Predicting the unpredictable: Transmission of drug-resistant HIV
We use a mathematical model to understand (from 1996 to 2001) and to predict (from 2001 to 2005) the evolution of the epidemic of drug-resistant HIV in San Francisco. We predict the evolutionary trajectories for 1,000 different drug-resistant strains with each strain having a different fitness relat...
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| Published in | Nature medicine Vol. 7; no. 9; pp. 1016 - 1020 |
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| Main Authors | , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Nature Publishing Group
01.09.2001
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| Subjects | |
| Online Access | Get full text |
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| Abstract | We use a mathematical model to understand (from 1996 to 2001) and to predict (from 2001 to 2005) the evolution of the epidemic of drug-resistant HIV in San Francisco. We predict the evolutionary trajectories for 1,000 different drug-resistant strains with each strain having a different fitness relative to a drug-sensitive strain. We calculate that the current prevalence of resistance is high, and predict it will continue to rise. In contrast, we calculate that transmission of resistance is currently low, and predict it will remain low. We show that the epidemic of resistance is being generated mainly by the conversion of drug-sensitive cases to drug-resistant cases, and not by the transmission of resistant strains. We also show that transmission of resistant strains has not increased the overall number of new HIV infections. Our results indicate that transmission of resistant strains is, and will remain, a relatively minor public health problem. |
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| AbstractList | We use a mathematical model to understand (from 1996 to 2001) and to predict (from 2001 to 2005) the evolution of the epidemic of drug-resistant HIV in San Francisco. We predict the evolutionary trajectories for 1,000 different drug-resistant strains with each strain having a different fitness relative to a drug-sensitive strain. We calculate that the current prevalence of resistance is high, and predict it will continue to rise. In contrast, we calculate that transmission of resistance is currently low, and predict it will remain low. We show that the epidemic of resistance is being generated mainly by the conversion of drug-sensitive cases to drug-resistant cases, and not by the transmission of resistant strains. We also show that transmission of resistant strains has not increased the overall number of new HIV infections. Our results indicate that transmission of resistant strains is, and will remain, a relatively minor public health problem. |
| Audience | Academic |
| Author | Aschenbach, A.N Gershengorn, H.B Blower, S.M Kahn, J.O |
| Author_xml | – sequence: 1 givenname: S.M surname: Blower fullname: Blower, S.M organization: Department of Biomathematics and UCLA AIDS Institute, UCLA School of Medicine – sequence: 2 givenname: A.N surname: Aschenbach fullname: Aschenbach, A.N organization: Department of Biomathematics and UCLA AIDS Institute, UCLA School of Medicine – sequence: 3 givenname: H.B surname: Gershengorn fullname: Gershengorn, H.B organization: Harvard Medical School – sequence: 4 givenname: J.O surname: Kahn fullname: Kahn, J.O organization: University of California, San Francisco and San Francisco General Hospital |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/11533704$$D View this record in MEDLINE/PubMed |
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| Copyright | COPYRIGHT 2001 Nature Publishing Group Copyright Nature Publishing Group Sep 2001 |
