AIDS research center official said his group, city health department acted prudently
Speaking during a panel discussion at The New School, Dr. Martin Markowitz, the researcher at the Aaron Diamond AIDS Research Center (ADARC) who found a virulent, drug-resistant AIDS virus in a New York City gay man, defended the decision to disclose the case to the city health department.
“This was perhaps the most drug-resistant virus we had seen,” Markowitz said at the June 22 event. “The virus appeared quite aggressive.”
The health department announced the case on February 11. It spawned a rash of dramatic headlines warning that a rapid-progressing form of drug-resistant HIV was loose in the gay community. The health department press conference also attracted intense criticism from some AIDS activists and researchers who disputed the science that lay behind it.
Markowitz said that a number of factors influenced the decision to bring the case to the health department.
The man had progressed from HIV-positive to AIDS in as short a time as three months or as long as 20 months. In either case, he is a rapid progressor. The move from being HIV-positive to having AIDS typically takes eight to ten years.
His virus was resistant to all the drugs in two of the four anti-HIV drug classes, with some resistance to most of the drugs in a third class, and no resistance to the one drug in the fourth class. The virus also showed vitality in replicating, which is unusual for strains of HIV that show drug resistance.
The man also reported having had many sex partners, with a number of those encounters occuring during the time when he is believed to have been recently infected. People who are newly infected typically have a high level of virus in their blood, semen and other bodily fluids and are highly infectious.
“We had no idea how many people he may have transmitted to,” Markowitz said. “That’s why the health department was notified and I still to this day believe we did the right thing.”
As more information has come out about the case, it has grown less compelling. The man is responding to treatment and has returned to work, according to an article in an April issue of New York magazine.
The health department ordered 39 testing labs across the country to search their databases for similar or identical cases “derived from New York City providers and/or residents since June 1, 2004, and prospectively through June 30, 2005.”
To date, no second case has been reported.
In a June 16 New York Post story, Dr. Scott E. Kellerman, the department’s assistant commissioner for HIV/AIDS Services, said “No patients with identical strains have been identified by the big labs in our attempts to find out whether this was more widespread, but the investigation is ongoing. It suggests that this might be an isolated case.”
Markowitz disputed the Post story.
“I think it was a bit inaccurate in that there is an ongoing epidemiological investigation,” he said.
The health department has also disputed the Post story, saying that the investigation is not yet completed.
The other participants on the panel titled “Gay Sex, Safe Sex: What is To Be Done?” were Dr. Perry N. Halkitis, a psychology professor at New York University and a co-director of the Center for Health, Identity, Behavior and Prevention Studies, George Ayala, director of the Institute for Gay Men’s Health, a joint project of the Gay Men’s Health Crisis and the AIDS Project Los Angeles, and Phill Wilson, director of the Black AIDS Institute.
The panel was moderated by Richard Goldstein, the author and journalist.