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New HIV strain in New York - 3 Months to Full Blown AIDS
New HIV strain in New York - 3
Months to Full Blown AIDS
http://www.politicalgateway.com/news/read.html?id=2861
Political Gateway- Feb 11- Dateline New York...
A new strain of HIV has been found in one man in New York. It appears he was
infected in December or close to it. He has full blown AIDS and the strain is
resistant to treatments.
Scroll down for the actual health department memo.
``We've identified this strain of HIV that is difficult or impossible to treat
and which appears to progress rapidly to AIDS,'' said New York City Health
Commissioner Thomas Frieden. ``We have not seen a case like this before. It
holds the potential for a very serious public health problem.''
``It is likely there are others infected with this strain and this individual
has infected others,'' Frieden said. The case is ``extremely concerning and a
wake-up call,'' he said.
``We're talking about a single case, but clearly the fact that we are dealing
with such broad resistance of drugs and the rapid clinical progression is quite
alarming,'' Valdiserri said.
``In this patient's case, onset of AIDS appears to have occurred within two or
three months and at most 20 months after HIV infection,'' Frieden said. The
patient, whose name was withheld, has symptoms usually associated ``with someone
who has very advanced disease,'' he said.
==========================================
Press Release
New York City Department of Health
and Mental Hygiene
Office of Communications
FOR IMMEDIATE RELEASE
CONTACT: Sandra Mullin/Sid Dinsay
Business Hours (212) 788-5290
After Business Hours (212) 764-7667
Friday, February 11, 2005
NEW YORK CITY RESIDENT DIAGNOSED WITH RARE STRAIN OF MULTI-DRUG RESISTANT HIV
THAT RAPIDLY PROGRESSES TO AIDS
Highly Virulent Strain Resistant to Three Types of HIV Drugs Is Rare In Patients
Not Previously Treated for HIV; Strain Is Also Associated with Rapid Onset of
AIDS
Health Dept. Urges At-Risk Groups To Stop Risky Sexual Behavior; Patients Who
Are On Treatment For HIV/AIDS And Are Doing Well Do Not Need Susceptibility
Testing Unless Advised By Their Physician
NEW YORK CITY - February 11, 2005 - A highly resistant strain of rapidly
progressive human immunodeficiency virus (HIV) has been diagnosed for the first
time in a New York City resident who had not previously undergone antiviral drug
treatment, according to the Department of Health and Mental Hygiene (DOHMH). The
strain of three-class antiretroviral-resistant HIV - or 3-DCR HIV - does not
respond to three classes of anti-retroviral medication, and also appears to
greatly shorten the interval between HIV infection and the onset of AIDS.
The patient is a male in his mid-40s who reported multiple male sex partners and
unprotected anal intercourse, often while using crystal methamphetamine (crystal
meth). He was first diagnosed with HIV in December 2004 and appears to have been
recently infected. The diagnosis of 3-DCR HIV was made shortly thereafter at the
Aaron Diamond AIDS Research Center. Since then, the patient has developed AIDS.
DOHMH is counseling and offering HIV testing to those contacts of the patient
who have been identified.
While drug resistance is increasingly common among patients who have been
treated for HIV, cases of 3-DCR HIV in newly-diagnosed, previously untreated
patients are extremely rare, and the combination of this pattern of drug
resistance and rapid progression to AIDS may not have been diagnosed previously.
Strains of 3-DCR HIV are resistant to three of the four available types of
antiviral drugs that are most commonly prescribed: nucleoside reverse
transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, and
protease inhibitors. This strain also caused a rapid onset of AIDS, which
usually occurs more than ten years after initial infection with HIV. In this
patient's case, onset of AIDS appears to have occurred within two to three
months, and at most 20 months, after HIV infection.
Health Commissioner Thomas R. Frieden, MD, MPH said, "This case is a wake-up
call. First, it's a wake up call to men who have sex with men, particularly
those who may use crystal methamphetamine. Not only are we seeing syphilis and a
rare sexually transmitted disease - lymphogranuloma venereum - among these men,
now we've identified this strain of HIV that is difficult or impossible to treat
and which appears to progress rapidly to AIDS. This community successfully
reduced its risk of HIV in the 1980s, and it must do so again to stop the
devastation of HIV/AIDS and the spread of drug-resistant strains. Second,
doctors in New York City must increase HIV prevention counseling, increase HIV
testing, obtain drug susceptibility testing for patients testing HIV-positive
who have not yet been treated, improve adherence to antiretroviral treatment,
and improve notification of partners of HIV-infected patients. Third, the public
health community has to improve our monitoring of both HIV treatment and of HIV
drug resistance, and we have to implement prevention strategies that work."
