Abstract

A mathematical model for testing the viral load as a good prognosis for the HIV infection

G. Sánchez, S. Bautista, A. Valencia, A. Colchero, Y.N. Caro

Instituto Nacional de Salud Pública, CIEE, Cuernavaca, Mexico

Background: For clinical and economical research, it is crucial to establish a relation between the CD4 cell depletion and the viral load because the viral load is considered a good illness evolution predictor. Right now the usefulness of this parameter as a predictor has being under inspection because some recent findings puts its validity under doubt. In this work we will present a validated mathematical model for HIV progression where we find there is no a correlation between viral load and the CD4 cell depletion.
Methods: We will use a matemathematical model that has been previously validated by the authors with cohort studies data. In line with current practice, we implement a standard method to measure the correlation between viral load and the CD4 depletion. Every six months and a year after the first measurements, we calculate a distribution of CD4 and viral load measurements and compare our model to CD4 and viral load correlations obtained from previously published patient data. . CD4 measurements will be repeated six months and a year after the first measurements. Correlations will be taken between viral load and CD4 depletions.
Results: Our results mirrored the results of actual patient data, namely, that there was no correlation between viral load and CD4 count.
Conclusions: It is of main importance to have a reliable illness predictor because most of the clinical HAART decisions depend highly on the patient prognosis. Recommendations based on economical evaluation will be affected as well because most economic models assume a purely linear relationship between CD4 depletions and viral load . Clearly, if the utility of viral load as a illness predictor is shown to be ineffective, new concepts and new researching have to be made.
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