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Transmission of Drug Resistant HIV Signals New AIDS Era

Recombinomics Commentary
March 20, 2005

>>He also said the men, who were both already HIV-positive, apparently had sex with each other…….

The new strain of the virus that both men tested positive for is known as multi-drug resistant HIV, or MDR-HIV.

Not only is it drug-resistant, but  it can progress from HIV to full-blown AIDS in a matter of months  <<

The transmission of 3-DCR from a New York City, NY patient to a Bridgeport CT patient signals a new AIDS era based on both genetic and social factors.

On  the genetic side, the NYC isolate combined three characteristics of aggressive HIV.  3-DCR NYC had a wild type replication capacity, but was resistant to three classes of anti-viral agents and could use two referent receptors to infect cells.  The properties were identified in three independent in vitro assays by ViroLogic and signaled genetic changes that were host independent.

However, although the HIV was host independent, it is probably a recombinant and was formed by recombining the genes of two distinct HIV genomes, which is facilitated by dual infections.  The dual infection was facilitated by a sexual encounter by two HIV infected people who have different HIV's.

Since both patients were HIV positive at the time of their encounter, opportunities for additional evolution of HIV is possible. 3-DCR CT is also resistant to three classes of HIV anti-virals, but the virus may be changing more via additional recombinations.  Since the merging of the three properties described above for 3-DCR NYC was identified after multiple sexual encounters with multiple partners, the potential for further spread is great.

Thus, increased frequencies of 3-DCR positive patients with other HIV positive patients can lead to further transmission of 3-DCR NYC, but also the potential for new variants. As the number of 3-DCR positive patients increase, the potential for more dual infections also increases because of the number of HIV positive patients engaging in unsafe sex with other HIV positive patients.

This increased frequency is driven in part by the success of anti-viral treatments, which changed the perception of HIV/AIDS from a fatal infection to a chronic manageable infection.

The emergence and transmission of 3-DCR NYC suggests that this new strain could spread and evolve rapidly and create a new deadly disease with limited treatment options.

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