Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.

Reuters NewMedia, Inc. - 11 July 1996
Cynthia Osterman

Dispelling more than a decade of despair, elated researchers presented evidence at the 11th International Conference on AIDS this week that potent drug "cocktails," including new medicines called protease inhibitors, can get the virus down to undetectable levels in the bloodstream.

Capping the optimistic news, scientists from the Aaron Diamond AIDS Research Centre in New York said on Thursday that a triple-drug combination wiped out all signs of the virus that causes AIDS in the blood of nine patients.

Those patients have stayed virus-free for periods ranging from three to 10 months. If the approach is proven to work, they might be cured in a year or two, said David Ho, one of the world's top AIDS researchers.

"We've turned a page and opened a new chapter in the history of the pandemic," said Dr. Martin Schechter, co-chair of the conference. "Many things we once thought were impossible are now within the realm of the achievable."

But mindful of past disappointments, sometimes caused by the virus' ability to change or mutate and thus outsmart the drugs, scientists were quick to note that there is still much they do not know about the human immunodeficiency virus.

"We have a long way to go," Schechter said. "It would be premature to start using the word 'cure' without caution."

Repeating a central theme of the conference, Schechter also stressed that the price and complexity of the new therapies places them beyond the reach of much of the world.

Still, advances announced here mark a startling breakthrough in the 15-year battle against the AIDS pandemic that has killed nearly six million people.

"It holds out for the first time in 15 years the possibility of a complete cure of HIV infection," said microbiologist John Coffin of Tufts University.

Introduced in the last six months, protease inhibitors block an enzyme crucial to one stage of the multiplication of HIV. Older drugs like AZT, part of a family of therapies called nucleoside analogues, attack the virus in an earlier stage of replication and the combination of the medicines appears to deliver a powerful one-two punch.

Ho's latest study used in the test were Norvir made by Abbott Laboratories Inc. (ABT.N) and the drugs AZT and 3TC from Glaxo Wellcome Plc (GLXO.L).

Merck & Co. (MRK.N) also has a protease inhibitor, Crixivan, available and other promising inhibitors are in development.

But Ho and his colleagues emphasised that they do not yet know how long people will have to take the drugs, which cost about $15,000 a year and can have unpleasant side effects.

Some doctors suspect the therapy may have to be life-long but Ho said the most recent findings give him reason to believe that a year or two might be enough -- but larger scale and longer studies are needed. "This is an experiment. No patient has been cured," he said.

Still unknown is whether the virus can rebound once the drug treatment is stopped. The only way to find out is to halt the therapy. The Aaron Diamond scientists will know by September, at the end of one year's treatment, whether they can do so with their first volunteer.

They must also investigate whether the virus hides in other parts of the body such as the nervous system even when it is eliminated from the bloodstream and lymph nodes. If so, the disease will be much harder to eradicate.

"This will begin to tell us the feasibility of eradication and that is the major goal," said Ho.
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