Optimal control and sensitivity analysis of SIV→HIV dynamics with effects of infected immigrants in sub‐Saharan Africa

Regional migration has become an underlying factor in the spread of HIV transmission. In addition, immigrants with HIV status has contributed with high‐risk of sexually transmitted infection to its “destination” communities and promotes dissemination of HIV. Efforts to address HIV/AIDS among conflict‐affected populations should be properly addressed to eliminate potential role of the spread of the disease and risk of exposure to HIV. Motivated from this situation, HIV‐infected immigrants factor to HIV/SIV transmission link will be investigated in this research and examine its potential effect using optimal control method. Nonlinear deterministic mathematical model is used which is a multiple host model comprising of humans and chimpanzees. Some basic properties of the model such as invariant region and positivity of the solutions will be examined. The local stability of the disease‐free equilibrium was examined by computing the basic reproduction number, and it was found to be locally asymptotically stable when ?₀<1 and unstable otherwise. Sensitivity analysis was conducted to determine the parameters that help most in the spread of the virus. Pontryagin's maximum principle is used to obtain the optimality conditions for controlling the disease spread. Numerical simulation was conducted to obtain the analytical results. The results shows that combination of public health awareness, treatment, and culling help in controlling the HIV disease spread.     

Dynamics of an HIV‐1 virus model with both virus‐to‐cell and cell‐to‐cell transmissions,general incidence rate,intracellular delay,and CTL immune responses

Direct cell‐to‐cell transmission of HIV‐1 is a more efficient means of virus infection than virus‐to‐cell transmission. In this paper, we incorporate both these transmissions into an HIV‐1 virus model with nonlinear general incidence rate, intracellular delay, and cytotoxic T lymphocyte (CTL) immune responses. This model admits three types of equilibria: infection‐free equilibrium, CTL‐inactivated equilibrium, and CTL‐activated equilibrium. By using Lyapunov functionals and LaSalle invariance principle, it is verified that global threshold dynamics of the model can be explicitly described by the basic reproduction numbers.     

HIV low viral load persistence under treatment: Insights from a model of cell-to-cell viral transmission

HIV infection persists despite long-term administration of antiretroviral therapy. The mechanisms underlying HIV persistence are not fully understood. Direct viral transmission from infected to uninfected cells (cell-to-cell transmission) may be one of them. During cell-to-cell transmission, multiple virions are delivered to an uninfected cell, making it possible that at least one virion can escape HIV drugs and establish infection. In this paper, we develop a mathematical model that includes cell-to-cell viral transmission to study HIV persistence. During cell-to-cell transmission, it is assumed that various number of virus particles are transmitted with different probabilities and antiretroviral therapy has different effectiveness in blocking their infection. We analyze the model by deriving the basic reproduction number and investigating the stability of equilibria. Sensitivity analysis and numerical simulation show that the viral load is still sensitive to the change of the treatment effectiveness in blocking cell-free virus infection. To reduce this sensitivity, we modify the model by including density-dependent infected cell death or HIV latent infection. The model results suggest that although cell-to-cell transmission may have reduced susceptibility to HIV drugs, HIV latency represents a major reason for HIV persistence in patients on suppressive treatment.     

The global dynamics of a model about HIV-1 infection in vivo

A four dimension ODE model is built to study the infection of human immunodeficiency virus (HIV) in vivo. We include in this model four components: the healthy T cells, the latent-infected T cells, the active-infected T cells and the HIV virus. Two types of HIV transmissions in vivo are also included in the model: the virus-to-cell transmission, and the cell-to-cell HIV transmission. There are two possible equilibriums: the healthy equilibrium, and the infected steady state. The basic reproduction number R ₀ is introduced. When R ₀ < 1, the healthy equilibrium is globally stable and when R ₀ > 1, the infected equilibrium exists and is globally stable. Through simulations, we find that, the cell-to-cell HIV transmission is very important for the final outcome of the HIV attacking. Some important clinical observations about the HIV infection situation in lymph node are also verified.      

HIV dynamics: Analysis and robust multirate MPC-based treatment schedules

Analysis and control of human immunodeficiency virus (HIV) infection have attracted the interests of mathematicians and control engineers during the recent years. Several mathematical models exist and adequately explain the interaction of the HIV infection and the immune system up to the stage of clinical latency, as well as viral suppression and immune system recovery after treatment therapy. However, none of these models can completely exhibit all that is observed clinically and account the full course of infection. Besides model inaccuracies that HIV models suffer from, some disturbances/uncertainties from different sources may arise in the modelling. In this paper we study the basic properties of a 6-dimensional HIV model that describes the interaction of HIV with two target cells, CD4⁺ T cells and macrophages. The disturbances are modelled in the HIV model as additive bounded disturbances. Highly Active AntiRetroviral Therapy (HAART) is used. The control input is defined to be dependent on the drug dose and drug efficiency. We developed treatment schedules for HIV infected patients by using robust multirate Model Predictive Control (MPC)-based method. The MPC is constructed on the basis of the approximate discrete-time model of the nominal model. We established a set of conditions, which guarantee that the multirate MPC practically stabilizes the exact discrete-time model with disturbances. The proposed method is applied to the stabilization of the uninfected steady state of the HIV model. The results of simulations show that, after initiation of HAART with a strong dosage, the viral load drops quickly and it can be kept under a suitable level with mild dosage of HAART. Moreover, the immune system is recovered with some fluctuations due to the presence of disturbances.     

