Multiple Strains Of HIV Can
Be Present In AIDS Victim
AIDS Alert
Vol. 16, No. 2, P. 24

AIDS Alert Vol. 16, No. 2, P. 24 2-7-1
An unusual occurrence of HIV drug mutations was noted recently in the examination of a Texas prisoner infected with HIV. The prisoner became infected with the virus while incarcerated, and within one year developed the nine HIV drug mutations despite having never received any antiretroviral drug therapy. "So this is the first report of transmission of highly resistant virus during primary infection in prisons," notes Dr. William O'Brien of the University of Texas Medical Branch and Division of Infectious Diseases in Galveston.
O'Brien discovered the unusual case while doing a comparison study of prison inmates and university patients. He found that members of both patient populations who tested with a higher than a 5,000 viral copy level, showed a significantly high level of resistance mutation, especially patients exposed to the drug 3TC. At this point, the primary difference between the two patient populations was that the incidence of mutation was higher at 80 percent in the prison population versus 50 percent within the university patient group.
While O'Brien was collecting his data, he encountered an inmate record that indicated the man exhibited high risk behaviors for infection although he had tested HIV-negative several times. In early 1997, the inmate finally tested HIV- positive but was never placed in any kind of drug therapy program. Less than one year later, blood tests revealed that the virus had mutated into nine different drug resistant strains, and then again another year later, the same nine strains were identified. O'Brien notes that when a patient is not receiving drug therapy, resistant mutations generally disappear over time, because the virus is able to grow faster without them.
He adds, "I've been cautioning patients for years that even if they already have HIV, it's theoretically possible they could get a virus that's worse than the one they already have." The findings also indicate that clinicians consider resistance testing prior to starting therapy for patients whose risk behaviors increase the likelihood that they were exposed to drug-resistant strains.

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