Predicting the unpredictable: Transmission of drug-resistant HIV
Predicting the unpredictable: Transmission of drug-resistant HIV
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DOI：
10.1038/nm0901-1016
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发表时间：
2001-09-01
期刊：
影响因子：
82.9
通讯作者：
Kahn, JO
中科院分区：
文献类型：
--
作者：
Blower, SM;Aschenbach, AN;Kahn, JO
我们使用一个数学模型来了解(从1996年到2001年)和预测(从2001年到2005年)旧金山耐药艾滋病毒流行的演变。我们预测了1,000种不同耐药菌株的进化轨迹，每个菌株相对于一个药物敏感菌株具有不同的适应度。我们计算出，目前耐药性的流行率很高，并预测它将继续上升。相比之下，我们计算出目前阻力的传播率很低，并预测它将保持在低位。我们表明，耐药性的流行主要是由药物敏感病例向耐药病例的转化而产生的，而不是通过耐药菌株的传播产生的。我们还表明，耐药毒株的传播并没有增加新感染艾滋病毒的总人数。我们的结果表明，耐药菌株的传播是并将继续是一个相对较小的公共卫生问题。
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.