The Case of the Mutant AIDS Virus
On Friday, New York City health officials issued this chilling announcement: A man is infected with a form of the AIDS virus that is not only resistant to three of the four classes of anti-HIV drugs, it is apparently so virulent that it causes full-blown AIDS in a matter of weeks rather than the usual decade or more. It will be super-difficult to treat, and it may be a super-fast killer.
New York City Health Commissioner Thomas Frieden first heard of the case on Jan. 22. Tests showed that the man had been infected for only a short time.
Frieden prudently had samples of the mysterious virus assessed by two independent labs. Both labs confirmed that it is resistant to all three of the classes of pill-form HIV drugs and that it attacks its victims with what are called CX4 cellular receptors, which are typically found only in those infected with HIV for a long time and in advanced stages of AIDS.
There is more bad news. The man is the victim of another U.S. epidemic -- methamphetamine use. While high and uninhibited, he had sex with more than 100 men over the last two years, often without using a condom. And he recalls little about those encounters -- certainly not the partners' names and addresses. There is little hope of tracing the virus, of studying the strain's transmission, of warning the victim's partners or stopping them from having more unprotected sex.
Frieden's warning on Friday was exactly right: "This is a wake-up call." AIDS isn't tamed, and it certainly isn't defeated.
Still, it didn't take long for the naysayers to appear. Dr. Robert Gallo, co-discoverer of HIV, called the announcement "irresponsible and outrageous." Other HIV scientists insisted that Frieden was wrong to issue an alert because highly mutated viruses are wimpy bugs -- they must surrender their powers of transmission to become drug- resistant. Still others insisted that it was biologically impossible for CX4 viruses to spread widely: Unless the city could prove the new HIV strain had been transmitted, the alarm was inappropriate.
Such reactions are hogwash. Denial and silence are the true dangers.
In 1981, all too many doctors and scientists ignored a Los Angeles report of six cases of strange pneumonia in gay California men. "What's the big deal with six sick homosexuals?" many said to me then. That was the birth of AIDS, which has now killed more than 25 million people and currently infects 40 million to 50 million.
