HIV that is being transmitted in large population clusters in the United States is more likely to cause high viral load in people who acquire it, leading US researchers to conclude that natural selection is causing HIV in the United States to become more infectious and virulent. The study by Dr Joel Wertheim of the University of California San Diego, Dr Walid Heneine of the Centers for Disease Control and Prevention and colleagues is published in Nature Communications.
Scientists have previously theorised that rapid onward transmission of HIV after primary infection would tend to favour the selection of HIV variants that produce a higher viral load set-point (the level at which viral load stabilises after the early peak in viral load during primary infection).
Absence - Diagnosis - Treatment - Selection - Variants
In the absence of early diagnosis and effective antiretroviral treatment, selection of these variants through more effective transmission would lead to a shorter period of asymptomatic HIV infection but more widespread transmission.
Although early diagnosis and treatment would suppress the viral loads of people diagnosed with HIV, larger sexual networks in which more frequent transmission could take place would tend to offset the effects of expanded antiretroviral treatment. Such network effects would only be limited by very early diagnosis (in the first weeks after acquiring HIV) and by tracing and testing the sexual contacts of people diagnosed in acute infection.
Researchers - University - California - San - Diego
Researchers at the University of California San Diego and the US Centers for Disease Control and Prevention investigated whether HIV variants are becoming more infectious and leading to higher viral loads using a large dataset of well-characterised HIV isolates.
They analysed 33,285 HIV-1 subtype B samples from individuals registered in the National HIV Surveillance System database. The samples were logged in the database after genotypic testing for HIV drug resistance. This analysis was restricted to samples tested for drug resistance within...
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