Studies Suggest Hiv Thailand Subtype More Deadly Than Others

[sbk]

Studies Suggest HIV Thailand Subtype More Deadly Than Others

By Tim Parsons

School of Public Health

December 3, 2007

Two studies led by researchers at the Johns Hopkins Bloomberg School of Public Health found that people infected with HIV in Thailand die from the disease significantly sooner than those with HIV in other parts of the world.

According to the researchers, the shorter survival time measured in the studies suggests that HIV subtype E, which is the most common HIV subtype in Thailand, may be more virulent than other subtypes of the virus.

Both studies are published in a special issue of the journal AIDS.

The first study followed 228 men over a 14-year period starting in 1991. All the men were serving in the Thai military and were HIV-negative when they enrolled in the study. The researchers tested for HIV every six months to determine approximately when the men acquired HIV. They were diagnosed at a time before combination antiretroviral drug therapy was available.

The researchers compared the group of Thai men to a group of similar HIV-positive men living in North America and Europe who were included in another study. The median time from HIV infection to death for the Thai men was 7.8 years compared to 11 years for HIV-positive men living in North America and Europe. The survival rate for the Thai men also was lower than in studies of similar populations living in low- and middle-income countries in sub-Saharan Africa where subtypes A, C, D and G circulate. The shorter survival after HIV infection among persons in Africa infected with subtype D, however, was similar to the survival among the Thai men.

"We were surprised to learn that the young military recruits from Thailand appeared to develop AIDS more quickly and have shorter survival after their HIV infection than persons in Africa who were carefully followed," said lead author Ram Rangsin, assistant professor of community and military medicine at Phramongkutklao College of Medicine in Bangkok, Thailand, who conducted the research while studying at the Bloomberg School of Public Health. "Fortunately, the men who have survived after their infection are now receiving treatment with effective antiviral drugs and doing very well."

For the second study, researchers followed a small group of male blood donors and their wives from 1992 to 2007. All the men and women were determined to have acquired HIV less than two years prior to enrolling in the study. The median survival rate from infection to death was 7.8 years for the men and 9.6 years for the women. Again, the survival rate was lower than the 11 years reported for HIV-positive men in developed countries.

"The fact that both young military conscripts and blood donors and their wives in Thailand had similarly shortened survival compared to persons in the U.S. and Africa — except those infected with subtype D viruses — suggests that viral subtypes D and E may be more virulent than many other viral subtypes," said Kenrad E. Nelson, a senior author of both studies and professor in the departments of Epidemiology and International Health at the Bloomberg School. "If we could understand better the virulence characteristics of these viruses, we might learn something more about why those with HIV infection progress to AIDS, usually many years after they are infected."

"The Natural History of HIV-1 Subtype E Infection in Young Men in Thailand With Up to 14 Years of Follow-up" was written by Rangsin, Phunlerd Piyaraj, Thira Sirisanthana, Narongrid Sirisopana, Onsri Short and Nelson. The research was supported by the Office of AIDS Research at the National Institutes of Health and by the Thailand Research Fund. Funding was also provided by the Fogarty International Center of the National Institutes of Health.

"Survival of Blood Donors and Their Spouses with HIV-1 Subtype E Infection in Northern Thailand 1992-2007" was written by Nelson, Caroline Costello, Vinai Suriyanon, Supaluk Sennun and Ann Duerr. The research was supported by the Centers for Disease Control and Prevention through the CONRAD program at East Virginia Medical School.

Source: Johns Hopkins Gazette

[Prakanong]

Thanks SBK

I think this follows on from other studies that aid the "Thai" sub-type is easier to catch also from straight vaginal sex - more of the virus in vaginal walls/membrane if I remember correctly.

One thing about the Thai military - they do allow a lot of studies for HIV and other diseases to be carried out - we use them and the military hospital in Bangkok is seen as one of our star's so to speak - they are very good.

[orchis]

Interesting. But shouldn't it say how many of the initially 228 hiv - men became hiv +?

At the beginning of the study there were no retrovirals in Thailand, did the hiv + in the group start taking them once they became available? Did the comparison group in North America and Europe take retrovirals? Were all these drugs regimen comparable? e.g. A lot of people in Thailand still take AZT which influences long time survival rates a lot, while in the "West" AZT is almost completely phased out.

[Prakanong]

Interesting. But shouldn't it say how many of the initially 228 hiv - men became hiv +?

At the beginning of the study there were no retrovirals in Thailand, did the hiv + in the group start taking them once they became available? Did the comparison group in North America and Europe take retrovirals? Were all these drugs regimen comparable? e.g. A lot of people in Thailand still take AZT which influences long time survival rates a lot, while in the "West" AZT is almost completely phased out.

