  Modeling viral dynamics in HIV/AIDS studies has resulted in a deep
understanding of pathogenesis of HIV infection from which novel antiviral
treatment guidance and strategies have been derived. Viral dynamics models
based on nonlinear differential equations have been proposed and well developed
over the past few decades. However, it is quite challenging to use experimental
or clinical data to estimate the unknown parameters (both constant and
time-varying parameters) in complex nonlinear differential equation models.
Therefore, investigators usually fix some parameter values, from the literature
or by experience, to obtain only parameter estimates of interest from clinical
or experimental data. However, when such prior information is not available, it
is desirable to determine all the parameter estimates from data. In this paper
we intend to combine the newly developed approaches, a multi-stage
smoothing-based (MSSB) method and the spline-enhanced nonlinear least squares
(SNLS) approach, to estimate all HIV viral dynamic parameters in a nonlinear
differential equation model. In particular, to the best of our knowledge, this
is the first attempt to propose a comparatively thorough procedure, accounting
for both efficiency and accuracy, to rigorously estimate all key kinetic
parameters in a nonlinear differential equation model of HIV dynamics from
clinical data. These parameters include the proliferation rate and death rate
of uninfected HIV-targeted cells, the average number of virions produced by an
infected cell, and the infection rate which is related to the antiviral
treatment effect and is time-varying. To validate the estimation methods, we
verified the identifiability of the HIV viral dynamic model and performed
simulation studies.
