Virulent Dutch Strain of HIV Elicits Measured Fear from Health Departments for those Living with HIV and Taking PrEP

A new virulent strain of HIV-1, the virus that causes AIDS for most people infected with the virus is causing a measured, cautionary measured response from  public health officials and epidemiologists, especially for those already living with the virus and the many who take the pre exposure prophylactic (PrEP) drugs Truvada and Descovy.

This is especially true for gay men and trans women who are receptive anal sex partners, i.e. bottoms.

Science: 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.

Medium:

1. If you’re at risk for HIV, practice safer sex more carefully now than ever. If you use IV drugs, do NOT share IV needles with anyone, no matter how safe or clean you think they are.
2. If you’re on PrEP — HIV drugs like Truvada and Descovy taken to prevent HIV infection — stay on them. Don’t skip doses. That is critical. DO NOT SKIP doses. Initial indications are that PrEP still works well, but consider using condoms as backup until experts learn more.
3. If you are HIV positive now, call your doctor about treatment information. Reinfection with the VB variant might cause serious health problems for you. This is still unclear. Until experts learn more, be more cautious than ever about reinfection. Above all, stay on your meds and DO NOT SKIP doses.
4. Antiretroviral treatment still works, even for the VB variant. Don’t panic. If you become HIV positive, even with VB, you can almost certainly be successfully treated, but if you’re on PrEP or being treated because you are positive, skipping doses of your meds might make you especially vulnerable to the VB variant.
5. Get tested, get treated. Testing is your most powerful way to stay healthy. If your sexual activity or IV drug use puts you at risk for HIV, call your doctor today and schedule a test. Then get on PrEP and learn about safer sex. If you don’t have a doctor or can’t afford a test, click this link to learn how you can be tested for free.
6. Get information. Call your doctor or call the HIV/AIDS hotline in your state to keep abreast of the latest news about the VB variant and HIV in general. Stay informed, stay healthy.