Physics-Durban Academic Group (School of Chemistry and Physics), University of KwaZulu-Natal, Westville Campus, Durban, South Africa.
PLoS One. 2012;7(11):e49492. doi: 10.1371/journal.pone.0049492. Epub 2012 Nov 28.
A new host-pathogen model is described that simulates HIV-MTB co-infection and treatment, with the objective of testing treatment strategies. The model includes CD4+ and CD8+ T cells, resting and activated macrophages, HIV and Mycobacterium tuberculosis (MTB). For TB presentation at various stages of HIV disease in a co-infected individual, combined treatment strategies were tested with different relative timings of treatment for each infection. The stages were early HIV disease, late HIV disease and AIDS. The main strategies were TB treatment followed by anti-retroviral therapy (ART) after delays of 15 days, 2 months and 6 months. ART followed by TB treatment was an additional strategy that was tested. Treatment was simulated with and without drug interaction. Simulation results were that TB treatment first followed by ART after a stage-dependent delay has the best outcome. During early HIV disease a 6 month delay is acceptable. During late HIV disease, a 2 month delay is best. During AIDS it is better to start ART after 15 days. However, drug interaction works against the benefits of early ART. These results agree with expert reviews and clinical trials.
描述了一种新的宿主-病原体模型，用于模拟 HIV-MTB 共感染和治疗，旨在测试治疗策略。该模型包括 CD4+和 CD8+T 细胞、静止和激活的巨噬细胞、HIV 和结核分枝杆菌（MTB）。为了在共感染个体的 HIV 疾病的各个阶段呈现结核病，采用不同的相对治疗时机对联合治疗策略进行了测试，每个感染的治疗时机不同。这些阶段包括早期 HIV 疾病、晚期 HIV 疾病和艾滋病。主要策略是在延迟 15 天、2 个月和 6 个月后，先进行结核病治疗，然后进行抗逆转录病毒治疗（ART）。另一种额外的策略是先进行 ART 治疗，然后进行结核病治疗。用和不用药物相互作用来模拟治疗。模拟结果表明，首先进行结核病治疗，然后根据疾病阶段进行依赖于延迟的 ART 治疗，效果最佳。在早期 HIV 疾病中，可接受 6 个月的延迟。在晚期 HIV 疾病中，2 个月的延迟最佳。在艾滋病中，最好在 15 天后开始 ART。然而，药物相互作用会降低早期 ART 的益处。这些结果与专家评论和临床试验一致。
