1. Reconciling founder variant multiplicity of HIV-1 infection with the rate of CD4$^{+}$ decline
- Author
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Baxter, James; https://orcid.org/0000-0001-6598-1784, Villabona-Arenas, Ch Julián; https://orcid.org/0000-0001-9928-3968, Thompson, Robin N; https://orcid.org/0000-0001-8545-5212, Hué, Stéphane; https://orcid.org/0000-0002-8580-6905, Regoes, Roland R; https://orcid.org/0000-0001-8319-5293, Kouyos, Roger D; https://orcid.org/0000-0002-9220-8348, Günthard, Huldrych F; https://orcid.org/0000-0002-1142-6723, Albert, Jan; https://orcid.org/0000-0001-9020-0521, Leigh Brown, Andrew; https://orcid.org/0000-0002-5700-3128, Atkins, Katherine E; https://orcid.org/0000-0001-5250-0558, Baxter, James; https://orcid.org/0000-0001-6598-1784, Villabona-Arenas, Ch Julián; https://orcid.org/0000-0001-9928-3968, Thompson, Robin N; https://orcid.org/0000-0001-8545-5212, Hué, Stéphane; https://orcid.org/0000-0002-8580-6905, Regoes, Roland R; https://orcid.org/0000-0001-8319-5293, Kouyos, Roger D; https://orcid.org/0000-0002-9220-8348, Günthard, Huldrych F; https://orcid.org/0000-0002-1142-6723, Albert, Jan; https://orcid.org/0000-0001-9020-0521, Leigh Brown, Andrew; https://orcid.org/0000-0002-5700-3128, and Atkins, Katherine E; https://orcid.org/0000-0001-5250-0558
- Abstract
HIV-1 transmission precipitates a stringent genetic bottleneck, with 75% of new infections initiated by a single genetic variant. Where multiple variants initiate infection, recipient set point viral load (SpVL) and the rate of CD4$^{+}$ T cell decline may be elevated, but these findings remain inconsistent. Here, we summarised the evidence for this phenomenon, then tested whether previous studies possessed sufficient statistical power to reliably identify a true effect of multiple variant infection leading to higher SpVL. Next, we combined models of HIV-1 transmission, heritability and disease progression to understand whether available data suggest a faster CD4 $^{+}$ T cell decline would be expected to associated with multiple variant infection, without an explicit dependency between the two. First, we found that most studies had insufficient power to identify a true significant difference, prompting an explanation for previous inconsistencies. Next, our model framework revealed we would not expect to observe a positive association between multiple variant infections and faster CD4 $^{+}$ T cell decline, in the absence of an explicit dependency. Consequently, while empirical evidence may be consistent with a positive association between multiple variant infection and faster CD4 $^{+}$ T cell decline, further investigation is required to establish a causal basis.
- Published
- 2024