The Health Department recently issued a Health Alert to physicians, hospitals
and other medical providers asking them to test all previously untreated
patients newly diagnosed cases for anti-HIV drug susceptibility. The Department
is monitoring laboratories for additional cases of 3-DCR HIV in newly diagnosed
persons. DOHMH is also working with New York State to establish a long-term
system for monitoring drug resistance in HIV-positive patients who have not yet
undergone treatment.
Dr. Frieden added, "Patients who are on treatment for HIV/AIDS and are doing
well do not need susceptibility testing unless advised to by their physician."
REMARKS BY MEDICAL AND COMMUNITY LEADERS
Dr. David Ho, CEO and Director of the Aaron Diamond AIDS Research Center, said
"This patient's infection with an HIV-1 strain that is not amenable to standard
antiretroviral therapy, along with his rapid clinical and immunological
deterioration, is alarming. While this remains a single case, it is prudent to
closely watch for any additional possible cases while continuing to emphasize
the importance of reducing HIV risk behavior."
"The rapidly growing crystal meth epidemic in New York city continues to play a
significant role in facilitating the transmission of HIV. In light of the
emergence of this virulent new strain, health care providers must be especially
vigilant in not only recognizing and diagnosing HIV infection, but also in
recognizing the signs and symptoms of crystal methamphetamine use in their
patients," said Dr. Antonio Urbina, Medical Director of HIV education and
training, at St. Vincent's Catholic Medical Center.
"Callen-Lorde is deeply concerned about this newly identified case of multiple
drug resistant HIV," said Jay Laudato, Executive Director of the Callen-Lorde
Community Health Center. "We urge all persons, both HIV negative and positive,
to only engage in safer sex practices in order to prevent new infections or
re-infection. For those persons who don't know their status, we urge HIV testing
and obtaining the information and support necessary to reduce their risk for HIV
infection. We also ask all gay and bisexual men to become knowledgeable about
the dangers of crystal methamphetamine and in particular its relationship to
sexual risk taking."
Dr. James Braun, President of the Physicians Research Network, said "We believe
that the transmission of treatment-resistant HIV was a disaster waiting to
happen, particularly in communities where safer sex is not practiced regularly
and in light of people using drugs like crystal meth. All primary care providers
in acute care settings need to know how to diagnose HIV in its earliest stages
and where to refer people so that new infections are properly worked up and
treated."
"HIV prevention is an ongoing process," said Ana Oliveira, Executive Director of
Gay Men's Health Crisis. We have to double our efforts and resources to maintain
treatment and prevention education for people who are infected as well as for
those who are not. New Yorkers must be vigilant and know that infection with
resistant strains of HIV can be avoided. People living with HIV can live healthy
and satisfying lives by protecting themselves and their partners, regardless of
HIV status."
Tokes M. Osubu, Executive Director of Gay Men of African Descent, said, "This is
the news we have all been fearing. While the recent advances in HIV treatment
have led to the improvement of countless lives, we have always known that many
people respond poorly to these therapies and for many others, the side effects
are devastating. Continued education about staying safe and avoiding HIV remains
our most potent weapon."
Dr. Jay Dobkin, Director of the AIDS Program at Columbia University Medical
Center, said, "This case is a striking reminder that the risk of getting
infected with HIV has not gone away. In fact, risky behavior may be even more
dangerous now since there is a chance of infection with a virus we may not be
able to treat."
"This case should drive home the point that substance use can lead to unsafe
sex, and unsafe sex can lead to infection with a highly drug-resistant strain of
HIV that can be extraordinarily difficult to treat and may cause rapid
progression to AIDS," said Roy M. Gulick, MD, Associate Professor of Medicine at
Weill Cornell Medical College in Manhattan.
Dr. Jack DeHovitz, Professor at SUNY-Downstate Medical Center said, "This
finding supports the need for enhanced availability of HIV testing, as well as
preventive interventions, which are effective in reducing subsequent HIV
transmission."
Know Your HIV Status
There is an epidemic of HIV and AIDS in New York City: more than 88,000 New
Yorkers are known to be living with HIV/AIDS, and an estimated 20,000 more are
believed to be living with HIV/AIDS and don't know it.
By knowing your HIV status, you can protect yourself, anyone you are having sex
with, and, if you are pregnant or planning pregnancy, your baby. Free and fully
confidential STD exams and treatment, as well as confidential or anonymous HIV
testing, are available at Health Department clinics throughout New York City.
Health insurance, proof of citizenship and/or parental consent are not required
to receive these services. Please call 311 or visit
http://www.nyc.gov/health
for a list of clinics and hours of operation
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