Subject: Ballooning AIDS Epidemic Poses Threat To Third World Stability
Date: Published: 6/3/87 99 lines
Source:  WALL STREET JOURNAL. Copyright Dow Jones & Co. Inc. 

   Ballooning AIDS Epidemic Poses Threat
   To Third World Stability, Official Says
    ---
   By Marilyn Chase
   Staff Reporter of The Wall Street Journal

   WASHINGTON -- The World Health Organization expects a
surge in cases of acquired immune deficiency syndrome that
could destabilize the political and economic systems of the
Third World, an official told the Third International
Conference on AIDS here.
   Separately, however, researchers gave heartening progress
reports on test-tube and clinical advances against the
epidemic of the fatal disease.
   "We face a precipitous increase in cases," said Jonathan
Mann, a WHO official based in Geneva, Switzerland.  With five
million to 10 million people estimated to be infected
world-wide, and a belief that 10% to 30% will develop AIDS
within five years, he warned one million active cases -- that
is, those showing symptoms -- could arise by 1991.
   Dr. Mann, a specialist on African AIDS who formerly was
based in Kinshasa, Zaire, said this has grave implications
for Africa.  "What political system could stand for long the
destabilizing effects of a 20% to 25% infection rate among
its young adults?  " he asked.
   Dr. Mann asked that industrialized countries neither
impose travel restrictions against Africans, nor cut off
health relief.  "Some have dared to say, 'Abandon Africa,' as
if the world were not one," he said.
    In the U. S., the AIDS virus currently infects one in 30
young to middle-aged men.  At the rate it is growing, by 1991
the disease will rank behind accidents as the second-highest
cause of premature death among men, added James Curran of the
U. S. Centers for Disease Control.  The figures for premature
death, measured in years of productive life lost, are
actuarial, based on life expectancy.
Though the U. S. has been spared the burden of pediatric
AIDS carried by Africa, this too is growing.  Currently, there
are 500 children with AIDS in the U. S., mostly black and
Hispanic.  One-third of such children now are born to mothers
who aren't intravenous drug users but contracted the virus
through heterosexual relations, sometimes with a drug-using
partner.  "This is the silent part of the epidemic and it's
alarming," Dr. Curran said.
   On the therapeutic front, Samuel Broder of the National
Cancer Institute counseled physicians and patients not to
despair:  "Even though we don't have a cure ...  we are well
on our way."
   Dr. Broder, who worked on developing AZT, the first drug
approved for treating AIDS, said its sister drug, DDC, has
boosted immune systems of a small group of patients.  But he
stressed that the news is preliminary, and doesn't guarantee
clinical benefits.  Currently used by 20 patients, the drug
causes side effects including rashes, mouth ulcers and a
temporary drop in blood platelets.  The drug has been licensed
to Hoffmann-La Roche Inc. 
AZT, made by Burroughs-Wellcome Co., is scheduled to enter
tests next month in an anticipated 1,500 people who carry the
AIDS virus but who are still healthy, to see if it can abort
onset of the disease.
   Both AZT and DDC work by slipping a false building block
into the virus's DNA. The whole family of drugs -- including
two new members called DDA and DDI -- may work against a
broad spectrum of retroviruses, which reproduce backwards
from RNA to DNA. These include the new African AIDS virus,
called HIV2, as well as a leukemia virus and a virus that
affects goats.
   One drawback of the AZT family has been its failure to
penetrate certain cells called macrophages that carry the
AIDS virus to the brain.  But a new class of drugs -- 
phosphorothioates -- can penetrate this cell, reported Makoto
Matsukura, another cancer institute scientist.
   Another strategy for getting drugs into macrophages will
be to package them in liposomes -- tiny fat spheres that are
drawing increasing interest as a drug delivery system, Dr. 
Broder said.
In addition, several compounds are being teamed up as
potential combination drugs.  Genentech Inc. scientist Grace
H. W. Wong reported the South San Francisco, Calif., company
discovered a synergy between tumor necrosis factor and gamma
interferon, which work together in the test tube to kill
AIDS-infected cells.  Other possible synergistic teams include
AZT and the herpes drug acyclovir, or AZT with DDC or DDA,
the cancer institute added.
   Anthony Fauci, director of the National Institute of
Allergy and Infectious Diseases, is investigating use of bone
marrow transplant as a possible therapeutic tool in 10
patients but said it is too early to speculate whether it may
work.

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