NY Case of Rapidly Progressing Multi-Drug Resistant HIV Infection

We urge all public and community health providers and the media to clarify the facts of this case, and to direct resources towards a comprehensive HIV prevention effort that confronts, rather than encourages, stigmatization of people at risk of, or living with, HIV.

The history of the AIDS epidemic has taught us that misinformation spreads more quickly than the virus itself.

All materials provided for fair use.

AIDS COMMUNITY / PRESS MATERIALS

February 25, 2005: COMMUNITY BRIEFING: MULTI-DRUG RESISTANT, FAST PROGRESSING HIV IN NYC
This fact sheet has been created by HIV prevention and treatment activists to supplement available materials on this case. We hope it will present background information on this case and provoke additional inquiry to understand more about its implications. In addition, it presents historical data that might be useful in putting this case into context.

It does not repeat basic information on HIV prevention, crystal meth, or the importance of medication adherence, as these are available elsewhere. In addition, it does not address significant concerns about the way this story was released and its subsequent coverage in the media, which are initiated in other document and still require additional discussion.
Download Briefing

MARCH 25, 2005: LETTER TO THE EDITOR, NEW YORK TIMES
"We write to express our profound dissatisfaction with the New York Times coverage of the recent public health alert regarding a case of infection with multi-drug resistant HIV.

We are concerned about an apparent trend in this reporting of this case in the Times that foregrounds support for the decision of the NYC Department of Health to publicize this case through the media, while criticisms of the DOH decision and the associated scientific investigation (conducted by the team of Dr. David Ho at the Aaron Diamond AIDS Research Center) are downplayed. This has led to not just a biased reporting on issues of opinion, but inaccuracies in reporting the facts of this case."
Download Letter

March 18 2005: LANCET editorial: HIV/AIDS: Doing What's Right
"One lesson to be drawn from this case, therefore, is that despite all the advances that have been made in understanding this virus and all the progress that has been made in developing new drugs, prevention remains the most effective strategy to combat HIV, especially prevention efforts that target high-risk groups, such as men who have sex with men, intravenous drug users, and sex workers and their clients."
Click here to access on Lancet website (requires free registration)

February 24, 2005: AIDS Community Statement and Backgrounder: NY Case of Rapidly Progressing Multi-Drug Resistant HIV Infection signed by 40 organizations
As community-based organizations seek to meet the mounting challenges of a maturing epidemic in a time of funding cuts, HIV/AIDS prevention, service and policy organizations must place this case in the context of our work but resist drawing conclusions from incomplete evidence.
Statement and Backgrounder

February 27, 2005: "Eradication of the SuperBug": Report by Martin Delaney"Twelve days after a press conference in New York launched a wave of hysteria-inducing claims about a virulent new super strain of HIV, the scientific process has finally had its say. The case of the single patient followed for about a month after he was shown to be HIV positive was presented to an audience of two thousand or more scientists at the annual Conference on Retroviruses and Opportunistic Infections in Boston. This was the venue that many scientists and commentators said should have been the first place for presentation of the case, instead of a hastily called press conference."
Download report

February 24, 2005: GMHC Open Letter: SQUASHING THE "SUPER-BUG": AN OPEN LETTER TO GAY AND BISEXUAL MEN
In the United States, recent media attention about a multi-drug resistant HIV (the 'super-bug') couldn't come at a worse time — when HIV prevention efforts are both increasingly censored and under funded. Unfortunately, many public health officials are currently relying on a one size fits all approach to preventing further transmission of HIV. Abstinence is promoted over more comprehensive sex education approaches that address contextual as well as individual level factors. There is plenty of research showing the strong link between important contextual factors — HIV/AIDS stigma, homophobia, class, racism, community cohesion, depression, substance use, etc — and individual level HIV risk. View on webpage

February 11, 2005: Project Inform Press Statement on the New York City
Department of Health Report of a “Super” Strain of HIV
Although the transmission of drug-resistant HIV is a serious concern, Project Inform believes that the current reports may be unnecessarily alarming to the public. There is currently too little information available, and doctors have followed the patient for too short a time, to draw any conclusions about the significance of this situation. However, several aspects of the story being reported warrant further explanation.
Statement

BACKGROUND MATERIALS

March 18. 2005: Infection with multidrug resistant, dual-tropic HIV-1 and rapid progression to AIDS: a case report (LANCET)
"Our patient seems to have been recently infected by a viral variant of HIV-1 resistant to multiple classes of antiretroviral drugs. Furthermore, his virus population is dual tropic for cells that express CCR5 or CXCR4 coreceptor. The infection has resulted in progression to symptomatic AIDS in 4-20 months... The intersection of multidrug resistance and rapid development of AIDS in this patient is of concern, especially in view of his case history, which includes high-risk sexual contacts and use of metamfetamine. The public health ramifications of such a case are great"
View on Lancet webpage (requires free registration)

February 26, 2005: Webcast of Special Symposium: Transmitted HIV-1 Drug Resistance and Rapid Disease Progression
Presented at Conference on Retroviruses and Opportunistic Infections: click on "Thursday" and go to last section of the page to view in a way that will work for your computer system. Or choose second link to go directly to viewing session in Windows Media Player:
Go to webpage
Go to Presentation in Media Player

February 24, 2005: Poster Presentation of Data from Aaron Diamond AIDS Research Center: "A Case of Apparent Recent Infection with a Multi-Drug-Resistant and Dual-Tropic HIV-1 in Association with Rapid Progression to AIDS"
Presented at Conference on Retroviruses and Opportunistic Infections (CROI), www.retroconference.org
Download poster

February 23, 2005: New York State Department of Health "Dear HIV/AIDS Service Provider" letter
Includes two page letter from Commissioner Novello and "Key Public Health Messages for HIV Service Providers".
Download letter (10 pages)

February 25, 2005: STATEMENT BY NEW YORK CITY HEALTH COMMISSIONER DR. THOMAS R. FRIEDEN ON RARE STRAIN OF HIV IN A NEW YORK CITY RESIDENT
On February 11, 2005, the New York City Department of Health and Mental Hygiene (DOHMH) reported a case of HIV infection with a strain that is resistant to many drugs in three classes of HIV medications, and which appears to have progressed to AIDS within 4 to 20 months after infection. We continue to move forward in our investigation to identify the source and potential spread of this strain... As we said on the day we made this announcement, we do not yet know whether this patient's combination of drug resistance and rapid progression of HIV to AIDS is an isolated event or is more widespread. As we also said on that day, we do not know what the clinical course will be for the affected patient. Several things are known...
View on webpage

February 11, 2005: New York City Department of Health and Mental Hygiene press release: "NEW YORK CITY RESIDENT DIAGNOSED WITH RARE STRAIN OF MULTI-DRUG RESISTANT HIV THAT RAPIDLY PROGRESSES TO AIDS"
NEW YORK CITY - February 11, 2005 - A highly resistant strain of rapidly progressive human immunodeficiency virus (HIV) has been diagnosed for the first time in a New York City resident who had not previously undergone antiviral drug treatment, according to the Department of Health and Mental Hygiene (DOHMH). The strain of three-class antiretroviral-resistant HIV - or 3-DCR HIV - does not respond to three classes of anti-retroviral medication, and also appears to greatly shorten the interval between HIV infection and the onset of AIDS
View on webpage