Doctor Defends HIV-Strain Warning

By MARILYN CHASE
Staff Reporter of THE WALL STREET JOURNAL
February 16, 2005; Page D4

Researcher David Ho defended his warnings of a dangerous new variant of the AIDS virus against critics who charged his report was premature and alarmist.

Dr. Ho, head of the Aaron Diamond AIDS Research Center in New York, alerted New York public-health officials about a patient who was infected with a highly drug-resistant version of HIV, the virus that causes AIDS, and who developed full-blown AIDS far more quickly than usual. Officials publicized the finding, setting off a controversy over whether the resulting public worry was warranted. Public-health officials say they want to curb the risky behavior that characterized the patient, a gay New Yorker in his late 40s who had fueled anonymous sexual encounters with the drug crystal methamphetamine.

Dr. Ho promised publish full details of his findings soon in a scientific journal. The virus was resistant to three of the four main types of AIDS medicines, making it difficult to treat.

Critics have said that given there is so far only a single case, "It's inappropriate to induce any type of hysteria," said Warner C. Greene, director of the Gladstone Institute of Virology and Immunology in San Francisco. "We should assemble all the data before making announcements about a new and more lethal strain of HIV ."

Some observers also questioned whether the patient's rapid decline into AIDS was due to some special strength of the virus, or due to independent problems with the patient's immune system or his drug use. Drug-resistant versions of HIV often end up declining in virulence, slowing the progression of patients to full-blown AIDS. Researchers at University of California at San Diego reported in December 2003 that methamphetamine hastens HIV replication, which could be a factor in the patient's illness.

"It's premature to declare this a 'super virus,' " said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases.

Dr. Ho vehemently denied the strain was crippled like many other strains of mutant HIV . "There's no indication this virus is wimpy in the laboratory," he said, though he conceded, "We cannot say it's particularly aggressive." Further study is needed, he said.

He also insisted the patient's declining immunity represented a real case of accelerated AIDS, not a temporary decline in immune function that often happens to HIV-infected patients before they clinically develop AIDS. Some critics have said it is premature to say the patient came down with AIDS in a short period of time.