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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">plos</journal-id>
<journal-id journal-id-type="nlm-ta">PLoS Genet</journal-id>
<journal-id journal-id-type="pmc">plosgen</journal-id><journal-title-group>
<journal-title>PLoS Genetics</journal-title></journal-title-group>
<issn pub-type="ppub">1553-7390</issn>
<issn pub-type="epub">1553-7404</issn>
<publisher>
<publisher-name>Public Library of Science</publisher-name>
<publisher-loc>San Francisco, USA</publisher-loc></publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">PGENETICS-D-14-00025</article-id>
<article-id pub-id-type="doi">10.1371/journal.pgen.1004179</article-id>
    <article-categories><subj-group subj-group-type="heading"><subject>Perspective</subject></subj-group>
        <subj-group subj-group-type="Discipline-v2"><subject>Biology</subject></subj-group></article-categories>
<title-group>
<article-title>Fifteen Years Later: Hard and Soft Selection Sweeps Confirm a Large Population Number for HIV In Vivo</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Rouzine</surname><given-names>Igor M.</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Coffin</surname><given-names>John M.</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib>
<contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Weinberger</surname><given-names>Leor S.</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib>
</contrib-group>
<aff id="aff1"><label>1</label><addr-line>The Gladstone Institutes, Gladstone Institute of Virology and Immunology, University of California San Francisco, San Francisco, California, United States of America</addr-line></aff>
<aff id="aff2"><label>2</label><addr-line>Tufts University, Sackler School of Biomedical Sciences, Boston, Massachusetts, United States of America</addr-line></aff>
<aff id="aff3"><label>3</label><addr-line>HIV Drug Resistance Program, Center for Cancer Research, National Cancer Institute, Frederick, Maryland, United States of America</addr-line></aff>
<contrib-group>
<contrib contrib-type="editor" xlink:type="simple"><name name-style="western"><surname>Fraser</surname><given-names>Christophe</given-names></name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"/></contrib>
</contrib-group>
<aff id="edit1"><addr-line>Imperial College London, United Kingdom</addr-line></aff>
<author-notes>
<corresp id="cor1">* E-mail: <email xlink:type="simple">igor.rouzine@gladstone.ucsf.edu</email></corresp>
<fn fn-type="conflict"><p>The authors have declared that no competing interests exist.</p></fn>
</author-notes>
<pub-date pub-type="collection"><month>2</month><year>2014</year></pub-date>
<pub-date pub-type="epub"><day>20</day><month>2</month><year>2014</year></pub-date>
<volume>10</volume>
<issue>2</issue>
<elocation-id>e1004179</elocation-id><permissions>
<copyright-year>2014</copyright-year>
<copyright-holder>Rouzine et al</copyright-holder><license xlink:type="simple"><license-p>This is an open-access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/" xlink:type="simple">Creative Commons Attribution License</ext-link>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p></license></permissions><related-article id="RA1" related-article-type="companion" ext-link-type="uri" vol="" page="e1004000" xlink:type="simple" xlink:href="info:doi/10.1371/journal.pgen.1004000"> <article-title>Loss and Recovery of Genetic Diversity in Adapting Populations of HIV</article-title></related-article><funding-group><funding-statement>This work was supported through an Alfred P. Sloan Research Fellowship (to LSW). The funder had no role in the preparation of the article.</funding-statement></funding-group><counts><page-count count="3"/></counts></article-meta>
</front>
<body><sec id="s1">
<title/>
