Báo cáo y học: New York City HIV superbug: fear or fear not?

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Báo cáo y học: " New York City HIV superbug: fear or fear not?"Retrovirology BioMed Central Open AccessCommentaryNew York City HIV superbug: fear or fear not?Stephen M Smith*1,2Address: 1Section of Infectious Diseases, Department of Medicine, Saint Michaels Medical Center, New Jersey, USA and 2Department of PreventiveMedicine and Community Health, The New Jersey Medical School, Newark New Jersey 07102, USAEmail: Stephen M Smith* - ssmith1824@aol.com* Corresponding authorPublished: 02 March 2005 Received: 28 February 2005 Accepted: 02 March 2005Retrovirology 2005, 2:14 doi:10.1186/1742-4690-2-14This article is available from: http://www.retrovirology.com/content/2/1/14© 2005 Smith; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract On February 11, 2005, the New York City Department of Health and Mental Hygiene announced that a city resident had recently been infected with a multi-drug resistant form of HIV and rapidly progressed to AIDS. The Health Commissioner, Thomas R. Frieden, called for increased vigilance against this new strain. Is this situation an emerging crisis or simply an unusual case report of rapid HIV progression? At the 12th Conference on Retroviruses and OpportunisticOn February 11, 2005, New York City (NYC) health offi-cials announced the discovery of a rare strain of multi- Infections (CROI) in Boston, Drs. David Ho and Martindrug resistant HIV that rapidly progresses to AIDS. Markowitz of the Aaron Diamond AIDS Research CenterAccording to the NYC Department of Health and Mental in Manhattan presented clinical and laboratory dataHygiene, a man in his mid-40s was diagnosed with HIV regarding the NYC resident[1]. He had tested negativelyinfection in December 2004. Shortly after his diagnosis, for HIV-1 antibodies several times before and in Maytesting, at the Aaron Diamond AIDS Research Center in 2003. His total lymphocyte counts during these timeManhattan, revealed that his virus was resistant to almost points were repeatedly normal. Investigators believe thatall anti-HIV therapeutics. Further, despite being infected the NYC resident may have been infected in Octoberfor only 2–20 months, the man had developed AIDS. 2004, when he, while on crystal methamphetamine,NYC Health Commissioner Thomas R. Frieden, MD, engaged in unprotected, receptive and insertive anal sexMPH, stated, This case is a wake-up call. First, its a wake- with multiple partners. In early November 2004, the NYCup call to men who have sex with men, particularly those resident developed a febrile illness, and then in Decemberwho may use crystal methamphetamine...now, weve 2004, he tested positive for antibodies against HIV. Hisidentified this strain of HIV that is difficult or impossible personal physician, concerned over the possibility ofto treat and which appears to progress rapidly to AIDS. recent acute HIV-1 infection, referred the NYC resident to Dr. Martin Markowitz. At the time of diagnosis, his CD4+Dr. Frieden called on this community to help stop the T-cell count was 80 cells/mm3 and it has since fallen tospread of this and other drug resistant strains of HIV. Healso called on NYC doctors and the public health system less than 50. The NYC resident meets one criterion for the diagnosis of AIDS; his CD4+ T-cell count is less than 200to improve HIV prevention counseling, to perform HIVdrug resistance testing among treatment naïve, HIV+ per- cells/mm3. His viral load has varied from ~ ...