14 February 2013 (SACEMA). Seminar on Modelling CD4 Trajectories in HIV-infected Children Starting ART
SPEAKER: Joanna Lewis
DATE: Thursday, 14th February 2013
VENUE: SACEMA Seminar Room, 19 Jonkershoek Road, Stellenbosch
Children’s immune systems develop over the first 20 years of life and are fundamentally different to adults’ in terms of lymphocyte numbers, turnover rates and population structure. These developmental differences mean that different approaches and statistical tools are required for studying the effects of HIV infection and ART on the paediatric as opposed to the adult immune system, and that conclusions drawn in adults may not necessarily extend to children.
This talk will describe some empirical and mechanistic models for changes in CD4 counts and the T-cell population in children starting antiretroviral therapy. By fitting these models to longitudinal data in a mixed-effects framework we have identified populations of children responding to ART in qualitatively different ways, and constructed predictive models of long-term CD4 count in children following different ART initiation strategies. The fully mechanistic models can also be used to estimate biologically meaningful rates of T-cell production and loss, shedding light on the mechanisms of T-cell reconstitution and the reasons for incomplete recovery of T-cell numbers