Mathematical Model of HIV-1 Dynamics with T Cell Activation

A deterministic in-host model of HIV-1 that incorporates naive and activated T cells is being investigated. The model represents the dynamics of five sub-sets of T cells and one class of HIV-1. The virus free and the infection persistent equilibria are found and their stability analysed. With the aid of suitable Lyapunov functionals, we have shown that the model equilibria are globally asymptotically stable under special conditions. The numerical simulation is performed to illustrate both the short term and long term dynamics of HIV-1 infection. The results of simulation are in agreement with published data with regard to CD4+ T cell concentration and the viral load.


Introduction
The most recent global health observatory (GHO, 2014) data of HIV/AIDS published by WHO [1] proclaims that around 78 million people have been infected with the HIV virus and about 39 million people have died of HIV virus. In the current scenario about 35 million people are living with HIV globally and the majority of the cases are in Sub-Saharan Africa where 70% of the total cases are found. The number of people dying from AIDS-related causes like AIDS-related Kaposi's sarcoma has been reduced with the increased access to antiretroviral therapy in low and middle income countries. This accentuates the importance of treatment of HIV through antiretroviral therapy.
The human immunodeficiency virus-1 (HIV-1) is a retrovirus containing two single strands of RNA. It is an enveloped virus that carries its own reverse tran-scriptase, an enzyme, responsible for transcribing viral RNA. HIV-1 is transmitted via three primary routes: unprotected sexual intercourse, mother to child (vertical transmission), and intravenously. HIV targets immune cells that carry a CD4 receptor. These cells include the CD4+ T cells and monocytes/macrophages. The CD4 receptor binds with the protein gp120 (found on the surface of the virus) in initiating cellular infection. This is a necessary step but not sufficient. A co-receptor is needed for proper infection. The virus uses a cytokine receptor on the surface of the host cell near the CD4 receptor to finish the lock and key entry process. It has been shown that individuals lacking the co-receptor have a natural immunity to infection by HIV-1 [2]. Once inside the host cell, the viral DNA can be inserted into the host cell's genome only upon cellular activation, and new viral particles are created and released.
Many HIV-1 in-host models that seek to elucidate the role of cellular immune response in the pathogenesis of HIV-1 infection have been developed. Some of these models could be reviewed in [3] [4] [5] [6]. Most of these models ignore the activation aspect of the naive T cells. T cells must first get activated to acquire the ability to perform their cytotoxic functions. For instance, CD4+ T cells (helper T cells) are activated upon recognition of their cognate antigen that is bound on major histocompatibility complex class II molecules presented on the surface of an activated antigen presentation cell such as macrophage, dendritic cell etc. For a complete activation process, a second non-specific signal is needed. Once a CD4+ T cell, through a T cell receptor, has recognised its cognate antigen, the next step is to transmit a signal from the surface of the T cell, where the recognition takes place, to the nucleus of the T cell. For the CD4+ T cell to switch from naive state to a state of activation, gene expression must be altered inside the nucleus.
Through the help of activated CD4+ T cells, other immune cells are recruited to the sight of an infection. This is normally done through secretion of chemical messengers (cytokines) by the helper T cells that act in an autocrine or paracrine manner. The activated CD8+ T cells, on the contrary, are only able to recognise their cognate antigen that is loaded on the major histocompatibility complex class I of the activated antigen presenting cells. And the recognition is facilitated through their T cell receptors.
With this background, we are motivated to develop an HIV-1 model that includes the activation of both the naive CD4+ and CD8+ T cells. We assume that the activation process of the CD8+ T cells is enhanced by the action of the activated CD4+ T cells. We further assume that both naive and activated CD4+ T cells are susceptible to HIV-1 infection.
In the current paper, we endeavour to address the following questions.
1) Under what conditions does the infection persistent equilibrium point exist?
2) What conditions must be satisfied for the model equilibria to remain stable?
3) What are the different outcomes in the HIV-1 infection?
Equation (1)  T cells and the last term is the per capita death rate constant.
The model parameters above with their definitions are summarised in Table   1.

