Drug-Resistant HIV Strain Can Rapidly Progress to AIDS
NYC man infected with HIV that replicates 36 percent faster than wild-type strains
FRIDAY, July 28 (HealthDay News) -- The same strain of multidrug-resistant HIV-1 found in 2004 in a 46-year-old New York City man that caused rapid progression to AIDS has also been identified in three other HIV-infected patients, according to a report in the July 28 Morbidity and Mortality Weekly Report. As a result of these and other cases, federal guidelines now recommend drug-resistance testing of patients before initiation of HIV-1 therapy.
The index patient, a crystal methamphetamine user, was diagnosed in 2004 with multidrug-resistant HIV after experiencing fever, pharyngitis and exhaustion. The patient developed full-blown AIDS in four to 20 months, much faster than the usual eight to 10 years. Genetic testing found his virus resistant to most antiretroviral drugs; its replication capacity was 36 percent greater than wild-type HIV.
Of the 14 sex partners he could name, 10 tested positive for a different HIV strain, one could not be located and three refused testing or said they had tested negative. Genotyping of all HIV-infected patients in the New York area identified two patients in New York and one in Connecticut infected with the same HIV strain. As of July 2006, the index patient and two men were clinically stable on antiretroviral therapy and one was lost to follow-up.
"To reduce HIV-associated morbidity and mortality in the United States, public health officials should intensify measures to improve early diagnosis, partner notification, and prevention counseling for persons (particularly men who have sex with men) who are HIV positive," according to the authors of the CDC report.