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摘要翻译：
背景：博茨瓦纳大约40%的成年人感染了艾滋病毒。博茨瓦纳抗逆转录病毒方案始于2002年，目前治疗34,000名患者，目标是到2009年治疗85,000名患者（约占感染艾滋病毒的成年人的30%）。我们预测了这种治疗方案可能导致的耐药HIV菌株的进化。我们讨论了我们的结果对世界卫生组织（世界卫生组织）提议的监测系统的影响，以检测非洲艾滋病毒的耐药菌株。方法：我们使用一个耐药性出现的数学模型。我们结合人口统计和治疗数据，对何时可能超过世界卫生组织监测阈值做出具体预测。结果：我们的结果表明--即使获得性耐药率很高，但进化的耐药菌株的传播性只有野生型菌株的一半--耐药菌株的传播将保持在低水平（到2009年<5%)，不太可能超过世界卫生组织的监测阈值。然而，我们的结果表明，如果耐药菌株和野生型菌株一样容易传播，到2009年，博茨瓦纳耐药菌株的传播可能会增加到15%。结论：世界卫生组织的监测系统设计用于检测超过5%阈值水平的传播耐药性。该系统是否能在2009年之前检测出博茨瓦纳的耐药菌株，将取决于出现的菌株的传播性。我们的结果表明，世界卫生组织可能需要很多年才能在其他撒哈拉以南非洲国家检测到传播耐药性，这些国家的治疗计划不如博茨瓦纳雄心勃勃。
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英文标题：
《The WHO surveillance threshold and the emergence of drug-resistant HIV
strains in Botswana》
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作者：
Raffaele Vardavas and Sally Blower
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最新提交年份：
2005
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分类信息：
一级分类：Quantitative Biology 数量生物学
二级分类：Populations and Evolution 种群与进化
分类描述：Population dynamics, spatio-temporal and epidemiological models, dynamic speciation, co-evolution, biodiversity, foodwebs, aging; molecular evolution and phylogeny; directed evolution; origin of life
种群动力学；时空和流行病学模型；动态物种形成；协同进化；生物多样性；食物网；老龄化；分子进化和系统发育；定向进化；生命起源
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一级分类：Quantitative Biology 数量生物学
二级分类：Other Quantitative Biology 其他定量生物学
分类描述：Work in quantitative biology that does not fit into the other q-bio classifications
不适合其他q-bio分类的定量生物学工作
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英文摘要：
Background: Approximately 40% of adults in Botswana are HIV-infected. The Botswana antiretroviral program began in 2002 and currently treats 34,000 patients with a goal of treating 85,000 patients (~30% of HIV-infected adults) by 2009. We predict the evolution of drug-resistant strains of HIV that may emerge as a consequence of this treatment program. We discuss the implications of our results for the World Health Organization's (WHO's) proposed surveillance system for detecting drug-resistant strains of HIV in Africa. Methods: We use a mathematical model of the emergence of drug resistance. We incorporate demographic and treatment data to make specific predictions as to when the WHO surveillance threshold is likely to be exceeded. Results: Our results show - even if rates of acquired resistance are high, but the drug-resistant strains that evolve are only half as transmissible as wild-type strains - that transmission of drug-resistant strains will remain low (< 5% by 2009) and are unlikely to exceed the WHO's surveillance threshold. However,our results show that transmission of drug-resistant strains in Botswana could increase to ~15% by 2009 if resistant strains are as transmissible as wild-type strains. Conclusion: The WHO's surveillance system is designed to detect transmitted resistance that exceeds a threshold level of 5%. Whether this system will detect drug-resistant strains in Botswana by 2009 will depend upon the transmissibility of the strains that emerge. Our results imply that it could be many years before the WHO detects transmitted resistance in other sub-Saharan African countries with less ambitious treatment programs than Botswana.
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PDF链接：
https://arxiv.org/pdf/q-bio/0512032
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