DOI

Chronic viral infections can persist for decades spanning thousands of viral generations, leading to a highly diverse population of viruses with its own complex evolutionary history. We propose an expandable mathematical framework for understanding how the emergence of genetic and phenotypic diversity affects the population-level control of those infections by both non-curative treatment and chemo-prophylactic measures. Our frameworks allows both neutral and phenotypic evolution, and we consider the specific evolution of contagiousness, resistance to therapy, and efficacy of prophylaxis. We compute both the controlled and uncontrolled, population-level basic reproduction number accounting for the within-host evolutionary process where new phenotypes emerge and are lost in infected persons, which we also extend to include both treatment and prophylactic control efforts. We used these results to discuss the conditions under which the relative efficacy of prophylactic versus therapeutic methods of control are superior. Finally, we give expressions for the endemic equilibrium of these models for certain constrained versions of the within-host evolutionary model providing a potential method for estimating within-host evolutionary parameters from population-level genetic sequence data.

Original languageEnglish
Article number1500
Number of pages21
JournalMathematics
Volume8
Issue number9
DOIs
StatePublished - Sep 2020

    Research areas

  • Basic reproduction number, Mathematical modeling, Multi-strain infectious diseases, Sensitivity analysis, MODELS, sensitivity analysis, mathematical modeling, DYNAMICS, multi-strain infectious diseases, basic reproduction number

    Scopus subject areas

  • Mathematics(all)

ID: 62878476