Could a simple surgical intervention eliminate HIV infection?
BACKGROUND
Human Immunodeficiency Virus (HIV) infection is a dynamic interaction of the pathogen and the host uniquely defined by the preference of the pathogen for a major component of the immune defense of the host. Simple mathematical models of these interactions show that one of the possible outcomes is a chronic infection and much of the modelling work has focused on this state.
However, the models also predict the existence of a virus-free equilibrium. Which one of the equilibrium states the system selects depends on its parameters. One of these is the net extinction rate of the preferred HIV target, the CD4+ lymphocyte. The theory predicts, somewhat counterintuitively, that above a critical extinction rate, the host could eliminate the virus. The question then is how to increase the extinction rate of lymphocytes over a period of several weeks to several months without affecting other parameters of the system.


METHODS
Proposed here is the use of drainage, or filtration, of the thoracic duct lymph, a well-established surgical technique developed as an alternative for drug immunosuppression for organ transplantation. The performance of clinically tested thoracic duct lymphocyte depletion schemes matches theoretically predicted requirements for HIV elimination.
Tepic
Slobodan
S
School of Veterinary Medicine, University of Zurich, Zurich, Switzerland. kyon@datacomm.ch
D004322:Drainage; D005374:Filtration; D015658:HIV Infections / Q000601:surgery*; D006801:Humans; D047589:Leukocyte Reduction Procedures; D008196:Lymph / Q000378:metabolism*; D008214:Lymphocytes; D013897:Thoracic Duct / Q000378:metabolism* / Q000601:surgery*