Subject: AIDS Conference Spawns Closer Look At Long-Term Survivors as Key to Cure 
Date: Published: 6/14/93 (71 lines)
Source: Wall Street Journal. Copyright Dow Jones & Co. Inc.

    AIDS Conference Spawns Closer Look
    At Long-Term Survivors as Key to Cure
    ----
    By Marilyn Chase
    Staff Reporter of The Wall Street Journal

    BERLIN -- The Ninth International Conference on AIDS broke up in
 a fractious but fertile session, as scientists lurch toward a
 concept of AIDS that unites two clashing patient profiles:  people
 with devastating immune collapse, and long-term survivors.
    As usual, the parley ended in a ritual theater of rage, as
 activists bellowed and blew whistles at closing speakers.  A man in a
 red feather boa briefly occupied the stage, and hundreds chanted:
 "No more talk, we want a cure."
    Unnerved, the host of the Berlin meeting, Karl-Otto Habermehl,
 lashed back at demonstrators, warning them in a news conference
 against making it "too difficult" for conference sponsors to hold
 the event.  Later, on a more conciliatory note, he said the
 disturbance was "a sign of how desperate people are all over the
 world."
    Among the ideas debated here were:  an emerging view of how HIV,
 the virus that causes AIDS, wreaks its havoc in the immune system,
 and the resurgence of an old and risky model of "live virus"
 vaccines.
    The prevailing concept now emerging from many labs depicts AIDS
 as a primary infection with HIV, leading to hybrid symptoms:  part
 infectious disease, part immune depression, part autoimmune disease
 with the body attacking itself.  Thus, polio pioneer Jonas Salk
 predicted it will be much harder than polio or rabies to immunize
 against.
    "AIDS is the Alzheimer's of the immune system," he said because
 the immune defense system lose its memory.
    HIV disease begins with a slow controlled infection, kept in
 check by a cascade of helpful immune responses, sometimes for years.
 Then the virus shifts into high gear -- through mutation, immune
 burnout, or mass cell death -- overflowing into the blood, and
 triggering a faster and more fatal phase of AIDS.  
    Long-term survivors -- people infected early in the epidemic but
 remaining robust -- are subjects of intense scrutiny as scientists
 probe the secrets of their immune control system.  Jay A. Levy of the
 University of California at San Francisco, said such people are
 protected by high levels of so-called "supressor" (or CD8) cells
 which should be exploited for clues to treatment.  Gene Shearer of
 the National Cancer Institute also is studying immune profiles of
 people who resist HIV despite exposure.
    While most people with HIV become very ill or die within a
 decade, there are some stubborn exceptions, like Joel Thomas of San
 Francisco.  A robust six-footer, Mr. Thomas says he knows he
 contracted the HIV 14 years ago in 1979 -- an accidental discovery
 obtained through a hepatitis B blood screening during the late 70's.
 Today, against the odds, he says he's "doing well" on a regimen of
 antivirals and immune-boosters.
    "The answer isn't hosing everybody down with AZT," Mr. Thomas
 asserted.
    Swedish researcher Lars Kallings noted, "AZT is still the
 mainstay of treatment."  But this meeting saw confidence eroded by
 the Concorde study, which said infected people don't gain any
 survival benefits from early AZT treatment until their immune
 systems collapse into AIDS.  
    Dr. Kallings said new drug studies should be linked with emerging
 knowledge about different virus types, genetic mutants, and stages
 of the disease.

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