First New HIV Strain in 19 Years Identified
scientificamerican.com
scientificamerican.com
> “It’s actually misleading to describe genetic diversity from the [Democratic Republic of the] Congo as a new subtype,” Worobey says, “because the only useful meaning of the term ‘subtype’” would come from identification of a lineage of the virus that has spread significantly beyond Central Africa. Guidelines for classifying new strains of HIV were established in 2000. The recently discovered subtype belongs to the most common form of HIV, group M, which accounts for more than 90 percent of all HIV cases, Rodgers says.
The amount of press that this has gotten, seems to me like a submarine marketing job by Abbott.
This actually raises an interesting question about potential diseases lurking in food sources. We now have 20/20 hindsight that eating an ape caused this and is therefore a bad idea. They obviously didn't know that when they chose to eat apes. There could be other such food sources that we don't know to be problematic yet. I am reminded of prions and mad cow, kind of a similar story.
The implications of food on longer term stuff like cancer will always be a hard thing to nail down but for serious diseases like this I don't think its currently a huge barrier.
It's getting harder. Privacy protections mean this type of analysis across hundreds of millions of records isn't really possible anymore. Without hundreds of millions of records, identifying "people who drank milk from Mr Smiths farm in 1969 were 200% more likely to get parkinsons 45 years later" couldn't be done.
Yet if Mr Smiths farm had cows with some as-yet unidentified prion disease, this is the only way we'd find it.
You think we have LESS data now than we did in the past?
We have more than ever, and easier ways of collecting data than we have ever had.
As soon as you stick the data through an algorithm without getting permission from everyone in the dataset, you're getting put in prison for GDPR violations. Have fun getting consent from 100M people with only their postal address from 50 years ago.
(1) Public Health Exemption Legislation
(2) Use the NSA/GCHQ to get the data, run the analysis and once you know the answer do parallel construction with a much smaller, legally available dataset.
Someone eats a monkey in rural Cameroon or Congo, and 10 years later they and their sexual partners have their immune system collapse. Will they know the connection?
Some sources say that happened circa 1910. It wasn't identified until the 80s. In the meantime there were some bunk theories tied to homosexuality, drug use, or poverty as the root cause.
I have heard that prion diseases can have even longer periods before they surface after exposure.
We didn't identify any retroviruses until the late 70s, we didn't know to look for them. That's different.
The first peer reviewed paper on human retroviruses wasn't until 1984.
https://retrovirology.biomedcentral.com/articles/10.1186/174...
In other words, it can take a long time to notice the correlation. I don't think it's much of a stretch to guess that there could be other such correlations, present and future, that have not been discovered or will take some time to discover.
[0] https://journals.lww.com/jaids/Abstract/publishahead/Complet...
but there are many people who would and do not use protection anyway. And taking PrEP means that's a less risky option than otherwise.
PrEP is for hiv negative people.
If you’re virus level is undetectable from treatment, then you’re not contagious.
It's a rather academic distinction given that it's the same drugs in either case. Definitionally, it's PrEP only if those drugs are being taken as a preventative measure.
a) PrEP significantly decreasing condom use
b) This being a net-negative when considering the hugely decreased risk of HIV transmission as a result.
If you believe this, don't you also believe that seatbelts encourage dangerous driving?
Again, we’re not talking about HIV. We’re talking about all the other potential viruses (including those known and still mutating). To think that we’re done seeing new fatal STDs is to ignore the history of biology and epidemics.
>A recent large epidemiological study showed that, for those diagnosed with HIV now, life expectancy is similar to someone who does not have the virus. The medical profession now considers HIV a chronic disease; it’s regarded in public health terms in the same category as, for example, type 2 diabetes. As a doctor I can tell you that, medically speaking, I’d rather have HIV than diabetes. While this might sound shocking or surprising, the facts speak for themselves: the prognosis for those with type 2 diabetes is much worse than for those with HIV.... For those with HIV, providing they take their medication, there are very few problems.
>Regardless of how well it is controlled, type 2 diabetes is a progressive disease, which results in the need to increase pharmacological therapies over time. A recent study conducted in Australia showed that, after six years, 44 per cent of patients no longer responded to oral medication and required insulin injections. Oral medications eventually fail in most people, meaning that injections are almost inevitable at some point.
>To put it starkly, the latest statistics show that because of Haart, HIV now no longer reduces your life expectancy, while having type 2 diabetes typically reduces it by ten years.
https://www.npr.org/sections/health-shots/2012/07/16/1566929...
Some of the older drug combinations were very troublesome. They've gotten better and people live longer, yes .. but they could have a lot of long term toxicity that's hard to judge until we can study groups of people who've survived on them into their later years.
You can control and even reverse type-2 diabetes by cutting sugars and starches from your diet if you do it early and are diligent. HIV infections cannot be reversed. Once you have it, you'll likely be on drugs for the rest of your life.
There's very little evidence of this actually happening. I'd be curious to see your grounds for making such a bald and unqualified statement. Such statements are usually based not on evidence but on stereotyping of gay male behaviors.
