Paper on hepatitis C

Together with Alexis Nangue and other colleagues from Cameroon we have just completed a paper on mathematical modelling of hepatitis C. What is being modelled here is the dynamics of the amount of the virus and infected cells within a host. The model we study is a modification of one proposed by Guedj and Neumann, J. Theor. Biol. 267, 330. One part of it is a three-dimensional model, which is related to the basic model of virus dynamics. It is coupled with a two-dimensional model which gives a simple description of the way in which the virus replicates inside a host cell. This intracellular process is related to the mode of action of the modern drugs used to treat hepatitis C. I gave some information about the disease itself and its treatment in a previous post. In the end the object of study is a system of five ODE with many parameters.

For this system we first proved global existence and boundedness of the solutions, as well as positivity (positive initial data lead to a positive solution). One twist here is a certain lack of regularity of the coefficients of the system. When some of the unknowns become zero the right hand side of the equations is discontinuous. This means that it is necessary to prove that this singular set is not approached during the evolution of a positive solution. The source of the irregularity is the use of something called the standard incidence function instead of simple mass action kinetics. The former type of kinetics has a long history in epidemiology and I do not want to try to explain the background here. In any case, there are arguments which say that mass action kinetics leads to unrealistic results in within-host models of hepatitis and that the standard incidence function is better.

We show that the model has up to two virus-free steady states and determine their stability. The study of positive steady states is more difficult and, at the moment, incomplete. We have proved that there cannot be more than three steady states but we do not know if there is ever more than one. Under increasingly restrictive assumptions on the parameters (restrictions which are unfortunately not all biologically motivated) we show that there is at least one positive steady state, that there is exactly one and that that one is asymptotically stable. Under certain other assumptions we can show that every solution converges to a steady state. This last proof uses the method of Li and Muldowney discussed in a previous post. Learning about this method was one of the (positive) side effects of working on this project. Another was an improvement of my understanding of the concept of the basic reproductive number as discussed here and here. During this project I have learned a lot of new things, mathematical and biological, and I feel that I am now in a stronger position to tackle other projects modelling hepatitis C and other infectious diseases.


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