Yeah - its 20 years since the Eureka moment for AZT!

Very recent article here

http://news.bbc.co.uk/1/hi/health/7117651.stm

[siam2007]

Studies Suggest HIV Thailand Subtype More Deadly Than Others

By Tim Parsons

School of Public Health

December 3, 2007

Two studies led by researchers at the Johns Hopkins Bloomberg School of Public Health found that people infected with HIV in Thailand die from the disease significantly sooner than those with HIV in other parts of the world.

According to the researchers, the shorter survival time measured in the studies suggests that HIV subtype E, which is the most common HIV subtype in Thailand, may be more virulent than other subtypes of the virus.

Both studies are published in a special issue of the journal AIDS.

The first study followed 228 men over a 14-year period starting in 1991. All the men were serving in the Thai military and were HIV-negative when they enrolled in the study. The researchers tested for HIV every six months to determine approximately when the men acquired HIV. They were diagnosed at a time before combination antiretroviral drug therapy was available.

The researchers compared the group of Thai men to a group of similar HIV-positive men living in North America and Europe who were included in another study. The median time from HIV infection to death for the Thai men was 7.8 years compared to 11 years for HIV-positive men living in North America and Europe. The survival rate for the Thai men also was lower than in studies of similar populations living in low- and middle-income countries in sub-Saharan Africa where subtypes A, C, D and G circulate. The shorter survival after HIV infection among persons in Africa infected with subtype D, however, was similar to the survival among the Thai men.

"We were surprised to learn that the young military recruits from Thailand appeared to develop AIDS more quickly and have shorter survival after their HIV infection than persons in Africa who were carefully followed," said lead author Ram Rangsin, assistant professor of community and military medicine at Phramongkutklao College of Medicine in Bangkok, Thailand, who conducted the research while studying at the Bloomberg School of Public Health. "Fortunately, the men who have survived after their infection are now receiving treatment with effective antiviral drugs and doing very well."

For the second study, researchers followed a small group of male blood donors and their wives from 1992 to 2007. All the men and women were determined to have acquired HIV less than two years prior to enrolling in the study. The median survival rate from infection to death was 7.8 years for the men and 9.6 years for the women. Again, the survival rate was lower than the 11 years reported for HIV-positive men in developed countries.

"The fact that both young military conscripts and blood donors and their wives in Thailand had similarly shortened survival compared to persons in the U.S. and Africa — except those infected with subtype D viruses — suggests that viral subtypes D and E may be more virulent than many other viral subtypes," said Kenrad E. Nelson, a senior author of both studies and professor in the departments of Epidemiology and International Health at the Bloomberg School. "If we could understand better the virulence characteristics of these viruses, we might learn something more about why those with HIV infection progress to AIDS, usually many years after they are infected."

"The Natural History of HIV-1 Subtype E Infection in Young Men in Thailand With Up to 14 Years of Follow-up" was written by Rangsin, Phunlerd Piyaraj, Thira Sirisanthana, Narongrid Sirisopana, Onsri Short and Nelson. The research was supported by the Office of AIDS Research at the National Institutes of Health and by the Thailand Research Fund. Funding was also provided by the Fogarty International Center of the National Institutes of Health.

"Survival of Blood Donors and Their Spouses with HIV-1 Subtype E Infection in Northern Thailand 1992-2007" was written by Nelson, Caroline Costello, Vinai Suriyanon, Supaluk Sennun and Ann Duerr. The research was supported by the Centers for Disease Control and Prevention through the CONRAD program at East Virginia Medical School.

Source: Johns Hopkins Gazette

this has actually been found out many years ago already. I remember I have read a similar report in 2003.

[londonthai]

can be that south asian are genetically less resistant to hiv than africans rather than type e being more virulent. It's known that some african prostitutes are completely resistant to hiv, probably due to their genes.

Edited December 4, 2007 by londonthai

[Dakhar]

can be that south asian are genetically less resistant to hiv than africans rather than type e being more virulent. It's known that some african prostitutes are completely resistant to hiv, probably due to their genes.

Not known by me, got a source?

[londonthai]

Not known by me, got a source?

program on the BBC some few years ago.

some scientists try to find a solution to HIV based on the fact

[slimdog]

Not known by me, got a source?

program on the BBC some few years ago.

some scientists try to find a solution to HIV based on the fact

An update to this story can be found at:

http://news.bbc.co.uk/2/hi/health/619316.stm

[girlx]

hmm i have a very good friend who is a (serious) sex addict, and he often runs amok in southeast asia, bareback, along with a couple of his friends who do the same. it scares the hel_l out of me. they have convinced themselves that heterosexual men do not easily get AIDS, and it doesn't help that for years of playing around hardcore in some of the worst areas of this continent, they haven't come down with anything more than the clap. i think they are just really lucky... i wish i could find some solid info on what the chances are of a heterosexual male getting HIV from a bargirl to bombard them with, but everything i have found can be easily blown off so far. i wish i could get them committed for mental help. i guess i have to accept that natural selection will get them.

