New, More Aggressive Strains Of HIV

[rawTOP]

The news this week is that Swedish researchers have found a new more aggressive strain of HIV in Guinea-Bissau, West Africa. The strain is a "recombinant" strain – meaning it's two strains combined. What's notable about this particular strain is that, left untreated it progresses to AIDS more quickly than other strains.

http://www.medicalnewstoday.com/articles/269510.php

But there are other regions that are seeing more aggressive strains of HIV as well… In Russia the numbers of people becoming poz is skyrocketing and it seems to be due to one particular strain that accounts for about 50% of new infections.

http://www.advocate.com/health/hiv-aids/2013/10/20/virulent-new-strain-hiv-discovered-russia

And in India they're seeing five new strains which are on the rise. These new strains result in higher viral loads than the older strains and they're thinking that higher viral loads means the people are more likely to infect others (makes sense).

http://www.ipsnews.net/2012/11/evolving-hiv-strains-worry-indian-scientists/

http://www.thehindu.com/sci-tech/health/medicine-and-research/three-to-five-new-strains-of-hiv1-rapidly-evolving-says-study/article4078611.ece

Back in the day before ARVs guys talked a lot about basic epidemiology. One of the foundations of epidemiology is that when two strains compete, the one that kills it's host fastest tends to lose out to ones that take longer to progress. The logic being that if you kill your host then that stops your ability to spread. So over time viruses tend to become weaker. There are a lot of exceptions to that rule, but to an extent it holds true. I always wondered what the effect of ARVs would be. ARVs let more virulent and deadly viruses survive longer – thanks to ARVs they no longer kill quickly – so the rules of natural selection (among viruses) don't apply. I would never want to go back to the days before ARVs – that was a rough time. But the downside of ARVs is more virulent viruses.

So the question becomes can tools like PrEP stand up to more aggressive strains of HIV?

[bearbandit]

I'd say that the Russian story is the one to be most concerned about. The other stories seem to emphasise HIV's capacity for mutation. The one story I frankly don't believe is the idea of "recombinant" HIV: it seems to be talking about superinfection which happens perhaps once per year around the entire world. A very rare event. Even if you're already positive, getting another strain of the virus, resistant to drugs you're using, isn't such a problem: HIV reverts to its wild type. Drug resistances fade. If I got fucked by (sounds so much better than "acquired from") someone whose HIV was (a) at infectious levels, and ( was resistant to one of the drugs I'm on, I frankly wouldn't be worried. The little passengers, once there are drugs around, are fighting for survival and they don't take kindly to strangers...

[rawTOP]

The one story I frankly don't believe is the idea of "recombinant" HIV: it seems to be talking about superinfection which happens perhaps once per year around the entire world. A very rare event.

Believe it…

http://www.medicaldaily.com/aggressive-new-hiv-strain-west-africa-develops-aids-more-rapidly-what-recombinant-virus-263970

Realize that they do DNA typing of the viruses to track mutations. So there's good, hard science behind the idea of recombinant viruses. I think you understand the idea - a person gets co-infected with another strain (it happens) and then the two strains mutate and form a new version of the virus and that new strain is the recombinant strain. It has DNA from the first two strains, but can act differently than it's parents. The article above says that recombinant strains tend to be more aggressive.

I think super-infection is more about strains that are multi-drug resistant. Co-infection is picking up another strain. Typically the strain you have will fight off the new strain, but if the new strain is stronger it can take over or an equilibrium is reached between the two (or they mutate into a recombinant). When you hear that someone's meds stopped working - that's probably because of one of these scenarios. They got exposed to a new strain and there was co-infection…

[wood]

So the question becomes can tools like PrEP stand up to more aggressive strains of HIV?

I've been wondering that myself, or does Truvada provide protection in a situation where a poz top is resistant to the drugs in Truvada..

Anyway, the new strains don't really surprise me, and something tells me this has been happening all along. In Russia especially many new infections are being seen in injection drug users who are already in poor health, so its no surprise they dont do well with HIV.

