"But without this ganging up on the same cell, the killer virus [that leads to AIDS] would go extinct, because evolution would select against it -- because it is less fit and replicates less," Wodarz explained.
That means that -- according to the model -- one way of keeping AIDS at bay might be to make sure that only one type of HIV invades a cell at any given time.
Specific cellular mechanisms do allow a second or third viral particle to enter a cell, and a medicine that thwarted these "party crashers" might keep the deadliest form of HIV from ever emerging, Wodarz speculated.
He pointed to wild monkeys that are infected throughout their lives with HIV-like simian immunodeficiency virus (SIV) but never get sick.
"Some of them have a lot of the virus, and it evolves a lot, but it does not cause AIDS, ever," Wodarz said. He suspects the monkey's immune cells may have evolved to block secondary viral entry and thereby keep the most dangerous strain of SIV at bay.
Not everyone is convinced by the new model, however.
Dr. Benigno Rodriguez is assistant professor of medicine at Case Western Reserve University in Cleveland, and a specialist in the evolution of HIV disease. He called Wodarz and Levy's paper "an interesting concept," but said it contained a few significant flaws.
First of all, he said, most of the available data suggests that HIV does get better at forming copies of itself as AIDS progresses. And Rodriguez believes the two scientists have left another important factor out of their model -- the fact that most AIDS patients' immune cells are not killed off by the virus directly but are destroyed by so-called "bystander" mechanisms that accompany AIDS.
"In an individual with advanced disease, if you look at the number of cells that are actually infected [with HIV], we are talking less than 1 percent," he said. "But, in reality, that individual may have lost 20, 30, 50 percent of his immune cells."
Rodriguez also questioned the importance of multiple strains of HIV infecting the same immune cell. "The data that we already have in hand shows that multiple infection is relatively infrequent," he said.
The bottom line, according to the Cleveland expert: As with any mathematical model, this one needs to be tested out in the laboratory.
Wodarz agreed that experimental verification is necessary, but he said mathematical disease models more often than not prove to be right.
In fact, he said, it was just such a model that led scientists to discover that HIV never stops evolving in the body -- even during infection's years-long asymptomatic phase.
"In HIV, mathematical models have led to great progress before," Wodarz said.
More information
To find out more about HIV/AIDS, head to the U.S. National Institute of Allergy and Infectious Disease |