Positivity of Solutions
For the model system above to be immunological meaningful, it is important to prove that all its state variables are non-negative for all times. In other words, solutions of the model above with positive initial data remain positive for all 0 t > . We thus show that our model is well posed in the sense that the populations do not become negative, and the populations are bounded. Also, the non-negative orthant is positively invariant, in other words, any trajectory that begins in the non-negative orthant remains there for all time.
For simplicity of notations, we let , : x n n a p n n a n a p n a , , , , , with positive coordinates and consider the system with initial values Then the solution The systems (1)-(6) can be rewritten as follows: Proof. Under the given initial conditions, it is easy to prove that the solutions of the system (9)-(14) are positive; if not, we assume a contradiction: that there exists a first time , 1, 2, , 6 In the first case, we have ( ) which is a contradiction. It means that In the second case, we have which is a contradiction. Hence, In the third case, which is a contradiction. Hence, show that the rest of the variables are non-negative.

Boundedness of Solutions
We already have a lower bound given by the above lemma 1 for the solutions of model (9)- (14) with nonnegative initial values. We now show that the solutions are bounded from above.
We denote by ( ) b C I the set of all continuous and bounded functions defined on the interval I taking values in 6  .
Proof. Because of Lemma 1, it only remains to prove the existence of an upper bound to the nonnegative solutions of system (9)- (14). Let ( ) Hence, we obtain ( ) ( )

Equilibria
To find the steady states of the model system (9)- (14), we set each differential equation to solve and solve the resulting system simultaneously from which we obtain two equilibria. These are infection , , , , , , where , , 0, 2,3,5, 6.


The method of Castillo-Chavez et al. [7] is used to compute the reproductive number for the model (9)- (14) and representing the total number of newly infected CD4 T cells arising out of one infected CD4 T cell. Heterogeneity is defined using groups defined by fixed characteristics: and further assume that A can be written in the form denote the virus free equilibrium, that is, (24) Therefore, Let us now state the infection persistent equilibrium, * ε .
The corresponding characteristic equation has the following eigenvalues From (40), we investigate the nature of eigenvalues by noting the following.
( ) ( ) By (41) and (42), we see that all the eigenvalues are negative and thus the infection free equilibrium, 0 ε , is locally asymptotically stable.

Global Stability of Infection Free Equilibrium, 0 ε
Theorem 3. Consider the system (9)- (14). The infection free equilibrium, 0 ε , is globally asymptotically stable if x Differentiating with respect to time, t, we get  x Since the arithmetic mean is greater than or equal to the geometrical mean, the first two terms of (48) are less than or equal to zero. And the global stability of 0 ε follows from LaSalle's Invariance principle [8].

Local Stability of Infection
with β chosen as our bifurcation parameter where From which we get the eigenvalues ( ) .
and the corresponding right eigenvector is ( ) T  T  1  2  3  4  5  6 , , , , , w w w w w w w = where Journal of Applied Mathematics and Physics The local dynamics of system (9)- (14) around 0 are totally governed by a and b.
φ  , 0 is locally asymptotically stable, and there exists a positive unstable equilibrium; when 0 1 φ <  , 0 is unstable and there exists a negative and locally asymptotically stable equilibrium; is locally asymptotically stable, and there exists a positive unstable equilibrium; φ  , 0 is unstable, and there exists a locally asymptotically stable negative equilibrium; when 0 1 φ <  , 0 is stable and a positive unstable equilibrium appears; > . When φ changes from negative to positive, 0 changes its stability from stable to unstable. Correspondingly a negative unstable equilibrium becomes positive and locally asymptotically stable.
Thus, 0 a < and 0 b > . Using Theorem 5 item (4), we have established the following result which only holds for 0 1 >  but close to 1: Theorem 6. The unique virus present equilibrium state guaranteed by Theorem 5 is locally asymptotically stable for 0  near 1.

