The Bay Area Reporter - May 13, 1996
Stephen LeBlanc

AIDS treatment activists and researchers anticipate that important new data will be presented at the conference regarding AIDS treatment and disease progression, though no startling announcements are expected. "We've trained researchers not to hold on to important data until these large conferences, and that is a very good thing," said Martin Delaney of San Francisco's Project Inform. "But this conference should provide us with more developed and mature data regarding the AIDS research headlines we've all seen during the past year." Delaney is one of more than 100 San Francisco Area treatment activists and researchers attending the conference.

Among the hoped-for data expected at the conference will be follow-up to the work announced by Robert Gallo's lab last December regarding the three soluble CD8+ cell factors that appear to inhibit HIV replication. Rumor about this work suggests that the discovery may be closer to clinical testing than anyone had previously believed.

Activists are also looking for updated reports from Gallo's lab regarding the use of natural, hormonal controls, such as HCG, a hormone found at high levels in pregnant women, that appears to help to control Kaposi's sarcoma. Rumor also suggests it may also have a powerful antiviral effect against HIV.

Combo therapy data

Much new data is also expected regarding the use of protease inhibitors in combination therapy. The last major data on protease inhibitors was presented in January at the 3rd Conference on Retroviruses and Opportunistic Infections, and before the FDA in March; in Vancouver, activists will be looking for six months of additional data which hopefully will give new insight into how best to use these drugs to prolong lives.

Attendees also see the conference as an opportunity to hear from less well-known researchers, who do not have the same access to publicity as the larger drug companies and more established scientists. Often, the most creative ideas and the first suggestions of new possible treatment strategies come from these less-famous scientist.

The Vancouver conference will allow the international HIV-affected community to reflect on the progress (or lack thereof) made since the 10th AIDS conference in Yokohama, held in 1994. While the message from that conference was how little progress in AIDS research had been made since the previous conference, the same message does not seem justified at this conference for several reasons.

For example, in the decade between the first major international conference on AIDS and the Yokohama conference, only three antiviral drugs, all closely related nucleoside analogues, had been developed and made available: AZT, ddC, and ddI. In the two years since Yokohama, five new compounds, the nucleoside analogs D4T and 3TC and three protease inhibitors, have been brought to market. The protease inhibitors represent an entirely new class of drugs that appears far more powerful in preventing viral replication than previously available anti-HIV therapies.

Clinical diagnostic measures have also improved. Two years ago, Yokohama conference attendees saw some of the first data regarding use of viral load testing (directly measuring the amount of virus in a person's blood) presented in a few small studies. Today, more than a dozen important studies have reported on the value of this test, and it is a crucial part of the anti-HIV drug testing and approval process. Perhaps more importantly, it is now widely used in North America and Europe to guide the use of treatment by doctors and patients.

Since Yokohama, an entirely new picture of HIV dynamics has emerged from the labs of Drs. David Ho and George Shaw. Scientists now believe that HIV does not have a dormant period, but instead is constantly replicating and constantly being eliminated from the body, and constantly but slowly destroying the immune system. This new understanding has given new focus to HIV research and treatment approaches.

A chance to reflect

The last two years also have seen an increased focus on finding treatment strategies to help people with advanced AIDS, with many researchers surprised that even people with very advanced AIDS are able to benefit from aggressive anti-HIV therapy.

Vancouver will provide a chance to reflect on why so little progress has been made towards development of either preventative or therapeutic HIV vaccines, and why so many of the approaches discussed in Yokohama have turned out to be flops (including some approaches now being hyped in commercially-sponsored clinical trials). Researchers and activists following this area are looking to Vancouver as a chance to regroup and identify new vaccine development strategies.

The conference will highlight the stark differences between the AIDS treatment and care available in medically advanced countries and that available in the poorest countries ravaged by AIDS, such as Haiti and many in Africa. In many poorer countries, even proven effective and inexpensive treatments, like Septra prophylaxis for PCP, are often not widely available, and there is essentially no access to older anti-viral treatments such as AZT and no access at all to the newer anti-virals except for the very wealthy. Questions have also recently arisen regarding delays between when some drugs, such as the new protease inhibitors, are available in the United States, and when they are available in other industrialized countries.

AIDS activists from around the world are planning to make their presence felt in Vancouver, in sharp contrast to Yokohama, where restrictive scholarship policies and enormous transportation and housing costs kept all but a few activists away. In Vancouver, more than 20 members of ACT UPs Golden Gate and East Bay will join with members of ACT UP chapters from Philadelphia, New York, Paris, and around the world to make sure the voices of people with AIDS are heard and that important information from the conference reaches HIV-affected communities.

Golden Gate members are presenting seven different abstracts in Vancouver, and ACT UP/Golden Gate is planning, with other ACT UPs, actions inside and outside the conference to focus on the lack of access to treatment options due to their sometimes exorbitant cost and their unavailability at any price in many parts of the world. The international AIDS activist community has learned, and will take to Vancouver, the lesson that people with AIDS must be present and heard when scientists, drug companies, and government officials gather to exchange data and to make decisions that will affect their lives. Different and better decisions are made when empowered person with AIDS are sitting at the table. t

To learn more about the 11th International Conference on AIDS, you can contact the conference at 1-800-780-AIDS or view their web page at http://www.interchange.ubc.ca/aids11/aids96.html. To learn more about ACT UP Golden Gate's planned actions at the conference, call us at 415-252-9200 or come to one of our Tuesday night meetings at 7:30 at 592 Castro Street, Suite B.
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