Drug-Resistant HIV Spreads; Implications Still Mysterious

posted: May 2, 2007 9:09 EST

By Nina Shapiro, Seattle Weekly

The number of men turning up in King County with drug-resistant HIV is growing. In February, public-health officials announced that a monitoring program had found four men whose strain of the human immunodeficiency virus showed resistance to at least 15 of the 29 available AIDS drugs. In the two months since, two more men have tested positive for the same strain. "It's not going away," says Susan Buskin, the health department's epidemiologist in charge of analyzing tests for drug resistance.

It sounds scary, and indeed the health department's announcement back in February aroused new fears of an HIV "superbug," as reporters referred to it when they called into King County from all over the country. But in fact, it's far from clear how much alarm is warranted.

King County is trying to puzzle out the significance of this strain in the wake of a famous New York City case. Two years ago, the health department there announced that it had found a man with a drug-resistant strain of HIV who had progressed rapidly to full-blown AIDS. The notion of a "superbug" took hold.

But new research published in the May 1 edition of The Journal of Infectious Diseases debunks that idea. Two papers detail how New York's health department tracked down the person who infected the New York man with the supposed superbug. It turned out that neither that person nor his partner (who had the same strain of HIV) had progressed rapidly to AIDS. This led researchers to conclude that it was something about the New York man — a weakened immune system due to his drug use, perhaps — that brought on AIDS more quickly, rather than the virus itself.

The examination revealed another, less encouraging finding. The source's partner had been "superinfected" with the drug-resistant strain of HIV; that is, he'd already had HIV and then got infected with the drug-resistant variety — a "cautionary tale," as one of the journal papers put it.

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» categories: AIDS | Nina Shapiro

Green Card Negative

posted: May 2, 2007 4:37 EST

By Jeneen Interlandi, Village Voice

What made Michelle Lopez deportable to her native Trinidad was the medical condition that she'd acquired while she was living in the United States.

From the U.S. citizen who fathered her daughter, she had contracted HIV and passed it to the daughter during pregnancy. Both were receiving treatment at a nearby clinic through New York's AIDS Drug Assistance Program (ADAP), a federally funded program that does not discriminate on the basis of citizenship.

If the federal government funded her drug regimen, however, it wasn't about to issue her a green card.

Since 1987, when testing positive for HIV still implied a death sentence, the U.S. has barred immigrants with the virus.

Designed to slow the spread of AIDS and prevent a burden of infected immigrants on the nation's health care system, the policy has failed on both counts, say its critics.

Because immigrants with HIV can't get green cards, they can't get the sorts of jobs that come with health care, forcing them to rely on programs like ADAP. And because they face the possibility of deportation, many opt not to get tested or treated, increasing the likelihood of spreading the virus to others. So instead of lowering the infection rate and lessening the burden on taxpayer-funded health programs, the policy may be doing the exact opposite.

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» categories: AIDS | Immigration | Jeneen Interlandi