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Friday, February 11

Full Blown AIDS in 3 Months

NYC Health Officials Find New, Virulent HIV Strain

Feb. 11 (Bloomberg) -- New York City doctors have discovered a previously unseen strain of HIV, which appears to be resistant to three of the four types of anti-viral drugs that combat the disease, and progresses from infection to full-blown AIDS in two or three months, the health department said.

``We've identified this strain of HIV that is difficult or impossible to treat and which appears to progress rapidly to AIDS,'' said New York City Health Commissioner Thomas Frieden.

Frieden said the case, diagnosed in a man in his mid-40s who reported multiple male sex partners and unprotected anal sex -- often while using the drug crystal methamphetamine -- was ``extremely concerning and a wake-up call.''

Antonio Urbina, medical director of HIV education and training at St. Vincent's Catholic Medical Center, site one of Manhattan's largest AIDS clinics, said at a news conference that the patient's use of crystal methamphetamine shows that the drug ``continues to play a significant role in facilitating the transmission of HIV.''

The drug reduces peoples' inhibitions and their likelihood of using condoms or other forms of safe sex, he said.

`Alarming'

While drug resistance is increasingly common among patients who have been treated for HIV, cases of three-class antiretroviral-resistant HIV -- or 3-DCR HIV -- in newly diagnosed, previously untreated patients are extremely rare, and the combination of this pattern of drug resistance and rapid progression to AIDS may not have been seen previously, the Health Department said in a news release.

The strain found in New York was ``highly unusual,'' said Ronald Valdiserri, 53, deputy director of the National Center for HIV, Sexually Transmitted Diseases and Tuberculosis at the U.S. Centers for Disease Control, in an interview.

``We're talking about a single case, but clearly the fact that we are dealing with such broad resistance of drugs and the rapid clinical progression is quite alarming,'' Valdiserri said.

Fuzeon

Frieden said the one drug the HIV strain isn't resistant to is Enfuvirtide, sold under the trade name Fuzeon, developed by Trimeris Inc. of Durham, North Carolina, and Roche Holding AG of Switzerland.

The drug, which costs a patient an average $20,000, is the first in a class called fusion inhibitors that work by preventing HIV from infecting healthy cells. It requires a 20-minute mixing process and twice-daily injections, according to the Fuzeon Web site.

The problem, Frieden and other physicians said, is that this drug is most effective when used in a ``cocktail'' with other retrovirus drugs such as nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors and protease inhibitors.

The normal time of progression from infection to full-blown AIDS in an untreated patient is about nine years, with death following within 18 months, said Carly Stanton, a spokeswoman for the U.S. Centers for Disease Control in Atlanta. For someone treated with anti-viral drugs, the average progression to disease from infection is 11 years, with death occurring within an average six years, Stanton said.

Fast Onset

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

James Braun, president of the Physicians Research Network, a public health advocacy group in the city, said, ``We believe that the transmission of treatment-resistant HIV was a disaster waiting to happen, particularly in communities where safer sex is not practiced regularly and in light of people using drugs like crystal meth.''

Doctors at the Aaron Diamond AIDS Research Center in Manhattan diagnosed the patient, Frieden said. David Ho, director of the center, said the fact that the patient's strain ``is not amenable to standard anti-viral therapy, along with his rapid clinical and immunological deteroriation, is alarming.''

Ho said that although this represents 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.''

AIDS Population

The city reported 4,941 new cases of AIDS in the fiscal year that ended June 30, 2004, an increase from 4,164 the preceding year, according to Health Department statistics. Persons diagnosed and living with HIV/AIDS in New York City totaled 88,479 out of a total population of 7.3 million in calendar year 2003, the last year in which statistics are available.

Trimeris stock traded at $13.25, up 51 cents, in composite trading on the New York Stock Exchange as of 2:40 p.m., and down $4.98 from a year ago. Roche shares traded at 123.2 Swiss Francs, up 0.5 francs, in composite trading in Zurich, down six Swiss Francs from a year ago.


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