HIV calls for passage amid the barrage of news about the coronavirus. Scientists from the University of Oxford have discovered a new variant of the human immunodeficiency virus (HIV) in the Netherlands that is much more aggressive and contagious than other known variants. The good news is that the usual antiretroviral treatments are also effective against this so-called ‘BV variant’. The bad news is that access to these medicines is not within everyone’s reach.
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The results of this research – published today in the magazine ‘Science’ and which have been disclosed by the University of Oxford in a press release– show that people infected with the new ‘variant VB’ (for ‘virulent subtype B’) showed significant differences before antiretroviral treatment compared to individuals infected with other HIV variants.
Among these differences, it is worth noting that they had a viral load (the level of the virus in the blood) between 3.5 and 5.5 times higher and the rate of decline in CD4 cells (the indicator of damage to the immune system) occurred twice as fast, putting them at risk of developing AIDS (acquired immunodeficiency syndrome) much more quickly. Individuals with the VB variant also showed a higher risk of transmitting the virus to other people.
It is “reassuring” – the press release underlines – that, after starting treatment, individuals with the VB variant had a recovery of the immune system and survival similar to those of people with other HIV variants.
However, the researchers stress that since the VB variant causes a more rapid decline in the immune system, it is critical that individuals are diagnosed early and begin treatment as soon as possible.
The VB variant is characterized by having many mutations spread throughout the genome, which means that no single genetic cause can be identified at this time.
Since the VB variant causes a more rapid decline in the immune system, it is critical that individuals are diagnosed early and begin treatment as soon as possible
Lead author Dr Chris Wymant, from the University of Oxford Big Data Institute, said: “Prior to this study, the genetics of the HIV virus were known to be relevant to virulence, implying that the evolution of a new variant could change its impact on health. The discovery of the VB variant has demonstrated this and also provided a rare example of the risk posed by the evolution of viral virulence.”
Lead author Professor Christophe Fraser, also from the University of Oxford Big Data Institute, stresses the importance of following World Health Organization (WHO) guidance so that people at risk of contracting HIV have access to to regular tests that allow early diagnosis, followed by immediate treatment: “This limits the time that HIV can damage a person’s immune system and endanger their health. It also ensures that HIV is suppressed as soon as possible, which prevents transmission to other people.
Located in 17 people
The VB variant was first identified in 17 HIV-positive people from the BEEHIVE project, an ongoing study collecting samples from across Europe and Uganda. Since 15 of these people came from the Netherlands, the researchers analyzed data from a cohort of more than 6,700 HIV-positive people in that country. In this way a further 92 individuals with the variant were detected, coming from all regions of the Netherlands, bringing the total to 109.
By analyzing the patterns of genetic variation between the samples, the researchers estimate that the VB variant first emerged in the late 1980s and 1990s in the Netherlands. It spread faster than other HIV variants during the 2000s, but its spread has slowed since about 2010.
The research team believe that the VB variant emerged ‘despite’ widespread treatment in the Netherlands, as effective treatment can suppress transmission.
As the current coronavirus pandemic has shown, new mutations in viral genetic sequences can have a significant impact on the transmissibility of the virus and the damage it causes. For many years it has been feared that this could happen in the HIV-1 virus, which already affects 38 million people worldwide and has caused 33 million deaths to date, according to data from Unaids, the United Nations program Against AIDS.