The study you link to does not back up the claim in your original comment. It will take a great real more work to discover the overall health impact of PrEP. It helps no-one to spread unevidenced claims based on anecdata and prejudice. We currently have no clear picture of the effect of PrEP on condom use. It's extremely difficult to get reliable data on that kind of thing. And note that some increase in the spread of treatable and relatively trivial STDs is absolutely a price worth paying, if it comes to that.
There's probably a paralell universe where PrEP was invented before condoms, and people like you are complaining about the fall in PrEP uptake caused by the availability of condoms...
What’s not backing it up? From the study’s abstract: Pre-exposure prophylaxis use was associated with a significant increase in rectal chlamydia (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19-2.13) and an increase in any STI diagnosis (OR, 1.24; 95% CI, .99-1.54). The association of PrEP use with STI diagnoses was stronger in later studies. Most studies showed evidence of an increase in condomless sex among PrEP users.
There are lots of studies. The overall picture is unclear. And some increase in condomless sex combined with a wide uptake of PrEP could be a net positive.
Your net positive would only be until a new virus comes along that creates a new epidemic. And that’s my point.
How does it do this? From where I'm sitting it's a very necessary protection for groups that are currently at risk and definitely need protecting from these things, such as sex workers. Wearing a hard hat doesn't give blessing to accidentally dropping something heavy enough to kill without it, I fail to see how this is any different.
Which common STDs other than HIV are not treatable?
But again my point is more about the future versus the current.
None of this is relevant to my original point: future pandemics.
You can also get vaccinated against HPV, which reduces the risks still further.
It seems pointless to speculate about future pandemics.
Don't seatbelts encourage dangerous driving then? Don't vaccines encourage poor hygiene? Time and time again scientists have invented something that makes life drastically safer and time and time again they've been a huge net positives.
It doesn't make any logical sense to me and I've never seen any compelling evidence that this causes it to be a net negative.
My personal experience shows the effect is non-zero, and this seems to confirm beyond my immediate community: https://www.ncbi.nlm.nih.gov/m/pubmed/29509889/
There is currently no evidence that PrEP "lulls many into a false sense of security". It's possible that the existence of a method that can effectively eliminate the risk of HIV transmission could cause a change in behaviour which exposes people to other, different risks. It is entirely far from clear that this is the case, or that if it were, then that there would still not be a net public health benefit.
PrEP is, FWIW, quite possibly more effective at HIV prevention than condom use is. It would plainly be ridiculous to be worried about the existence of condoms, because they were likely to "implicitly bless dangerous behaviour", and we have plenty of evidence that abstinence campaigns pushing this message are absolute failures.
Again — I already said PReP was highly effective as a public health tool against HIV, but in doing so, we leave the door open to many new kinds of viruses that it doesn’t protect against given the lack of condom usage.
Update: It’s not to hard to find data that verifies my personal experience: https://www.ncbi.nlm.nih.gov/m/pubmed/29509889/
But what is ignorant is to decide where other people's risk thresholds should be. You're right that no one wants to wear a condom. It's not a false sense of security to have condomless sex because of PrEP. It's real sense of security. People feel safer, and they are safer from HIV.
People are afraid of dying, and no one enjoys thinking about catching a death sentence when they have sex, especially sex that's been (and is) strongly stigmatized. If personally, you decide that extra security isn't enough, that is a great decision. If you want to think about the future, and the risk of catching a resistant strain of a bacterial infection, or some yet-understood (new kinds of) viral infection, that is totally okay! But I don't think it's okay for you to say everyone should think the same way.
It's hard to measure the "risk" of the anxiety caused by gay sex.
I’m not spreading fear. I’m looking at this history of viral epidemics and saying it’s foolish to think that now that we have PReP there’s no other way to die from sex. Does PReP stop Ebola? Or even bacterial infections that are antibiotic-resistent?
HIV in humans is only decades old. That’s nothing in the timeline of humanity. At some point in the future another terrible STD will come along. The history of viral mutations guarantees it. And PReP won’t be able to stop it, condoms might, but those on PReP will be vulnerable.
Again, is PReP making a big dent in the spread of HIV? Yes. Is it allowing some to feel ok about not using a condom where as they would have before? Absolutely. It’s “net positive” (no pun intended) for now... until the next scarier virus comes along...
If you want to worry about Ebola, and use condoms because of a possible risk of contracting Ebola, I would say you have set your risk threshold at a place more conservative / risk-averse than pretty much every sexual adult, at least in my part of the world. Every interaction with another organism, whether it's a handshake or sharing the same air, carries the risk of transmitting something terrible and scary. And there are people who think about that, and probably have different standards for sharing drinks, or double dipping, or handshaking strangers, or whatever. Other people do not care. They will hug someone who has the flu. It's a personal call.
When someone has sex without a condom and takes PrEP, I argue they are not thinking "Oh good, there's no possible way I'm going to die." They are not even thinking "I will not get any STIs". They are thinking "Oh, good, I don't have to think about dying from HIV". That's not foolish. Your characterization is unrealistic and equivocates risk-taking with foolishness. You imply (say) that people are ignorant of the risks, as opposed to taking a deliberate risk. And I would be more careful before saying something so offensive and disrespectful. That's where I set _my_ risk threshold, at least.
