Samuel Alizon

Virulence evolution and the trade-off hypothesis: history, current state of affairs and the future.

It has been more than two decades since the formulation of the so‐called ‘trade‐off’ hypothesis as an alternative to the then commonly accepted idea that parasites should always evolve towards avirulence (the ‘avirulence hypothesis’). The trade‐off hypothesis states that virulence is an unavoidable consequence of parasite transmission; however, since the 1990s, this hypothesis has been increasingly challenged. We discuss the history of the study of virulence evolution and the development of theories towards the trade‐off hypothesis in order to illustrate the context of the debate. We investigate the arguments raised against the trade‐off hypothesis and argue that trade‐offs exist, but may not be of the simple form that is usually assumed, involving other mechanisms (and life‐history traits) than those originally considered. Many processes such as pathogen adaptation to within‐host competition, interactions with the immune system and shifting transmission routes, will all be interrelated making sweeping evolutionary predictions harder to obtain. We argue that this is the heart of the current debate in the field and while species‐specific models may be better predictive tools, the trade‐off hypothesis and its basic extensions are necessary to assess the qualitative impacts of virulence management strategies.

Linking within- and between-host dynamics in the evolutionary epidemiology of infectious diseases.

Nested models (also called embedded models) explicitly link dynamical processes that occur at different scales. Recently there has been considerable interest in linking within- and between-host levels of disease dynamics in the study of pathogen evolution. Here we review the extent to which these nested models have increased our understanding of pathogen evolution. We suggest that, although such models have been useful for determining the nature of tradeoffs between epidemiological parameters and for evaluating the consequences of conflicting selection pressures at different scales, the vast majority of previous results could likely have been obtained without the use of nested models per se. Nevertheless, these models have proven very useful through their highlighting of the importance of within-host disease dynamics on pathogen evolution.

Virulence and Pathogenesis of HIV-1 Infection: An Evolutionary Perspective

Background Why some individuals develop AIDS rapidly whereas others remain healthy without treatment for many years remains a central question of HIV research. Of the quantities that predict how quickly an untreated infection progresses, the most widely used is set-point viral load. This measure varies by orders of magnitude between infected individuals and is predictive of infectiousness and time to onset of AIDS. Host factors, predominantly linked to the immune system, are known to influence the set point, but much variation remains unexplained. A transmission chain with heritable virulence. Individuals infected with HIV show differences in clinical progression. Untreated infections are characterized by viral loads (the viral particle density in the blood) that are relatively stable for years, but they can differ by orders of magnitude between individuals. Host factors clearly influence viral load, but viral loads have also recently been found to correlate among individuals in transmission pairs and chains. This indicates a moderate to strong influence of viral genotype on the viral load. Strikingly, this influence persists for years and across transmission events, despite intense within-host viral evolution. A transmission chain with heritable virulence. Individuals infected with HIV show differences in clinical progression. Untreated infections are characterized by viral loads (the viral particle density in the blood) that are relatively stable for years, but they can differ by orders of magnitude between individuals. Host factors clearly influence viral load, but viral loads have also recently been found to correlate among individuals in transmission pairs and chains. This indicates a moderate to strong influence of viral genotype on the viral load. Strikingly, this influence persists for years and across transmission events, despite intense within-host viral evolution. Advances We review recent evidence showing that HIV genotype influences the set-point viral load far more than anticipated. Our summary of published estimates suggests that 33% (95% confidence interval, 20 to 46%) of the variation is attributable to the virus. Because set-point viral load is heritable (partially controlled by virus genotype) and is linked to transmissibility, it is likely to have evolved to maintain transmission fitness and may continue to evolve in response to diverse selection pressures. These findings are unexpected and paradoxical because rapid and error-prone viral replication should favor within-host adaptation and rapidly scramble signals of viral genotype as infection progresses, rather than leaving a lasting footprint that is preserved throughout an infection and from one infection to the next in transmission chains. Outlook We propose that resolving the paradox of heritability of set-point viral load will provide new insights into the mechanisms of HIV pathogenesis. To this end, we provide three parsimonious, testable, and nonexclusive explanatory mechanisms. The first states that HIV evolution in virulence genes is more functionally constrained than previously thought. The second proposes that virulence of HIV is mediated through the virus’s capacity to systemically activate target cells in which it can efficiently replicate. The capacity to activate would not be expected to evolve rapidly because it does not provide a specific selective advantage to virus strains that activate more cells; rather, it is an advantage shared by all viruses. The third mechanism implicates the preferential transmission of viruses that are stored in nonreplicating cells or during early infection, and the disproportionate influence on long-term pathogenesis of these early viruses. In addition to these insights into mechanisms of pathogenesis, we believe that this research highlights a major gap in our knowledge of HIV. The identification of the genetic determinants of HIV virulence, which appear to vary between closely related strains of the virus, should be a major priority. Thus, whole-genome association studies that are focused on the virus genome should be pursued and expanded, as well as more functional and mechanistic studies, which could be guided by hypotheses such as those presented here. HIV Virulence A major focus of research on HIV is on host responses to infection—understandably, because the virus targets the immune system and because of the interest in vaccine development. In reviewing what little research has been done on viral virulence determinants, Fraser et al. (10.1126/science.1243727) present evolutionary explanations for some of the poorly understood phenomena that mark HIV infection, including long-term survivorship, latency, rapid within-host evolution, and inheritability of between-host virulence. Why some individuals develop AIDS rapidly whereas others remain healthy without treatment for many years remains a central question of HIV research. An evolutionary perspective reveals an apparent conflict between two levels of selection on the virus. On the one hand, there is rapid evolution of the virus in the host, and on the other, new observations indicate the existence of virus factors that affect the virulence of infection whose influence persists over years in infected individuals and across transmission events. Here, we review recent evidence that shows that viral genetic factors play a larger role in modulating disease severity than anticipated. We propose conceptual models that reconcile adaptive evolution at both levels of selection. Evolutionary analysis provides new insight into HIV pathogenesis.

Multiple infections, immune dynamics, and the evolution of virulence.

Understanding the effect of multiple infections is essential for the prediction (and eventual control) of virulence evolution. Some theoretical studies have considered the possibility that several strains coexist in the same host (coinfection), but few have taken their within‐host dynamics explicitly into account. Here, we develop a nested approach based on a simple model for the interaction of parasite strains with their host’s immune system. We study virulence evolution by linking the within‐host dynamics to an epidemiological framework that incorporates multiple infections. Our model suggests that antigenically similar parasite strains cannot coexist in the long term inside a host. We also find that the optimal level of virulence increases with the efficiency of multiple infections. Finally, we notice that coinfections create heterogeneity in the host population (with susceptible hosts and infected hosts), which can lead to evolutionary branching in the parasite population and the emergence of a hypervirulent parasite strategy. We interpret this result as a parasite specialization to the infectious state of the hosts. Our study has experimental and theoretical implications in a virulence management perspective.

Emergence of a convex trade-off between transmission and virulence.

Most models of virulence evolution assume that a parasite cannot raise its transmission rate without causing more harm to its host. However, the existence of such trade‐off relationships has recently been challenged. Here, we study how a trade‐off can emerge from a model that explicitly incorporates within‐host dynamics. We find that the existence and the convexity of the trade‐off are robust, which implies a definite level of evolutionarily stable virulence (ESV) for the parasite. However, we also show that the dependence of the ESV on parameter values may be very strong. One possible consequence of this sensitivity is that relationships between transmission and virulence observed across populations need not conform to the patterns expected on the basis of a common (fixed) trade‐off. We discuss possible experiments and implications of our results for the development of virulence management strategies.

Phylogenetic approach reveals that virus genotype largely determines HIV set-point viral load.

HIV virulence, i.e. the time of progression to AIDS, varies greatly among patients. As for other rapidly evolving pathogens of humans, it is difficult to know if this variance is controlled by the genotype of the host or that of the virus because the transmission chain is usually unknown. We apply the phylogenetic comparative approach (PCA) to estimate the heritability of a trait from one infection to the next, which indicates the control of the virus genotype over this trait. The idea is to use viral RNA sequences obtained from patients infected by HIV-1 subtype B to build a phylogeny, which approximately reflects the transmission chain. Heritability is measured statistically as the propensity for patients close in the phylogeny to exhibit similar infection trait values. The approach reveals that up to half of the variance in set-point viral load, a trait associated with virulence, can be heritable. Our estimate is significant and robust to noise in the phylogeny. We also check for the consistency of our approach by showing that a trait related to drug resistance is almost entirely heritable. Finally, we show the importance of taking into account the transmission chain when estimating correlations between infection traits. The fact that HIV virulence is, at least partially, heritable from one infection to the next has clinical and epidemiological implications. The difference between earlier studies and ours comes from the quality of our dataset and from the power of the PCA, which can be applied to large datasets and accounts for within-host evolution. The PCA opens new perspectives for approaches linking clinical data and evolutionary biology because it can be extended to study other traits or other infectious diseases.

