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U.S. News

Experts Continue to Question Implications of Detection of Rare, Drug-Resistant HIV Strain

February 16, 2005

Some HIV/AIDS experts have "questioned why such an uproar has emerged" over the detection of a rare, drug-resistant HIV strain and expressed concern that the public health alert issued in New York City last week might have been "premature," the Los Angeles Times reports (Maugh/Bernstein, Los Angeles Times, 2/16). However, Dr. David Ho, director of the Aaron Diamond AIDS Research Center -- where the patient was diagnosed as HIV-positive in December 2004 -- said the alert was necessary, the Wall Street Journal reports (Chase, Wall Street Journal, 2/16). New York City Department of Health and Mental Hygiene officials last week at a news conference announced they had detected in a local patient a rare strain of HIV that is highly resistant to most antiretroviral drugs and causes a rapid onset of AIDS. The city health department also issued an alert to physicians, hospitals and medical providers asking them to test all HIV-positive patients for evidence of the strain. City Health Commissioner Thomas Frieden said, "We have not seen a case like this before. It holds the potential for a very serious public health problem" (Kaiser Daily HIV/AIDS Report, 2/15). Ho defended the warning, saying that although more investigation into the strain is necessary, he alerted officials because he "feared" other cases might be undetected. He added that he plans to publish his complete findings in a scientific journal "soon," according to the Journal (Wall Street Journal, 2/16).

Experts Question Alert
"This is something we need to be aware of," Dr. Irwin Chen, director of the University of California-Los Angeles AIDS Institute, said. However, he added that "we'd have to see a cluster or group in the same area before it becomes more of a serious issue." Dr. Warner Greene, director of the Gladstone Institute of Virology and Immunology, said, "I really wish that more studies had been done and that we had a much better understanding of the properties of this virus before these alarming announcements" (Los Angeles Times, 2/16). Dr. Anthony Fauci, director of NIH's National Institute of Allergy and Infectious Diseases, speaking on "CNN Live From" on Monday, said, "Whether or not you can call this a super bug, I have some skepticism about that at this point in time. We need to investigate it further, just the way they are doing that in New York City, which is appropriate." He added, "But I think there has been some alarm about whether or not this is going to be a whole new change in HIV in this country, and it's way ... premature to say that" (O'Brien et al., "CNN Live From," CNN, 2/14). Some health experts said the "scare tactics" could backfire, according to the Los Angeles Times. "One model of prevention is to say that if we scare people enough, they'll change their behavior," Dr. Steven Tierney, director of HIV prevention at the San Francisco Department of Public Health, said, adding, "But 25 years into the epidemic, that hasn't happened. ... If some of your messages are phony and trumped up, then what reason do people have to respond to any of your messages?" (Los Angeles Times, 2/16).

NYC Health Department Changes AIDS Program
Following the detection of the new HIV strain, the New York City health department is "[a]cting with added urgency" to reorganize its AIDS program to encourage "more aggressive collection of crucial information" about the spread and treatment of HIV/AIDS, Frieden announced on Tuesday, the New York Times reports. The program, which had been called the Bureau of HIV/AIDS Services, will be renamed the Bureau of HIV/AIDS Prevention and Control, according to the New York Times. Frieden emphasized that privacy concerns are "supremely important" and said that the implementation of one new measure he considers "crucial" might require legislation to change state law, according to the New York Times. The measure would allow city and state officials to keep information about the viral loads of HIV-positive people to determine how patients are responding to treatment. Frieden said that of the estimated 50,000 HIV-positive New Yorkers currently taking antiretroviral drugs, "we really don't have much of a sense of what treatment they are on, whether the treatment is appropriate, how they are doing, whether the viral loads are suppressed, how many of them have drug resistance to one or more classes of antiretrovirals, [or] whether that number and proportion have increased in recent years." Another measure would require laboratories throughout the state to test and report whether HIV strains are responding to medication to track the disease and provide feedback to physicians on the best available treatment for patients, according to Frieden. The proposed changes have been studied for at least a year, but the recent discovery of the new HIV strain "added to the urgency," Frieden said (Santora/Altman, New York Times, 2/16).

Back to other news for February 16, 2005

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Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2005 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.



  
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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.
 
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