Bifurcation analysis of the HIV‐1 within host model

In this paper, a bifurcation solution's analysis is proposed for an HIV‐1 within the host model around its chronic equilibrium point, this is carried out based on Lyapunov–Schmidt approach. It is shown that the coefficient b, which represents the healthy CD4⁺ T‐cells growth rate, is a bifurcation parameter; this means that the rate of multiplication of healthy cells can have serious effects on the qualitative dynamical properties and structural stability of the infection evolution dynamics. Copyright © 2015 John Wiley & Sons, Ltd.     

Optimal strategies for mitigating the HIV/AIDS epidemic in the Philippines

The human immunodeficiency virus (HIV) impairs a person's immune system against many infections and some types of cancer, leading to acquired immunodeficiency syndrome (AIDS), which is characterized by severe illnesses. The number of HIV infections in the Philippines has increased, more than doubled, within the last decade. This alarming HIV crisis in the country requires urgent actions. In this study, a mathematical model is developed to describe the disease transmission in the Philippines. Disease-free and endemic equilibria are obtained, stability analysis is performed, and the basic reproduction number is computed. Sensitivity analyses and subset selection are performed to identify influential parameters and to determine an identifiable parameter set given measurements, respectively. Available data on the number of asymptomatic aware infectious, those who are in the AIDS stage, and those under treatment are utilized to estimate key epidemiological parameters such as transmission, treatment, and screening rates. Uncertainty of these parameter estimates is quantified through bootstrapping method. Furthermore, intervention strategies are investigated in the framework of optimal control theory. Control measures include precaution, HIV screening, antiretroviral treatment, and pre-exposure prophylaxis (PrEP) treatment. These various control efforts are compared with regard to cost efficiency and effectiveness in reducing the number of infected individuals. Given limited available control measures, the PrEP-only scenario is shown to be the most cost-effective, followed by other scenarios that combine PrEP with other controls.     

The role of CD4 T cells in immune system activation and viral reproduction in a simple model for HIV infection

CD4 T cells play a fundamental role in the adaptive immune response including the stimulation of cytotoxic lymphocytes (CTLs). Human immunodeficiency virus (HIV) which infects and kills CD4 T cells causes progressive failure of the immune system. However, HIV particles are also reproduced by the infected CD4 T cells. Therefore, during HIV infection, infected and healthy CD4 T cells act in opposition to each other, reproducing virus particles and activating and stimulating cellular immune responses, respectively. In this investigation, we develop and analyze a simple system of four ordinary differential equations that accounts for these two opposing roles of CD4 T cells. The model illustrates the importance of the CTL immune response during the asymptomatic stage of HIV infection. In addition, the solution behavior exhibits the two stages of infection, asymptomatic and final AIDS stages. In the model, a weak immune response results in a short asymptomatic stage and faster development of AIDS, whereas a strong immune response illustrates the long asymptomatic stage. A model with a latent stage for infected CD4 T cells is also investigated and compared numerically with the original model. The model shows that strong stimulation of CTLs by CD4 T cells is necessary to prevent progression to the AIDS stage.     

Dynamics and control of a system of two non‐interacting preys with common predator

In this paper, we consider a Holling type model, which describes the interaction between two preys with a common predator. First, we give some sufficient conditions for the globally asymptotic stability and prove that local stability implies global stability. Then, we present a set of sufficient conditions for the existence of a positive periodic solution with strictly positive components. Finally, the optimal control strategy is developed to minimize the number of predator and maximize the number of preys. We also show the existence of an optimal control for the optimal control problem and derive the optimality system. The technical tool used to determine the optimal strategy is the Pontryagin Maximum Principle. Finally, the numerical simulations of global stability and the optimal problem are given as the conclusion of this paper. Copyright © 2011 John Wiley & Sons, Ltd.     

Stabilization of HIV/AIDS model by receding horizon control

This work concerns the stabilization of uninfected steady state of an ordinary differential equation system modeling the interaction of the HIV virus and the immune system of the human body. The control variable is the drug dose, which, in turn, affects the rate of infection of CD4⁺ T cells by HIV virus. The feedback controller is constructed by a variant of the receding horizon control (RHC) method. Simulation results are discussed.     

