Modelling the evolution of HIV-1 virulence in response to imperfect therapy and prophylaxis.

ABSTRACT: Average HIV-1 virulence appears to have evolved in different directions in different host populations since antiretroviral therapy first became available, and models predict that HIV drugs can select for either higher or lower virulence, depending on how treatment is administered. However, HIV virulence evolution in response to "leaky" therapy (treatment that imperfectly suppresses viral replication) and the use of preventive drugs (pre-exposure prophylaxis) has not been explored. Using adaptive dynamics, we show that higher virulence can evolve when antiretroviral therapy is imperfectly effective and that this evolution erodes some of the long-term clinical and epidemiological benefits of HIV treatment. The introduction of pre-exposure prophylaxis greatly reduces infection prevalence, but

SUBMITTER: Smith DR 

PROVIDER: S-EPMC5322411 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature