TY - JOUR T1 - Increasing Clinical Virulence in Two Decades of the Italian HIV Epidemic A1 - Müller, Viktor A1 - Maggiolo, Franco A1 - Suter, Fredy A1 - Ladisa, Nicoletta A1 - De Luca, Andrea A1 - Antinori, Andrea A1 - Sighinolfi, Laura A1 - Quiros-Roldan, Eugenia A1 - Carosi, Giampiero A1 - Torti, Carlo Y1 - 2009/05/29 N2 - Author Summary The AIDS epidemic claims more lives per year than any other infectious disease, even though its cause, the Human Immunodeficiency Virus (HIV), is the youngest of all major human pathogens. The recent origin and great evolutionary potential of the virus raise the possibility that the virus might still be adapting to humans. Of primary interest is whether the virulence of the virus, i.e. its ability to cause disease, has been changing over time. Unfortunately, previous results have yielded conflicting results. We investigated time trends of virulence in the Italian HIV epidemic and found increasing virulence. The use of an established methodology allowed, for the first time, direct comparison with results obtained in other epidemics. The comparisons revealed that genuine differences exist in the trends of HIV virulence between different epidemics. Thus, there is no single time trend of HIV virulence worldwide. Our results are consistent with the hypothesis of increasing HIV virulence; however, clinical virulence combines viral and host factors, and the effect of host factors could not be excluded in our analysis. JF - PLOS Pathogens JA - PLOS Pathogens VL - 5 IS - 5 UR - https://doi.org/10.1371/journal.ppat.1000454 SP - e1000454 EP - PB - Public Library of Science M3 - doi:10.1371/journal.ppat.1000454 ER -