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We consider disease-causing mutations that are lethal when homozygous. Lethality involves the very strongest form of negative selection, with the selection coefficient against the disease-carrying homozygote having its maximum value of unity. We determine results for the behavior of the frequency of a lethal allele in an effectively infinite population. This includes an estimate of the time it takes to achieve equilibrium, and a description of transient behavior associated with a sudden change in the fitness of the heterozygote. We determine analogous results for a finite population, showing that a lethal disease-causing allele needs to be described by a modified Wright-Fisher model, which deviates from the standard model, where selection coefficients are assumed small compared with 1. We show that a by-product of the dynamics, resulting from the absence of the disease-allele carrying homozygote in adults, is the general constraint that the frequency of the disease-causing allele cannot exceed1    2. The results presented in this work should prove useful to a number of areas including analysis of lethal/near lethal mutations in Mendelian disorders and, in particular, for exploring how mutation-selection-drift balance explains the current spectrum of mutation frequencies in humans. While the number of empirical examples of overdominance in lethal genetic disorders is not large, relatively high observed heterozygote frequencies may be a hint of transient heterozygous advantage in nature. For lethal disorders with anomalous frequencies, such as cystic fibrosis and Tay-Sachs, our analysis lends further support to the role that transitory episodes of weak overdominance may play in the evolution of lethal mutations.

Influence of Dominance and Drift on Lethal Mutations in Human Populations