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Tests in [David Ho]'s laboratory and elsewhere have shown that the rare strain from the man whose case started the investigation is resistant to 19 of the 20 licensed anti-retroviral drugs. AIDS experts said that the strain may have led to the rapid onset of AIDS in the man or that his immune defenses may have been weakened by drug use or genetic factors

The city health officials said they had detected the rare strain of HIV in one man whose case they described as particularly worrisome because it merged two unusual features: resistance to nearly all antiretroviral drugs used to treat the infection, and stunningly swift progression from infection to full-fledged AIDS. That combination, the officials said, could signal a new, more menacing kind of infection, and its discovery set in motion an anxious search by city workers to find the man's sexual partners and have them tested. Project Inform, a 20-year-old group in San Francisco providing information about AIDS and treatment, called the reports 'unnecessarily alarming to the public.' What is not clear yet, several experts said, is whether the disease progressed so rapidly because the virus was strong or the patient was weak. About 1 percent of all people infected are 'slow progressors,' who take decades to get sick. The reasons are unknown, but some have genetic mutations that disable the receptors on the outside of the CD-4 immune system cells to which the virus attaches

AIDS viruses isolated from two people are being studied to determine whether either might be the source of a rare and potentially more aggressive form of H.I.V. detected in a New York City man, an AIDS scientist involved in the studies said yesterday. Laboratory tests in Dr. [David Ho]'s laboratory and elsewhere have shown that the strain from the man whose case started the investigation is resistant to 19 of the 20 licensed anti-retroviral drugs. AIDS experts said that the strain might have led to the rapid onset of AIDS in the man or that his immune defenses might have been weakened by drug use or genetics. On Friday, Dr. Thomas R. Frieden, the commissioner of the New York City Department of Health and Mental Hygiene, said the man's case was the first in which a strain of H.I.V. had been found that showed both resistance to multiple classes of drugs and apparently led to a rapid progression from infection to AIDS. Each component has been reported earlier

About 1 percent of all people infected are ''slow progressors,'' who take decades to get sick. The reasons are unknown, but some have genetic mutations that disable the receptors on the outside of the CD-4 immune system cells to which the virus attaches. The man in New York, who is clearly a fast progressor, has a ''dual-tropic'' strain of the virus, which means it can attach to two types of receptors, which are nicknamed the R5 and X4 receptors, on the outside of the CD-4 cell. In the vast majority of people who get infected, said Dr. Robert C. Gallo, a co-discoverer of the AIDS virus, the first infections are attached to the R5 receptors. Only after several years do the X4 receptors kick in, and then the patient's condition often worsens quickly

About 1 percent of all people infected are 'slow progressors,' who take decades to become sick. At the other end of the spectrum will be 1 percent to 2 percent who are 'fast progressors,' who go to full-blown AIDS -- meaning low numbers of CD-4 immune-system cells and opportunistic infections such as Pneumocystis carinii pneumonia - - in months. The average time between infection and AIDS is seven to 10 years. The New York man, who is clearly a fast-progressor, has a 'dual- tropic' strain of the virus, which means it can attach to two types of receptors, nicknamed the R5 and X4 receptors, on the outside of the CD-4 cell. In a vast majority of infected people, said Dr. Robert Gallo, a co-discoverer of the AIDS virus, the first infections are attached to the R5 receptors. Only after several years do the X4 receptors kick in, and then the patient often goes downhill quickly

On the day after the announcement a rare strain of the AIDS virus was found in a New York City man, scientists said much work needed to be done to assess just how dangerous the virus is. Anthony Fauci, a prominent AIDS researcher and head of the National Institute of Allergy and Infectious Diseases, said he had seen cases where two sexual partners had been infected by the same strain and 'one does reasonably well, and the other progresses fulminantly' - meaning the immune system of the second person collapses rapidly. At the other end of the spectrum will be one to two per cent who are 'fast progressors,' who go to full-blown AIDS - meaning very low numbers of CD-4 cells and opportunistic infections like pneumocystis carinii pneumonia - in months. The average time between infection and AIDS is seven to 10 years

The strain, A/California/7/2004 (H3N2), was first identified from a specimen taken from a patient who had influenza in September, said Dr. Carol Glaser, chief of the viral branch of the California Department of Health Services. The federal Centers for Disease Control and Prevention in Atlanta identified the strain as a new one in January, Glaser said. On Thursday at the World Health Organization headquarters in Geneva, a panel of influenza experts recommended including the California strain in next season's vaccine. The panel meets twice a year to try to match the strains included in the vaccine recommended for each hemisphere with those expected to be circulating in those hemispheres during the next season. The vaccine is produced in sequential steps. The manufacturers start about January with the strain that they least expect to be changed, then move to the second strain. In a third step, they produce the newest strain, expected by the end of March. Then they produce the entire vaccine

In May 2003, the man tested negative for H.I.V., health officials said. Investigators believe he contracted H.I.V. in October 2004, when he engaged in unprotected anal sex with multiple partners while using crystal methamphetamine. The man found some of his partners on an Internet Web site, officials said, though they would not identify the site. Health officials said they were working with those who used the Web site to reach as many people as possible who might have been infected or are worried that they could have been. ''We believe that the transmission of treatment-resistant H.I.V. was a disaster waiting to happen, particularly in communities where safer sex is not practiced regularly and in light of people using drugs like crystal meth,'' Dr. [James Braun] said. ''All primary care providers in acute care settings need to know how to diagnose H.I.V. in its earliest stages and where to refer people so that new infections are properly worked up and treated.'' A rare strain of H.I.V. is resistant to three of the four classes of drugs used to treat the disease. Here is how H.I.V. replicates, and the points in the process where drugs can act

The limited epidemiological investigation in this case shows that the patient could have developed AIDS in as quickly as two months, but that it might have taken as long as 10 months, [Thomas R. Frieden] said. On average, it takes 10 years from the time a person is first infected with HIV to the development of AIDS. So for some patients AIDS can occur in months, while in others it can take 20 or more years. In May 2003, the man tested negative for HIV, health officials said. Investigators believe that he contracted HIV in October 2004, when he engaged in unprotected anal sex with multiple partners while using crystal methamphetamine. The man found some of his partners on an Internet web site, officials said, although they would not identify the site. Health officials said they were working with those who used the Web site to reach as many people who might have been infected or might be worried that they could have been. In fact, Frieden said all people newly diagnosed with HIV should be tested to see if the strain is drug-resistant. He said the means are available to conduct the tests, which are complex to perform and expensive. Frieden asked physicians to report any case in which a strain is resistant to three classes of drugs