Virulent variant of HIV-1 circulating in the Netherlands

[Jim Allen]

So 109 people have been identified to have the “VB variant” (for virulent subtype B) of HIV in the Netherlands. It seemed the decline in CD4 count in the absence of treatment, is nearly double from common strains within the region with CD4 counts dropping to below 200 within 2 - 3 years post acquiring this HIV strain.

This strain is believed to have been around since the '90s and current testing and treatment is both effective at identifying the infection and providing treatment.

https://www.science.org/doi/10.1126/science.abk1688

We discovered a highly virulent variant of subtype-B HIV-1 in the Netherlands. One hundred nine individuals with this variant had a 0.54 to 0.74 log10 increase (i.e., a ~3.5-fold to 5.5-fold increase) in viral load compared with, and exhibited CD4 cell decline twice as fast as, 6604 individuals with other subtype-B strains. Without treatment, advanced HIV—CD4 cell counts below 350 cells per cubic millimeter, with long-term clinical consequences—is expected to be reached, on average, 9 months after diagnosis for individuals in their thirties with this variant. Age, sex, suspected mode of transmission, and place of birth for the aforementioned 109 individuals were typical for HIV-positive people in the Netherlands, which suggests that the increased virulence is attributable to the viral strain. Genetic sequence analysis suggests that this variant arose in the 1990s from de novo mutation, not recombination, with increased transmissibility and an unfamiliar molecular mechanism of virulence.

POZ.Com writeup.

Why You Don’t Need to Worry
https://www.poz.com/article/alarmed-newly-identified-highly-virulent-strain-hiv

[Jim Allen]

Reminds me of the 2015 reports on the strain found in Cuba. Although, it feels like there is more mainstream interest this time around with a variant being found in the Netherlands. 

https://www.poz.com/article/aggressive-HIV-26822-9074

https://time.com/3711260/hiv-strain-cuba/

The study, conducted by researchers from the University of Leuven in Belgium, followed several reports of HIV-infected people in Cuba developing AIDS in less than three years, far faster than the usual 10 years it typically takes. All patients infected with CRF19, a recently-discovered strain of the HIV virus, had higher levels of it in their body.