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

• Authors: Bruce Levin, Emory University; J.J. Bull, University of Texas; Frank M. Stewart, Brown University
• Journal Title: Emerging Infectious Diseases
• Volume: Volume 7, Number 3(Suppl)
• Publisher: U.S. National Center for Infectious Diseases | 2001, Pages 505-511
• Type of Work: Article | Final Publisher PDF
• Subjects: 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.