Posted on 02/11/2005 6:07:56 PM PST by neverdem
By THE ASSOCIATED PRESS
Filed at 8:06 p.m. ET
NEW YORK (AP) -- New York's first diagnosed case of highly drug-resistant HIV in a person never before treated for the virus is ``a wake up call'' to anyone who has unprotected sex, the city's health commissioner said Friday.
The patient, a man in his mid-40s who had unprotected sex with other men, contracted a strain of HIV that is ``difficult or impossible to treat and which appears to progress rapidly to AIDS,'' said the Health Commissioner Dr. Thomas Frieden.
The diagnosis ``is a wake up call to men who have sex with men,'' Frieden said at a news conference.
The commissioner said the city's health authorities are working with the federal Centers for Disease Control in Atlanta to find other possible cases of the drug-resistant HIV strain that quickly turns into AIDS.
``We are not aware of another case like this in the United States, or elsewhere,'' said Dr. Ron Valdiserri, deputy director of the CDC's National Center for HIV, STD, and TB Prevention.
New York health officials are now trying to locate the man's sex partners to offer them testing. The city has not released his name.
The man was first diagnosed in December 2004 at the Aaron Diamond AIDS Research Center on Manhattan's East Side. He apparently had been infected recently after years of what Frieden said was the riskiest sexual behavior -- unprotected anal intercourse. The man developed AIDS as early as two or three months after diagnosis.
``To go from infection to disease in months is very unusual,'' said Frieden, noting that HIV can take as many as 10 years to develop into AIDS.
Another factor that may have contributed to the careless sexual behavior was his use of crystal methamphetamine -- or ``crystal meth,'' Frieden said. ``It's a drug that reduces inhibitions and protective impulses.''
The patient's three-class antiretroviral-resistant HIV did not respond to three of four classes of anti-retroviral medication most commonly prescribed. He is now receiving a fourth ``cocktail'' in hopes his rare HIV strain will respond, health officials said.
Drug resistance is increasingly common among HIV-positive people, including some who had never been treated before -- but not with such a fast progression to AIDS, Valdiserri said.
What makes this case important to scientists is ``the double whammy of resistance to three classes of drugs, in combination with the rapid clinical course of the HIV to AIDS,'' Valdiserri said. ``The message to the American public is that HIV remains a very formidable adversary. We can't let down our vigilance.''
Dr. James Braun, president of the Physicians Research Network, a New York-based not-for-profit organization of clinicians serving HIV patients, said the New York case comes as no surprise: ``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.''
More than 88,000 New Yorkers are known to be living with HIV/AIDS, and an estimated 20,000 more are believed to be infected and don't know it, according to the city's health department.
Frieden said the gay community successfully reduced its risk of AIDS after the first big epidemic in the 1980s. ``And it must do so again to stop the spread of drug-resistant strains.''
On the Net:
New York City Department of Health and Mental Hygiene: http://www.nyc.gov/health
At least a Darwin Award!
Well, some of the things I know about meth is that it is sometimes injected, and people who are on it usually look pretty scabby and scuzzy. I think it is simpler than the meth causing "mutations." I think you do a lot of drugs, you're going to get sick.
I'm not inclined to think so. Meth works very much like adrenaline(epinephrine). I'm more inclined to think it stressed the immune system besides lose the inhibition about doing stupid acts.
bttt
And lesbians, a group least likely to get AIDS, but who can get breast cancer, are at the front lines campaigning for AIDS money.
Hat's off to you, Ash, yer doin' it right! Trust me when I tell ya, you'll be glad you did.
Thanks - that very good information. Looks like it costs $12-15K for keeping a patient on the antiviral "cocktail" of drugs for one year. I don't know what the lifetime costs for an AIDS patient are, but this is good to know.
I find this to be the classic bureaucrat's view of a government program "saving" money. They are taking general revenue dollars to keep a patient's private insurance going (paying the private insurance premium already in place with tax dollars, rather than letting the patient drop the insurance and go 100% on the back of the taxpayer) - and they celebrate the savings that this represents over direct state Medicaid payment for the treatment. It can only be regarded as savings if you assume that the seropositivity of some number of people in FL is a given. It's as if we need to declare victory and celebrate Florida's use of private insurance - when in fact all they are doing in is spreading the cost over a larger pool (the universe of the insured in a given patient's private insurance). So - Florida taxpayers win and all private insurance carrier insured lose. You have spread losses to some undefined group outside the jurisdiction of FL. But of course all other states are doing the same to other states, including FL.
The prospect of saving money by eliminating the behaviors that contribute to seropositivity in the first place - not considered. This is the insanity of AIDS policy.
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