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The Body Covers: The 39th Annual Meeting of the Infectious Diseases Society of America
HIV/AIDS: Antiretroviral Therapy (Poster Session 87)

October 27, 2001

A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

  • Predicting the Unpredictable: The Transmission of Drug-Resistant HIV (Poster 655)
    Authored by S. Blower, A.N. Aschenbach, School of Medicine, UCLA, Los Angeles, CA; H.B. Gershengorn, Harvard University, Boston; J.O. Kahn, UCSF and San Francisco General Hospital, San Francisco


Mathematical modeling is about rationally predicting the future based on data from today. Mathematical modeling is always a simplification and an abstraction of reality, but that simplification allows you to identify critical steps and their relative importance in predicting what is going to happen.

Blower has written important papers about mathematical modeling and the HIV epidemic in San Francisco. In 2000 he published an important article in Science. Using mathematical modeling of the HIV epidemic in San Francisco, he suggested that widespread treatment of HIV might reduce the rate of transmission by reducing the viral load of a given population. His group also predicted that an increase in risk behavior of only 10% would result in an increase in the incidence rate of HIV infection. Unfortunately, that is exactly what has happened. The widespread availability of an effective treatment, and the perception that AIDS is a controllable disease has changed the sexual behavior of large segments of the population, increased high risk practices and resulted in a new wave of infections.

In this abstract, Blower tackled a different problem -- the transmission of drug-resistant strains in the San Francisco community. He mathematically modeled the transmission potential of 1,000 different drug-resistant strains for the years 1995 to 2005. His conclusion was that although the current prevalence of drug resistance is high (29%), most of it is due to the acquisition of resistance during treatment and not because of the acquisition of resistant strains. The transmission of resistant strains will remain low. The main problem is not the acquisition of resistant strains, but the transmission of sensitive ones. New cases of HIV have gone up. Public health efforts should focus on trying to prevent new infections, rather than worrying too much about resistant strains.

By the way, the authors have recently published the papers that lead to this abstract in Nature Medicine. If you like modeling, it is worth reading. The full reference is: S.M. Blower, A.N. Aschenbach, H.B. Gershengorn, J.O. Kahn. Nature Medicine 7, 1016-1020 (September 2001).


A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

See Also
The Body's Guide to HIV Drug Resistance
HIV Mutations



  
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Please note: Knowledge about HIV changes rapidly. Note the date of this summary's publication, and before treating patients or employing any therapies described in these materials, verify all information independently. If you are a patient, please consult a doctor or other medical professional before acting on any of the information presented in this summary. For a complete listing of our most recent conference coverage, click here.

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