INTEC   05402
INSTITUTO DE DESARROLLO TECNOLOGICO PARA LA INDUSTRIA QUIMICA
Unidad Ejecutora - UE
artículos
Título:
Optimizing thymic recovery in HIV patients through multidrug therapies
Autor/es:
VICENTE COSTANZA; PABLO S. RIVADENEIRA; FEDERICO BIAFORE; CARLOS D'ATTELLIS
Revista:
BIOMEDICAL SIGNAL PROCESSING AND CONTROL
Editorial:
ELSEVIER SCI LTD
Referencias:
Año: 2012 p. 2345 - 2356
ISSN:
1746-8094
Resumen:
An optimal control approach based on an enlarged nonlinear model for the
dynamics of HIV infection and thymic function is composed to simulate
and evaluate antiretroviral therapies. In addition to the relevant
biological agents, an extra state variable is included, associated with
the thymus capacity for healthy cells production. The methodology
contemplates eventual deleterious effects of drugs over children's
thymus recovery. The intake of ?Reverse Transcriptase Inhibitors? and
?Protease Inhibitors? are modeled as two independent control variables,
each affecting a different term in the dynamics, so extending the
prevailing pure-HAART-therapy analysis. The objective function designed
here is also more inclusive than usual, accounting for the costs of the
two drug families involved and for the thymus deterioration, in addition
to penalizing eventual virus excess and healthy cells deficits. The
search for the best combined therapy is treated as an optimal control
problem. A hybrid version of Dynamic Programming for continuous and
discrete variables is used to treat the problem numerically. Long
time-horizons are explored, aiming to avoid typical peaks in drug
prescriptions found at the beginning and at the end of the optimization
periods. Results indicate that certain combinations of drugs are more
convenient than pure protocols when the value of thymus functioning is
relevant, specially for children patients.