Towards a new combination therapy with vectored immunoprophylaxis for HIV: Modeling "shock and kill" strategy

Latently infected cells are considered as a major barrier to curing Human Immunodeficiency Virus (HIV) infection. Reactivation of latently infected cells followed by killing the actively infected cells may be a potential strategy ("shock and kill") to purge the latent reservoir. Based on vectored immunoprophylaxis (VIP) experiment that can elicit bNAbs, in this paper a mathematical model is formulated to explore the efficacy of "shock and kill" strategy with VIP. We derive the basic reproduction number R₀ of the model and show that R₀ completely determines the dynamics of the model: if R₀<1, the disease-free equilibrium is globally asymptotically stable; if R₀>1, the system is uniformly persistent. Numerical simulations suggest that the "shock and kill" strategy with VIP can effectively control HIV infection while this strategy cannot eradicate the reservoir without VIP although it can alleviate the HIV infection. To model the administration of drugs and vaccine more realistically, pharmacokinetics and pulse vaccination are incorporated into the model of ordinary differential equations. The resultants are described by impulsive differential equations. The thresholds are obtained for the frequency and strength of the vaccination to eliminate the viruses. Furthermore, the most appropriate times are numerically investigated for starting a short-term latency-reversing agents (LRAs) treatment relative to ART considering the toxicity of LRAs. The results show that LRAs treatment at the beginning of ART might be a better option. These results have important implications for the design of HIV cure-related clinical trials.

Global Dynamics of SARS-CoV-2 Infection with Antibody Response and the Impact of Impulsive Drug Therapy

Mathematical modeling is crucial to investigating tthe ongoing coronavirus disease 2019 (COVID-19) pandemic. The primary target area of the SARS-CoV-2 virus is epithelial cells in the human lower respiratory tract. During this viral infection, infected cells can activate innate and adaptive immune responses to viral infection. Immune response in COVID-19 infection can lead to longer recovery time and more severe secondary complications. We formulate a micro-level mathematical model by incorporating a saturation term for SARS-CoV-2-infected epithelial cell loss reliant on infected cell levels. Forward and backward bifurcation between disease-free and endemic equilibrium points have been analyzed. Global stability of both disease-free and endemic equilibrium is provided. We have seen that the disease-free equilibrium is globally stable for R0<1, and endemic equilibrium exists and is globally stable for R0>1. Impulsive application of drug dosing has been applied for the treatment of COVID-19 patients. Additionally, the dynamics of the impulsive system are discussed when a patient takes drug holidays. Numerical simulations support the analytical findings and the dynamical regimes in the systems.

MODELING MONOCYTE-DERIVED DENDRITIC CELLS AS A THERAPEUTIC VACCINE AGAINST HIV

Successful immunologic control of HIV infection can be achieved in long-term non-progressors or HIV-1 controllers. Dendritic cells (DCs) are required for specific antigen presentation to naïve T lymphocytes and for antiviral, type I interferon secretion. To understand this mechanism, we develop a mathematical model that describes the role of direct presentation (replicating virus-infected DCs or other [Formula: see text] T cells directly) and cross presentation (DCs obtain antigen processed in other infected cells such as [Formula: see text] T lymphocytes) during HIV-1 infection. We find equilibria and determine stability in the case of no vaccination, and then, when vaccination is taken, we determine analytical thresholds for the strength and frequency of the vaccine to ensure the disease-free equilibrium remains stable. Our theoretical results suggest that the restoration of DC numbers may be predictive of immune restoration and may be a goal for immunotherapy to enhance viral control in a larger proportion of patients.