A decrease in drug resistance levels of the HIV epidemic can be bad news

The effect of intrinsic stochasticity on transmitted HIV drug resistance patterns

“…(Blower et al, 2000(Blower et al, , 2001Sánchez et al, 2005Sánchez et al, , 2006 (Sánchez et al, 2005).…”

“…That is, the temporal behaviour of individual epidemics is not consistent among surveys. While it is possible that these A c c e p t e d m a n u s c r i p t 6 trends are real, arising from temporal changes in clinical conditions or behaviour (Sánchez et al, 2005(Sánchez et al, , 2006, it is important to avoid incorrect interpretations which may lead to ill-informed, detrimental changes in public health policies. For example, observed declines in transmitted drug resistance may lead to decreased support for HIV drug-resistance monitoring or drug adherence counselling (Sánchez et al, 2006).…”

HIV Drug-resistant Strains as Epidemiologic Sentinels

“…In our previous study (35), we extended the basic modeling framework detailed in (25) to incorporate additional complexity, including 2-3 separate categories of acutely infected persons, depending on whether a person was infected with a drug-sensitive HIV strain, a strain resistant to monotherapy, or a strain resistant to triple-drug therapy. In doing so, we were able to distinguish among acutely PERSPECTIVE infected persons, who are clinically and epidemiologically distinct from uninfected and chronically infected persons (e.g., we can consider them to engage more frequently in high-risk behavior (2) than chronically infected persons).…”

“…To determine which processes could have caused the observed decrease in F R , we built a mathematical model of HIV transmission ( Figure 1); a more mathematically detailed explanation of our analysis can be found in our previous study (35). We then simulated the epidemic using this model and varied each of the parameters shown in Figure 1 (e.g., the average number of high-risk contacts in 1 year, the likelihood of transmitting HIV given a high-risk contact, the fraction of persons with acute or chronic HIV Figure 1.…”

Stochastic model of an influenza epidemic with drug resistance

“…In the past few years, many studies have focused on this topic (Austin and Anderson, 1999;Blower and Volberding, 2002;Blower and Chou, 2004;Blower and Gerberding, 1998;Blower et al, 2005;Ferguson et al, 2003;Hayden, 2001;Hayden, 2006;Levin et al, 1999;Levin et al, 2004;Longini Jr. et al, 2005;Moscona, 2005;Regoes and Bonhoeffer, 2006;Sánchez et al, 2005;Stilianakis et al, 1998). Some of these studies investigated drug resistance in tuberculosis (Blower and Chou, 2004;Blower and Gerberding, 1998), some in HIV (Blower and Volberding, 2002;Blower et al, 2005;Sánchez et al, 2005), and some in HSV-2 . In addition, there have been studies on the development of drug resistance during influenza epidemics (Ferguson et al, 2003;Hayden, 2001;Hayden, 2006;Longini Jr. et al, 2005;Moscona, 2005;Regoes and Bonhoeffer, 2006;Stilianakis et al, 1998).…”