HIV infection may seem more manageable today, but what if you got a strain of the virus that couldn’t be treated? Recent studies confirm that this happens easier than we might want to admit. And the result: AIDS and death, just as if this were 1985.
The new anti-HIV drugs introduced in the last five years have made a lot of difference in the AIDS epidemic, but they also have a darkside potential: Viral strains emerge which are resistant to the drugs. The more careless HIV-plus people are about taking their meds, the faster such strains develop; and the more different drugs a person has to try, the more resistance will increase. By the time a non-adherent patient has crashed multiple combinations, his/her HIV strain may be virtually untreatable. And if you catch their HIV, you won’t have many treatment options either. It’s called “multi-drug resistant HIV” or MDR-HIV.
At the Eighth Retroviral Conference in February, one study addressed 14 newly infected people, all infected by the same the source person with MDR-HIV that was resistant against all three classes of HIV meds.
Another case described a convict in the Texas prison system. Although HIV-negative when he went in, he became infected with a strain that had two major resistance points. He continued to engage in risky behavior, and within a year he had HIV with nine resistance mutations against all three drug classes. This is called “super-infection” – acquiring overlaying HIV strains which make the situation worse.
Americans, especially young people and gay men, have developed a mis-impression about HIV, believing that it isn’t a big deal anymore, that it can be treated. In some respects, it isn’t as dangerous. But MDR-HIV is growing, and we have nothing to effectively fight it. Yes, our choices about personal behavior and safety do still matter.
This article appears in April 6 • 2001.