Washington State
men contract hard-to-treat HIV strain

A hard-to-treat strain of the virus that causes AIDS has been found in four gay men in King County, Wash., and authorities fear it could spread. There is no evidence that the troublesome strain of HIV is spreading rapidly, but its appearance underscores the need for renewed emphasis on safe-sex practices, officials in the Seattle-King County public health department said Thursday. ''There may be more cases we don't know about,'' said Bob Wood, the agency's HIV/AIDS program director. ''We are still working to learn more about these individuals and the virus they have contracted,'' said Dorothy F. Teeter, interim director of the department. ''We are concerned for these individuals and their partners and are continuing our investigation.'' The same genetic strain of HIV was found over a 15-month period in four men, each of whom identified as methamphetamine users with multiple sex partners, though none is known to have had sex with any of the other three, officials said. ''That's highly unusual,'' said Peter Shalit, who treats HIV and AIDS patients and directs research on the disease at Swedish Medical Center. One possibility is that there is a new strain of multidrug-resistant HIV that is spread more easily than previous drug-resistant strains, ''definitely a scary prospect,'' Shalit said. ''There's no evidence that this has spread outside of King County,'' said Patrick Sullivan, chief of the behavioral and clinical surveillance branch at the Atlanta-based Centers for Disease Control and Prevention. But the CDC hasn't compared this strain with any outside King County because the agency studies disease from a population, not an individual, perspective, he said Friday in a telephone interview. One man in New York, diagnosed with HIV in December 2004, was found to have a multidrug-resistant type of HI. He, too, had multiple, anonymous male sexual partners and a history of methamphetamine use, according to the CDC. Nationally, 2% to 3% of the HIV strains found in humans may be resistant to two to three classes of drugs, Sullivan said. While at least 100 King County residents die of AIDS annually, there is evidence of declining condom use and other safe-sex practices, especially among gay drug users, said Wood, who is gay and has medically managed his own HIV infection for more than 20 years. ''There's a lot of complacency,'' he said. ''People need to know that some of these new infections may be impossible to treat.'' Seattle was among the first metropolitan areas in the country to begin a surveillance program for multidrug-resistant HIV in 2003. Since then, doctors and other health care providers have been asked to test routinely for drug resistance in anyone who is HIV-positive and to report any indication of multidrug-resistant strains. Before Thursday, health officials had identified 12 cases of multidrug-resistant HIV in the county, none as resistant to antiviral drugs as the strain found in these four men. None of the four men has experienced any symptoms, Wood said, but experts fear that drug-resistant HIV could progress to AIDS much faster than typical HIV. In addition, Robert D. Harrington, director of the Harborview Medical Center clinic for HIV patients, said treatment for those who are resistant to several types of drugs could cost more than twice as much as the $15,000 a year that is needed for typical HIV. (AP)