Aggressive Form of HIV Discovered in Cuba

Researchers report a recombinant form of the HIV virus in Cuba that appears to be much more aggressive than other forms of the virus, and progresses to AIDS so quickly that patients may not even realize they’ve been infected.

A team led by Anne-Mieke Vandamme, MD, PhD, a professor in the department of microbiology and immunology at KU Leuven’s Laboratory for Clinical and Epidemiological Virology, studied the blood of 52 recently infected patients in Cuba progressing to AIDS within 3 years of infection—fast progressors—and compared them with 21 recently infected patients not progressing to AIDS in the same time period, and 22 patients progressing to AIDS during the same period, for whom it was known their HIV diagnosis was more than 3 years ago.
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Their study found that the “aggressive” variant CRF19—a recombinant virus of 3 other variants, subtype A, subtype D, and subtype G—was only found among the fast progressors, says Vandamme. CRF19 was not found in the other 2 groups, indicating “a strong association between CRF19 and fast progression,” she says. Some of these patients had tested HIV-negative in the previous year, were diagnosed with HIV infection, and already had AIDS at diagnosis, adds Vandamme.

For such patients, “one may not immediately think of HIV infection when presenting with symptoms, and if diagnosis is done too late, patients may die before treatment can stop the progression.”

Vandamme recommends further research to confirm this association in more patients, noting that only 9 CRF19 patients wound up being recruited for the KU Leuven study. To date, this variant is not spreading outside of Cuba “except for some rare cases,” she says, adding that the virus was originally identified in Africa, although “we are not aware [of it] spreading there.”

These patients “have to be cared for as any other rapid progressors,” adds Vandamme. “Treatment is efficient in CRF-19 patients. For all patients with risk behavior, it is essential that they get tested frequently, such that they can be treated in time to prevent disease progression.”

—Mark McGraw

Reference

Kouri V, Khouri R, et al. CRF19_cpx is an Evolutionary fit HIV-1 Variant Strongly Associated With Rapid Progression to AIDS in Cuba. EBioMedicine. 2015.