HIV and Aids scientists and advisers on both sides of the Atlantic urged caution on Sunday over suggestions that a new fast-acting strain of the HIV virus resistant to most anti-retroviral drugs had emerged in New York.
Health officials in New York suggested that a man in his 40s, who reported multiple sex partners and unprotected anal intercourse, often under the influence the amphetamine crystal meth, might be the harbinger of an aggressive form of the disease which can normally take eight to 10 years or more to develop.
Thomas Friedman, the city’s health commissioner, said on Friday the strain might be ”difficult or impossible to treat”.
The unnamed man was only diagnosed with HIV in December, after complaining of feeling ill in November. He had reported tested negative in May 2003, but is now said to be displaying full-blown Aids, suggesting the disease took from two to 20 months to progress.
Multi-drug resistance and rapid progression have both been recorded among Aids patients before but it was the combination that worried New York officials, who said the patient showed resistance to three of the four classes of retroviral drugs.
They have also been worried that increasing abuse involving crystal meth in the city may help lead to more unsafe sex through loss of inhibitions.
Michael Bloomberg, the mayor, quoted in Sunday’s New York Times, said: ”It is just a sin in our society when we know how it is transmitted from one person to another and we should be able to conduct themselves such that they don’t catch it themselves, and certainly that they do not infect anybody else.”
However a number of specialists warned against jumping to conclusions. Robert Gallo, a co-discoverer of the Aids virus, told the NYT the combination may be just chance.
”It can be the patient, not the virus that is rare,” he said.
Roger Pomerantz, of Thomas Jefferson University in Philadelphia, suggested: ”Every medical centre in a major metropolitan area will have cases like this. You’ve got to really prove something before you go on CNN and scream about a super-strain.”
In Britain, Barry Evans a consultant epidemiologist for the government’s Health Protection Agency, said: ”At the moment, it is only a single case. There is enormous variation in people’s progress to Aids. We know of some people, only a small number of cases historically, who have progressed very quickly.”
He said he preferred to wait until there was more evidence in scientific literature about the detailed structure and molecular basis of the virus in this case before being able to consider whether it was more virulent. Other questions that need investigating, he said, included seeing whether substance abuse increased a person’s susceptibility to disease.
He also said that even if a patient showed resistance to a specific class of drug, it did not necessarily mean that he or she would be resistant to every drug in the class. ”Having said all that, it is a bit of a wake-up call, saying there is virus being transmitted that is resistant to a significant number of drugs.”
Jo Robinson, a senior specialist in health promotion for the Terrence Higgins Trust, also urged caution, saying it was a … storm in a teacup”.
Some people did show Aids symptoms temporarily after HIV diagnosis because their immune system seemed to go haywire. ”That can happen no matter what strain of HIV you pick up and the fact this has happened with multi-resistant HIV is mere chance.” – Guardian Unlimited Â