FOUR LOCAL MEN FOUND TO HAVE DRUG-RESISTANT STRAIN OF HIV

Four men in King County have tested positive for a similar strain of
HIV that is highly resistant to drugs, public health officials said
Thursday, raising the concern that others who had sex with them could
also be infected with this aggressive and often untreatable infection.

"There may be more cases we don't know about," said Dr. Bob Wood,
director of the HIV/AIDS program for Public Health -- Seattle & King County.

"We are still working to learn more about these individuals and the
virus they have contracted," said Dorothy Teeter, interim director of
the health department. "We are concerned for these individuals and
their partners, and are continuing our investigation."

What's most concerning, added Wood, is that the virus identified in
the four men is a similarly resistant genetic strain despite the fact
that none of them reportedly had any contact with one another. All
are gay men who used crystal methamphetamine and had many sexual
partners, he said.

"This is mostly about behavior," said Wood, who is gay and has
medically managed his own HIV infection for more than 20 years. "Men
who have sex with men need to know that drug-resistant strains can
and are being transmitted and may be much less treatable."

At least 100 King County residents still die of AIDS every year, Wood
noted, yet unsafe sexual behavior has increased within certain
segments of the local population -- most notably among drug-using
members of the gay community.

"There's a lot of complacency," Wood said. "People need to know that
some of these new infections may be impossible to treat."

Dr. Peter Shalit, a physician who cares for people with HIV/AIDS and
directs HIV/AIDS research at Swedish Medical Center, said it's
especially worrisome that four men with no known common relationship
would all have the same strain of drug-resistant virus.

"That's highly unusual," Shalit said. Though it's too early to say,
he said this could indicate that we have in the community a new
strain of multidrug-resistant HIV that is more easily spread than
previous drug-resistant strains.

"That's definitely a scary prospect," Shalit said.

Public health officials are working with the men and their health
care providers to try to locate and test their sexual partners for
HIV and drug resistance. In 2003, Seattle and King County was one of
the first metropolitan areas in the U.S. to launch a surveillance
program for multidrug-resistant HIV.

Wood and Teeter asked that physicians and other health care providers
routinely test for drug resistance among anyone with a positive HIV
test and report any cases of suspected multidrug-resistant strains.
Officials recommend that sexually active, drug-using gay and bisexual
men at exceptionally high risk for infection be tested every three
months. Others in high-risk categories should be tested yearly.

Public health officials previously had identified 12 other cases of
multidrug-resistant HIV in King County. But none of them was as
highly resistant to anti-viral drugs as these four related cases.
This new strain was first identified in a man in 2005 and in three
other men last year.

None of the four men has experienced any symptoms, Wood said.
However, experts are concerned about the possibility that
drug-resistant HIV can progress to AIDS much faster than is the case
with the typical HIV infection.

Drug-resistant HIV is not a new problem, Wood said, and there is no
evidence yet to suggest this new strain is any more transmissible.

"But it's certainly a reminder that this can still be a deadly
disease," he said.

HIV infection today is treated with a number of drugs to which the
virus can develop resistance. The virus genetically mutates and
"learns" how to better defend against the drug. People with HIV are
able to keep the infection at bay by moving to a different drug regimen.

Learn More

metrokc.gov/health/news/07020101.htm.

who.int/drugresistance/hivaids/en/