Elsevier

Current Opinion in Virology

Volume 28, February 2018, Pages 92-101
Current Opinion in Virology

The impact of HIV-1 within-host evolution on transmission dynamics

https://doi.org/10.1016/j.coviro.2017.12.001Get rights and content
Under a Creative Commons license
open access

Highlights

  • HIV-1 within-host evolution is short-sighted and favours more virulent viruses.

  • Systemic HIV-1 infection is mainly established by a single variant propagation.

  • Ancestral strains with high transmission fitness appear to be preferentially transmitted.

  • Viral adaptation within a host can reduce the epidemiological fitness of HIV-1.

  • Insights from within-host evolutionary dynamics can improve HIV-1 transmission analyses.

The adaptive potential of HIV-1 is a vital mechanism to evade host immune responses and antiviral treatment. However, high evolutionary rates during persistent infection can impair transmission efficiency and alter disease progression in the new host, resulting in a delicate trade-off between within-host virulence and between-host infectiousness. This trade-off is visible in the disparity in evolutionary rates at within-host and between-host levels, and preferential transmission of ancestral donor viruses. Understanding the impact of within-host evolution for epidemiological studies is essential for the design of preventive and therapeutic measures. Herein, we review recent theoretical and experimental work that generated new insights into the complex link between within-host evolution and between-host fitness, revealing temporal and selective processes underlying the structure and dynamics of HIV-1 transmission.

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Contributed equally.