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控制艾滋病毒/艾滋病传播的最佳策略:以南非为例。

Optimal strategy for controlling the spread of HIV/AIDS disease: a case study of South Africa.

机构信息

Department of Mathematics and Applied Mathematics, University of the Western Cape, Bellville, 7535, South Africa.

出版信息

J Biol Dyn. 2012;6:475-94. doi: 10.1080/17513758.2011.628700. Epub 2011 Oct 26.

DOI:10.1080/17513758.2011.628700
PMID:22873601
Abstract

HIV/AIDS disease continues to spread alarmingly despite the huge amounts of resources invested in fighting it. There is a need to integrate the series of control measures available to ensure a consistent reduction in the incidence of the disease pending the discovery of its cure. We present a deterministic model for controlling the spread of the disease using change in sexual habits and antiretroviral (ARV) therapy as control measures. We formulate a fixed time optimal control problem subject to the model dynamics with the goal of finding the optimal combination of the two control measures that will minimize the cost of the control efforts as well as the incidence of the disease. We estimate the model state initial conditions and parameter values from the demographic and HIV/AIDS data of South Africa. We use Pontryagin's maximum principle to derive the optimality system and solve the system numerically. Compared with the practice in most resource-limited settings where ARV treatment is given only to patients with full-blown AIDS, our simulation results suggest that starting the treatment as soon as the patients progress to the pre-AIDS stage of the disease coupled with appreciable change in the susceptible individuals' sexual habits reduces both the incidence and prevalence of the disease faster. In fact, the results predict that the implementation of the proposed strategy would drive new cases of the disease towards eradication in 10 years.

摘要

尽管投入了大量资源来对抗艾滋病,但艾滋病病毒/艾滋病(HIV/AIDS)疾病仍在惊人地传播。需要整合现有的一系列控制措施,以确保在发现治愈方法之前,持续减少疾病的发病率。我们提出了一种使用性行为改变和抗逆转录病毒(ARV)疗法作为控制措施来控制疾病传播的确定性模型。我们制定了一个固定时间最优控制问题,该问题受模型动力学的约束,目标是找到两种控制措施的最佳组合,以最小化控制努力的成本以及疾病的发病率。我们根据南非的人口统计学和 HIV/AIDS 数据来估计模型的初始状态条件和参数值。我们使用庞特里亚金极大值原理来推导出最优系统,并通过数值方法求解系统。与大多数资源有限的环境中的实际情况相比,在这些环境中,只有在患者出现完全性艾滋病时才给予 ARV 治疗,我们的模拟结果表明,一旦患者进入艾滋病前期阶段,就开始治疗,并配合易感人群性行为的明显改变,会更快地降低疾病的发病率和流行率。事实上,结果预测,实施拟议的策略将在 10 年内使新发病例趋于消除。

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Optimal strategy for controlling the spread of HIV/AIDS disease: a case study of South Africa.控制艾滋病毒/艾滋病传播的最佳策略:以南非为例。
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