Subject: Patients Who Tested Negative for HIV Cause Search of Files, Raise Questions Date: Published: 7/23/92 (73 lines) Source: Wall Street Journal. Copyright Dow Jones & Co. Inc. Technology & Health: Patients Who Tested Negative for HIV Cause Search of Files, Raise Questions ---- By Marilyn Chase Staff Reporter of The Wall Street Journal AMSTERDAM -- After a firestorm of publicity erupted at the AIDS conference here, doctors and researchers are combing through their patient records to search for people who have AIDS-like symptoms but who inexplicably test negative for the AIDS virus. Jeffrey Laurence of Cornell University Medical School ignited the controversy when he said he had found five such cases among his patients -- people with classic AIDS symptoms, such as pneumonia, drastic weight loss and severely weakened immune systems, but who lack any detectable sign of the human immunodeficiency virus which, by definition, causes AIDS, or acquired immune deficiency syndrome. AIDS is a fatal affliction spread by sexual contact and exposure to infected blood. Four of the five patients had AIDS risk factors, such as engaging in needle sharing and unprotected sex. Dr. Laurence's findings, slated for publication in the British journal Lancet, came out in Newsweek on the eve of the conference. Because of the sensational nature of the findings, surprised conference officials hastily arranged a special session to air Dr. Laurence's report. In that session, some doctors said they had seen what appeared to be similar cases, bringing the total to several dozen and setting off intense press coverage and infighting among the experts. Here are questions and answers on the major issues raised. Is this a concern for the general population? James Curran, AIDS chief of the U. S. Centers for Disease Control, said this doesn't represent a major new public health threat. Heterosexuals who have tested negative for the AIDS virus -- and who have no other AIDS risk factors and continue to practice safety precautions -- shouldn't fear for their personal health. Gay men who engage in unprotected sex and drug users who share needles, as well as their sex partners, continue to be at highest risk for AIDS. So what do Dr. Laurence's findings mean? Under the formal CDC definition of AIDS, Dr. Laurence's patients don't have AIDS because, so far, they test negative for HIV in the blood. Dr. Laurence told AIDS conferees it is possible the patients at one point had HIV in their bodies but that it had "burned out" as their conditions deteriorated. However, these patients have AIDS-like symptoms. Researchers noted that sometimes a patient's immune system collapses for no known reason. Cancer, organ transplant drugs, age or environmental factors are among the possible causes. The most alarming possibility raised is that these cases could represent a new strain of AIDS virus, or an entirely different virus. But that could take months or years to determine. What does this say about the reliability of AIDS blood tests? For the two known strains of the AIDS virus, the test remains highly reliable. If these cases represent a new strain of the virus or an as-yet undiscovered germ, then researchers will have to isolate it and develop tests for it. Is the blood supply safe? James Allen, an official with the U. S. National AIDS Program, a government agency, said at a news conference that the blood suppply in the U. S. or any country that conducts standard antibody screening remains very safe. Why is he so confident? Most of Dr. Laurence's patients were among those at high risk for AIDS. Such individuals wouldn't pass current screening by blood banks and couldn't donate blood. In addition, there isn't any evidence their illness can be transmitted. [This article is made available here by Dow Jones Co. for the personal and non-commercial use of callers to this bbs, in the hope that it will be of some help to those who are suffering from the disease and others who are seeking to help them.]