<p>Even among RNA viruses, which generally exhibit high evolutionary plasticity due to low fidelity of their RNA polymerases, HIV-1 is second only to HCV for its ability to generate within-host genetic diversity <xref ref-type="bibr" rid="pgen.1004179-Coffin1">[1]</xref>. HIV's rapid generation time leads to this high genetic diversity. The unfortunate consequences of HIV's rapid evolution are resistance to antiretroviral drugs <xref ref-type="bibr" rid="pgen.1004179-Coffin1">[1]</xref>, partial escape from immune responses <xref ref-type="bibr" rid="pgen.1004179-Ganusov1">[2]</xref>–<xref ref-type="bibr" rid="pgen.1004179-Goonetilleke1">[4]</xref>, the ability to switch tropism for target cells <xref ref-type="bibr" rid="pgen.1004179-Coakley1">[5]</xref>, and potential threats to new therapeutic strategies <xref ref-type="bibr" rid="pgen.1004179-Rouzine1">[6]</xref>, <xref ref-type="bibr" rid="pgen.1004179-Metzger1">[7]</xref>. The forces driving and influencing HIV evolution include Darwinian selection, limited population size, linkage, recombination, epistasis, spatial aspects, and dynamic factors (particularly due to the immune response). These factors, and the parameters that define them, can be difficult to discern. One of the most elusive parameters critically important for the rate of evolution in every medically relevant scenario is the “effective population number” (<italic>N<sub>e</sub></italic><sub>ff</sub>) (<xref ref-type="fig" rid="pgen-1004179-g001">Figure 1</xref>). By definition, the census population size of HIV is the total number of infectious proviruses integrated into the cellular DNA of an individual at a given time. However, the genetically relevant <italic>N<sub>e</sub></italic><sub>ff</sub> may differ substantially from the census population size. In this volume of <italic>PLOS Genetics</italic>, Pennings and colleagues <xref ref-type="bibr" rid="pgen.1004179-Pennings1">[8]</xref> use new insights into “hard” and “soft” selective sweeps to estimate the effective population size of HIV.</p>
<fig id="pgen-1004179-g001" position="float"><object-id pub-id-type="doi">10.1371/journal.pgen.1004179.g001</object-id><label>Figure 1</label><caption>
<title>Beneficial viral mutants (red) arise in the “effective” virus subpopulation (<italic>N</italic><sub>eff</sub>, pink circle) and spread gradually to the entire “census” population (blue circle).</title>
<p>For a number of reasons (see the text), the effective population may be much smaller than the census population.</p>
</caption><graphic mimetype="image" xlink:href="info:doi/10.1371/journal.pgen.1004179.g001" position="float" xlink:type="simple"/></fig>
<p>The search for <italic>N</italic><sub>eff</sub> (and other HIV evolutionary parameters) has gone on for almost two decades, following every turn and hitting each pothole on the eventful road of HIV modeling <xref ref-type="bibr" rid="pgen.1004179-Rouzine2">[9]</xref>. The rapidity of resistance to monotherapy (in 1–2 weeks) was explained by the deterministic selection of alleles that preexist therapy in minute quantities <xref ref-type="bibr" rid="pgen.1004179-Coffin1">[1]</xref>. The large numbers of virus-producing cells (∼10<sup>8</sup>) in the lymphoid tissue of experimentally infected macaques seemed to confirm this simple Darwinian selection model <xref ref-type="bibr" rid="pgen.1004179-Haase1">[10]</xref>. However, the Darwinian view has faced challenges. Tajima's “neutrality test” applied to HIV sequences in untreated patients assumed that selection was neutral and predicted much smaller “effective” populations, of <italic>N</italic><sub>eff</sub>∼10<sup>3</sup> <xref ref-type="bibr" rid="pgen.1004179-LeighBrown1">[11]</xref>. Since Tajima's approach was designed to detect isolated selective sweeps at one or a few mutant sites—while HIV exhibits hundreds of diverse sites in vivo—two groups re-tested the result. A linkage disequilibrium (LD) test <xref ref-type="bibr" rid="pgen.1004179-Rouzine3">[12]</xref> and analysis of the variation in the time to drug resistance <xref ref-type="bibr" rid="pgen.1004179-Frost1">[13]</xref> arrived at the same value, <italic>N</italic><sub>eff</sub> = (5–10)×10<sup>5</sup>, for an average patient (with the mutation rate ∼10<sup>−5</sup> per base). Such populations are sufficiently large for deterministic selection to dominate, yet not large enough to neglect stochastic effects altogether. The LD test <xref ref-type="bibr" rid="pgen.1004179-Rouzine3">[12]</xref> is affected by recombination, and HIV's recombination rate had not been well measured at that time. The recent measurement of 5×10<sup>−6</sup> crossovers per base per HIV replication cycle in an average untreated individual <xref ref-type="bibr" rid="pgen.1004179-Batorsky1">[14]</xref>–<xref ref-type="bibr" rid="pgen.1004179-Josefsson1">[16]</xref> updates <italic>N</italic><sub>eff</sub> to (1–2)×10<sup>5</sup>, not far from the original value. A recent study of the pattern of diversity accumulation in early and late HIV infection confirms the range of <italic>N</italic><sub>eff</sub> <xref ref-type="bibr" rid="pgen.1004179-Maldarelli1">[17]</xref>. However, all these estimates of <italic>N</italic><sub>eff</sub> are lower bounds.</p>
