Epidemiology, evolution, and future of the HIV/AIDS pandemic.

• Type of Material: Article
• Authors: Bruce Levin, Emory University; J.J. Bull, University of Texas; Frank M. Stewart, Brown University
• Language: English
• Date: 2001
• Publisher: U.S. National Center for Infectious Diseases
• Publication Version: Final Published Version
• Copyright Statement: Emerging Infectious Diseases is published by the Centers for Disease Control and Prevention, a U.S. Government agency. Therefore, all materials published in Emerging Infectious Diseases are in the public domain and can be used without permission.
• Final Published Version (URL): http://www.ncbi.nlm.nih.gov/pmc/issues/175935/
• Title of Journal or Parent Work: Emerging Infectious Diseases
• ISSN: 1080-6040
• Volume: 7
• Issue: 3(Suppl)
• Start Page: 505
• End Page: 511
• Grant/Funding Information: This endeavor received support from the following research grants: NIH GM33782 (BRL), AI40662 (BRL), GM 57756 (JJB), the NSF DEB9726902(JJB), and TIAA/CREF (FMS).
• Research Categories: Health Sciences, Epidemiology; Biology, Virology

Abstract

We used mathematical models to address several questions concerning the epidemiologic and evolutionary future of HIV/AIDS in human populations. Our analysis suggests that 1) when HIV first enters a human population, and for many subsequent years, the epidemic is driven by early transmissions, possibly occurring before donors have seroconverted to HIV-positive status; 2) new HIV infections in a subpopulation (risk group) may decline or level off due to the saturation of the susceptible hosts rather than to evolution of the virus or to the efficacy of intervention, education, and public health measures; 3) evolution in humans for resistance to HIV infection or for the infection to engender a lower death rate will require thousands of years and will be achieved only after vast numbers of persons die of AIDS; 4) evolution is unlikely to increase the virulence of HIV; and 5) if HIV chemotherapy reduces the transmissibility of the virus, treating individual patients can reduce the frequency of HIV infections and AIDS deaths in the general population.