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Time-since-infection Immunological Model for Hepatitis C and Observed Treatment Profiles

Hepatitis C infection becomes chronic in most patients leading to end-stage liver disease. The standard-of-care treatment for HCV patients is only suboptimal. Several patients who exhibit undetectable viral load during, at the end of, or six months after cessation of therapy, observes relapse over variable time. This suggests that there may exist, a sub-clinical threshold, which governs the achievement of lasting cure. We propose an immunological model of hepatocytes and HCV to investigate this threshold behavior, where the infected hepatocytes are differentiated by the age of infection in them. The goal of the model is to obtain observed patient profiles if treatment is provided. Preliminary analysis of the model provides conditions for existence of two endemic equilibria for R0 < 1. Analysis of a reduced model without age of infection suggests backward bifurcation at R0 = 1. Artificial values of the parameters are taken to show bistability region for R0 < 1. However, it may not be possible to observe the patient profile in this region without treatment. The critical reproduction number below which the disease free equilibrium is stable may lead us to the decisive sub-clinical viral load threshold.

Article Number:
MTBI-06-03M

Year:
2009

Authors:
Swati Debroy

time-since-infection_immunological_model_for_hepatitis_c_and_observed_treatment_profiles.pdf