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Possible New Strain of HIV Investigated

Resistance to Treatment and Rapid Progression to AIDS Give Rise to Superbug Fears

Is a Superbug Really Here?

Despite the frightening possibilities, many AIDS researchers remain skeptical that a superbug is in our midst.

"Right now there are two very basic questions that are not being answered publicly, and they are intrinsic to how frightening this story really is," says Valentine.

The first question: Is the New York City man infected by more than one strain of HIV?

The second question: Did his CD4 cell count (an indication of disease progression) ever respond to treatment, even for just a short while?

Why is this information critical? Valentine says it's not unheard of for one person to be infected with two strains of HIV: one a "wild" or unmutated strain that progresses rapidly but responds well to drugs, and a second "mutated" strain that replicates slowly but does not respond to treatment.

Although the "wild" strain becomes the basis for initial diagnosis, once treatment is started that virus recedes, allowing the mutated virus, which does not respond to drugs, to come forward. If medication is then stopped in response to the drug-resistant virus, the "wild," rapidly progressing strain moves forward again.

It is this back-and-forth motion, says Valentine, that can make it appear as if one superbug is at work when it's really the work of two separate strains.

"If at any point the New York patient had responded to drugs, there's good reason to believe this dual diagnosis holds the key to what we are seeing now, " says Valentine.

2 HIV Strains May Combine

In a slightly different scenario, Klotman says it's possible two different strains of the virus were contracted almost simultaneously from two different sources, and they landed in a single cell.

"It has been well documented in the past that when two strains infect a single cell they can recombine their genetic material and create a new and seemingly more powerful virus," says Klotman.

And indeed, both dual-infection theories are plausible since the New York City man admitted to not only being promiscuous, but also a heavy user of crystal methamphetamine, a street drug that lowers inhibitions and increases risky sexual behavior.

Says Valentine, "If it is really true that there is a superbug, a highly drug-resistant virus that is also replicating like gangbusters, then this is a very scary story. But based on the information released thus far, we cannot make that determination."

Both New York City health officials and experts from the Aaron Diamond AIDS Research Center, where 3DCR-HIV was originally isolated, did not respond to WebMD's requests for comments.

Ultimately, however, the one factor everyone seems to agree on is this: Even if 3DCR-HIV does not turn out to be the superbug we fear, it serves to remind us that the possibility of a more deadly strain of HIV could be around the bend.

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