Most communicable and aggressive HIV variant found in the Netherlands

A new variant of the HIV virus described as “highly virulent” was revealed this Thursday (3) in an article in the scientific journal Science.

Named “variant VB”, short for “virulent variant of subtype B”, it has been shown to be able to lead to a higher viral load in the blood compared to other types of the virus; to be more transmissible; and to decrease the body’s T-CD4 defense cells more rapidly.

The authors of the research, led by a team from Oxford University in England, estimate that the variant emerged in the Netherlands between the late 1980s and the 1990s, spread in the 2000s and started to lose strength from 2010. But this is the first time the variant has been described and mapped in individuals — BV infection was confirmed in 109 people analyzed in the study, the vast majority in the Netherlands. The researchers also detected one case in Switzerland and another in Belgium.

One of the authors, researcher Chris Wymant, explained by email to BBC News Brazil that the results should not worry the population, because the ideal response to this and other variants of HIV already exists: tests and treatment.

By the way, there is good news from the study. Compared to other types of HIV, the VB variant was shown to be more virulent, transmissible and aggressive in people who had not yet undergone treatment. However, after treatment, people with the VB variant began to show CD4 cell recovery and mortality indicators similar to those with other types of HIV.

“The discovery of this variant reinforces the importance of guidelines that already exist: that individuals at risk of contracting HIV have access to regular testing, allowing for early diagnosis, followed by prompt treatment,” wrote Wymant, a senior researcher at the University of Oxford and specialist in the evolution of viruses.

HIV is the virus that causes Acquired Immunodeficiency Syndrome (AIDS). UNAIDS (Joint United Nations Program on HIV/AIDS) estimates that 37.7 million people were living with HIV worldwide in 2020, the year in which 1.5 million new infections occurred. That year, an estimated 680,000 people died from AIDS-related health problems (against 1.9 million in 2004 and 1.3 million in 2010).

In 2020, 73% of people with HIV had access to treatment, which is now drug-based — often just one pill taken daily — and considered very effective.

3 to 5 times higher viral load

HIV has a few subtypes, strongly related to locality. For example, in Africa, the most common subtypes are A, C and D; in Europe, subtype B. According to a study published last year, in Brazil, subtype B is also the most frequent.

Wymant explains that within subtypes, there is branching into variants.

“Finding a new variant is normal, but finding a new variant with unusual properties is not. Especially one with greater virulence”, says the researcher.

“The worst-case scenario would be the emergence of a variant that combines high virulence, high transmissibility and resistance to treatment. The variant we discovered has only the first two of these characteristics.”

At diagnosis, before treatment, people with the VB variant had a viral load 3.5 to 5.5 times higher than those with other types of HIV; the rate of decline in CD4 cells was twice as fast, putting them at much faster risk of developing AIDS.

The researchers say the variant was possibly the result of mutations that happened over time and was only revealed now for a few reasons — such as the fact that the genetic sequencing of samples from people with HIV is relatively recent.

The investigation into the variant began because scientists involved in the BEEHIVE project detected 17 individuals with an unusually high viral load. BEEHIVE was created in 2014 with the aim of monitoring the influence of genetics on HIV infections, and it does so by tracking the health of patients in European countries and Uganda. As researchers genetically analyzed samples from these and more patients, they detected a new variant.

“We consider that the virus (in the form of the VB variant) emerged despite a strong treatment program in the Netherlands, and not because of it. The other side of the coin is that excellent monitoring in the Netherlands has made detection of a variant such as this one,” Wymant points out.