Global properties of a class of HIV infection models with Beddington–DeAngelis functional response

In this paper, the global properties of a class of human immunodeficiency virus (HIV) models with Beddington–DeAngelis functional response are investigated. Lyapunov functions are constructed to establish the global asymptotic stability of the uninfected and infected steady states of three HIV infection models. The first model considers the interaction process of the HIV and the CD4 ⁺ T cells and takes into account the latently and actively infected cells. The second model describes two co‐circulation populations of target cells, representing CD4 ⁺ T cells and macrophages. The third model is a two‐target‐cell model taking into account the latently and actively infected cells. We have proven that if the basic reproduction number R₀ is less than unity, then the uninfected steady state is globally asymptotically stable, and if R₀ > 1, then the infected steady state is globally asymptotically stable. Copyright © 2012 John Wiley & Sons, Ltd.     

A fractional order HIV/AIDS model based on the effect of screening of unaware infectives

In this paper, a fractional order model for the spread of human immunodeficiency virus (HIV) infection is proposed to study the effect of screening of unaware infected individuals on the spread of the HIV virus. For this purpose, local asymptotic stability analysis of the disease‐free equilibrium is investigated. In addition, the model is studied for different values of the fractional order to show the relation between the variations of the reproduction number and the order of the proposed model. Finally, numerical solutions are simulated by using a predictor‐corrector method to illustrate the dynamics between susceptible individuals and unaware infected individuals.     

Computational Control of an HIV Model

We consider a computational approach to solving an optimal control formulation of optimal drug scheduling in HIV infected individuals. The optimal control problem is transformed using the control parameterisation enhancing technique (CPET), which enables efficient computation of an optimal control using a relatively coarse discretisation. A number of numerical difficulties with the model are discussed, and for illustration, numerical examples are solved.     

Bifurcation analysis of a multidelayed HIV model in presence of immune response and understanding of in‐host viral dynamics

In this paper, we proposed a multidelayed in‐host HIV model to represent the interaction between human immunodeficiency virus and immune response. One delay was considered to incorporate the time required by the virus for various intracellular events to make a host cell productively infective, and the second delay was introduced to take into account the time required for adaptive immune system to respond against infection. We extensively analyzed this multidelayed model analytically and numerically. We show that delay may have both destabilizing and stabilizing effects even when the system contains a single immune response delay. It happens when there exists two sequences of critical values of this delay. If the system starts with stable state in absence of delay, then the smallest value of these critical delays causes instability and the next higher value causes stability. The system may also show stability switching for different values of the virus replication factor. These results demonstrate the possible reasons of intrapatients and interpatients variability of CD4⁺ T cells and virus counts in HIV‐infected patients.     

The population‐level impact of HBV and its vaccination on HIV transmission dynamics

Hepatitis B virus (HBV) and its vaccination strategy may affect human immunodeficiency virus (HIV) transmission dynamics because both viruses have synergistic effects. To quantitatively assess the potential impact of HBV and its vaccination strategy on HIV transmission dynamics at the population level, in this paper, we formulate a deterministic compartmental model that describes the joint dynamics of HBV and HIV. We first derive the explicit expressions for the basic reproduction numbers of HIV and HBV and analyze the dynamics of HIV and HBV subsystems, respectively. Then a systematic qualitative analysis of the full system is also provided, which includes the local and global behavior. By using a set of reasonable parameter values, the full system is numerically investigated to assess the potential impact of HBV and its vaccination strategy on HIV transmission. The direct and indirect population level impact of HBV on HIV is demonstrated by calculating the fraction of HIV infections attributable to HBV and the difference between HIV prevalence in the presence and absence of HBV, respectively. The findings imply that the increase of HBV vaccination rate may unusually accelerate HIV epidemics indirectly, although the direct effect of HBV on HIV transmission decreases as HBV vaccination rate increases. Finally, the potential impact of HIV on HBV transmission dynamics is investigated by way of parenthesis. Copyright © 2016 John Wiley & Sons, Ltd.     

On strategies on a mathematical model for leukemia therapy

A mathematical model for leukemia therapy based on the Gompertzian law of cell growth is studied. It is assumed that the chemotherapeutic agents kill leukemic as well as normal cells.Effectiveness of the medicine is described in terms of a therapy function. Two types of therapy functions are considered: monotonic and non-monotonic. In the former case the level of the effect of the chemotherapy directly depends on the quantity of the chemotherapeutic agent. In the latter case the therapy function achieves its peak at a threshold value and then the effect of the therapy decreases. At any given moment the amount of the applied chemotherapeutic is regulated by a control function with a bounded maximum. Additionally, the total quantity of chemotherapeutic agent which can be used during the treatment process is bounded too.The problem is to find an optimal strategy of treatment to minimize the number of leukemic cells while at the same time retaining as many normal cells as possible.With the help of Pontryagin’s Maximum Principle it was proved that the optimal control function has at most one switch point in both monotonic and non-monotonic cases for most relevant parameter values.A control strategy called alternative is suggested. This strategy involves increasing the amount of the chemotherapeutical medicine up to a certain value within the shortest possible period of time, and holding this level until the end of the treatment.The comparison of the results from the numerical calculation using the Pontryagin’s Maximum Principle with the alternative control strategy shows that the difference between the values of cost functions is negligibly small.