<p>Pennings et al. <xref ref-type="bibr" rid="pgen.1004179-Pennings1">[8]</xref> continue this quest for an effective population size of HIV using a new method based on a theoretical calculation of the probability of multiple introductions of a beneficial allele at a site before it is fixed in a population <xref ref-type="bibr" rid="pgen.1004179-Pennings2">[18]</xref>. The prediction does not depend on whether mutations are new or result from standing variation prior to therapy. The authors use sequence data obtained from 30 patients who failed suboptimal antiretroviral regimens, including efavirenz <xref ref-type="bibr" rid="pgen.1004179-Bacheler1">[19]</xref>—a non-nucleoside reverse transcriptase (RT) inhibitor (NNRTI)—and who exhibited a rise of drug-resistant alleles in RT. The sequence data reveal fixation of two alleles, both corresponding to an amino-acid replacement K103N. Pennings et al.'s analysis focuses on the genetic composition at RT codon 103 and the adjacent 500 nucleotides. Based on the changes in the genetic diversity in this region, 30 fixations are classified into “hard” selective sweeps with a single parental sequence, or “soft” sweeps with multiple parental sequences. Observing that both types of sweep occurred at similar frequencies (also confirmed by observations in other resistance codons), the authors predict <italic>N</italic><sub>eff</sub> = 1.5×10<sup>5</sup>, in agreement with the LD test.</p>
<p>Pennings et al. also discuss why “selectively neutral” methods based on synonymous diversity underestimate the population size. It is well known that a selection sweep lowers the diversity at linked sites (hence the term “sweep”) and any method assuming selective neutrality translates lower diversity to smaller <italic>N</italic><sub>eff</sub>. The interesting part is the dynamic component of this effect. Pennings et al. demonstrate that rapid sweeps are followed by long periods when the diversity recovers at the linked sites (for synonymous sites, these periods are very long). From another angle, we can add that selection shortens the time to the common ancestor, which decreases the sequence divergence. The ancestral-tree argument is rather general and also applies to a large number of linked sites evolving under selection <xref ref-type="bibr" rid="pgen.1004179-Brunet1">[20]</xref>–<xref ref-type="bibr" rid="pgen.1004179-Neher2">[23]</xref>.</p>
<p>The previous estimates <xref ref-type="bibr" rid="pgen.1004179-Rouzine3">[12]</xref>, <xref ref-type="bibr" rid="pgen.1004179-Frost1">[13]</xref>, <xref ref-type="bibr" rid="pgen.1004179-Maldarelli1">[17]</xref> were lower bounds on <italic>N</italic><sub>eff</sub>. In contrast, the Pennings et al. study puts a number on <italic>N</italic><sub>eff</sub>. However, this number (<italic>N</italic><sub>eff</sub> = 1.5×10<sup>5</sup>) raises a question: why is <italic>N</italic><sub>eff</sub> so far below the census population size of 10<sup>8</sup> or more? Pennings et al. offer an elegant explanation of this relatively small <italic>N</italic><sub>eff</sub> in the spirit of the “traveling wave” approach <xref ref-type="bibr" rid="pgen.1004179-Tsimring1">[24]</xref>–<xref ref-type="bibr" rid="pgen.1004179-Hallatschek1">[27]</xref>. They note that resistant alleles at different sites emerge against different fitness backgrounds. To be fixed, alleles conferring a small benefit must emerge in the most-fit genomes <xref ref-type="bibr" rid="pgen.1004179-Neher3">[28]</xref>, <xref ref-type="bibr" rid="pgen.1004179-Good1">[29]</xref>; hence, the effective <italic>N</italic><sub>eff</sub> for these alleles is small. Alleles with a larger beneficial effect can explore a larger fraction of population (larger <italic>N</italic><sub>eff</sub>). Conceptually, this idea is quite correct; quantitatively, in the context of drug resistance, some problems arise. For example, the fitness benefit from a resistance mutation (under drug) is almost 100%, while the difference between the fittest and the average genome (in untreated patients) is a modest ∼10% <xref ref-type="bibr" rid="pgen.1004179-Batorsky1">[14]</xref>. Indeed, the average selection coefficient is quite small, ∼0.5% <xref ref-type="bibr" rid="pgen.1004179-Batorsky1">[14]</xref>, <xref ref-type="bibr" rid="pgen.1004179-Neher1">[15]</xref>.</p>
