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meds for starin o???

Sep 14, 2003

Doctor Pierone, it's me again... Could you please, find out what are the medicinesthat work against hiv rare strain 0(Cameroon)? Is it true that this starin is more virulent? Please, knowing that this strain is rare, take your time for researching informations about it, but answer me! Forgive my bad English. Hoping to read your answer, thanks a lot. Miss Sadness

Response from Dr. Pierone

Miss Sadness, your English is much better than my Cameroonian so please don't fret. I have researched group O HIV as per your request and am here to report.

First, as a refresher, HIV worldwide is divided into 2 species, HIV-1 and HIV-2. HIV-2 made the jump to humans from African green monkey (sooty mangabey) and is mainly located in Central Africa. HIV-1 is responsible for the vast majority of human infection and was transmitted to humans from Chimpanzees.

HlV-1 is divided into 3 groups, M for major, O for outlier, and N for non M/non O (this makes sense). The great majority of infections worldwide are group M, which has 9 pure subtypes A-K (A to D, F to H, J, and K). Group O occurs mainly in central and west central Africa, but rare cases have been reported in Europe and the U.S (linked to transmission from central Africa).

The Cameroon (your favorite watering hole) is distinguished by harboring both group N and O types of HIV. There is wider diversity of HIV infection the Cameroon than just about anywhere else in the world (please don't ask me why, I just treat patients in Florida).

I was not able to find any studies that suggest that group O is more aggressive or virulent than non-group O virus. However, similar to HIV-2, there are studies that suggest that group O virus is resistant to non-nucleoside reverse transcriptase inhibitors (Sustiva, Nevirapine). So in the case of infection with group O protease inhibitor-based therapy should be used. Hope this helps. GP

Which specific symptoms will cause you to recommend HAART if CD4 count is normal and VL undetectable?

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