Detecting a new HIV strain, infected people can turn to AIDS after only 2-3 years

A team of researchers at the University of Oxford, UK, recently discovered a new highly virulent HIV strain (named VB) that has been 'hiding' in the Netherlands for decades. Notably, VB has more than 500 mutations, and people infected with the new strain are likely to switch to AIDS (the last stage of HIV) only 2-3 years after being diagnosed. This is much faster than the average time of 6-7 years for other HIV strains.

The study was published in the journal Science on February 3. Although the new HIV strain is highly virulent, modern treatments still suppress the virus, and the team insists its emergence is 'nothing to be alarmed about'.

The new HIV strain has more than 500 mutations

New findings show that patients infected with 'variant VB' have blood levels of the HIV virus 3.5-5.5 times higher than people infected with other strains. Their immune systems are also rapidly depleted. However, what is special is that after receiving treatment, their immune systems are able to recover and survive similar to people infected with other HIV strains.

'There is nothing alarming about this new HIV variant,' said epidemiologist Chris Wymant at the University of Oxford, lead author of the study.

According to the researchers, the new strain probably appeared in the late 1980s and early 1990s in the Netherlands, but began to decline around 2010.

The HIV virus is constantly evolving, and even a person can get a different version of it. This difference lies in the mutations. These different viruses can be grouped, like siblings with different DNA, but the same family. At a higher level, we can group them into the same strain.

HIV subtypes are often strongly correlated with geography. In Africa, for example, subtypes A, C, and D are the most common. In Europe and the US, sub-strain B is the most common. This regional disparity was formed when HIV first spread around the world in the mid-twentieth century and has changed little since.

What makes the VB variant special is that it has more than 500 mutations. According to the above study, the authors found that out of 109 people infected with the VB variant, only 4 currently live outside the Netherlands, however, they are still in Western European countries.

They initially identified the VB variant in 17 HIV-positive individuals when analyzing the dataset from the BEEHIVE project. This is a data project on the health of people living with HIV in Europe and Uganda. In which, 15/17 people infected with the new strain came from the Netherlands. So, they further studied the data of 6,700 other Dutch people who were HIV-positive and identified 92 similar patients.

In the data obtained, the VB variant that appeared earliest in a patient's specimen was diagnosed in 1992. This is the first version of it. The last time people infected with this mutation was detected in 2014.

Risk of turning to AIDS after only 2-3 years if infected with a new strain of HIV

When measuring the rate and extent of the immune system's decline through CD4 T cells, the researchers found that it happened twice as fast in people infected with the VB mutant. This puts patients at risk of turning into AIDS, the end stage of HIV, many times faster.

In addition to the large impact on the immune system, the team also found that VB was more contagious. This conclusion was reached after comparing different versions of the VB variant in HIV patients. They are very similar, indicating that the virus was spreading rapidly to other people before it could accumulate many mutations.

The next important finding of this study is that the VB strain may not have spread outside the Netherlands. They analyzed samples from a study of people living with HIV in Switzerland from 2009. Of these, only three had the associated virus strain.

Based on those findings, the authors hypothesized that if not treated early, people carrying the HIV VB strain are likely to develop AIDS only two to three years after diagnosis. This is much faster than the average time of 6-7 years for other HIV strains.

The similarity in age, sex, suspected mode of HIV infection and place of birth led the authors to suggest that hundreds of new mutations could be responsible for the increased virulence and transmissibility of the VB strain.

Furthermore, the authors were unable to identify which genetic mutation in the VB variant makes it so virulent. However, they hope future studies can answer this question.

Early diagnosis and treatment are very important

Modern interventions still seem to be effective on VB, so the team is pretty sure that the popular Dutch HIV treatment doesn't make the virus stronger and that early treatment is very important.

'Our findings underscore the importance of the World Health Organization's (WHO) guideline, which states that individuals at risk of HIV infection should receive routine diagnostic testing and prompt treatment. , said researcher Christophe Fraser, co-author. This work also supports the hypothesis that viruses can become more virulent. The Delta variant is considered an example for this statement.

Therefore, the discovery of a new HIV strain is "a warning to the world never to be overconfident when it says the virus will become progressively weaker", Mr Wymant told AFP.

Meanwhile, virologist Michael Emerman, of the Fred Hutchinson Cancer Research Center in Seattle, US, expressed concern about the potential impact of the information that the authors at the University of Oxford put out. According to NBC News, he said that if misunderstood, many people will misunderstand the VB strain as a 'deadly super HIV strain'. Mr. Emerman's worries are not unfounded.

In 2005, researchers in New York, USA, discovered a gay man infected with a strain of HIV believed to be highly virulent. He contracted AIDS after 20 months of infection. At that time, all available antiviral treatments were ineffective. This person said that he regularly used meth and had unprotected sex with multiple partners.

Tom Frieden, an infectious disease physician, later appointed Director of the Centers for Disease Control and Prevention (CDC), held a press conference in February 2005 about this finding and presented a number of warnings about a serious threat to public health. The announcement from the CDC created a global panic about the virus.

In the end, the New York patient responded well to the treatment, with no other cases of HIV infection and the development of the disease so quickly.

Past experience makes the authors at the University of Oxford rather cautious when drawing conclusions. According to epidemiologist Wymant, widespread testing and immediate initiation of treatment after diagnosis can help detect people infected with the VB variant and ensure it does not affect the patient dangerously.