Modeling dynamic interactions between pre-exposure prophylaxis interventions & treatment programs: predicting HIV transmission & resistance

Clinical trials have recently demonstrated the effectiveness of Pre-Exposure Prophylaxis (PrEP) in preventing HIV infection. Consequently, PrEP may soon be used for epidemic control. We model the dynamic interactions that will occur between treatment programs and potential PrEP interventions in reso...

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Main Authors:	Supervie, Virginie, Barrett, Meagan, Kahn, James S., Musuka, Godfrey, Moeti, Themba Lebogang, Busang, Lesogo, Blower, Sally
Format:	Online
Language:	English
Published:	Nature Publishing Group 2011
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3240958/

id	pubmed-3240958
recordtype	oai_dc
spelling	pubmed-32409582011-12-22 Modeling dynamic interactions between pre-exposure prophylaxis interventions & treatment programs: predicting HIV transmission & resistance Supervie, Virginie Barrett, Meagan Kahn, James S. Musuka, Godfrey Moeti, Themba Lebogang Busang, Lesogo Blower, Sally Article Clinical trials have recently demonstrated the effectiveness of Pre-Exposure Prophylaxis (PrEP) in preventing HIV infection. Consequently, PrEP may soon be used for epidemic control. We model the dynamic interactions that will occur between treatment programs and potential PrEP interventions in resource-constrained countries. We determine the consequences for HIV transmission and drug resistance. We use response hypersurface modeling to predict the effect of PrEP on decreasing transmission as a function of effectiveness, adherence and coverage. We predict PrEP will increase need for second-line therapies (SLT) for treatment-naïve individuals, but could significantly decrease need for SLT for treatment-experienced individuals. If the rollout of PrEP is carefully planned it could increase the sustainability of treatment programs. If not, need for SLT could increase and the sustainability of treatment programs could be compromised. Our results show the optimal strategy for rolling out PrEP in resource-constrained countries is to begin around the “worst” treatment programs. Nature Publishing Group 2011-12-07 /pmc/articles/PMC3240958/ /pubmed/22355700 http://dx.doi.org/10.1038/srep00185 Text en Copyright © 2011, Macmillan Publishers Limited. All rights reserved http://creativecommons.org/licenses/by-nc-sa/3.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-ShareALike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Supervie, Virginie Barrett, Meagan Kahn, James S. Musuka, Godfrey Moeti, Themba Lebogang Busang, Lesogo Blower, Sally
spellingShingle	Supervie, Virginie Barrett, Meagan Kahn, James S. Musuka, Godfrey Moeti, Themba Lebogang Busang, Lesogo Blower, Sally Modeling dynamic interactions between pre-exposure prophylaxis interventions & treatment programs: predicting HIV transmission & resistance
author_facet	Supervie, Virginie Barrett, Meagan Kahn, James S. Musuka, Godfrey Moeti, Themba Lebogang Busang, Lesogo Blower, Sally
author_sort	Supervie, Virginie
title	Modeling dynamic interactions between pre-exposure prophylaxis interventions & treatment programs: predicting HIV transmission & resistance
title_short	Modeling dynamic interactions between pre-exposure prophylaxis interventions & treatment programs: predicting HIV transmission & resistance
title_full	Modeling dynamic interactions between pre-exposure prophylaxis interventions & treatment programs: predicting HIV transmission & resistance
title_fullStr	Modeling dynamic interactions between pre-exposure prophylaxis interventions & treatment programs: predicting HIV transmission & resistance
title_full_unstemmed	Modeling dynamic interactions between pre-exposure prophylaxis interventions & treatment programs: predicting HIV transmission & resistance
title_sort	modeling dynamic interactions between pre-exposure prophylaxis interventions & treatment programs: predicting hiv transmission & resistance
description	Clinical trials have recently demonstrated the effectiveness of Pre-Exposure Prophylaxis (PrEP) in preventing HIV infection. Consequently, PrEP may soon be used for epidemic control. We model the dynamic interactions that will occur between treatment programs and potential PrEP interventions in resource-constrained countries. We determine the consequences for HIV transmission and drug resistance. We use response hypersurface modeling to predict the effect of PrEP on decreasing transmission as a function of effectiveness, adherence and coverage. We predict PrEP will increase need for second-line therapies (SLT) for treatment-naïve individuals, but could significantly decrease need for SLT for treatment-experienced individuals. If the rollout of PrEP is carefully planned it could increase the sustainability of treatment programs. If not, need for SLT could increase and the sustainability of treatment programs could be compromised. Our results show the optimal strategy for rolling out PrEP in resource-constrained countries is to begin around the “worst” treatment programs.
publisher	Nature Publishing Group
publishDate	2011
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3240958/
_version_	1611495460884709376

Modeling dynamic interactions between pre-exposure prophylaxis interventions & treatment programs: predicting HIV transmission & resistance

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