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Why some individuals develop AIDS rapidly whereas others remain healthy without treatment for many years remains a central question of HIV research. An evolutionary perspective reveals an apparent conflict between two levels of selection on the virus. On the one hand, there is rapid evolution of the virus in the host, and on the other, new observations indicate the existence of virus factors that affect the virulence of infection whose influence persists over years in infected individuals and across transmission events. Here, we review recent evidence that shows that viral genetic factors play a larger role in modulating disease severity than anticipated. We propose conceptual models that reconcile adaptive evolution at both levels of selection. Evolutionary analysis provides new insight into HIV pathogenesis.

Original publication

DOI

10.1126/science.1243727

Type

Journal article

Journal

Science (New York, N.Y.)

Publication Date

03/2014

Volume

343

Addresses

Medical Research Council Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.

Keywords

Humans, HIV-1, HIV Infections, Virulence Factors, Viral Load, Adaptation, Physiological, Evolution, Molecular, Virus Replication, Virulence, Models, Biological, Host-Pathogen Interactions, Selection, Genetic