Empty Sites can Promote Altruistic Behavior

Abstract Spatial structure has been shown to promote altruistic behavior, however, it also increases the intensity of competition among relatives. Our purpose here is to develop a model in which this competition is minimized, more precisely a local increase in fecundity has a minimal competitive effect on the fitness of nearby individuals. We work with an island model in which sites are allowed to be empty, choosing our demographic rules so that in patches with higher fecundity, empty sites are filled at a higher rate. We also allow dispersal rates to evolve in response to the proportion of empty sites in the patch. Patches with different numbers of empty sites differ in frequency, in within-patch consanguinity, and in reproductive value. Using an inclusive fitness argument, we show that our model does promote altruism; indeed Hamiltons Rule is shown to hold. The only negative effect on an actor of a gift of fecundity to a patchmate turns out to be a slight decrease in reproductive value due to an increased probability of an empty site being occupied. We show that altruists are most favored in islands with an intermediate number of empty sites.

The virulence-transmission trade-off in vector-borne plant viruses: a review of (non-)existing studies.

The adaptive hypothesis invoked to explain why parasites harm their hosts is known as the trade-off hypothesis, which states that increased parasite transmission comes at the cost of shorter infection duration. This correlation arises because both transmission and disease-induced mortality (i.e. virulence) are increasing functions of parasite within-host density. There is, however, a glaring lack of empirical data to support this hypothesis. Here, we review empirical investigations reporting to what extent within-host viral accumulation determines the transmission rate and the virulence of vector-borne plant viruses. Studies suggest that the correlation between within-plant viral accumulation and transmission rate of natural isolates is positive. Unfortunately, results on the correlation between viral accumulation and virulence are very scarce. We found only very few appropriate studies testing such a correlation, themselves limited by the fact that they use symptoms as a proxy for virulence and are based on very few viral genotypes. Overall, the available evidence does not allow us to confirm or refute the existence of a transmission–virulence trade-off for vector-borne plant viruses. We discuss the type of data that should be collected and how theoretical models can help us refine testable predictions of virulence evolution.

Within-host and between-host evolutionary rates across the HIV-1 genome

BackgroundHIV evolves rapidly at the epidemiological level but also at the within-host level. The virus’ within-host evolutionary rates have been argued to be much higher than its between-host evolutionary rates. However, this conclusion relies on analyses of a short portion of the virus envelope gene. Here, we study in detail these evolutionary rates across the HIV genome.ResultsWe build phylogenies using a relaxed molecular clock assumption to estimate evolutionary rates in different regions of the HIV genome. We find that these rates vary strongly across the genome, with higher rates in the envelope gene (env). Within-host evolutionary rates are consistently higher than between-host rates throughout the HIV genome. This difference is significantly more pronounced in env. Finally, we find weak differences between overlapping and non-overlapping regions.ConclusionsWe provide a genome-wide overview of the differences in the HIV rates of molecular evolution at the within- and between-host levels. Contrary to hepatitis C virus, where differences are only located in the envelope gene, within-host evolutionary rates are higher than between-host evolutionary rates across the whole HIV genome. This supports the hypothesis that HIV strains that are less adapted to the host have an advantage during transmission. The most likely mechanism for this is storage and then preferential transmission of viruses in latent T-cells. These results shed a new light on the role of the transmission bottleneck in the evolutionary dynamics of HIV.

Epidemiological and clinical consequences of within-host evolution

Many viruses and bacteria are known to evolve rapidly over the course of an infection. However, epidemiological studies generally assume that within-host evolution is an instantaneous process. We argue that the dynamics of within-host evolution has implications at the within-host and at the between-host levels. We first show that epidemiologists should consider within-host evolution, notably because it affects the genotype of the pathogen that is transmitted. We then present studies that investigate evolution at the within-host level and examine the extent to which these studies can help to understand infection traits involved in the epidemiology (e.g. transmission rate, virulence, recovery rate). Finally, we discuss how new techniques for data acquisition can open new perspectives for empirical and theoretical research.