In a study published November 6, 2019, in the Journal of Acquired Immune Deficiency Syndromes, researchers with the healthcare company Abbott Laboratories revealed that they have found three people in the Democratic Republic of Congo (DRC) with a new strain of HIV. The discovery marks the first time that a new subset of HIV has been identified since the year 2000. “Identifying new viruses such as this one reminds us that to end the HIV pandemic, we must continue to outthink this virus and use the latest advancements in technology and resources to understand its full scope,” says Mary Rodgers, PhD, a principal scientist of infectious disease research at Abbott. Since the HIV/AIDS epidemic came to public attention, in the early 1980s, the World Health Organization estimates that 75 million people have been infected with the HIV virus and about 32 million people have died of HIV around the globe. The annual death toll from HIV has dropped dramatically since the mid-1990s because of effective treatments. Abbott uncovered the new “subtype L” HIV virus through its global viral surveillance program, which it began 25 years ago to monitor HIV and hepatitis viruses around the world. The program has identified mutations by collecting more than 78,000 samples containing HIV and hepatitis viruses from 45 countries. The surveillance ensures that the company’s diagnostics for blood screening and infectious disease detection remain up-to-date. Abbott is making the new strain sequence available to the research community to evaluate whether there are more sequences of subtype L in circulation.
No Imminent Danger
HIV, like other viruses, has a capacity to mutate, so this discovery is not entirely unexpected, according to William Schaffner, MD, an infectious-disease specialist and a professor of preventive medicine and health policy at the Vanderbilt University School of Medicine in Nashville, Tennessee, who was not involved in the study. “I don’t think the public need be alarmed,” he says. “It is well anticipated that treatment will work against this strain. We don’t have the actual testing results yet, but that has certainly been the case in other strains we have encountered. So we have every reason to be optimistic.” Dr. Rodgers says that existing tests and treatments are designed to target the parts of the virus that are common to all subgroups, so this new strain may act similarly to other strains within this main group. “I don’t have scientific evidence that antiretroviral treatments will work with this new subtype. That said, since subtype L is part of the major group of HIV, Group M, I would expect current treatments to work with it,” she says. More research is needed to confirm that current therapy can successfully treat the new strain and to discover how common this strain may actually be.
Treatments Have Lowered Rates of HIV/AIDS
Today, a structured treatment plan including three or more antiretroviral (ARV) drugs can stop the progression of HIV, according to the World Health Organization. The medications can’t eliminate the virus, but they can keep the amount of virus in the blood at a low level. With the “viral load” low, the immune system can grow stronger. The National Institute of Allergy and Infectious Diseases says that this type of combination therapy helped get the major health crisis under control in the mid-1990s. By 1995, AIDS (acquired immunodeficiency syndrome), which is caused by HIV, was the number-one killer of Americans between ages 25 and 44, according to the Centers for Disease Control and Prevention (CDC). Today, the age-adjusted HIV-related death rate has dropped by more than 80 percent since its peak, according to a report from the Kaiser Family Foundation. The CDC calculated that about 50,000 Americans died from AIDS in 1995. That number in 2016 had plummeted to 15,800. “Research tells us that when people with HIV take ARV therapy as prescribed, their viral load [amount of HIV in their blood] can become undetectable,” says Rodgers. “If it stays undetectable, they can live long, healthy lives. And when successful treatment lowers the viral load to undetectable levels, this can greatly reduce or eliminate the risk of HIV transmission.” Ultimately, scientists would like to see a vaccine that protects people against the spread of HIV, according to Schaffner. But genetic variants such as this demonstrate how difficult it may be to reach that goal. “This discovery shows what a challenge it is to develop a vaccine, because this is a virus that has a capacity to mutate and occur in a variety of different strains,” he says.
