The Washington Blade; Friday, January 24, 1997
Lisa Keen

The news was not a big surprise for AIDS activists who have been carefully weighing the delirium against the data since last June when the first talk of "eradication" surfaced. That talk sprang out of a surge in optimism over reports earlier in the year that a new class of drugs -- protease inhibitors -- were reducing the amount of virus in the blood to levels so low that available tests could no longer detect it. But those available tests measured only as low as 200 particles per milliliter, so no one really knew whether the virus was gone. Still, the euphoria surrounding such positive results from the new drug treatments fueled the wildly optimistic speculation last summer that the end of the epidemic might be near.

On Wednesday night, Ho threw a cold bucket of water on that optimism.

"Can HIV be eradicated from an infected person?" asked Ho during his speech opening the Fourth Conference on Retroviruses and Opportunistic Infections here in D.C. "The answer is clear: We don't know."

At a press conference Wednesday afternoon prior to the speech, Ho, who heads up the Aaron Diamond AIDS Research Center in New York, said that the new triple-drug regimens using a protease inhibitor and two nucleoside analogs have not eliminated the AIDS virus from any of the Diamond Center's 20 patients who began treatment within 90 days of becoming infected about a year and a half ago.

The 20 patients have been on one of two triple-drug regimens since that time, said Ho. Half got an AZT-3TC-Ritonavir combination, and the other half got an AZT-3TC-Indinavir combination.

In response to a question from a reporter, Ho acknowledged that the Center had to revise its plan -- much ballyhooed at the International Conference on AIDS in Vancouver in July -- to stop treatment on some of those patients by the end of 1997 to see if the virus was in fact gone. Ho said he revised the plan after determining since July that the virus takes at least two to two and a half years to "decay" out of "known compartments" in the body; thus it will be at least another year before that decay could presumably eliminate the virus from those "known compartments," such as the blood and various immune system cells. But a much more cautious Ho this week declined to predict whether he might be ready to have those 20 patients stop treatment in a year, noting that "there could be additional compartments that we don't know about."

Ho said at the press conference that the Diamond Center is also expanding its study to determine whether the virus is still detectable in semen or in lymphoid tissue when it is undetectable in the blood. So far, he said, there appears to be no evidence of actively replicating virus in those sites. There is some evidence of virus, he said, but it is "defective" virus incapable of replicating. But Ho also acknowledged that scientists cannot rule out the possibility that "defective" virus might merge and mutate in a way to become infectious again.

A parallel study, said Ho, is also examining whether the triple-drug combinations are as effective in patients who begin treatment much later after infection than 90 days. So far, he said, the results seem "very comparable."

Since the dramatically positive results on protease inhibitor combinations were first revealed at last year's Retrovirus Conference, this year's conference has become a premier forum for announcing news on AIDS treatments and research. The conference, which began Wednesday night and runs through Sunday, is presenting the freshest new data on the clinical benefits of a large number of combination therapies, preliminary research on several whole new classes of antivirals, and the latest knowledge in how the AIDS virus enters a person's cells and replicates.

Reports from the conference this week are embargoed from publication by the news media until after they are presented at the conference, and the majority of reports to be presented yesterday were embargoed until after Blade deadline. The Blade will have a report on those presentations and the rest of the conference in next week's issue.

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