Subject: Plans for AIDS Vaccine Trials Urged Although Drugs Remain Experimental 
Date: Published: 7/22/92 (94 lines)
Source: Wall Street Journal. Copyright Dow Jones & Co. Inc.

    Technology & Health:
    Plans for AIDS Vaccine Trials Urged
    Although Drugs Remain Experimental
    ----
    By Marilyn Chase
    Staff Reporter of The Wall Street Journal

    AMSTERDAM -- The AIDS epidemic is raging so fast that world AIDS
 experts must start planning how to launch large-scale vaccine trials
 now, even though vaccines are still experimental, a top U. S. health
 official warned the International Conference on AIDS.  
    Daniel Hoth, a top AIDS expert at the National Institutes of
 Health in the U. S., said it will take at least two years to plan
 vaccine tests, recruit the needed 2,000 to 5,000 healthy volunteers
 and cope with resulting social and political problems.
    "We cannot be sure a vaccine will work," Dr. Hoth said.  But he
 said scientists must start planning immediately to avoid a spiraling
 of the global infection rate while waiting for the perfect vaccine.
    In a chilling mathematical model of the epidemic, he argued it
 would be better to start tests of a vaccine that is 60% effective,
 than to wait for one that is 90% effective.  Given a population of
 one million, with 10% of the people infected with AIDS, Dr. Hoth
 projected an early start could prevent 145,000 new infections; delay
 could mean 22,000 people would become infected.
    So far, no single vaccine has emerged as a sure tool of
 prevention, though about a dozen possible vaccines are working their
 way through safety tests in the U. S. and Europe.  Studies made
 available here this week continue to show such vaccines are
 relatively nontoxic and bolster the immune system.  But because the
 AIDS virus mutates, many doctors are discouraged about the prospects
 for a vaccine that would prevent AIDS.  
    Assuming a vaccine is readied for large-scale trials, Stephen K. 
 Lwanga, director-general of the Uganda AIDS Commission, argued
 strongly that poor nations need assurances from the West that they
 will get the necessary education and technical support and, most
 importantly, that the vaccine will be affordable.
    "People in Uganda are anxiously awaiting a remedy," he said.
 However, Mr. Lwanga was concerned about the West's eagerness to
 launch large-scale trials in AIDS-devastated poor countries.  Dr. 
 Hoth assured him that the U. S. intends to test vaccines in the
 developed world as well.
    AIDS conference delegates also witnessed a cameo appearance by
 Dr. Jeffrey Laurence of Cornell University Medical School, whose
 pending report in the British journal Lancet touched off fresh
 controversy here yesterday.  Dr. Laurence has described five patients
 from his New York practice with AIDS-like symptoms who tested
 negative for AIDS.  
    Dr. Laurence speculated in a special session that it's possible
 "HIV was there but got burned out" in his patients.  He called for
 further study to determine whether his patients suffered from a new
 kind of AIDS virus or whether some other microbe caused their
 AIDS-like symptoms.
    Dr. Laurence's observations were first made public in Newsweek
 magazine and caused considerable surprise at the AIDS conference.
 However, two other AIDS experts said they have seen similar cases.
    Dr. Luc Montagnier of the Pasteur Institute in Paris, a
 discoverer of the AIDS virus, and Dr. David Ho of the Diamond AIDS
 Center in New York each said they too have seen patients with
 AIDS-like symptoms, but no detectable AIDS anitbodies in their
 blood.  Doctors test for AIDS by checking blood for antibodies that
 the body makes to fight the AIDS virus.  Dr. Montagnier said his two
 patients had no AIDS antibodies in their blood but that he found
 antibodies in their urine.
    Dr. James Allen of the U. S. Public Health Service said there
 isn't any reason to assume the U. S. blood supply has been
 contaminated by some undetected AIDS virus, but other U. S. officials
 privately said they were troubled by what Dr. Laurence's findings
 could mean for both the blood supply and future treatment
 strategies.
    The U. S. Centers for Disease Control AIDS chief, James Curran,
 came under fire for playing down the new cases.  However, Dr. Curran
 said he's now heard of at least two dozen such cases, including
 those reported anecdotally here, and he said his agency will
 continue to investigate the cases.
    Separately, Robert Redfield of the Walter Reed Army Medical
 Center provided his latest research on using a vaccine to bolster
 the immune systems of patients already infected with AIDS.  In a
 study of 15 volunteers, Dr. Redfield found those who received the
 vaccine had a decrease in the amount of AIDS virus in their blood
 when compared with an unvaccinated control group whose virus levels
 rose as much as 47%.  However, Dr. Hoth, of the National Institutes
 of Health, noted that it is very hard to measure virus levels
 because sometimes the AIDS virus hides in the lymph nodes and can't
 be detected.
    In the 15-volunteer study, Dr. Redfield used a biogenetically
 engineered vaccine produced by MicroGeneSys Inc. of Meriden, Conn.

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