Miami Herald - Friday, October 26, 1984

Such efforts are probably "doomed to failure" unless doctors can find a way to destroy the virus that causes the relentlessly deadly disease, said the researchers at the National Institutes of Health. A report on the rebuilding effort, which was published in Thursday's New England Journal of Medicine, coincided with a medical paper, presented at a medical conference in California, that says researchers may spend "10 or more years" trying to find a cure for AIDS. The conference was also told that heterosexual men and women may eventually be in as much danger of catching AIDS as the homosexual men who are now believed to be most at risk.

The paper was presented at the 70th annual congress of the American College of Surgeons in San Francisco.

AIDS will persist as a "major clinical problem for the next 10 or more years," Paul A. Volberding of San Francisco General Hospital told the conference. Another report at the meeting said recent studies in Africa and Haiti show that AIDS is predominant among heterosexual men and women in roughly equal numbers.

"The suspicion previously has been that it's easier to spread through anal intercourse," said Volberding.

Theory may change

But now, he said, doctors are questioning whether the disease can spread through vaginal intercourse as well, adding that the disease has begun appearing in prostitutes.

"I think what matters is how many partners you have and their exposure, not the type of sex you have," Volberding said.

Doctors have been experimenting with a variety of substances, including interferon and transplanted bone marrow, to try to undo the damage of acquired immune deficiency syndrome, which ruins such cells -- all of which led to the effort to rebuild the AIDS victim's immune system.

"All of these (experiments) may be able to do something, but I think that unless we can get at the etiology -- namely the virus -- we're not going to be successful in curing anyone," said Dr. H. Clifford Lane. "Eliminating or paralyzing the virus is the key to successful therapy, and that's where we should direct our research efforts."

Doctors have been experimenting with interferon and interluken-2, another natural anti-germ hormone, in an effort to restore AIDS victims' defenses against disease. Although the results of this work have not yet been published, Lane said there's no evidence that they alone will eliminate AIDS.

Other scientists are searching for anti-viral drugs that might be useful against AIDS. One potential candidate is suramin, a medicine used to treat African sleeping sickness. In the test tube, at least, suramin halts the reproduction of HTLV-3, the germ that's thought to cause AIDS.

No breakthroughs

However, Lane cautioned, "I surely don't think we have any major therapeutic breakthroughs on the horizon."

The latest research was directed by Lane at the National Institutes of Health in Bethesda, Md. AIDS wipes out a particular type of white blood cells, or lymphocytes, called helper T-cells. These cells are essential regulators of the body's assault on microbes.

The doctors attempted to treat a 35-year-old man with AIDS by giving him transfusions of lymphocytes as well as bone marrow from his genetically identical twin.

At first, the therapy seemed to be working. The man initially had no helper cells, but after the transplant, their numbers rose steadily for three months.

He showed an allergic reaction to an injected protein, something that hadn't happened before. This suggested that they had transferred immunity from the twin and was another a hopeful sign.

Then his helper cell levels began to fluctuate wildly, and 10 months after the marrow transplant, he died with multiple infections.

"You can imagine how excited we were during those few months," Lane said. "Then to see the disease recurring made us think that those additional lymphocytes were being attacked in the same manner" by the AIDS virus.

The research showed that partially restoring natural immunity and replacing the destroyed blood cells cannot reverse AIDS.

"We had a glimmer of the fact that what we did had some major effect on the immune system," Lane said, "and that major effect was inadequate to make the patient better."

Doomed to failure

In their published study, the researchers concluded that "efforts directed toward restoring the immune system may be doomed to failure if strategies are not devised that can deal with the causative factors."

According to the Centers for Disease Control, more than 6,300 AIDS cases have been reported in the United States since 1981. Nearly three-quarters of them are male homosexuals, and experts believe the disease is spread through intimate contact with body fluids, such as blood and semen.
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