A nonlinear MPC approach to minimize toxicity in HIV-1 infection multi-drug therapy

This work addresses the problem of minimizing the toxicity of the therapy applied to control HIV-1 infection when a multi-drug therapy is (as usually) employed. An approach based on nonlinear model predictive control (MPC), in which the input is a train of impulses corresponding to periodic pill administration to the patient, is followed. Patient adherence to treatment and their impact on virus drug resistance is considered in the model used. The control objective consists of driving the viral load to a low specified value while minimizing the amount of drugs administered to the patient. Since various dose combinations of reverse transcriptase inhibitor (RTI) and protease inhibitor (PI) drugs can be given depending on the weights of the cost function minimized by periodic MPC while attaining the same control objective, it is proposed that these weights can be adjusted to minimize the toxicity of the drug cocktail administered. This approach is illustrated by means of simulation in a model that incorporates both pharmaco-kinetics and pharmaco-dynamics of the drugs considered. Copyright CONTROLO 2012.