title: Criticality of timing for anti-HIV therapy initiation.
abstract: The time of initiation of antiretroviral therapy in HIV-1 infected patients has a determinant effect on the viral dynamics. The question is, how far can the therapy be delayed? Is sooner always better? We resort to clinical data and to microsimulations to forecast the dynamics of the viral load at therapy interruption after prolonged antiretroviral treatment. A computational model previously evaluated, produces results that are statistically adherent to clinical data. In addition, it allows a finer grain analysis of the impact of the therapy initiation point to the disease course. We find a swift increase of the viral density as a function of the time of initiation of the therapy measured when the therapy is stopped. In particular there is a critical time delay with respect to the infection instant beyond which the therapy does not affect the viral rebound. Initiation of the treatment is beneficial because it can down-regulate the immune activation, hence limiting viral replication and spread.
authors.affiliation: Institute for Computing Applications Mauro Picone, National Research Council of Italy, Rome, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Castiglione
authors.forename: Paola
authors.initials: P
authors.lastname: Paci
mesh_terms: D019380:Anti-HIV Agents / Q000494:pharmacology*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D003198:Computer Simulation; D015536:Down-Regulation; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000378:metabolism*; D006801:Humans; D008297:Male; D008956:Models, Chemical; D015233:Models, Statistical; D012984:Software; D019562:Viral Load; D014779:Virus Replication
chemical_list: D019380:Anti-HIV Agents