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| References | Catania, J.A. (b6) 2000; 290 (b18) 1999; 48 Blower, S.M., Porco, T.C., Darby, G. (b5) 1998; 4 Gallant, J.E. (b22) 2000; 283 Kleijnen, J.P.C., Helton, J.C. (b39) 1999; 65 Hansel, A., Bucher, H.C, Nuesch, R., Battegay, M.J. (b21) 2001; 26 Quinn, T.C. (b31) 2000; 342 Blower, S.M., Gerberding, J.L.G. (b3) 1998; 76 Paredes, R. (b27) 2000; 160 Blower, S.M., Gershengorn, H.B., Grant, R.M. (b16) 2000; 287 Iman, R.L., Helton, J.C. (b38) 1988; 8 Huang, W. (b20) 2001; 183 (b17) 1998; 48 Havlir, D.V. (b25) 2000; 283 Gazzard, B., Moyle, G. (b34) 1998; 352 Hogg, R.S. (b9) 1998; 279 b7 Hecht, F.M. (b12) 1998; 339 Descamps, D. (b23) 2000; 283 Conway, B. (b28) 2001; 6 Blower, S.M., Small, P.M., Hopewell, P.C. (b2) 1996; 273 Blower, S.M. (b30) 1995; 1 Espinal, M.A. (b1) 2001; 344 Pialoux, G. (b24) 1998; 339 Blower, S.M., Koelle, K., Kirschner, D., Mills, J. (b36) 2001; 98 Solomon, H. (b14) 2000; 14 Stoddart, C.A. (b33) 2001; 7 Ledergerber, B. (b8) 1999; 282 Ghani, A.C., Henley, W.E., Donnelly, C.A., Mayer, S., Anderson, R.M. (b26) 2001; 15 Blower, S.M., Koelle, K., Lietman, T. (b4) 1999; 5 (b19) 2001; 50 Blower, S.M., Dowlatabadi, H. (b29) 1994; 2 Little, S.J. (b32) 2001; 322 Palella, F.J. (b11) 1998; 338 Blower, S.M. (b37) 2001; 15 Tchetgen, E., Kaplan, E.H., Friedland, G.H. (b35) 2001; 26 Little, S.J. (b13) 1999; 282 Yerly, S. (b15) 1999; 354 Detels, R. (b10) 1998; 280 11533695 - Nat Med. 2001 Sep;7(9):993-4 Nat Med. 2003 Jan;9(1):146. JA Catania (BFnm09011016_CR6) 2000; 290 G Pialoux (BFnm09011016_CR24) 1998; 339 SJ Little (BFnm09011016_CR32) 2001; 322 B Ledergerber (BFnm09011016_CR8) 1999; 282 JE Gallant (BFnm09011016_CR22) 2000; 283 RS Hogg (BFnm09011016_CR9) 1998; 279 RL Iman (BFnm09011016_CR38) 1988; 8 TC Quinn (BFnm09011016_CR31) 2000; 342 MA Espinal (BFnm09011016_CR1) 2001; 344 FM Hecht (BFnm09011016_CR12) 1998; 339 E Tchetgen (BFnm09011016_CR35) 2001; 26 SM Blower (BFnm09011016_CR36) 2001; 98 BFnm09011016_CR18 BFnm09011016_CR19 BFnm09011016_CR17 SM Blower (BFnm09011016_CR30) 1995; 1 SM Blower (BFnm09011016_CR4) 1999; 5 FJ Palella Jr (BFnm09011016_CR11) 1998; 338 CA Stoddart (BFnm09011016_CR33) 2001; 7 SM Blower (BFnm09011016_CR16) 2000; 287 B Gazzard (BFnm09011016_CR34) 1998; 352 R Detels (BFnm09011016_CR10) 1998; 280 B Conway (BFnm09011016_CR28) 2001; 6 SJ Little (BFnm09011016_CR13) 1999; 282 SM Blower (BFnm09011016_CR2) 1996; 273 SM Blower (BFnm09011016_CR3) 1998; 76 SM Blower (BFnm09011016_CR5) 1998; 4 A Hansel (BFnm09011016_CR21) 2001; 26 D Descamps (BFnm09011016_CR23) 2000; 283 BFnm09011016_CR7 JPC Kleijnen (BFnm09011016_CR39) 1999; 65 DV Havlir (BFnm09011016_CR25) 2000; 283 H Solomon (BFnm09011016_CR14) 2000; 14 S Yerly (BFnm09011016_CR15) 1999; 354 W Huang (BFnm09011016_CR20) 2001; 183 AC Ghani (BFnm09011016_CR26) 2001; 15 SM Blower (BFnm09011016_CR37) 2001; 15 SM Blower (BFnm09011016_CR29) 1994; 2 R Paredes (BFnm09011016_CR27) 2000; 160 |
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| Snippet | We use a mathematical model to understand (from 1996 to 2001) and to predict (from 2001 to 2005) the evolution of the epidemic of drug-resistant HIV in San... |
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| SubjectTerms | Acquired immune deficiency syndrome AIDS Anti-HIV Agents - pharmacology Anti-HIV Agents - therapeutic use Drug resistance Drug Resistance, Microbial Epidemics HIV HIV Infections - epidemiology HIV Infections - virology HIV-1 - drug effects HIV-1 - physiology Human immunodeficiency virus Humans Infections Medicine Models, Theoretical Pathogens Public health Publishing San Francisco - epidemiology |
| Title | Predicting the unpredictable: Transmission of drug-resistant HIV |
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