The efficacy of antiviral drug, HIV viral load and the immune response

TL;DR

This paper extends a viral dynamics model to analyze how time-varying antiviral drug efficacy influences HIV viral load and immune response, revealing conditions for short-lived or sustained drug effects and their interaction with immune responses.

Contribution

It introduces a modified model incorporating time-dependent drug efficacy and analyzes the impact on viral load and immune response, including a simple solvable mathematical model.

Findings

Low drug efficacy leads to temporary viral load reduction.

High drug efficacy causes a sustained decrease in viral load.

CTL response increases the critical drug efficacy over time.

Abstract

Developing antiviral drugs is an exigent task since viruses mutate to overcome the effect of antiviral drugs. As a result, the efficacy of most antiviral drugs is short-lived. To include this effect, we modify the Neumann and Dahari model. Considering the fact that the efficacy of the antiviral drug varies in time, the differential equations introduced in the previous model systems are rewritten to study the correlation between the viral load and antiviral drug. The effect of antiviral drug that either prevents infection or stops the production of a virus is explored. First, the efficacy of the drug is considered to decreases monotonously as time progresses. In this case, our result depicts that when the efficacy of the drug is low, the viral load decreases and increases back in time revealing the effect of the antiviral drugs is short-lived. On the other hand, for the antiviral drug with high efficacy, the viral load, as well as the number of infected cells, monotonously decreases while the number of uninfected cells increases. The dependence of the critical drug efficacy on time is also explored. Moreover, the correlation between viral load, the antiviral drug, and CTL response is also explored. In this case, not only the dependence for the basic reproduction ratio on the model parameters is explored but also we analyze the critical drug efficacy as a function of time. We show that the term related to the basic reproduction ratio increases when the CTL response step up. A simple analytically solvable mathematical model is also presented to analyze the correlation between viral load and antiviral drugs.