A condition for successful escape of a mutant after primary HIV infection

Cytotoxic T lymphocytes (CTLs) vigorously restrict primary human immunodeficiency virus (HIV) infection. However, the frequently erroneous process of viral replication favors the creation of mutants not recognizable by primary CTLs. Variants that tolerate the mutations may have selective advantage and may increase in abundance, until the immune system reacts against them. Therefore, such variants represent a way of propagating the viremia. With the aid of a simple mathematical model, here we estimate the intensity of CTL cross-reactivity against different strains of HIV in a typical progressor. We show that below a critical intensity of cross-reactivity, the concentration of a mutant created at primary peak grows and causes a secondary peak in viremia. Above this critical intensity, such a mutant strain is prevented from reaching a detectable level. We speculate about how this result may contribute to the design of an anti-HIV vaccine.