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BioMed Research International
Volume 2014 (2014), Article ID 472869, 9 pages
http://dx.doi.org/10.1155/2014/472869
Research Article

Computational Study to Determine When to Initiate and Alternate Therapy in HIV Infection

1Department of Systems Immunology and Braunschweig Integrated Centre of Systems Biology, Helmholtz Centre for Infection Research, Inhoffenstraße 7, 38124 Braunschweig, Germany
2Institut für Geophysik und extraterrestrische Physik, Technische Universität Braunschweig, Mendelssohnstraße 3, 38106 Braunschweig, Germany
3Institute for Biochemistry, Biotechnology and Bioinformatics, Braunschweig University of Technology, Braunschweig, 38106 Braunschweig, Germany

Received 15 February 2014; Revised 7 April 2014; Accepted 10 April 2014; Published 11 May 2014

Academic Editor: Filippo Castiglione

Copyright © 2014 Matthias Haering et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

HIV is a widespread viral infection without cure. Drug treatment has transformed HIV disease into a treatable long-term infection. However, the appearance of mutations within the viral genome reduces the susceptibility of HIV to drugs. Therefore, a key goal is to extend the time until patients exhibit resistance to all existing drugs. Current HIV treatment guidelines seem poorly supported as practitioners have not achieved a consensus on the optimal time to initiate and to switch antiretroviral treatments. We contribute to this discussion with predictions derived from a mathematical model of HIV dynamics. Our results indicate that early therapy initiation (within 2 years postinfection) is critical to delay AIDS progression. For patients who have not received any therapy during the first 3 years postinfection, switch in response to virological failure may outperform proactive switching strategies. In case that proactive switching is opted, the switching time between therapies should not be larger than 100 days. Further clinical trials are needed to either confirm or falsify these predictions.