A generalized multi-strain model of HIV evolution with implications for drug-resistance management

Since 1996, the National Institutes of Health and other organizations have recommended offering Highly Active Antiretroviral Therapy (HAART) to all patients infected with HIV. Although HAART provides a powerful strategy for HIV treatment, it does not prevent completely the development of multi-drug resistant strains, and drug resistance is the primary reason for treatment failure. A better control of drug-resistance risk is critical for the success of long-term antiviral therapy in HIV patients. Recent research focuses on how to develop new drugs, but little has been done to control resistance risk by using an appropriate treatment regime. In this paper, we propose a generalized multi-strain model of HIV evolution with viral mutations. Based on this model, we suggest a drug switching strategy to minimize resistance risk and preserve long-term control of the HIV infection for the case in which the patient only has one kind of drug-resistance virus. Though simulations, this model can also be used for detecting and minimizing the resistance risk for the patients who develops multiple drug-regimen resistance.