[katana]

i wish i could find some solid info on what the chances are of a heterosexual male getting HIV from a bargirl to bombard them with,

Hi girlx,

From Wikipedia, the chances of a man contracting HIV from one sexual encounter (insertive penile-vaginal intercourse without condom) with an HIV positive female are given as 1 in 2000 ie 0.05%.

http://en.wikipedia.org/wiki/Hiv

[dee123]

so thats 2000 to 1 for a white, black and asian male?

[DirkGently]

I read a similar article about a more virulent African strain that had been spread by Africans in a certain community somewhere in the states. Could this be happening here? I notice a lot more Africans around Bangkok these days. Coincidence?

[Dakhar]

hmm i have a very good friend who is a (serious) sex addict, and he often runs amok in southeast asia, bareback, along with a couple of his friends who do the same. it scares the hel_l out of me. they have convinced themselves that heterosexual men do not easily get AIDS, and it doesn't help that for years of playing around hardcore in some of the worst areas of this continent, they haven't come down with anything more than the clap. i think they are just really lucky... i wish i could find some solid info on what the chances are of a heterosexual male getting HIV from a bargirl to bombard them with, but everything i have found can be easily blown off so far. i wish i could get them committed for mental help. i guess i have to accept that natural selection will get them.

Nasty, and herpes is so easily passed around too....

[londonthai]

From Wikipedia, the chances of a man contracting HIV from one sexual encounter (insertive penile-vaginal intercourse without condom) with an HIV positive female are given as 1 in 2000 ie 0.05%.

http://en.wikipedia.org/wiki/Hiv

I seen an estimate 1 in 200 for a man and many times more risky for a female

[geriatrickid]

This is sort of old news. Other studies have been out there for a few years indicating that asian strains were resistant. The most prevalent subtype was B, then all of a sudden subtype E took hold in Thailand. I dug out one of my USAIDS reports from 2001 and this should give some insight on what happened;

A likely interpretation of these findings is as follows. An initial outbreak of subtype B infection occurred among Bangkok injectors. At the same time, sex work was rapidly spreading subtype E. Infection levels at some Bangkok drug treatment centers went from zero to almost 40 percent in less than eight months and infection levels among sex workers rose at comparable rates. However, as many of the younger, more sexually active injectors visited sex workers, they acquired subtype E and then retransmitted it both to other sex workers and to other drug users through needle sharing. Over time, the behavioural linkages among these epidemics and the competitive pressures among the subtypes resulted in subtype E becoming dominant.

Drug injectors tend to have the worst strains of diseases for obvious reasons.

And now here's my 1 bht's worth; I think the resistance developed because the HIV was treated in more advanced stages of disease development, e.g. secondary AIDS and when patients were feeling better or could not afford their medication or were not followed for compliance (most likely scenario if drug users are involved) the treatment was stopped and the disease came back. (Same model as TB resistance.) As IDUs share needles and aren't too worried about responsible sexual behaviour, the seeds for a quick spread were sown.

(ed. fonts)

Edited December 9, 2007 by geriatrickid

[katana]

From Wikipedia, the chances of a man contracting HIV from one sexual encounter (insertive penile-vaginal intercourse without condom) with an HIV positive female are given as 1 in 2000 ie 0.05%.

http://en.wikipedia.org/wiki/Hiv

I seen an estimate 1 in 200 for a man and many times more risky for a female

From the table on that site, it gives a 5 in 10,000 chance.

Where do you get 1 in 200 from?

[moldy]

The most reliable study on HIV transmission was the Padian study. It got neatly binned and the author stopped talking about it. It showed that HIV transmission through sex was near to zero. Even if you do follow the official line I think we're talking abut a 2000/1 shot and this is not high enough to cause the supposed pandemic.

Regarding this latest Thai study, well it's just an old story rehashed. It's just another attempt to shore up a rather poor mathematical model. Scientists with the help of a rather dodgy test, and an ever growing number of aids defining illnesses have come up with a completely over the top figure of HIV infection numbers. As the mathematical models do not support the figures, they look for other reasons, this can vary from a super mutated virus, to lack of circumsicion, etc, etc.

It's pure poppycock really. But when billions are being made, who cares where the truth lies?

Still reco. condoms though, lots of other nasties around.