Could a simple surgical intervention eliminate HIV infection?
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BioMed Central
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Could a simple surgical intervention eliminate HIV infection? Slobodan Tepic* Address: School of Veterinary Medicine, University of Zurich, Zurich, Switzerland Email: Slobodan Tepic* - [email protected] * Corresponding author
Published: 31 August 2004 Theoretical Biology and Medical Modelling 2004, 1:7
doi:10.1186/1742-4682-1-7
Received: 03 August 2004 Accepted: 31 August 2004
This article is available from: http://www.tbiomed.com/content/1/1/7 © 2004 Tepic; licensee BioMed Central Ltd. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Human Immunodeficiency Virus (HIV) infection is a dynamic interaction of the pathogen and the host uniquely defined by the preference of the pathogen for a major component of the immune defense of the host. Simple mathematical models of these interactions show that one of the possible outcomes is a chronic infection and much of the modelling work has focused on this state. Bifurcation: However, the models also predict the existence of a virus-free equilibrium. Which one of the equilibrium states the system selects depends on its parameters. One of these is the net extinction rate of the preferred HIV target, the CD4+ lymphocyte. The theory predicts, somewhat counterintuitively, that above a critical extinction rate, the host could eliminate the virus. The question then is how to increase the extinction rate of lymphocytes over a period of several weeks to several months without affecting other parameters of the system. Testing the hypothesis: Proposed here is the use of drainage, or filtration, of the thoracic duct lymph, a well-established surgical technique developed as an alternative for drug immunosuppression for organ transplantation. The performance of clinically tested thoracic duct lymphocyte depletion schemes matches theoretically predicted requirements for HIV elimination.
Dynamics of HIV infection and selection of equilibrium states
of which is virus-free, has not been discussed in any of the recent publications on HIV response to anti-viral drugs.
Reports on the high turnover rates of HIV and its preferred target, CD4+ lymphocytes, during the latent phase of HIV infection [1-3] have established the virus as a prime suspect for direct demolition of the immune system. These clinical findings have also stimulated further efforts at modeling [4,5], and quantitative experimental observation [6]. Major journals have a preference for experimental or clinical data, and the results of mathematical modelling have not reached the broader AIDS research community. For example, the most interesting result of a simple dynamic model published several years ago [7], namely the existence of multiple equilibrium states, one
For a general medical audience it would be desirable to describe the basic feature
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