
reduction fall to below 15% after a three
determinant of HIV transmission dynamics,
days. Of concern, is the possible development
which
of drug resistance HIV in the PrEP and
infection, the prevalence of infection and the
PEP, following the low drugs adherence9.
doubling time of epidemic. Furthermore, this
are
basically
the
incidence
of
research revealed the impact of ARVs in

developing countries where the treatment is
CONCLUSION
targeted on the behavioural core group i.e. the
The various research work were aimed

at demonstrating the value of mathematical
modeling as analytic tool on social and
behavioural sciences in HIV; the need for
ARVs to be considered as an unconventional
prevention tool and not simply a therapeutic
remedy on the basis of the fact that, they are
administered mostly (if not only) to the HIV
sex workers which exhibit a high level of

risky activities. Therefore the ARVs should
be viewed as an unconventional prevention
tool and not simply a therapeutic remedy on
the basis that, they are administered mostly (if
not only) to the HIV infected patients as
both preventive and therapeutic measure, but
not to the uninfected individuals.
infected patients as both preventive and

therapeutic measure, but not to the uninfected
More so, the need for easy access and
finding an
increase in the use of ARVs in the developing
insight into the early-time dynamics of HIV
countries in order to enhance significantly, a
infection using PrEP and PEP, as treatmentsas
reduction in both mortality and overall
well as to identify the gap in the current
transmission of HIV was well emphasized.
literature
Under the best of all possible conditions,
individuals. It is also used in
and
to
suggest
the
possible
mathematical modeling analysis have shown
directions for future research.
that treating a substantial fraction of HIV

Its
scientific
evidently
efficacy
that
uses
behavioural
mathematical
modeling as their laboratory equivalent.

Mathematical modeling as it has become
infected individual with ARVs, coupled with

the decrease in risky behaviour, could
eventually lead to eradication of HIV
epidemics albeit in 50 100 years.
more sophisticated is efficiently used to

Remarkably, a theoretical stochastic
9

modeling for the prevention and treatment

strategies resulting from the early dynamics
of HIV infection using PrEP and PEP, as
Page 15
Authors monograph
Bassey, B. E.
treatments was formulated and used. A simple
the models are simple and they could
and more complex models, simplified to
be adapted to other viral infections
simple one - compartment and two
such as HCV(hepatitis C virus) or
compartments, were formulated and used for
influenza in the future;
the analysis. The models favoured analytical
modeling research should include
formulation as against numerical formulation
varying
and
improved models of early infections;
the
results
indicates
that
reverse
transcriptase inhibitors as in the case of
drug
adherence
in
an
further development of models for
PrEP, were somewhat more effective than
drug resistance, in combination with
protease inhibitors. However, in the presence
an appropriate epidemiological model
of extreme high dosage of antiretroviral
in
therapy (ART), taken within 72 hours of
transmission in the context of PrEP is
exposure for 28 days, post exposure
highly recommended; and
prophylaxis (PEP) is known to be successful
studying
the
likelihood
of
with more experimental data, the
in the prevention and of occupational
existing model could be reparametized
infection. The research therefore, identifies
to capture the essential stage of local
PrEP as the HIV prevention measure with
expansion
ARTs taken in advance of possible exposure.
involvement for sexual exposure.
However, the efficacy of PEP depends on the

treatment initiation delay after exposure and
duration of treatment which must conform to
the drug time dependent efficacy. It was
however noted that the only impediment in
the implementation, is the cost of low
adherence.
The models set a general framework
which can be adopted for the treatment of
sexual
exposure
to
HIV.
The
work
highlighted a number of recommendations:

-
resorting to mathematical modeling as

the only way out in tackling studies
which
seems
not
visible
experimental investigations;
in
Also
followed
recommended
modeling, are:
by
for
lymph
future
can global and local
disparities be aburden in current HIV

infection? For example, why is there a
generalized epidemic in sub-Saharan Africa?
How much is behavioural (e.g., concurrent
partnerships), and how much is biologic (e.g.,
circumcision, cofactor STIs)? Why are there
such large racial disparities in HIV prevalence
in industrialized countries? How much of this
is attributable to simple immigration? How do
we make progress in further reducing the
epidemic among MSM? Should serosorting
(i.e., encouraging HIV-positive individuals to
partner with other HIV-positive individuals)
Page 16
Authors monograph
Bassey, B. E.
and other forms of risk network segregation

be promoted? In all populations, what mix of
imperfect
interventions
transmission
treatment
and
might
down
to
prevention
together
lower
bring
than
the
reproductive threshold?
Finally, in my opinion, from the articles,
possibilities
abound
for
improved
mathematical models for the prevention and

treatment of sexually transmitted diseases (i.e.
STDs, HIV, TBs, HCV, etc.). The research
and its recommendations that follows, is of
great benefit in understanding how HIV
vaccine can help in controlling infections
during the first few hours to few days of
infection. The model here is a valuable tool
BIBLIOGRAPHY
1.
Jessica M. C., Bernard P. K. and
Daniel C. Mathematical models to
bettercombat HIV: Stochastic analysis of preand post-exposure prophylaxis against HIV
infection//Journal of Society for Industrial
and Applied Mathematics (SIAM),2003.Vol.
73, No. 2, pp904 928, Philadelphia, USA.
2.
Sally B. and Paul F. Predicting the
public
health
impact
of
antiretroviral:Preventing HIV in developing
countries//AIDScience
- Prevention and
Vaccine Research, 2003.vol. 3, No. 11, pp113, California, United States.
3.
Susan C., Samuel J. C, and
Martina M. Mathematical models for HIV
transmission dynamics: Tools for Social and
Behavioural Science Research//J. Acquir
Immune DeficSyndr, 2008. 47 (. Suppl 1):
s34 s39, doi : 10.1097/QAL, Washington,
Seattle, WA.
for future research studies.
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Mathematical modeling of the dynamics of the spread of HIV infection May 21, 2014

MINISTRY OF EDUCATION AND SCIENCE OF THE RUSSIAN FEDERATION

"THE KUBAN STATE UNIVERSITY"

MATHEMATICAL MODELING OF THE DYNAMICS OF THE

Kuban State University

(350040, 149, Ctavrapolskaya street),Krasnodar, Russia

Chapter 1. MathematicalmodellingforHIVTransmission dynamics:

Chapter 2.Predicting the public health impact of anti-retroviral:

research widely establishes the usefulness and

A paper review mathematical

how mathematical modeling has contributed

modeling of the dynamics of the spread of

to our understanding of the dynamics and

disparities in the global spread of HIV.

infection among heterogeneous population,

According to the authors, HIV transmission is

is a stratify summary of three major articles,

considered via two main factors: biologic and

all geared on the use of mathematical

modelling to study the dynamics, predictions

Furthermore, the basic routes of HIV

and prevention strategies of transmission of

transmission between persons could be

HIV. A seemingly motivating factor for the

understood and widely known. But the

explicit use of mathematical modelling in all

determinants of the corresponding disparities

the three research papers is the fact that,

in prevalence and trends among population

mathematical modelling is a real life

remain an area of debate and of intense

studying course and is central to applied

scientific research. It is also obvious that

these disparities have their roots in the

First we consider the mathematical

transmission system which arises from the

models for HIV transmission dynamics: tools

understanding of the system its components

for social and behavioural science research1.

This paper focused on attempt to overcome

mathematical models not only provide a way

the needed understanding of social and

to examine the potential effects of proximate

behavioural determinants of HIV related

biologic and behavioural determinant of HIV

risk behaviour. From the authors point of

transmission dynamics alone, but importantly

view, the cumulative impact of individual

serve as a research tool in this endeavours.

behaviours on the population level HIV

outcome, can be subtle and counterintuitive

and method of studying these, were rarely

predicting the public health impact of anti-

part of a traditional social science or

retroviral: Preventing HIV in developing

countries2. The authors, using mathematical

models, clinically attempted discussing the

Susan C., Samuel J. C, and Martina M. Mathematical