The evolution of substitutions conferring drug resistance to HIV-1 is both episodic, occurring when patients are on antiretroviral therapy, and strongly directional, with site-specific resistant residues increasing in frequency over time. While methods exist to detect episodic diversifying selection and continuous directional selection, no evolutionary model combining these two properties has been proposed. We present two models of episodic directional selection (MEDS and EDEPS) which allow the a priori specification of lineages expected to have undergone directional selection.
The models infer the sites and target residues that were likely subject to directional selection, using either codon or protein sequences. Compared to its null model of episodic diversifying selection, MEDS provides a superior fit to most sites known to be involved in drug resistance, and neither one test for episodic diversifying selection nor another for constant directional selection are able to detect as many true positives as MEDS and EDEPS while maintaining acceptable levels of false positives. This suggests that episodic directional selection is a better description of the process driving the evolution of drug resistance.
When exposed to treatment, HIV-1 and other rapidly evolving viruses have the capacity to acquire drug resistance mutations (DRAMs), which limit the efficacy of antivirals. There are a number of experimentally well characterized HIV-1 DRAMs, but many mutations whose roles are not fully understood have also been reported. In this manuscript we construct evolutionary models that identify the locations and targets of mutations conferring resistance to antiretrovirals from viral sequences sampled from treated and untreated individuals. While the evolution of drug resistance is a classic example of natural selection, existing analyses fail to detect the majority of DRAMs. We show that, in order to identify resistance mutations from sequence data, it is necessary to recognize that in this case natural selection is both episodic (it only operates when the virus is exposed to the drugs) and directional (only mutations to a particular amino-acid confer resistance while allowing the virus to continue replicating). The new class of models that allow for the episodic and directional nature of adaptive evolution performs very well at recovering known DRAMs, can be useful at identifying unknown resistance-associated mutations, and is generally applicable to a variety of biological scenarios where similar selective forces are at play.