新疆维吾尔自治区艾滋病抗病毒治疗病毒动力学与宏观疫情关联的理论流行病学模型研究

项目名称： 新疆维吾尔自治区艾滋病抗病毒治疗病毒动力学与宏观疫情关联的理论流行病学模型研究

项目编号： No.U1503123

项目类型： 联合基金项目

立项/批准年度： 2016

项目学科： 管理科学

项目作者： 彭志行

作者单位： 南京医科大学

项目金额： 50万元

中文摘要： 传统的研究艾滋病防治的宏观理论模型大多是针对高危人群的预防与保护，微观的病毒动力学模型虽能描述HIV药物治疗的效果、给出病毒是否消除的阈值，但忽略了药物在体内的代谢过程。然而，不同的服药方式（时间、剂量）和病人的依从性对体内药物浓度有重要影响。本课题通过建立新疆艾滋病治疗的病毒动力学和药物动力学的复合模型，探索新疆艾滋病治疗对疾病进展和新发感染的影响，分析治疗的最佳起始时间、耐药性与治疗效果的量化关系，探明疫情发展的主要因素。在此基础上建立基于微观的病毒动力学和基于群体的传染病宏观感染关联的耦合模型，研究HIV个体的疾病进展对整体疫情、群体防治的影响；探索治疗覆盖率、治疗开始时间、用药方案对降低病死率和新发感染率的影响。以课题组在新疆维吾尔自治区不同地区、不同人群的治疗队列和疫情监测数据为基础，发展模型参数估计方法，预测患者HIV病毒演化和疫情的发展趋势，发展HIV多尺度模型建模方法。

中文关键词： 艾滋病；理论流行病学；抗病毒治疗；队列研究；病毒载量

英文摘要： The majority traditional macroscopic models of HIV/AIDS prevention and control were applied to the high-risk groups. Microcosmic virus dynamics models can describe the effects of HIV drug therapy and give threshold to eliminate virus except the metabolic process of drugs in the body. However, different ways of taking medicine, including time and dose, and the compliance of patients had important influence on drug concentration in the body. This research, based on the complex model of kinetics of viruses in the individual and drugs, studied the effects of different treatment modalities for disease progression and new infections. The study also aimed to establish the optimal control model for the spread of HIV and optimize the combination of prevention and control measures. We established coupling model associated viral dynamics of individual with macro-infection of group of infectious disease to study the effect on the overall HIV epidemic and prevention groups of the individual disease progress. The model also explored the influence of reducing case fatality rate and new infection rate by different coverage of treatment, treatment starting time and drug regimens, proved a major factor in the development of the epidemic in Xinjiang. Based on the date of the treatment cohort and epidemic surveillance in different groups of different regions in Xinjiang, we estimated parameters of the model and forecasted the development of HIV viral evolution and epidemic situation. At the same time, we developed the new multi-scale method of modeling HIV biological statistical model.

英文关键词： AIDS;Theoretical epidemiology;Antiretroviral therapy ;Cohort study;Viral load