Researchers have discovered that a variant of HIV has circulated in the Netherlands for many decades. It is more contagious and faster to develop into serious illness.
These findings were published in Science on Thursday and demonstrate how HIV can evolve to cause more severe disease and faster transmission.
Joel Wertheim, an associate professor of medicine at University of California, San Diego who was not part of the study, wrote a perspective on the findings that was also published in Science.
This study is a reminder that viruses do not always become weaker over time, even in an age of COVID variants. Wertheim states, “We shouldn’t underestimate the potential for virus evolution.” This study should be seen as a stark contrast to the assertion that all viruses will invariably evolve to become benign.
It’s a contagious discovery
A curious collection of samples led to the discovery of the HIV variant.
Chris Wymant was the lead author of this study and senior researcher at University of Oxford’s Big Data Institute. He noticed something unusual in a BEEHIVE database. This project collects HIV samples from Uganda, as well as other countries, in order to aid scientists in understanding how the virus evolves.
He said that a recent group of 17 samples showed unusual mutations. 15 of those samples were from the Netherlands.
Wymant and his coauthors wanted more information so they looked into another Dutch study that had more data. The researchers discovered that 109 people had this variant, and they didn’t know it. This was back in 1992. Wymant believes that the variant first appeared in late 1980s. It gained momentum around 2000, and then slowed down around 2010.
This variant of HIV causes a three- to fourfold increase in viral load than the usual HIV infection. Wymant says this characteristic makes the virus more contagious and accelerates its progression to serious illness.
He says the good news is that existing medications are very effective in treating even highly virulent variants of this virus. This reduces transmission and lowers the risk of severe illness.
Wymant states, “Nobody should feel alarmed.” It responds just as well to treatment than HIV normally does.
He says that there is no need for special treatment to be developed for this variant. This variant does not show any signs of resistance to medications like some HIV variants. However, the variant is very fast and people should get medicine as soon as possible.
How to slow down the variant
Adeba Kamarulzaman (president of the International AIDS Society) said that the research was “nicely done” with well-designed results. She did not participate in the study.
She also notes that it helps to answer a pressing question in HIV research. Researchers had previously wondered if HIV-infected people are more susceptible to getting sicker or more contagious due to how their immune system responds. However, individual reactions are only part of the equation. This can also occur if the virus becomes more severe and is easier to transmit.
Kamarulzaman warns of the possibility that this mutation could occur in other areas. Kamarulzaman warns that if there are many HIV patients in one area with this type of variant, but they don’t take medication, you will have more people with advanced diseases much faster.
She recommends that you have “early or frequent testing, and immediately initiate treatment to prevent this from happening.” It is not the goal to find a particular variant of HIV, but to diagnose new HIV cases so that treatment can begin as soon as possible. She adds that some countries are still struggling to do this and need more support.
This is how the Dutch variant was eventually slowing down before researchers could even identify it.
Wymant states that the public health intervention in the Netherlands that has been implemented and expanded over the past decade or so — improving access to treatment, getting people tested as quickly as possible, and getting them on treatment as soon is possible — has helped decrease the number of this variant even though we didn’t know it existed.
Rapid treatment can also slow down viral evolution so that variants such as these are less likely.
Wertheim states, “This does not mean that we should change our strategy.” “This just means that we should do more of the things we already do.”