The underlying issues

A few weeks after the announcement that "a gay man who has had many sexual relations with people whose name he did not even know, in a drug use context" had got infected with an unknown and deadly virus, some aspects have come to light that show that the political haste, scientific vanity, hardly hidden homophobia and pure hard-line moral conservatism had more to do with this situation than scientific methods.

First, Ho and his colleague Marty Markowitz, both from the Aaron Diamond Center of New York, admitted that they could not say this man’s viral population was not mixed and be made up of more than one HIV strain. Secondly, this so-called multi-resistant strain is not resistant to the three families of antiretrovirales but only to two (nucleosides and protease inhibitors). For this reason the patient is being treated, apparently successfully, with efavirenz and enfuvirtide (T-20). And thirdly, the strain in question is a dual tropic one, that is to say, it has the ability to use without distinction the chemokine co-receptors CCR5 and CXCR4, which, although many might not know what this means, is by no means a groundbreaking discovery: for years now the four types of viral tropisms have been described –CCR5, CXCR4, dual and mixed. In fact, new antiretroviral compounds currently in development are based on these therapeutic targets.

The discussion on the implication for the general health of this supposed "discovery" ran parallel to its diffusion to the general public’s mind. Thomas Frieden, the Health Commissioner for NY, made a call to gay men with risky sexual practices to come forward for HIV and multiresistance tests, evoking the shadow of the "risk groups", a move supported by our now more than famous David Ho. Curiously, this same day, the only company in the world that performs multi-resistant HIV tests, ViroLogic, sent out a press release praising the virtues of their resistant test, which just happened to include a statement from Mr. Ho. What neither the company or Mr. Ho clarified at any moment is that David Ho is a member of the Scientific Advisory Board of ViroLogic, and that his brother Sydney is the Head of public relations of the same company. Some rival scientists have brought up this connection. Was it for jealousy or a true conflict of interests?