Investigation on Hepatitis C Virus Reinfection in HCV/HIV Coinfected Individuals

Abstract

The aim of this thesis is to reconcile the disconnected and sparse, but ever growing, information being published on the phenomenon of reinfection of Hepatitis C in HCV/HIV coinfected individuals, as well as providing a purely theoretical and a functional mathematical model that can be expanded upon with future research. The thesis can be divided into 2 parts. The first half focuses on providing the essential context, starting from the disease, how it was and currently is treated to then tackle the call to action by international organizations and what is impeding the eradication objectives set: reinfection. From exploring the context, starting from the main protagonists being the virus and the cures of pre-DAA and post-DAA. Regarding the eradication goals for 2030, the Sustainable Development Goals of the United Nations Agenda and the World Health Organization’s many handbooks and strategy guidelines. To highlight the world recognized importance of what appears to be a major obstacle in achieving the eradication goals, the reinfection and the micro-elimination of the virus in these target populations. There we find the argument for why this thesis is written. The second part instead focuses on the mathematical study of how prediction can be performed for this reinfection phenomena through compartmental models. Three models are constructed, one purely theoretical, a second simplified version as a bridge between the first, and the third being the functional model. In view of the possibility of application in a future where more data is available, with de-escalation of complexity in its second iteration as well as a practical application of said model in a third iteration constructed with one the co-advisor’s studies in mind: “Hepatitis C Virus Reinfection in People with HIV in Taiwan After Achieving Sustained Virologic Response with Antiviral Treatment: The RECUR Study.” (Liu et al., 2022)

The aim of this thesis is to reconcile the disconnected and sparse, but ever growing, information being published on the phenomenon of reinfection of Hepatitis C in HCV/HIV coinfected individuals, as well as providing a purely theoretical and a functional mathematical model that can be expanded upon with future research. The thesis can be divided into 2 parts. The first half focuses on providing the essential context, starting from the disease, how it was and currently is treated to then tackle the call to action by international organizations and what is impeding the eradication objectives set: reinfection. From exploring the context, starting from the main protagonists being the virus and the cures of pre-DAA and post-DAA. Regarding the eradication goals for 2030, the Sustainable Development Goals of the United Nations Agenda and the World Health Organization’s many handbooks and strategy guidelines. To highlight the world recognized importance of what appears to be a major obstacle in achieving the eradication goals, the reinfection and the micro-elimination of the virus in these target populations. There we find the argument for why this thesis is written. The second part instead focuses on the mathematical study of how prediction can be performed for this reinfection phenomena through compartmental models. Three models are constructed, one purely theoretical, a second simplified version as a bridge between the first, and the third being the functional model. In view of the possibility of application in a future where more data is available, with de-escalation of complexity in its second iteration as well as a practical application of said model in a third iteration constructed with one the co-advisor’s studies in mind: “Hepatitis C Virus Reinfection in People with HIV in Taiwan After Achieving Sustained Virologic Response with Antiviral Treatment: The RECUR Study.” (Liu et al., 2022)