S.D. man could have aggressive HIV strain

LENNY IGNELZI / Associated Press
San Diego County public health officer Dr. Nancy Bowen yesterday urged people who think they might be infected with HIV to get tested.

An unidentified San Diego resident may be infected with the same rare, aggressive and highly drug-resistant strain of HIV found last week in a New York City man who has rapidly become ill with AIDS, health officials said yesterday.

"(The local person's) HIV has a similar molecular makeup as the patient in New York City," said Dr. Nancy Bowen, the San Diego County public health officer who held a press conference about the finding yesterday afternoon in San Diego.

It's important to notify the public about a new and possibly supervigorous strain of HIV so people can take extra precautions, Bowen said. But "I don't think it will do anybody any good to get panicked about this," she said, emphasizing that many details are still being sorted out.

Several AIDS specialists said it was odd to see public-health officials sound such widespread alarm after only one person became sick. They questioned whether the virus is truly a lethal variety, or whether the New York patient's immune system, extensive use of methamphetamines and genetic makeup might be contributing factors to his rapidly deteriorating condition.

But public health agencies and the federal Centers for Disease Control and Prevention said the announcement was necessary because they haven't seen an HIV strain that becomes drug-resistant and progresses to AIDS so quickly, as in the case of the New York man.

Bowen urged people who think they might be infected with HIV to get tested. If infection is confirmed, the individuals should visit a doctor and request a second blood test to determine what genetic strain of the virus they might have.

The AIDS virus mutates regularly, changing its molecular structure over time, so blood testing is normally done to make sure each patient's genetic strain is vulnerable to anti-viral drugs being prescribed. If the strain isn't vulnerable, doctors must find other medications.

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Bowen said the San Diego resident tested positive for the rare HIV strain last fall – after the patient's health provider sent a sample of his or her blood to ViroLogic, an HIV typing reference laboratory in Northern California.

There was no alarm until the New York City man recently became ill and was found to have a molecular strain resistant to virtually all anti-viral drugs. His case prompted public health officials nationwide to check with the reference lab for a similar strain among other HIV patients.

The reference lab's database then linked the New York strain to that of the San Diego person and an unidentified New York City resident.

Researchers don't know yet whether the New York and San Diego strains are an exact match, Bowen said. They also haven't determined if the three individuals know one another. It will take at least a week to decide if the HIV strains are identical, said Dr. David Ho, director of the Aaron Diamond AIDS Research Center in Manhattan.

Federal and California health officials are trying to locate the San Diego resident through the reference laboratory, find his or her doctor and ultimately get in touch with the infected person. They want to see if this individual is ill, to conduct further testing and to notify sexual partners who may be at risk of contracting HIV.


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If the person was tested under anonymous conditions, in which a name is not given, it could be impossible to locate his or her whereabouts. The patient also may have moved away from San Diego or died.

Health officials said the New York patient reportedly had unsafe anal sex with hundreds of partners while taking crystal methamphetamine. The drug's stimulating effect and erasure of inhibitions contribute to sex marathons that have increased the spread of HIV, they explained.

Medical investigators believe that the New York patient found some of his partners on an Internet Web site. They are working with men who used the site to reach as many people as possible who might have been infected or are worried about the risk.

Yesterday, Bowen reissued precautions for drug users, urging them to not share needles or syringes. She also urged sexually active individuals to abstain from intercourse or to commit to a long-term, mutually monogamous relationship with a partner who has tested HIV-negative.

Correct and consistent use of a condom can reduce the risk of spreading sexually transmitted diseases, she added.

Bowen said she hopes the finding will prompt "people who are not sure of their (HIV) status but who are at risk to decide that they want to find out. That's one of our main messages."

In the past three or four years, about 400 San Diego County residents each year have been diagnosed with AIDS. In January, four new patients were diagnosed, bringing the total number of county residents diagnosed with AIDS since 1981 to 12,237. Of those, 54 percent have died.

The New York Times News Service contributed to this report