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Relational concurrency, stages of infection, and the evolution of HIV set point viral load.
Goodreau, Steven M; Stansfield, Sarah E; Murphy, James T; Peebles, Kathryn C; Gottlieb, Geoffrey S; Abernethy, Neil F; Herbeck, Joshua T; Mittler, John E.
Afiliación
  • Goodreau SM; Department of Anthropology, Campus Box 353100, Seattle, WA 98195, USA.
  • Stansfield SE; Department of Anthropology, Campus Box 353100, Seattle, WA 98195, USA.
  • Murphy JT; Department of Microbiology, Campus Box 357735, Seattle, WA 98195, USA.
  • Peebles KC; Department of Epidemiology, Campus Box 357236, Seattle, WA 98195, USA.
  • Gottlieb GS; Departments of Medicine and Global Health, Campus Box 356420, Seattle, WA 98195, USA.
  • Abernethy NF; Department of Biomedical Informatics and Medical Education, Campus Box 358047, Seattle, WA 98195, USA.
  • Herbeck JT; Department of Global Health, University of Washington, Campus Box 353100, Seattle, WA 98195, USA.
  • Mittler JE; Department of Microbiology, Campus Box 357735, Seattle, WA 98195, USA.
Virus Evol ; 4(2): vey032, 2018 Jul.
Article en En | MEDLINE | ID: mdl-30483403
HIV viral load (VL) predicts both transmission potential and rate of disease progression. For reasons that are still not fully understood, the set point viral load (SPVL) established after acute infection varies across individuals and populations. Previous studies have suggested that population mean SPVL (MSPVL) has evolved near an optimum that reflects a trade-off between transmissibility and host survival. Sexual network structures affect rates of potential exposure during different within-host phases of infection marked by different transmission probabilities, and thus affect the number and timing of transmission events. These structures include relational concurrency, which has been argued to explain key differences in HIV burden across populations. We hypothesize that concurrency will alter the fitness landscape for SPVL in ways that differ from other network features whose impacts accrue at other times during infection. To quantitatively test this hypothesis, we developed a dynamic, stochastic, data-driven network model of HIV transmission, and evolution to assess the impact of key sexual network phenomena on MSPVL evolution. Experiments were repeated in sensitivity runs that made different assumptions about transmissibility during acute infection, SPVL heritability, and the functional form of the relationship between VL and transmissibility. For our main transmission model, scenarios yielded MSPVLs ranging from 4.4 to 4.75 log10 copies/ml, covering much of the observed empirical range. MSPVL evolved to be higher in populations with high concurrency and shorter relational durations, with values varying over a clinically significant range. In linear regression analyses on these and other predictors, main effects were significant (P < 0.05), as were interaction terms, indicating that effects are interdependent. We also noted a strong correlation between two key emergent properties measured at the end of the simulations-MSPVL and HIV prevalence-most clearly for phenomena that affect transmission networks early in infection. Controlling for prevalence, high concurrency yielded higher MSPVL than other network phenomena. Interestingly, we observed lower prevalence in runs in which SPVL heritability was zero, indicating the potential for viral evolution to exacerbate disease burden over time. Future efforts to understand empirical variation in MSPVL should consider local HIV burden and basic sexual behavioral and network structure.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Virus Evol Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Virus Evol Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido