Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
Newsday - February 2, 1994
Laurie Garrett - Staff Writer
At the same time, a second group of researchers reported that the current test for health status among HIV-positive people - measurement of CD4 immune cells - is wildly inaccurate in people who are also infected with another virus, HTLV-1. Such people, they said, may be sick while CD4 levels remain normal.
That's important because AIDS medical care, as well as reimbursements for medical and social services, assumes that CD4 counts drop as people get sicker. The new finding suggests that some people may fail to get treatment or social services because of the inaccuracy of the test.
New York City leads the nation in HTLV-1 incidence because the virus is common in the Caribbean and the Amazon region, and is seen among immigrants from those areas.
An estimated 5 percent of adults living in Brooklyn are infected with the HTLV-1 virus, according to federal researchers. HTLV-1 causes adult T-cell leukemia in 1 percent to 5 percent of infected people.
The HTLV-1 study, which appears in today's issue of the Journal of the American Medical Association, was done in Brazil on 25 patients who were infected with both HIV and HTLV-1 and 93 people who were only infected with HIV. It found that people who were infected with both viruses could have full-blown AIDS, and even die, without suffering a drop in CD4 cells.
The same phenomenon is being seen in the United States, said Dr. Thomas Quinn of the National Institute of Allergy and Infectious Diseases, one of the study's authors.
"We have two patients here in Baltimore who have CD4 levels of 1,000 [the level seen in healthy people], but they're dying of AIDS," Quinn said. "These patients are dually infected with HIV and HTLV-1."
There's currently no other way than CD4 counts to monitor illness in the earlier stages of the disease.
Nobel Laureate David Baltimore and his colleagues at Rockefeller University in Manhattan announced discovery of another method in this week's Proceedings of the National Academy of Sciences.
The test measures the levels of a chemical called mRNA (messenger ribonucleic acid), which can indicate how actively the AIDS virus is replicating itself. To cause illness, HIV must first make billions of copies of itself.
The Rockefeller group studied blood samples from 18 HIV-infected New Yorkers for seven years. By measuring jumps in the subjects' viral mRNA levels, the scientists could predict illness up to two years before it was obvious.
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