A Decrease in Drug Resistance Levels of the HIV Epidemic Can Be Bad News

Details

• Personal Author:
  Getz WM ; Grant RM ; Gross KL ; Porco TC ; Sanchez MS
• Description:
  Transient decreases in the proportion of individuals newly infected with an HIV-resistant virus (primary resistance) are documented for several cities of North America, including San Francisco. Using a staged SI deterministic model, we identified three potential causes consistent with the history of the epidemic: (1) increase in risky behaviour, (2) reduction in the proportion of HIV-acutely infected individuals undergoing treatment, and (3) replacement of mono- and dual-drug therapies with triple-drug therapies. Although observed patterns resemble scenario 1 most closely, these explanations are not mutually exclusive and may have contributed synergistically to the decline. Under scenario 1 the counterintuitive situation arises where, although the proportion of primary resistance cases decreases transiently, the epidemic worsens because the actual numbers of infected individuals and of drug resistance carriers increases. Our results call for improved efforts to control the epidemic in developed nations, and highlight the usefulness of drug resistant strains as epidemiological markers. [Description provided by NIOSH]
• Subjects:
  Behavior Communicable Disease Control Drug Therapy Epidemiology HIV Immune System Occupational Health Risk Assessment Risk Factors Safety
• Keywords:
  Behavior-patterns Disease-control Disease-prevention Disease-transmission Diseases Drug-therapy Drugs Immunology Models Risk-analysis Risk-factors

  More +
• ISSN:
  0092-8240
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  67
• Issue:
  4
• NIOSHTIC Number:
  nn:20028958
• Citation:
  Bull Math Biol 2005 Jul; 67(4):761-782
• Email:
  msanchez@nature.berkeley.edu
• Federal Fiscal Year:
  2005
• Peer Reviewed:
  True
• Source Full Name:
  Bulletin of Mathematical Biology
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:e56b4c38a002b4757b02d9e28ce8e846234caffbc018c2e92aed339375ebdc1819743a40b5cc501005593c79cf0818bbdfc615da0b6840ac7e96ec13fa9ae5e1
• Download URL:
  https://stacks.cdc.gov/view/cdc/190044/cdc_190044_DS1.pdf
• File Type:
  [PDF - 1.69 MB ]