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Health

Drug-resistant HIV strain alarms officials

New York man developed full-blown AIDS within months


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(CNN) -- Health officials in New York City are alarmed after a man infected with a highly drug-resistant strain of HIV progressed to full-blown AIDS within months of diagnosis.

That raises the possibility that a hard-to-treat variant of the virus could be spreading among gay and bisexual men who use the drug methamphetamine.

"This case is a striking reminder that the risk of getting infected with HIV has not gone away," said Dr. Jay Dobkin, director of the AIDS program at Columbia University.

"In fact, risky behavior may be even more dangerous now since there is a change of infection with a virus we may not be able to treat," Dobkin said in a press release from the New York City Department of Health and Mental Hygiene.

The department has issued an alert to doctors and hospitals to check other newly diagnosed HIV cases to see if they are also infected with the drug-resistant variant.

Health officials also are monitoring laboratories for additional cases.

"This case is a wake-up call," Health Commissioner Thomas Frieden said in the release.

The man, in his mid-40s, had not previously been treated for HIV. He was diagnosed last December and his infection appeared to be recent, health officials said.

He reported having multiple male sex partners and unsafe anal sex, often while using a crystallized form of methamphetamine, known as "crystal meth."

The man's HIV strain proved to be resistant to three of the four available types of antiviral drugs used to keep HIV in check.

While patients being treated for HIV do develop drug resistance, finding such resistance in someone who has never taken HIV drugs is "extremely rare," according to the city health department.

Even more alarming to health officials was the fact that the patient has already progressed to full-blown AIDS -- something that typically takes more than 10 years after initial HIV infection.

"In this patient's case, onset of AIDS appears to have occurred within two to three months, and at most 20 months, after HIV infection," the health department's statement said.

Noted AIDS researcher Dr. David Ho, director of the Aaron Diamond AIDS Research Center in New York, said the case "is alarming."

"While this remains a single case, it is prudent to closely watch for any additional possible cases while continuing to emphasize the importance of reducing HIV risk behavior," Ho said in the health department's press release.

Public officials have long expressed concern that gay and bisexual men were abandoning safer sex practices, particularly the use of condoms during anal sex, that successfully reduced the spread of AIDS in the 1980s and 1990s, before antiviral treatments were available.

Contributing to their concern is the increased popularity of crystal meth, which can impair judgment and heighten sexual sensation.

"The rapidly growing crystal meth epidemic in New York continues to play a significant role in facilitating the transmission of HIV," said Dr. Antonio Urbina, director of HIV education at St. Vincent's Catholic Medical Center in New York.

"Health care providers must be especially vigilant in not only recognizing and diagnosing HIV infection, but also in recognizing the signs and symptoms of crystal methamphetamine use in their patients," he said in the health department's release.


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