MEDICAL UPDATE: HIV Diversity

MEDICAL UPDATE: HIV Diversity

Being Alive Newsletter; February 1992
Mark Katz, MD, reported by Warren Jones and Walt Senterfitt

Five years ago, we assumed that everyone infected with HIV had the same virus. We've come to recognize in the last several years that there are many different subtypes and strains of HIV. Five distinct subtypes have been recognized thus far, and these contain hundreds of different strains. Each person who is HIV-infected harbors many of these strains at any given time.

We don't know exactly how many strains are typically found in a person, but it is thought to number anywhere from a handful to several dozen. Also, if you look at a person's strain population today, and then again one year from now, there will have been significant mutation. So each person carries several or many different strains and these strains may change over time.

This variation may be another "cofactor" in HIV infection's progression to AIDS. That is, potential differences in virulence among strains may help explain the fact that some people remain fairly stable with good T-cell counts over many years, and other people seem to have a much more rapid progression.

Over the next year, we may see answers to such questions as: Which are the more virulent strains and which are less so? Is it possible to create a laboratory test to "type" someone's HIV? Would it serve any useful function for the individual and his care providers to know if he/she is carrying 30 or 40 different strains? Would it pay to know how much variation there is in a person from month to month or year to year?

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