AIDS Mutation Appears
By Patricia Conklin
From Switzerland to San Francisco, a new strain of drug resistant AIDS has been detected by physicians. Though cautioning against panic, Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases in Bethesda, Maryland, says that catching this strain of the virus, since there are no drugs to treat it, would be analogous to becoming infected in the early 1980s when there were no HIV treatments available.
While the AIDS virus that has been tracked since then now seems at least marginally manageable among a growing number of more responsive patients due to the arrival of protease inhibitors, the newly detected strain gives no signs of similar heartening responses, according to Dr. Frederick Hecht, an assistant clinical professor of medicine who works for the AIDS Research Institute at the University of California.
Multiple mutations of the AIDS virus are now more likely to arise, according to the physician/researcher, as the virus struggles to surmount blockages initiated by medical researchers using at least four recently-developed anti-HIV medicines.
Following a lengthy, intensive tracking route, Dr. Hecht discovered that an infected patient, a middle-aged gay male, had become infected after a single sexual experience that took place without the protection of a condom. The HIV-positive man by whom this man was infected had previously been treated with reverse transcriptease inhibitors as well as eight other anti-retroviral drugs. These treatments, however, had been administered irregularly at best.
The sporadic treatments, according to Dr. Hecht, probably helped contribute to the emergence of the new drug-resistant HIV which was then transmitted to the middle-aged patient.
Such a transmission, Hecht insisted, has never before been documented. The July 30 issue of The New England Journal of Medicine will publish Dr. Hecht's research.
Documentation of HIV transmissions that are drug-resistant, those taking place between one patient and another have been previously made, although these involved only AZT and not protease inhibitors.
New Evidence: Battered Immune Systems Rebuilding
Dr. Bridgette Autran, a researcher at the Pitie-Salpetrire Hospital in Paris, believes that battered immune systems can be rebuilt if HIV patients use long-term protease inhibitor therapy. The therapy, says Dr. Autran, shows potential for keeping patients in good health indefinitely.
Since therapy reduces virus levels, a patient's battered immune system has a chance to be rebuilt, thus keeping at bay life-threatening AIDS-related infections. Dr. Autran's findings are clear from records kept on hundreds of patients taking protease inhibitors and who have shown encouraging signs of "sustained" boosts to their immune systems.
A rise in white blood cells (CD4 cells) which are the principal targets of HIV, has been noted. These cellsŚknown as "na´ve" because they have never before been exposed to the virusŚrecognize HIV as an invader, says Dr. Autran. A boost to the immune system showed significant drops in such opportunistic infections as tuberculosis and cytomegalvirus.
The "bottom line" according to the French researcher, is that if the potent drug cocktails work, suppressing viral loads, the "na´ve" immune cells emerge and activate.
No one knows where these "na´ve" cells are originating.