TY - JOUR T1 - The Evolutionary Dynamics of a Rapidly Mutating Virus within and between Hosts: The Case of Hepatitis C Virus A1 - Luciani, Fabio A1 - Alizon, Samuel Y1 - 2009/11/13 N2 - Author Summary Rapidly mutating viruses, such as hepatitis C virus, can escape host immunity by generating new strains that avoid the immune system. Existing data support the idea that such within-host evolution affects the outcome of the infection. Few theoretical models address this question and most follow viral diversity or qualitative traits, such as drug resistance. Here, we study the evolution of two virus quantitative traits—the replication rate and the ability to be recognised by the immune response—during an infection. We develop an epidemiological framework where transmission events are driven by within-host dynamics. We find that the replication rate of the virus that initially infects the host has a strong influence on the epidemiological success of the disease. Furthermore, we show that the cross-reactive immune response is key to determining the outcome of the infection (acute or chronic). Finally, we show that the timing of the start of an anti-viral treatment has a strong effect on viral evolution, which impacts the efficiency of the treatment. Our analysis suggests a new mechanism to explain infection outcomes and proposes testable predictions that can drive future experimental approaches. JF - PLOS Computational Biology JA - PLOS Computational Biology VL - 5 IS - 11 UR - https://doi.org/10.1371/journal.pcbi.1000565 SP - e1000565 EP - PB - Public Library of Science M3 - doi:10.1371/journal.pcbi.1000565 ER -