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"The Super AIDS" is a general term describing potentially more deadly mutants of the human immunodeficiency virus. The phrase "The Super AIDS" is used informally in discussion and entertainment, such as the South Park episode The Death of Eric Cartman. Some reports have used the term "the super AIDS" regarding multidrug resistant strains of HIV-1 (MDR HIV-1) found in New York City in 2005. The initial case was described by New York City Health Commissioner Thomas Frieden as holding "the potential for a very serious public health problem", and by Ronald Valdiserri, deputy director of the National Center for HIV, as "quite alarming", though the strain retained vulnerability to enfuvirtide. During a subsequent thirteen-month study in New York City, laboratories genotyping HIV to predict drug resistance were asked to report all genotypes resistant to more than three nucleoside/nucleotide analogue reverse transcriptase inhibitors, or any non-nucleoside reverse transcriptase inhibitor, or more than three protease inhibitors. The resulting data, from 189 persons, indicated a low prevalence of multidrug resistance in newly infected persons, but led to funding for further studies. In 2006, provisional data indicated that 15% of new infections were resistant to one antiretroviral drug, and 3.2% to two such drugs. As a result the U.S. Department of Health and Human Services changed its guidelines to recommend testing for drug resistance before beginning antiretroviral treatment in new patients. HIV infection Typically, the "wild" type of HIV (the strain of HIV found in individuals not treated with antiretroviral drugs) is much more effective at attacking the human immune system than the types that evolve in the presence of antiretroviral drugs. Thus, by changing the selection pressure (from being infection driven to being drug-avoidance driven) retroviral drug treatment causes HIV to evolve to a more innocuous form, less efficient at infecting T-cells. The Super AIDS, however, was a strain that was not only resistant to anti-retroviral drugs, but it was more effective than "wild" HIV at infecting T-cells
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