In a Darwinian sense, how does HIV evolve? How does "treatment interruption" work?

In laymans terms, anti-retroviral treatments cause HIV to hide. Temporarily stopping the treatment makes them come out of hiding and you can attack them with more drugs. It's a fairly simple and effective method of controlling the number of viruses.

Say you're treating a patient with reverse transcriptase inhibitors. He gets better at first, then starts to get worse again.

What happened is one HIV particle mutated randomly so that its enzyme is no longer affected by the inhibitor. It has a selective advantage, so it takes over the population and begins causing the disease.

Repeat with every drug treatment possible with HIV's high mutation rate, and you have a nigh untreatable disease.

It evolved due to natural selection. Some mutation or other made a disease afflicting some African monkeys also able to take on larger primates.

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