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NEW NY CASE
Feb 21, 2005

Dr. Bob,

Being a sexually active negative gay male I tend to follow HIV prevention tips and developments in the news. While I appreciate we are learning more about this awful virus daily I am a bit troubled by the recent news story on this new strain discovered in New York.

First, I do not in any way mean to doubt the significance of this single case. However - right now in the entire scope of things it is just that one case. Does this single case warrant such announcement by the New York Health Department without further scientific study or additional cases?

If weeks from now we find that this gentleman has a flawed immune system or is an extreme one off case of a rapid progressor will this weaken further the diminishing audience and creditability of HIV health professionals preaching to high risk communities? If this new strain proves to be what has been suggested would it still have been more beneficial to approach the public with more than one case and/or even a hint of more medical information?

Regardless of the outcome of this scary potential development in the HIV crisis, I have real trouble with the dramatic presentation by these medical professionals. Sketchy information was provided on the clinical progression actual determination of AIDS diagnosis and ability of treatments that have been even mildly beneficial. Considering the information that was provided it seemed like a new beginning of finger pointing and blame towards the gay community.

Let us hope for the best and if this is proven a rare extreme .0000000000000000000000000000000001% case I suggest we release the email addresses of these professionals to worried worts around the world.

Best, Concerned UK

Response from Dr. Frascino

Hello,

Yes, I tend to agree with you. There has been a frenzy of activity engulfing HIV specialists and health officials since the announcement on Feb. 11 of a single patient infected with multiple-drug-resistant HIV that had rapidly progressed to full-blown AIDS over what was believed to be only a few months. The ominous headlines and blanket news coverage this story got over the next few days raised the specter of a reemerging epidemic that would mirror the early days of the epidemic when HIV was not treatable. Of note is that behind this "science by press conference" are amazingly few solid facts. Instead, what we have are copious unanswered questions and an impressive amount of rampant speculation. You would be amazed at the number of folks who have written to me over the past week panicked by what they "heard about" this case. The history of the AIDS epidemic continues to teach us over and over again that misinformation spreads more quickly than the virus itself.

The story is still unfolding and I'm sure I'll hear more about it this week at the AIDS convention in Boston. I'll try to keep everyone posted.

One point I should make now is that the emergence of drug resistance is an issue with virtually all infectious diseases over time. We have been monitoring the emergence of HIV drug resistance for a number of years and, as expected, it's increasing. Resistance to a single class of drugs is most common but resistance to all three classes (as in the NYC patient) has certainly been well documented before. The combination of multi-drug-resistant strain combined with rapid progression is what's scaring the bejesus out of folks. So is this a case of two relatively rare phenomena that serendipitously happened to coincide or is this yet another ominous turn in an epidemic that too many people have become apathetic to??? Time will tell. At least folks are taking about AIDS once again in this country and that may ultimately turn out to be a good thing. America needs to realize that HIV/AIDS is not a distant threat, but rather a clear and present danger. That much is true.

However, we must rely on peer-reviewed science, not frenzied speculation, go guide our efforts for prevention and cure.

As for revealing the "professionals'" e-mail addresses to the worry warts, well, that would be just too, too mean.

Dr. Bob


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