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Derrick DeBose

on 23 April 2015

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Transcript of HIV

The results of the Granich paper was it would cost three times as much money to give someone ART right away, than giving it to patients when their CD4+ is less than 350.
Even though it costs all three times as much, the costs would be reduced as progress towards elimination is achieved.
June 30, 2013 the World Health Organization now suggests that people with a CD4+ of 500 or less should get ART, instead of less than 350.
Context of Paper
How HIV spreads mathematically...
alpha =.0025 %transmission rate
gamma =1/11 %death rate of people not on art
tau=.92 %people starting art
sigma=1/25 %death rate of people on art
epsilon=.01 %people getting infected from people on art
S(t+1) =S(t)-alpha*S(t)*(I(t)+(epsilon*A(t)));
I(t+1) =I(t) + alpha*S(t)*(I(t)+(epsilon*A(t))) - tau*I(t) - gamma*I(t);
A(t+1) =A(t) +tau*I(t)-sigma*A(t);
R(t+1) =R(t) +gamma*I(t)+ sigma*A(t);
HIV stands for Human immunodeficiency virus, which is a retrovirus that causes aids. HIV targets white blood cells in the body.

There is no cure for HIV, but there is a treatment called Antiviral Therapy (ART), which slows down HIV.
What is HIV?
What will it take to make this plan happen?
The cost of this plan is around 17 billion dollars per year.
The cost is presumed to decrease after less people become infected.
Some people argue that 17 billion dollars is to much money and that because of that the plan is not a good idea
SIAR Model
SIR Model
The Granich paper states how we can reduce the transmission of HIV
The plan is to treat all infected people before their white blood cell count dwindles and their immune system is weaker
By following through with this plan we will be able to decrease the amount of people that get infected
Patients will be put in antiretroviral therapy (ART) to slow down the HIV virus in the body
Granich Paper
The Granich paper suggests that when people are diagnosed with HIV they need to start taking ART right away. In reality people who are HIV positive have to start taking ART when their CD4 is less than 350. The name of this paper is Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model.
Study Design
In 2007 only 3 million people worldwide were being giving ART, but there was still 6.7 million people who were not being treated
The theory of voluntary and immediate treatment was then born
It is not sure if this plan will work and eliminate HIV, but it's a good start
The Granich paper was published in 2008 however present day the WOH( World Health Organization) has decided to give ART to people with a CD4 less than 500.
It has been six years and even though people are now treated quicker they are still not treated immediately
By Derrick DeBose. Giselle Martinez, and Jada Layne
This paper implies that after people are given ART their chances of infecting somebody else decreases
If people are given ART immediately there chances of living longer increases
The paper also implies that this plan has it's risks and there are chances it that it will not work
Prevalence without Art
Granich Model
Mortality with ART
What's Ethical when it comes to testing ?
Prevalence With ART
Incidence without ART
Mortality Without ART
Prevalence Without ART
Testing should only be done to people who want to know if they are HIV positive
People shouldn't be forced to be tested because we all have free will
Incidence with Art
Moving towards the elimination of HIV and AIDS
Full transcript