Why Is No One Talking About The New Highly Virulent HIV Strain: VB Variant Detected in the Netherlands That Poses a Serious Threat!

HIV News: A new subtype of HIV-1 has emerged, causing rapid decline in immune system function and increasing vulnerability to AIDS and has now been found to have spread globally!


 
Researchers have discovered a highly virulent variant of subtype-B HIV-1 circulating in the Netherlands, causing alarm in the medical community.
 
This new HIV strain, known as the "VB variant," is responsible for a 3.5-fold to 5.5-fold increase in viral load compared to other subtype-B strains, and has been linked to a doubling in the rate of CD4 cell decline. The swift progression of this new HIV strain could lead to a higher number of people developing AIDS within 2 to 3 years of diagnosis.
 
The study led by researchers from Oxford University-UK with findings published in early 2022, analyzed data from well-characterized European cohorts and identified a subtype-B lineage of HIV-1 that has been circulating in the Netherlands for several years.
https://www.thailandmedical.news/news/breaking-new-highly-virulent-hiv-variant-discovered-in-netherlands-that-is-now-spreading-around-europe-beware-having-sex-with-the-dutch-or-british

Despite the study findings in early 2022, not much was covered about it in the media or HIV News coverages and not much was done by the medical community to control its spread. While it was falling in terms of spread and was unique only in the Netherlands when the study was published, new emerging data shows that is has risen once again in the last few months and is now also found in various geolocations across the globe!
 
This variant has undergone extensive changes across the genome, affecting almost 300 amino acids, making it difficult to pinpoint the mechanism for its elevated virulence.
 
The VB variant is believed to have originated from de novo mutation in the 1990s, not recombination. It presents increased transmissibility and an unfamiliar molecular mechanism of virulence.
 
The study identified 109 individuals infected with the VB variant, who experienced CD4 cell decline at twice the rate of those infected with other subtype-B strains. Without treatment, individuals in their thirties infected with the VB variant could reach advanced HIV ie CD4 cell counts below 350 cells per cubic millimeter..on average, 9 months after diagnosis!
 
CD4 cells are crucial for the immune system's function, and the rapid decline caused by the VB variant poses a significant risk to the health of those infected.

The study found that at the time of diagnosis, CD4 counts for VB individuals were already lower than for non-VB individuals. This decline continued at a faster rate, doubling the speed at which the immune system is compromised. If left untreated, individuals with the VB variant could develop AIDS-related complications within 2 to 3 years of diagnosis, as opposed to the 6 to 7 years for those with non-VB HIV stra ins.
 
The VB variant has been identified in individuals from various regions of the Netherlands, with a higher prevalence in the south and a lower presence in Amsterdam. The majority of those affected are men who have sex with men (82%). The age at diagnosis, as well as the suspected mode of transmission and place of birth, were found to be typical for HIV-positive people in the Netherlands, suggesting that the increased virulence is directly attributable to the viral strain itself.
 
The discovery of the VB variant raises significant concerns for global health, as HIV continues to affect millions of people worldwide. The rapid progression of the VB strain could lead to increased morbidity and mortality rates if not adequately addressed. It also highlights the importance of continued monitoring of HIV virulence and the development of new strategies for the prevention, diagnosis, and treatment of this devastating virus.
 
VB Variant Genotype: Unraveling the Enigma of the New Strain
The groundbreaking BEEHIVE project and ATHENA data revealed the enigmatic VB variant, with 17 whole genomes and 92 partial pol gene sequences, painting a complex picture of this new HIV-1 strain.
 
A staggering 250 amino acid changes, 509 nucleotide changes, and mysterious insertions and deletions have left scientists puzzled and whether these mutations were the origin of the VB variant's enhanced virulence.
 
Among the VB genomes, 16 were likely CCR5-tropic, while only one was possibly CXCR4-tropic. The prevalent drug-resistance mutation, M41L, was found in 91 out of 109 partial pol gene sequences, though it only causes low-level resistance to zidovudine. Astoundingly, two whole genomes were discovered to be recombinants with another subtype-B cluster, and no candidate "recombination parent" was found, implying the many mutations distinguishing the VB variant may have arisen de novo.
 
Descriptive analyses exposed 30 amino acid substitutions linked to escape from CTL response and 13 negatively associated. Comparisons with 16 other Dutch subtype-B clades revealed the VB variant's number of mutations is typical when normalized by its overall level of divergence. Interestingly, the VB variant had lower dn/ds values for env, pol, and tat genes.
 
At codon position 77 of the Vpr protein, the VB consensus is arginine instead of the common glutamine found in other Dutch subtype-B sequences. Arginine is linked to increased T cell apoptosis and decline in mouse models, but it has been commonly observed in subtype B, making it unlikely to be the sole cause of the observed virulence effect. The enigma of the VB variant genotype continues to challenge scientists as they race to uncover its secrets!
 
Circulation Of VB Strain Declined And Then Increased And Is Now Spreading Globally!
The rise of the fearsome VB Variant and then gradual fall and rise again with the strains now detected in various geolocations across the world in the last few months has sent sends shockwaves through the scientific community but strangely no media coverage has been found!
 
The discovery of the VB variant, a highly virulent subtype-B HIV-1 strain, has left experts reeling. With its rapid CD4 cell decline and increased transmissibility, this ferocious strain has been circulating in the Netherlands since the late 1990s. Astonishingly, the 109 individuals with the VB variant share typical characteristics for people living with HIV in the Netherlands, suggesting the increased virulence is a property of the virus, not the affected individuals.
 
A Big Health Threat
The VB variant's virulence poses a considerable threat, as individuals may progress to advanced HIV by the time they are diagnosed, even in the highly monitored context of the Dutch HIV-1 epidemic. The threat would be even greater in contexts with less awareness and monitoring. The search for the underlying virulence mechanism is underway, with in vitro investigations expected to shed light on the virus's genotype and potential molecular or cellular-level mechanisms.
 
In a sensational twist, the basic theory of an infectiousness-virulence trade-off may be challenged by the VB variant. This theory states that we would not expect highly virulent viruses to spread widely in a population without widespread treatment.
 
New Hypothesis
Our discovery of its rise again and global spread now might spark interest in whether widespread treatment could shift the balance of the infectious-virulence trade-off toward higher virulence, thus promoting the emergence and spread of new virulent variants.
 
The discovery of this highly virulent and transmissible VB variant underscores the importance of frequent testing for at-risk individuals and adherence to recommendations for immediate treatment initiation for every person living with HIV. The battle against the VB variant rages on, and only time will tell what other mysteries this formidable foe may hold.
 
Conclusion
In conclusion, the identification of a highly virulent HIV-1 subtype-B variant in the Netherlands poses a serious threat to public health. With its rapid rate of CD4 cell decline and potential to cause AIDS within 2 to 3 years of diagnosis, this new strain underscores the need for ongoing research and surveillance of HIV. The global community must remain vigilant and committed to combating this evolving virus and finding new ways to protect those most vulnerable to infection
 
More media coverage should be done on this new threat and HIV clinics and doctors around the world should be educated to look out for this new strain. The gay community that is at higher risk and also sex workers and promiscuous individuals should be warned of this new threat!
 
Even more worrisome is that this new VB strain is still mutating and with various SARS-CoV-2 sub-lineages especially the XBBs, BA.5 and BA.2 variants around, these highly “promiscuous” viruses that love mutating and are evolving rapidly might just spawn an interesting reassortant strain.

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