|
|
·
For Immediate Release
Contact: Gary Blick, MD, 153 East Avenue, Suite 32, Norwalk, CT 06851
phone: 203-852-9525, fax: 203-854-0371
CT Physician Identifies Source of New York City HIV “Supervirus” and Describes How HIV “Superinfection” Can Lead to New HIV Strains Resistant to All Drugs.
HIV-positive individuals can potentially become “superinfected” with new, drug-resistant strains of HIV-1 through unsafe sexual practices, according to a paper to be published in the May 1 issue of The Journal of Infectious Diseases. Gary Blick, MD, of Circle Medical LLC, and colleagues describe how infection with a second strain of HIV, known as “superinfection”, can also lead to evolution of new, highly multi-drug resistant “recombinant” strains of HIV-1 when these newly introduced strains recombine with the original strain of HIV-1 in someone who is already infected. This finding calls into question the increasingly popular sexual practice of “serosorting”, an attempt to reduce sexual transmission of HIV to uninfected people and increase intimacy between HIV-positive partners whereby HIV-positive individuals seek out other HIV-positive sexual partners for unsafe sexual activities.
The researchers were confidentially examining HIV genetic resistance tests following issuance of a public health alert on February 11, 2005 by the New York City Health Department. The alert was issued after an individual (referred to as NYC) was diagnosed with a unique multi-drug-resistant strain of HIV and rapidly progressed to AIDS within months of his diagnosis, raising the possibility that an HIV-1 “supervirus” may have been identified. Dr. Blick linked NYC and the probable source (CT01) historically, and epidemiologically and genetically confirmed this finding from CT01’s resistance tests acquired two days prior and subsequent to the time when the two individuals had participated in unsafe sexual activities approximately two months prior to NYC’s diagnosis.
NYC had been previously confirmed to be HIV-negative. CT01 had been diagnosed with HIV and had taken antiretroviral therapy (ARV) for over 10 years, during which time his HIV had become resistant to 19 of 21 available ARV medications, thus leading to the resistant strain of HIV contracted by NYC. Transmission of HIV resistant to 3 classes of HIV drugs has previously been reported but occurs less than 2% of the time. Dr. Blick believes that since this strain of HIV-1 has not caused CT01 to rapidly progress to AIDS, NYC’s progression was not explained by the HIV-1 variant alone, suggesting other issues may have been involved, such as NYC’s acknowledged crystal methamphetamine abuse, sexual promiscuity and unsafe sexual practices, or other genetic or immunological factors.
While determining that CT01 had passed a drug-resistant strain of HIV-1 to a previously uninfected individual, Dr. Blick and colleagues stumbled upon an even more surprising result, that CT01 “had also superinfected his long-term HIV-positive partner (CT02) with this multi-drug resistant strain of HIV. In 2002, CT02’s virus looked virtually identical to CT01’s, and “CT02 did not rapidly progress to AIDS, further confirming that we are not dealing with a supervirus.” Dr. Blick further points out that, “At the time of this investigation, only 23 such cases of HIV superinfection had been published in the medical literature.” Continued investigation revealed that sometime between 2002 and 2004, part of CT01’s resistant HIV and part of CT02’s original strain of HIV-1, which had rare and unique drug resistance mutations to ARV at the time, had “recombined in CT02 to produce a strain of HIV that was resistant to every single antiretroviral drug that was available at that time.”
Dr. Blick says, “What this means is that HIV-positive individuals who engage in serosorting, unsafe sexual intercourse with other HIV-positive individuals, run the risk of becoming superinfected with drug-resistant HIV and producing recombinant strains of HIV that may be even more dangerous and drug-resistant than the strains of HIV they already harbor. These new strains can render the drugs they are currently taking useless in controlling their HIV and, in turn, can be passed on to other individuals via unsafe sexual activities.” While serosorting may reduce HIV transmission to uninfected individuals, “this paper illustrates that the practice of serosorting among two HIV-positive individuals may have serious, potentially devastating consequences.” With these issues in mind, Dr. Blick said, “As the HIV-1-positive community engages in serosorting with increasing frequency, it is the responsibility of healthcare providers and public health workers to counsel HIV-1-positive individuals about the need to continue practicing safer sex techniques with other HIV-1-positive individuals due to the risks of becoming HIV-1 superinfected, producing viral recombinant strains, and acquiring other sexually transmitted diseases.”
For additional information contact:
Gary Blick, MD
Medical and Research Director, Circle Medical, LLC
153 East Avenue, Suite 32, Norwalk, CT 06851
phone: 203-852-9525, fax: 203-854-0371, cell: 203-550-0242
###