<p>There may be several other reasons for <italic>N</italic><sub>eff</sub>&lt;10<sup>8</sup>, as follows.</p>
<list list-type="roman-lower"><list-item>
<p>By considering only 500 bases (∼5%) of the HIV genome, the study may underestimate the number of genetic backgrounds in which the resistant allele can be observed.</p>
</list-item><list-item>
<p><italic>N</italic><sub>eff</sub> is likely to vary in time—similar to viremia, which decays strongly after the onset of therapy and rebounds after its failure—and the placement of the inferred population size within the therapy time frame is unclear. Specifically, it is unclear from the empirical source <xref ref-type="bibr" rid="pgen.1004179-Bacheler1">[19]</xref> whether K103N mutations are generated before therapy (which is likely, considering that the mutation of interest decays very slowly in vivo in untreated patients and therefore has a low mutation cost <xref ref-type="bibr" rid="pgen.1004179-Palmer1">[30]</xref>) or after therapy fails for another reason (see <xref ref-type="fig" rid="pgen-1004179-g001">Figure 1</xref> in <xref ref-type="bibr" rid="pgen.1004179-Bacheler1">[19]</xref>). In the first scenario, inferred <italic>N</italic><sub>eff</sub> = 10<sup>5</sup> is the pretreatment number. In the second scenario, the pretreatment number must be much higher than 10<sup>5</sup>, since the replicating census population is reduced by a large factor (∼100) following initiation of therapy.</p>
</list-item><list-item>
<p>Other factors, such as variation of the population number among patients and the spatial organization of the infected tissue <xref ref-type="bibr" rid="pgen.1004179-Frost2">[31]</xref> (both neglected in the test), may be relevant. Furthermore, the authors' calculations rely on the assumption of equal mutation rates for the two resistance mutations analyzed (both transversions). If the underlying rate of AAA to AAC is much greater than that of to AAT, the cited analysis would have underestimated the frequency of soft sweeps, yielding an underestimate of <italic>N</italic><sub>eff</sub>.</p>
</list-item><list-item>
<p>A significant complicating factor is the presence, in the parent study <xref ref-type="bibr" rid="pgen.1004179-Bacheler1">[19]</xref>, of other drugs, particularly the nucleoside RT inhibitors (NRTIs) AZT and 3TC. In some cases, mutations conferring resistance to these drugs may have also contributed to failure (e.g., during the precursor monotherapy; see <xref ref-type="fig" rid="pgen-1004179-g001">Figure 1</xref> in <xref ref-type="bibr" rid="pgen.1004179-Bacheler1">[19]</xref>), and the requirement for these additional changes would have made the frequency of resistant strains much less than the estimate. For virus that escaped the combination treatment in the absence of NRTI mutations, replication was most likely occurring only in a fraction, or “sanctuary,” of cells that did not receive an inhibitory dose of these drugs. Either or both of these effects would have led to a potentially large underestimate of <italic>N</italic><sub>eff</sub>. Indeed, a recent study of rapid NNRTI resistance, in SIV-infected monkeys treated with efavirenz monotherapy, used an ultrasensitive PCR assay to estimate the pre-therapy level of either K103N mutation as less than 0.0001% <xref ref-type="bibr" rid="pgen.1004179-Boltz1">[32]</xref>, implying a total replicating population of &gt;10<sup>6</sup>.</p>
</list-item></list>
<p>For these reasons, the value <italic>N</italic><sub>eff</sub> = 1.5×10<sup>5</sup> obtained in the study of Pennings et al. should probably still be regarded as a lower bound. At the same time, the study solidifies our understanding of HIV evolution as a Darwinian process and leads to important questions regarding the structure of HIV population, which are still waiting for new insights.</p>
</sec></body>
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