Global Stability of Infection Persistent Equilibrium, * ε
Theorem 7. Consider the system (9) ln ln 1 ln ln Differentiating along the solutions of system (9)-(14), we get 6 * * * *  3  6  1  2  1  2  3  6  1  2  3  6   1  1  1  1 1 , Using the conditions of the infection persistent equilibrium point, * Since the arithmetic mean is greater than or equal to the geometrical mean, all the three terms of (62) are less than or equal to zero. And the global stability of * ε follows from LaSalle's Invariance principle [8].

Numerical Simulations
To illustrate the analytic results obtained above, we give some simulations using the parameter values in Table 2 and Table 3. Numerical results are displayed in the following figures.
In the following Figure 1 we demonstrate the existence of the virus free equilibrium point, 0 ε . This signifies the case when there is no infection present. In other words, it is a scenario where the pathogen that had initially invaded the host has been cleared either through the action of the immune response or treatment (or both). Of course in our case, there is no treatment. So this clearance is all attributed to the immune response. In Figure 2(a) we simulate the dynamics of naive CD4+ T cells and productively infected cells. The naive CD4+ T cells are assumed to have an initial concentration of 10 6 cells per mL. We also assume that the productively infected CD4+ T cell population is initially zero. We observe from the figure that the naive CD4+ T cell population declines from its maximum value and attains its minimum value after about one and half years ( ) 2 0 x Initial activated CD4+ T cells 0 cells ml −1 [11] ( ) 3 0 x Initial productively infected CD4+ T cells 0 cells ml −1 [11] ( ) 4 0 x Initial naive CD8+ T cells 5 × 10 5 cells ml −1 [11] ( ) 5 0 x Initial activated CD8+ T cells 0 [11] ( ) 6 0 x Initial HIV-1 virions 3 virions ml −1 [12] Journal of Applied Mathematics and Physics  In the following Figure 2 we demonstrate the existence of an infection persistent equilibrium point, * ε . This represents a scenario when the host is invaded by a pathogen, herein referred to as HIV-1, and the infection is established. We simulate our model with 0 1.1667 =  , where the basic reproduction number, 0  , results from utilising the data in Table 1. In Figure 3, we simulate the long term dynamics of HIV-1 infection. In Figure 3( In Figure 3, we simulate the long term dynamics of HIV-1 infection over a period of 3500 days. we observe from (34) that when the population of productively infected CD4+ T cells at steady state approaches zero, the population of the uninfected naive CD4+ T cells, in the long run, rebounds to the non-infected steady state. The numerical simulation attests to this observation in Figure 1(a). And as expected when the productively infected CD4+ T cells increase in number substantially, the population of uninfected CD4+ T cells declines to very low levels before attaining its steady state value. This is illustrated in Figure 2(a).

Discussion and Conclusion
In Equation (35) we note that when the level of infected CD4+ T cells approaches zero, then the steady state values, * , 2,5 j x j = also approach zero due to low levels of antigenic stimulation. Note that when the number of infected CD4+ T cells increases unboundedly it may result in exhaustion which may ultimately impair the activation mechanism of precursors. From Equation (36), we observe that when the steady state value of infected CD4+ T cells approaches zero, the steady state value of the naive CD8+ T cells approaches the non-infected steady state. This is due to the fact that there are now a small number of activated CD4+ T cells available to aid in the activation of these precursors.
Hence, there will be less number of activated CD8+ T cells. From (37), we see that the non-infected steady state value, , of the naive CD8+ T cells is decreased due to the activation mechanism. Also, from (37) and (38) we see that when the activation rates approach zero, the steady state of the naive CD8+ T cells rebounds to its non-infected state and that of activated CD8+ T cells approaches zero. Hence, there will be a small number of cytotoxic T cells to kill the infected CD4+ T cells.