New superbug or tempest in a teapot?

In mid-February this year, New York City Health Commissioner Thomas Frieden called a press conference to announce that a case of rapidly progressing, multidrugresistant HIV/AIDS had been identified. Although drug resistance is common, and rapid progression to AIDS is rare but not unheard of, it is the combination of both factors in one patient that raised the fear among public health officials that a new, particularly virulent ‘super-strain’ of HIV/ AIDS had emerged. The virus, described in March by Martin Markowitz and colleagues at the Aaron Diamond AIDS Research Center in New York (Markowitz et al, 2005), where the patient was referred, was deemed to be replication-competent in vitro—unusual for a resistant form—and had other features rarely seen in a newly diagnosed patient. The patient, a gay man in his 40s who had had unprotected sex with scores of partners, had been infected anywhere from 4 to 20 months before his diagnosis in December 2004. So far, none of the patient’s partners have been found to have the same strain, according to an update issued April 1, but laboratories performing resistance testing have identified several patients whose strains may be related. In the meantime, the patient is responding to a complex course of drug treatment. Testing of his sexual contacts is ongoing, and may take weeks to months to complete, according to the New York Department of Health and Mental Hygiene.