[bearbandit]

I've been wondering that myself, or does Truvada provide protection in a situation where a poz top is resistant to the drugs in Truvada...

PrEP is best used in a belt and braces situation: when the poz guy is at a very low viral load vie medication (TasP), and the neg guy is taking PrEP. If a guy is resistant to both FTC and tenofovir, what we're really saying is that his virus is resistant to those drugs, so any virus in his cum will be resistant also. (About 10% of guys who achieve an undetectable VL are not undetectable via semen counts. The figure seems to be lower for guys who take an integrase inhibitor.) Hence the need for him to keep his VL as low as possible, as any virus that does slip through the drugs he's taking are going to laugh in the face of truvada.

[VoiceOfReason]

It's just a matter of time until there's a super-strain of the disease that's more aggressive & drug-resistant. The CDC has officially given up in "education on awareness and prevention" of abstaining from becoming infected and are now just focused on people getting tested and medicated. Yep, you heard right gents we're all just numbers now to a system that ultimately really doesn't care in the end about you or I. But regardless you've got so many that are living in the moment and don't care about the consequences in the choices they make or the actions that effect others whether deliberate or not.

If there's anything that AIDS has shown us in it's 32 plus years from it's creation to it's introduction into the human populace is that it's a unique virus unlike anything anyone has ever known, seen, or dealt with from a medical to a social stand point. Except for a few cases of those who were "cured" it's a disease that once infected you're gonna die from it. Regardless of treatments and meds it's gonna happen. Since AIDS is a combination of multiple viral sequences enabling it to mutate and adapt rather quickly to adverse forces used to fight it, shows that it's evolution and elusiveness in a steady treatment is relentless. So many think that because there's advancements in the medical treatments like the cocktails, prep, etc that these somehow are "cures" or disable the virus from doing the inevitable to it's host. Wrong answer, and in some cases these treatments are not done correctly or are not affordable to many. So all in all for those who fall in either category of taking the meds and not finishing them or can no longer afford them in the discontinued treatment but still have sex are enabling the very real possibility of a whole new health threat. One that may really start dwindling down the populations of those it was targeted to effect.

[wood]

You know.. I'm trying to take you seriously and I'm thinking now that I shouldn't. You not only are not a "voice of reason" you also have no idea what the hell you are talking about. I work in public health and your fear mongering that you call education does NOTHING to help or inform people. Your "information" and ideas are wrong and or don't work. Lastly despite what you think its people like you that actually hurt the cause by pretending that existing and older ideas work, despite being proven otherwise.

and honestly if you want to look at HIV from a purely epidemiological point of view the simple and easy way to stop the spread is to quarantine and kill the people who have the virus, not let them in the general population, oh wait that would be you....

[FunCheerSlut]

On 11/30/2013 at 4:18 PM, rawTOP said:

Believe it…

[think before following links] http://www.medicaldaily.com/aggressive-new-hiv-strain-west-africa-develops-aids-more-rapidly-what-recombinant-virus-263970

Realize that they do DNA typing of the viruses to track mutations. So there's good, hard science behind the idea of recombinant viruses. I think you understand the idea - a person gets co-infected with another strain (it happens) and then the two strains mutate and form a new version of the virus and that new strain is the recombinant strain. It has DNA from the first two strains, but can act differently than it's parents. The article above says that recombinant strains tend to be more aggressive.

I think super-infection is more about strains that are multi-drug resistant. Co-infection is picking up another strain. Typically the strain you have will fight off the new strain, but if the new strain is stronger it can take over or an equilibrium is reached between the two (or they mutate into a recombinant). When you hear that someone's meds stopped working - that's probably because of one of these scenarios. They got exposed to a new strain and there was co-infection…

You have no idea how long I have been trying to find this answer. I have had this question forever. Thank you @rawTOP for such an excellent resource and concise explanation. Yet this still doesn't deter us - so is it really that dangerous? Has treatment evolved to provide any type of quality of life into old age? Have we learned enough recently to develop a vaccine for any or all future strains of HIV? Will we be getting a vaccine for that one-day? So many questions...sorry.