Novel Genetics of Emerging 3-DCR NYC HIV Recombinant
Recombinomics Commentary
February 16, 2005
>> Resistance -- common in chronic AIDS cases being treated with drugs -- is also found in 3% to 15% of recently infected people too, said Julio Montaner, a professor of medicine at the University of British Columbia in Vancouver. Moreover, multiple-drug resistance in newly infected people with rapid collapse of immunity isn't new, he said. He found such a phenomenon in 2001, and in 2003 published his findings in the journal AIDS. <<
The concern over 3-DCR NYC is related more to the altered genetics of the virus and its simultaneous appearance on both coasts, than the rapid progression to AIDS in one patient. The press release from ViroLogic described three assays that yielded a genetic / biological convergence that had both been seen previously. These tests measured the ability of the virus to grow, attack the immune system, and resist treatment. Other viruses had been found to possess one or two of the properties, but not all three. The unique convergence was found in only three isolates. Two are from NYC partners while the third is from San Diego. The San Diego and one of the NYC infections appear to have happened in the same time frame (fall of 2004).
The association of this convergence on AIDS progression has only been reported for one patient and progression was rapid. Many more patients will be required to create a reasonable range of progression times. However, because the convergence is rare, the genetic convergence and progression times are both testable and reportable.
The spread of this virus also remains to be determined. As of last fall it was rare, but found on both coasts. If these two cases are related, then the spread may be limited. If they are not, then the simultaneous appearance may signal recent widespread transmission of a novel HIV.
The key finding however, is the generation of a new virus which is likely to be a recombinant, creating a stable convergence of the three properties of 3-DCR NYC
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