Mathematical modeling of liver enzyme elevation in HIV mono-infection

HIV-infected individuals are increasingly becoming susceptible to liver disease and, hence, liver-related mortality is on a rise. The presence of CD4+ in the liver and the presence of C–X–C chemokine receptor type 4 (CXCR4) on human hepatocytes provide a conducive environment for HIV invasion.In this study, a mathematical model is used to analyse the dynamics of HIV in the liver with the aim of investigating the existence of liver enzyme elevation in HIV mono-infected individuals. In the presence of HIV-specific cytotoxic T-lymphocytes, the model depicts a unique endemic equilibrium with a transcritical bifurcation when the basic reproductive number is unity. Results of the study show that the level of liver enzyme alanine aminotransferase (ALT) increases with increase in the rate of hepatocytes production. Numerical simulations reveal significant elevation of alanine aminotransferase with increase in viral load. The findings presuppose that while liver damage in HIV infection has mostly been associated with HIV/HBV coinfection and use of antiretroviral therapy (ART), it is possible to have liver damage solely with HIV infection.

► ALT elevation exists in HIV mono-infected without using therapy. ► Level of ALT highest when HIV is equally likely to infect CD4+ cells or hepatocytes. ► Model has a unique endemic equilibrium with a transcritical bifurcation for R0=1R0=1.