Fraser, Christophe, Hollingsworth, T. Déirdre, Chapman, Ruth, de Wolf, Frank and Hanage, William P. (2007) Variation in HIV-1 set-point viral load : epidemiological analysis and an evolutionary hypothesis. Proceedings of the National Academy of Sciences of the United States of America, Vol.104 (No.44). pp. 17441-17446. doi:10.1073/pnas.0708559104

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Abstract

The natural course of HIV-1 infection is characterized by a high degree of heterogeneity in viral load, not just within patients over time, but also between patients, especially during the asymptomatic stage of infection. Asymptomatic, or set-point, viral load has been shown to correlate with both decreased time to AIDS and increased infectiousness. The aim of this study is to characterize the epidemiological impact of heterogeneity in set-point viral load. By analyzing two cohorts of untreated patients, we quantify the relationships between both viral load and infectiousness and the duration of the asymptomatic infectious period. We find that, because both the duration of infection and infectiousness determine the opportunities for the virus to be transmitted, this suggests a trade-off between these contributions to the overall transmission potential. Some public health implications of variation in set-point viral load are discussed. We observe that set-point viral loads are clustered around those that maximize the transmission potential, and this leads us to hypothesize that HIV-1 could have evolved to optimize its transmissibility, a form of adaptation to the human host population. We discuss how this evolutionary hypothesis can be tested, review the evidence available to date, and highlight directions for future research.

Item Type:	Journal Article
Subjects:	Q Science > QH Natural history > QH301 Biology R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Faculty of Science > Life Sciences (2010- ) Faculty of Science > Mathematics
Journal or Publication Title:	Proceedings of the National Academy of Sciences of the United States of America
Publisher:	National Academy of Sciences
ISSN:	0027-8424
Official Date:	30 October 2007
Dates:	Date Event 30 October 2007 Published
Date of first compliant deposit:	23 December 2015
Volume:	Vol.104
Number:	No.44
Page Range:	pp. 17441-17446
DOI:	10.1073/pnas.0708559104
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Related URLs:	Publisher

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