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Author Eden, J.-S.; Chisholm, R.H.; Bull, R.A.; White, P.A.; Holmes, E.C.; Tanaka, M.M. doi  openurl
  Title Persistent infections in immunocompromised hosts are rarely sources of new pathogen variants Type Journal Article
  Year (down) 2017 Publication Virus evolution Abbreviated Journal Virus Evol  
  Volume 3 Issue 2 Pages vex018  
  Corporate Author Thesis  
  Address School of Biotechnology and Biomolecular Sciences, and Evolution & Ecology Research Centre, University of New South Wales, Sydney, NSW 2052, Australia  
  Keywords epidemiology; immunocompromised host; modeling; norovirus; substitution rate; virus evolution  
  Abstract Many viruses, including human norovirus and influenza, cause self-limiting diseases of short duration. However, infection by the same viruses in an immunocompromised host can result in prolonged illness in the absence of effective treatment. Such persistent infections are often characterized by increased genetic diversity with potentially elevated rates of evolution compared to acute infections, leading to suggestions that immunocompromised hosts represent an important reservoir for the emergence of novel viral variants. Here, we develop a mathematical model that combines epidemiological dynamics with within-host evolution to quantify the relative contribution of immunocompromised hosts to the overall rate of pathogen evolution. Using human norovirus as a case study we show that the majority of evolutionary substitutions are expected to occur in acute infections of immunocompetent hosts. Hence, despite their potential to generate a high level of diversity, infections of immunocompromised hosts likely contribute less to the evolution and emergence of new genetic variants at the epidemiological scale because such hosts are rare and tend to be isolated. This result is robust to variation in key parameters, including the proportion of the population immunocompromised, and provides a means to understand the adaptive significance of mutations that arise during chronic infections in immunocompromised hosts.  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 2057-1577 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28775894 Approved no  
  Call Number NCSU @ edshirle @ Serial 3542  
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