Understanding patterns of HIV multi-drug resistance through models of temporal and spatial drug heterogeneity.

ABSTRACT: Triple-drug therapies have transformed HIV from a fatal condition to a chronic one. These therapies should prevent HIV drug resistance evolution, because one or more drugs suppress any partially resistant viruses. In practice, such therapies drastically reduced, but did not eliminate, resistance evolution. In this article, we reanalyze published data from an evolutionary perspective and demonstrate several intriguing patterns about HIV resistance evolution - resistance evolves (1) even after years on successful therapy, (2) sequentially, often via one mutation at a time and (3) in a partially predictable order. We describe how these observations might emerge under two models of HIV drugs varying in space or time. Despite decades of work in this area, much opportunity remains to create mode

SUBMITTER: Feder AF 

PROVIDER: S-EPMC8412921 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature