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Researchers Document Rare Case of Second HIV Infection with Different Strain
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Associated Press (09.05.02)::Stephanie Nano
Swiss researchers have documented a rare case of a patient
contracting a second HIV infection two years later with a
different strain of the virus. The researchers said the case
could have implications for the development of an AIDS vaccine,
and its occurrence strongly supports the practice of safe sex for
those already infected with HIV.
Dr. Bernard Hirschel of the University of Geneva, one of the
researchers, said they were able to document the case because the
patients was enrolled in an AIDS drug study to test early
treatment of the virus. Successfully treated for over two years,
the patient was taken off the drugs when he received an
experimental vaccine intended to boost his immune system. Months
later in April 2001, and weeks after he had unprotected sex with
men, his virus level increased sharply and he was found to be
infected with a different strain of HIV. The research, with an
accompanying editorial, is published in Thursday's New England
Journal of Medicine (Vol. 347, No. 10, P. 731-736; with editorial
at P. 756-758).
"It just shows how little we understand what's happening
with HIV-related immunity," said Hirschel. Doctors have long
assumed that a patient's natural immunity would keep them from
getting HIV more than once. A similar Boston case was reported by
Dr. Bruce D. Walker at the Barcelona AIDS conference; last month
a report on two cases in injection-drug users in Thailand was
published. According to an editorial by Walker and Dr. Philip
J.R. Goulder of Massachusetts General Hospital, the Swiss report
provides "convincing evidence that HIV-1 superinfection can occur
long after an initial infection is established."
"With sexual activity seemingly increasing among persons
with HIV-1 infection, this is a public health message that needs
to be broadcast loud and clear," they wrote. Walker added that
vaccines are already being developed for geographic areas and
that researchers anticipate that one vaccine may not protect
against all strains. He noted that variations in HIV are greater
than those in the flu virus, which requires a new vaccine every
year.
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