title: Impact of early treatment programs on HIV epidemics: An immunity-based mathematical model.
abstract: While studies on pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) have demonstrated substantial advantages in controlling HIV transmission, the overall benefits of the programs with early initiation of antiretroviral therapy (ART) have not been fully understood and are still on debate. Here, we develop an immunity-based (CD4+ T cell count based) mathematical model to study the impacts of early treatment programs on HIV epidemics and the overall community-level immunity. The model is parametrized using the HIV prevalence data from South Africa and fully analyzed for stability of equilibria and infection persistence criteria. Using our model, we evaluate the effects of early treatment on the new infection transmission, disease death, basic reproduction number, HIV prevalence, and the community-level immunity. Our model predicts that the programs with early treatments significantly reduce the new infection transmission and increase the community-level immunity, but the treatments alone may not be enough to eliminate HIV epidemics. These findings, including the community-level immunity, might provide helpful information for proper implementation of HIV treatment programs.
authors.affiliation: Department of Applied Mathematics, University of Western Ontario, London, Ontario N6A 5B7, Canada. Electronic address: srahma33@uwo.ca.
authors.forename: S M Ashrafur
authors.initials: SM
authors.lastname: Rahman
authors.affiliation: Department of Mathematics and Statistics, University of Missouri-Kansas City, MO 64110, USA.
authors.forename: Naveen K
authors.initials: NK
authors.lastname: Vaidya
authors.affiliation: Department of Applied Mathematics, University of Western Ontario, London, Ontario N6A 5B7, Canada.
authors.forename: Xingfu
authors.initials: X
authors.lastname: Zou
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015496:CD4-Positive T-Lymphocytes; D058872:Epidemics / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology / Q000628:therapy; D006801:Humans; D008962:Models, Theoretical
chemical_list: D018501:Antirheumatic Agents
keywords: Antiretroviral therapy; Basic reproduction number; CD4+ T cell count; Community-level immunity; HIV