The possibility of HIV-positive men becoming superinfected with drug-resistant strains has become a growing concern, a prominent HIV doctor warned this week.

Sexual health physician Dr Robert Finlayson was reporting on news from the 11th Conference on Retroviruses and Opportunistic Infections held in February.

Finlayson told Sydney Star Observer that reports suggested superinfection was a difficult thing to find, but wherever people have looked they have found it.

When the strains are different, or drug-resistant, then it might have very serious consequences as far as your disease process rapidly progressing, Finlayson said, although he admitted the numbers were small.

According to one study, as many as five percent of positive men in the sample were reported as being infected with a different strain of the virus.

Superinfection was first described in heterosexuals in Switzerland several years ago and there’s been a real reluctance to accept information that might translate into a return to advising positive people to have safe sex with each other -¦ Finlayson said. But I think only Luddites would now be saying that it doesn’t occur and it’s of no importance.

John Daye, treatments spokesperson for NAPWA, concurred but called for a sense of perspective. Daye also attended the conference, when the report on superinfection by researchers at the University of California was a hot topic.

I think in terms of positive people, it’s really important that they’re aware of the ramifications of unsafe sex between positive people, Daye told the Star. That’s a choice that people individually have to make. I wouldn’t want to lecture people on this, but the evidence now is that this exists.

For some positive people the idea that they might lose a few drug options may not be a burning concern, but for others it will be, Daye said. What we do need to do as agencies and service providers is to let people know what the evidence is showing. The implications are that if people are transmitting drug-resistant virus then they may have fewer drug options in the future.

Finlayson added, Some people are of the view that it happens very, very frequently, but when all the strains are similar, it’s very hard to detect and maybe doesn’t matter much.

A fact sheet about superinfection is currently being developed by the AIDS Treatment Project of Australia (

The news wasn’t all bad, however. Australian researchers presented encouraging results on a therapeutic (not preventative) vaccine for HIV, although the product still required further testing. There were also encouraging results reported from a new class of antiretroviral drugs called HIV attachment inhibitors, although Daye said their effectiveness is yet to be proven.

The big message, according to Finlayson? Don’t smoke.

If you give up smoking it will massively improve your health as far as high blood pressure and cardiovascular disease risk goes, he said. Being fit, not being overweight, not being sedentary and not smoking are big pluses for people with HIV.

I got the message loud and clear that when I’m telling someone for the first time that they’ve got HIV, if I can get them to stop smoking, that will dramatically improve their health and reduce their chances of having serious illness events in the next 20 years or so, Finlayson said.

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