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Multiple Strains
Aug 25, 2006

Dear Robert, Thank you so much for the humor and gusto you build into your answers, it keeps me grounded and reminds me that laughter is just as much part of HIV treatment as is taking my meds and eating well.

I attend a group for positive gay men in Sydney, and have attached the link to the following article from the most recent conference in Canada, that I have posted on our group e-mail discussion board.

Cases of HIV Infections With Multiple Strains More Common Than Previously Believed, Researchers Say August 17, 2006 http://www.thebody.com/kaiser/2006/aug17_06/multiple_strains.html?m164h

One of the participants responded by saying:-

Thanks for bringing this article to our attention L, however the article quotes findings based on a study in Kenya, which I would imagine does not have the access to HAART that we do.

This would mean that the study subjects most likely have a high viral load, therefore making them highly infectious compared to someone here who is on HAART and therefore has a low or hopefully, undetectable viral load.

This article only skims the surface and is very much in the style of 'magazine journalism'.

I would not be too worried personally about this article, as too many factors are unknown and like a number of us said at the last AH, if it where the case, we should have been dead years ago..!

Do you know where I can find evidence of the research that this article was based on? I tried following the links they attached but am none the wiser. I am interested to know if his answer will stand up against science or if the continued bare backing that is advocated holds no risk of future damage to his immune system.

Thank you,

L Sydney 25/8/2006

Response from Dr. Frascino

Hello L,

I do not have all the details of this particular study. Often at medical conferences, information is presented in abstract form or in short oral presentations. The details of the study often are not available until the study is published in a peer-reviewed medical journal, which may be a number of months after it was first presented at a conference.

The take-home lesson (and caution) from this study is that dual infections/superinfection may indeed be more common than we had recently suspected. It is certainly true that someone whose viral load is suppressed to undetectable levels on HAART is less infectious than someone with a sky-high viral load; however, that was not the point of this study, nor should it impact the take-home lesson that barebacking is indeed dangerous. Superinfection is real and can have disastrous consequences. Is it worth the risk? Not on your life!

Dr. Bob

Cases of HIV Infections With Multiple Strains More Common Than Previously Believed, Researchers Say

August 17, 2006

Cases in which an HIV-positive person is infected with more than one strain of the virus are more common than previously believed, Canadian and U.S. scientists said Monday at the XVI International AIDS Conference in Toronto, CanWest News Service/Vancouver Sun reports. Researchers reported that eight so-called "superinfection" cases have been discovered among 57 HIV-positive women in Mombasa, Kenya. According to the study, many of the women contracted a second strain of the virus within one year of their first infection, while other infections occurred up to five years after their first infection. While it is unclear whether the risk of contracting multiple strains of HIV is as likely as being infected for the first time, data are "starting to suggest" that reinfection is a concern, Julie Overbaugh, associate program head at the Fred Hutchinson Cancer Research Center, said, adding that although the study is thought to be the largest of its kind, only 57 women were involved. The findings might be significant for HIV-positive people who seek other HIV-positive people for unprotected sex because they might become infected with a different strain, Overbaugh said. In addition, there also are indications that infection with multiple strains of HIV speeds the progression of the virus, according to CanWest News Service/Sun. As a result, it is important that even partners who are both HIV-positive use safer sex practices to prevent the virus passing between them, according to Bill Cameron, a professor of medicine at the University of Ottawa and the Ottawa Hospital. Related studies among sex workers in South Africa show that people who first test positive for the virus can have two different strains of HIV. "It may be that they got them from one partner, but it looks like they probably got sequentially infected," Overbaugh said. The findings of the superinfection studies might have negative implications for HIV/AIDS vaccine development because current research aims to protect against a "natural HIV infection," not a superinfection, according to CanWest News Service/Vancouver Sun. With multiple strains of the virus, it not only could be mutating but also combining with other forms of the virus to produce a strain "that looks different from either one," Cameron said (Kirkey, CanWest News Service/Vancouver Sun, 8/15).



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