New research from the University of Oxford finds a new variant of HIV, the virus that causes AIDS, that is potentially more infectious and could more seriously affect the immune system. So far, 109 people, most of whom live in the Netherlands, have the variant.
More aggressive HIV strain that leads to AIDS twice as fast discovered in Netherlands
The new variant is highly virulent and potentially lethal without early detection, according to researchers from the University of Oxford. Individuals with an HIV infection need quick treatment before the virus can ravage their immune system.
Scientists call this variant “VB” (virulent subtype B) and add that it may also have implications for COVID-19, since continuous mutations keep fueling the ongoing pandemic.
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For many years, there have been concerns this could arise in HIV and the new study appears to confirm this possibility. The AIDS-causing virus affects 38 million people worldwide and has claimed 33 million lives.
“Before this study, the genetics of the HIV virus was known to be relevant for virulence, implying that the evolution of a new variant could change its impact on health. Discovery of the VB variant demonstrated this, providing a rare example of the risk posed by viral virulence evolution,” says lead author Dr. Chris Wymant in a media release.
New HIV variant causes illness twice as fast
The new strain, called the VB variant, damages the immune system, weakening people’s ability to fight everyday infections and diseases much faster than the previous HIV strains, scientists say.
It also means that people who contract the new variant may develop AIDS faster. Researchers also found that VB has a viral load (the amount of virus detected in blood) 3.5 to 5.5 times higher than the current strain, indicating that it could also be more infectious.
Immune system damage occurred twice as fast
The CD4+T cell decline (a sign of immune damage by HIV) was twice as fast in people with the variant, researchers say. “By the time they were diagnosed, these individuals were vulnerable to developing AIDS within 2 to 3 years,” study authors wrote.
Absent treatment, critically low CD4 cell counts “with long-term clinical consequences” is expected to happen 9 months after diagnosis on average for people in their 30s with VB variant, they said.
“The VB variant’s ability to facilitate transmission, damage the immune system, and interrupt treatment is a reminder how smart the virus is evolving over time,” said Anthony J. Santella, DrPH, MCHES, professor of Health Administration and Policy at the University of New Haven.
How to slow down the variant
This research was “nicely done” and “well-designed,” says Adeeba Kamarulzaman, president of the International AIDS Society and professor of medicine at the University of Malaya, who did not work on the study.
It also helps answer a pressing question in the field of HIV research, she notes. Previously, researchers wondered whether people get sicker or are more contagious because of how their immune systems respond to the virus. The study found that individual responses are part of it but not all. It can also happen if a virus evolves to cause more severe illness and readier transmission.
Kamarulzaman warns that a mutation like this could happen in other places. If a number of HIV patients in a particular area have this kind of variant but isn’t taking medication, “you are going to have a lot more people with advanced disease a lot more quickly,” she says.
To prevent this from happening, she says, “early tests or frequent testing and immediate initiation of treatment is the way to go.” The goal isn’t to identify a specific variant but rather to diagnose new cases of HIV so that treatment may start as soon as possible. But some countries still struggle to do that, and they need more support, she adds.
“The public health intervention that’s been rolled out and expanded in the Netherlands over the last decade or so — improving access to treatments, getting people tested as soon as possible, getting them onto treatment as soon as possible — has helped reduce the numbers of this variant, even though we didn’t know that it existed,” Wymant says.
Rapid treatment also helps slow viral evolution, so variants like these are less likely to emerge. “This doesn’t mean we need to change strategy,” Wertheim says. “It just means we need to do more of what we’re already doing.”
New HIV strain is ‘not a public health crisis’
All of these variants pass from person to person in the same ways, such as unprotected sex and sharing needles. However, researchers say some are easier to pass on than others. Study authors believe VB emerged in spite of widespread treatment and awareness campaigns regarding HIV – not because of it. Effective drugs can suppress transmission.
Patients showed typical characteristics for people living with HIV in the Netherlands including age, sex, and suspected mode of transmission. This indicates the increased transmissibility is due to a property of the virus itself – rather than any differing behaviors of the people with the virus.
Reassuringly, after starting treatment, immune system recovery and survival rates were similar to those involving other strains. However, the researchers stress that VB causes a more rapid decline in immune system strength. This makes it critical individuals receive early diagnosis and treatment after infection. Further research to understand the mechanisms could reveal new targets for next-generation antiretroviral drugs.
The study also notes VB displays many mutations throughout its genome. A single genetic cause for this is not clear at this stage. Dr. Joel Wertheim, an HIV expert at the University of California-San Diego, who did not take part in the study, says sexually active individuals should not panic.
“Observing the emergence of more virulent and transmissible HIV is not a public health crisis,” Dr. Wertheim tells SWNS in a statement. “Let us not forget the overreaction of the claim of ‘Super AIDS’ in 2005.”
“Alarm was raised over a rapidly progressing, multidrug-resistant HIV infection found in New York that was ultimately restricted to a single individual,” Wertheim concludes.
There are two main types of HIV – HIV-1 (the most common) and HIV-2 (relatively uncommon and less infectious). Like many viruses, HIV has the ability to mutate and change over time – within the main types of HIV there are many genetically distinct subgroups.
There are two types of HIV, HIV-1 and HIV-2, as well as several related viruses that infect certain monkeys or great apes. HIV-1 can be found throughout the world, but HIV-2 is almost exclusively limited to West Africa. HIV-1 is transmitted more easily than HIV-2, and HIV-1 infection progresses more rapidly to AIDS.
The group has nine named strains: A, B, C, D, F, G, H, J, and K. Some of these have sub-strains. Researchers find new strains all the time as they learn more about HIV-1 group M. The B strain is the most common in the U.S. Worldwide, the most common HIV strain is C.
HIV 2 binds less efficiently than HIV 1 with the receptor molecule CD4 on the cell surface. Initially, people infected with HIV 2 have lower levels of virus in the bloodstream. As levels rise, health deteriorates and transmission to others increases.
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