Inferring HIV Transmission Dynamics from Phylogenetic Sequence Relationships

摘要

Despite the range of resources directed at understanding the HIV pandemic over the past 25 years, surprisingly little is known about how HIV infection spreads through populations. Unlike some other infectious diseases, acute infection with HIV is difficult to identify. HIV disease most often manifests years after the transmission event. Together with the special challenges involved in determining exposures related to sexual behavior or drug use, all of these factors have made it difficult to apply the tools of traditional epidemiologic investigation. Recent antibody testing strategies to identify incident HIV for surveillance programs have met with limited success [1]. Key questions that remain unanswered by empirical data include the role of acute infections in sustaining the current pandemic, and the effects of antiretroviral treatment programs on transmission of drug-resistant and drug-susceptible strains of HIV. Without really understanding how HIV spreads, it is difficult to optimize prevention or control strategies.