Let's see.. so far in this thread I've been accused of being prejudice against gays (ad hominem), had goal posts moved repeatedly from my original post, accused of having no data and when presented it's rejected without sufficient reason provided, had my own personal experiences negated as if they don't happen and when acknowledged they're minimized, and now apparently I'm a fear monger. Amazing what happens when you point out vulnerabilities in public health with PReP!
That's great for you that you're educated enough to perform rational risk analysis (assuming so given you're on HN) -- and you're willing to take the non-trivial semi-known long-term side effect trade offs. Plus you're honest with yourself about exactly what PReP is. However, that doesn't mean everyone follows. A diversity of education and logic-oriented thinking exists out there, yet sex is universal. I've personally heard individuals express that now that they're on PReP there's nothing to worry about so they can have condom-less sex worry-free, so I know this is non-zero. This is foolish.
I think it's dishonest to not acknowledge the risks and vulnerabilities of a large population on PReP. Please look at a short history of epidemics [1] and tell me we're somehow magically done. Ebola was an example of something that once was contained now spreading again. Drug-resistant Neisseria gonorrhoeae is classified as an urgent threat by the CDC [2], and isn't shared by a handshake (to my knowledge). And that classification is from 2013. What will 2025 look like? 2045?
Nothing about what I've said is saying we shouldn't have PReP. My original comment said it's made a big dent in the spread of HIV... hardly fear mongering. But it DOES make some portion of users feel safe to have condomless sex, and that creates new vectors that condoms were protecting against. Why is this so hard to acknowledge?
Yes, PrEP _allows_ (makes) many people to feel safe having sex without a condom. Yes, this shift can have consequences for the transmission of other diseases. It's not hard to acknowledge that. It follows completely that if there's a new outbreak, its transmission will be accelerated because people are having sex without condoms. I am not following your other postings on here, so I can't say if you think I haven't acknowledged those things, or what. I think you're talking about other people on this thread, in which case, why? Maybe something in how your expressing your thoughts feels really radical to you, but to be you've been expressing pretty obvious ideas. I can't tell if you got to this point after a previous disagreement, or if this is your baseline feeling about PrEP, but I will say if you just focus on the negative aspects of things that are already stigmatized, you're perpetuating stigma! And my push back on that doesn't mean the negative aspects aren't true (though we should always be dubious). It means I don't like your framing of the situation.
Disease is the cost of doing business. Getting down to business? You didn't like the handshake analogy, but think about all the different things we can do to mitigate the spread of disease. We do a lot of them! But we also share buses, go to big events, and we also have sex with each other. It's not wrong to do those things without worry. And it doesn't mean the risk isn't there, it just means you don't worry about it. It rubs me the wrong way that you decide what's foolish to worry about and not.
I don’t think I’m being radical at all, and I’m glad you agree with my points. If you read my original post, then you should agree with it. But there are quite a lot of replies against, and many disagreed that it would lead to less condom usage.
I don’t, however, believe I’m perpetuating stigma. I’m pointing out that new (to the world) strains of HIV are a perfect example of what worries me about a generation that feels a false sense of security. I’ve already watched previous generations die off, and I don’t want to see lessons lost. If you want to call my concern stigmatizing, we’ll then I wear that with pride.
We learned in the 80s/90s that safe sex meant condom use, and that did have a tangible impact. For those particularly at risk PrEP is great because condoms break. Abstinence is the only thing that’s 100% and it’s unrealistic. But removing condom usage because we think there’s no more diseases to worry about beyond HIV to me is foolish, and the evidence of the history of epidemics validates that.
“The most recent of the three samples used to identify HIV-1 group M subtype L has been sitting in an Abbott freezer since 2001. ... Abbott researchers found two additional examples of the strain—in samples from 1983 and 1990”
I admire the foresight of having kept these samples where they could be studied with future techniques.
https://www.theaidsinstitute.org/education/aids-101/where-di...
Someone had a cut on their hand while butchering a monkey. No sex necessary.
Unrelated, but interesting: the infection rate of HIV even when having unprotected sex with somebody who is not at undetectable levels is quite low. The HIV doctor I spoke with said that it was on the order of 1 to 5 %.
Male to female is more common, female to male less so. Both are rare.
Using a condom makes the odds in the millions.
Lets suppose hypothetically than saliva would inactivate this virus in humans. Most probably there would be still some humans without this defense mechanism. And they would be totally normal humans otherwise, indistinguisable than other people unless tested chemically that just would produce a saliva with low antimicrobial activity (and could allow the disease to jump to other people).
https://www.independent.co.uk/life-style/love-sex/why-would-...
https://en.wikipedia.org/wiki/Endogenous_retrovirus
So where did HIV come from? Who knows. It( not the current version of HIV, something similar) has been with us for millions of years in 1 form or another. Enough to leave a large mark on what makes us, us, our DNA.