Is India sitting on an HIV/AIDS time bomb?

The HIV-AIDS laboratory at the Bangalore-based Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR) has in a research study found that the Human Immuno -deficiency Virus Type I (HIV-1) has been undergoing a process of viral evolution in India over the past decade and possibly in other parts of the world, too. The scientists found the emergence and expansion of 5 new strains of HIV-1 rapidly replacing the standard viral strain.

The study raises several questions with serious implications for the viral fitness, evolution and disease management. The most important of all the concerns is the possibility of the new HIV strains altering the landscape of the HIV demographics in India.

Interestingly, according to UNAIDS Global Report 2010, the rate of viral expansion had slowed or even declined in several global regions, including India. But the new findings may well invite a rethink on how HIV/AIDS might be moving in for another kill in the time to come.

Lead researcher, Udaykumar Ranga, professor, JNCASR, said they team of researchers believe that the new viral strains of HIV have a stronger “viral promoter” to make them smarter in making more daughter viruses to improve their chances of transmission to new hosts. But it is not yet established whether they are likely to promote a faster development of the dreaded Acquired Immune Deficiency Syndrome (AIDS).

“We first recognised this virus strain about 10 years ago, around 2003. At the time we thought this virus will not survive. It was present in about 1-2% of those who had contracted HIV virus. However two years ago, we started checking again and this time around we saw that this variant form of HIV had spread to 20-30% per cent of the patients,” said Ranga, adding that at least 163 samples had been collected in the last two years.

The study, which has been accepted for publication in Journal of Biological Chemistry of The American Society for Biochemistry and Molecular Biology on Tuesday, is the first of its kind to identify that a major family of HIV-1 is undergoing an evolutionary modification.

What is cause for concern is that people infected with the new HIV strains seem to contain more virus in their blood. The data has been generated from several individual hospitals from different parts of the country.  The clinical findings have been substantiated by a quantum of laboratory experiments using viral, immune and molecular strategies.

A similar process of viral evolution has also been observed in other countries such as South Africa, China and Southern Brazil, which have the same family of HIV-1 as in India.

The work involved JNCASR’s active collaboration with several research institutes and hospitals that specialize in HIV management, including the YRG Centre for AIDS Research and Education (YRG CARE), Chennai; St John’s National Academy of Health Sciences, Bangalore among others.