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A transmission-virulence evolutionary trade-off explains attenuation of HIV-1 in Uganda

Title: A transmission-virulence evolutionary trade-off explains attenuation of HIV-1 in Uganda
Authors: Blanquart, F; Grabowski, MK; Herbeck, J; Nalugoda, F; Serwadda, D; Eller, MA; Robb, ML; Gray, R; Kigozi, G; Laeyendecker, O; Lythgoe, KA; Nakigozi, G; Quinn, TC; Reynolds, SJ; Wawer, MJ; Fraser, C
Contributors: Commission of the European Communities
Publisher Information: eLife Sciences Publications
Publication Year: 2016
Collection: Imperial College London: Spiral
Subject Terms: Science & Technology; Life Sciences & Biomedicine; Biology; Life Sciences & Biomedicine - Other Topics; GENITAL ULCER DISEASE; SIMPLEX-VIRUS TYPE-2; VIRAL LOAD; PROGNOSTIC MARKERS; PROSPECTIVE COHORT; SET-POINT; PROGRESSION; POPULATION; INFECTION; RAKAI; adaptation; epidemiology; evolutionary biology; genomics; global health; quantitative genetics; selection; transmission-virulence trade-off; viral evolution; virus
Description: Evolutionary theory hypothesizes that intermediate virulence maximizes pathogen fitness as a result of a trade-off between virulence and transmission, but empirical evidence remains scarce. We bridge this gap using data from a large and long-standing HIV-1 prospective cohort, in Uganda. We use an epidemiological-evolutionary model parameterised with this data to derive evolutionary predictions based on analysis and detailed individual-based simulations. We robustly predict stabilising selection towards a low level of virulence, and rapid attenuation of the virus. Accordingly, set-point viral load, the most common measure of virulence, has declined in the last 20 years. Our model also predicts that subtype A is slowly outcompeting subtype D, with both subtypes becoming less virulent, as observed in the data. Reduction of set-point viral loads should have resulted in a 20% reduction in incidence, and a three years extension of untreated asymptomatic infection, increasing opportunities for timely treatment of infected individuals.
Document Type: article in journal/newspaper
Language: English
Relation: eLife; http://hdl.handle.net/10044/1/48184; https://dx.doi.org/10.7554/eLife.20492; 339251; 657768
DOI: 10.7554/eLife.20492
Availability: http://hdl.handle.net/10044/1/48184; https://doi.org/10.7554/eLife.20492
Rights: © 2016 Blanquart et al. This article is distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use and redistribution provided that the original author and source are credited.
Accession Number: edsbas.E7D2EC7F
Database: BASE