A Less Deadly Form Of HIV?

There’s new evidence of it:

Rapid evolution of HIV, the human immunodeficiency virus, is slowing its ability to cause AIDS, according to a study of more than 2,000 women in Africa. Scientists said the research suggests a less virulent HIV could be one of several factors contributing to a turning of the deadly pandemic, eventually leading to the end of AIDS.

This has long been thought likely (I covered it on the Dish in 2005). Viruses do better the longer their hosts survive. But it’s fascinating to see it proven – and to marvel at the speed of natural selection. Of course, the usual suspects years ago – specifically the New York Times – were warning us that the virus was mutating into something much worse – remember super-AIDS? That merely goes to show that projecting morals onto viruses is a foolish game. Jason Koebler unpacks the study:

“Theory predicts, all other things being equal, that infections causing new epidemics will reduce in virulence over time because pathogens require host survival to transmit,” [Oxford University researcher Philip] Goulder wrote.

None of this is to say that HIV, left untreated, is going to be harmless anytime soon. But it does appear as though the virus is evolving in that direction—and more quickly than would be expected naturally, thanks to antiretroviral therapies. … Already, roughly 1 in 300 infected people are able to keep HIV in check, indefinitely, at undetectable levels, without any therapy at all. These people are called “​long-term nonprogressors.” In a few years, that number could go up to 5 or 10 percent, Goulder said. “Over tens of decades, maybe the majority of people will be able to control it without treatment,” he added.

Clare Wilson also reads through the research:

One reason for the change could be the growing use of HIV drugs, says Goulder. People with the most virulent form of the virus get sick sooner and start drug treatment. This reduces the level of the virus in their blood and sexual fluids almost to zero, so they are unlikely to pass it on. This means that a more aggressive virus is less likely to be transmitted.

“It’s a benefit of therapy that nobody thought of,” says Goulder. “That’s another reason to provide it.”

Which is yet another reason why the most important thing to do with HIV is to get as many people in the vulnerable populations onto PrEP, and as many infected people on serious meds. Jason Millman outlines how far we have to go on that:

[F]or the first time in the past year, the number of HIV patients who started receiving medication was greater than those newly infected with the virus, according to the ONE Campaign. … However, diagnoses attributable to male-to-male sexual contact saw increases for nearly every group, with those 13-24 years old recording the largest increase (133 percent) of any group. Of the 1.2 million Americans who had HIV in 2011, just 40 percent said they were seeing a medical professional for the virus and 37 percent had a prescription, the CDC revealed last week. Just 30 percent of those infected the virus under control.

That’s completely unacceptable. And we gay men need to find a way to reach the most vulnerable among us.