Modeling the effect of exogenous Interleukin 7 in HIV patients under antiretroviral therapy with low immune reconstitution

Abstract : Fight against HIV and AIDS has shown major improvements inlife expectancy and quality of life of HIV-infected people since the introductionof the cART. Today, viral load dramatically decreases a few weeks after startingantiretroviral therapy, and it becomes undetectable after 6 months for most ofpatients. This usually leads to an adequate reconstitution of CD4+T cells pool,but this is not necessarily always true. This thesis is focalised on these \lowimmunological responder" patients, who have not reached acceptable levels ofCD4+ T cells count despite undetectable viral load 6 months after having startedthe cART therapy.Today, Interleukin 7 (a cytokine naturally secreted in the bone marrow andthe thymus) is considered as one of the rare potential solution to boost the immunesystem in this situation. During this thesis work, we have collaborated toanalyze data from the INSPIRE 2 & 3 trials, where repeated cycles (3 subcutaneousinjections) of recombinant human Interleukin 7 have been administeredto a total of 107 of these \low responder patients".We have used dynamical models based on systems of ordinary differentialequations to study the ffect of the exogenous Interleukin 7 on CD4+ T cellsthrough the three INSPIRE studies. A mathematical model together with amixed effects model applied on the biological parameters of the ODE systemand a \model for the observations" make up the structure of our work. Amaximum likelihood approach based on an adaptation of a Newton-like methodis combined with a maximum a posteriori estimation in a semi-Bayesian context.
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Ana Jarne Munoz. Modeling the effect of exogenous Interleukin 7 in HIV patients under antiretroviral therapy with low immune reconstitution. Santé publique et épidémiologie. Université de Bordeaux, 2015. English. ⟨NNT : 2015BORD0410⟩. ⟨tel-01273295⟩

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