Researchers Still Divided Over Significance of New York City Case of Rare, Drug-Resistant HIV Strain
February 25, 2005
Experts on Thursday at the 12th Annual Conference on Retroviruses and Opportunistic Infections in Boston remained divided about whether the detection of a rare, drug-resistant HIV strain in a New York City man represents "a scientific oddity or a public health menace," the San Francisco Chronicle reports (Russell, San Francisco Chronicle, 2/25). Officials from the New York City Department of Health and Mental Hygiene on Feb. 11 announced they had detected in a local man a strain of HIV that is resistant to most antiretroviral drugs and possibly causes a rapid onset of AIDS. The city health department issued an alert to physicians, hospitals and medical providers asking them to test all HIV-positive patients for evidence of the strain. This combination of highly drug-resistant HIV and rapid progression to AIDS had not been identified before (Kaiser Daily HIV/AIDS Report, 2/22). The "mystery" case remains "unsolved" despite receiving the "attention of several thousand AIDS researchers from around the world" at the conference on Thursday, the Washington Post reports (Brown, Washington Post, 2/25). The strain has been detected in only one case, there is "no evidence" that the virus is "readily transmissible" and scientists are still uncertain if the man might be infected with several HIV subtypes that each are resistant to some antiretroviral drugs, according to the Chronicle (San Francisco Chronicle, 2/25). Dr. David Ho, director of the Aaron Diamond AIDS Research Center -- where the patient was diagnosed in December 2004 -- on Friday is expected to discuss the case in detail at the conference, the New York Daily News reports (Shin, New York Daily News, 2/25).
Researchers Defend Alert
"These kinds of cases have been reported before," Martin Delaney, founder of San Francisco's Project Inform, said, adding, "A lot of clinicians see this stuff, and they don't call press conferences." AIDS advocate Mark Harrington said, "It's much ado about an anecdote." AIDS physician Steven Deeks said that "host factors" -- patient traits rather than virus traits -- are "almost certainly the cause" of the man's rapid progression to AIDS, according to the Chronicle. However, the case still highlights the need for safer sex in "an environment populated by a still-dangerous virus" and has focused attention on the "out-of-control methamphetamine use in young, gay men," according to Deeks, the Chronicle reports (San Francisco Chronicle, 2/25). Dr. Harold Jaffe, a professor of public health at Oxford University and former director of the CDC's National Center for HIV, STD and TB Prevention, said the case spotlights the problem of people engaging in high-risk behaviors. "More than two decades into the HIV/AIDS epidemic, why are some persons still placing themselves at high risk for infection?" he asked. In some cases, populations are difficult to reach with health education, others incorrectly believe that treatment with antiretroviral medications means a person cannot spread the disease and still others have lost "their fear of the virus," Jaffe said, according to Reuters (Reuters, 2/24). Although using such cases as scare tactics is wrong, the "important thing is to put out the facts," he said, adding, "If the facts are scary, then people will be scared" (San Francisco Chronicle, 2/25).
Probable Acquisition of Multi-Drug-Resistant HIV in Man With Subsequent Rapid HIV Disease Progression: Reality and Reaction
This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily HIV/AIDS Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.