The HIV/AIDS Transmission Model With Antiretroviral Therapy

Background: The HPTN052, support the result that the antiretroviral therapyhas the role to prevent the transmission of HIV in serodiscordant couples, and a96%relative reduction in linked HIV transmissions. Based on this study, the World HealthOrganization recently recommended offering antiretroviral therapy to all HIV-positivepartners from serodiscordant couples to reduce the risk of transmission, no matterwhat the CD4is [1]. The HPTN052is a prospective and randomized clinical trial,Whether or not such a public health approach is feasible and durable in china or in adeveloping country has not been analyzed. Dealing with the drug resistance and otherseries of problems which treatment induced, need further study.Objects: Based on the research background, this thesis try to ascertain thecharacteristic of antiretroviral therapy in preventing the transmission of HIV inserodiscordant couples. The mathematical model is expected to assess the effects ofantiretroviral therapy and drug resistance to HIV transmission.Methods: Join the databases by SQL-Server, and Cox proportional hazardanalyses were used to evaluate the effect of antiretroviral therapy in seroconversioncouples; Make assumptions and establish an HIV/AIDS dynamics model with drugresistance, calculate the threshold value of the basic reproductive number by the nextgeneration matrix and then analyzed stability of two equilibriums by constructingLyapunov function, acquired the affection of drug resistance by the Formula of basicreproductive number. Findings:95%data are joined up,38,862HIV discordant couples of follow-upwere included. HIV incidence was1.3/100person-years (95%CI1.2,1.3) amongtreated couples and2.6/100person years (95%CI2.4,2.8) among treatment-na vecouples. The reduction in transmission was significant in the first year of follow-up,with the benefit gradually declining until the protection was no longer significant aftersome years; the statistical differences are related to the covariates. Analysis themathematical model of HIV/AIDS transmission, and confirm the close connectionbetween the basic reproduction number and drug resistance. When R0<1, the systemwas globally asymptotically stable and the disease become extinct. Otherwise, thesystem had a unique endemic equilibrium which was also globally asymptoticallystable, and the disease become epidemic.Conclusion: Antiretroviral therapy for HIV discordant couples is a feasible,public health prevention strategy on a national, developing country scale. Thedurability of this protection, however, needs to be further studied due to the existenceof drug resistance.