San Francisco Chronicle - Saturday, August 15, 1992

At an urgent meeting called by the federal Centers for Disease Control to gather up-to-date information on the mysterious immune system abnormalities, scientists said that evidence so far for a viral cause of the illnesses was weak. Moreover, analysis has found that some of the ill individuals may have immune system abnormalities explained by tuberculosis or other infections.

While emphasizing that he was "keeping an open mind," Dr. Anthony Fauci, the top AIDS official for the National Institutes of Health, said the suggestions of viruses were inconsistent and "can be explained by a variety of technical factors. . . . There is nothing definitive about what we have heard."

Fauci noted that no one had been able to duplicate the findings of University of California at Irvine scientist Dr. Sudhir Gupta, who last month reported evidence of viral particles in the blood samples of several patients with the AIDS-like disease.

Since wide publicity at the international AIDS conference last month, the issue has dominated discussions among AIDS researchers and caused significant public anxiety because of fears for the safety of the blood supply.

FIRST DETAILED PRESENTATIONS

Such concerns prompted the CDC to hold the meeting, which included the first detailed scientific presentations by the three American researchers who have been searching for AIDS-like viruses. Also presented were updates from the CDC and others on patients with unexplained depletion of "CD4 T-lymphocytes" but no evidence of HIV infection. HIV causes the acquired immune deficiency syndrome by destroying these key immune system cells.

Overall, the new data presented suggest that researchers may be dealing with a heterogeneous group of disorders, some potentially serious, others not.

What scientists heard "did not give us any information to believe that we are dealing with an infectious agent (such as a virus) that is causing a transmissible disease," Fauci said.

Researchers heard reports of people who have the immune system abnormality but are not ill, and cases where the immune system abnormality has gone away over time. Other presentations suggested that the affliction could be caused by tuberculosis or other infections that can depress the immune system.

SHARP CONTRAST

In sharp contrast to HIV infection where the immune system undergoes a steady downhill course, the immune deficiency appears to remain stable over time in many of the cases presented yesterday.

Dr. Gerald Quinnan of the U.S. Food and Drug Administration said it would be premature to consider additional screening tests for the blood supply until there was evidence that the immune system abnormalities being studied were transmissible through blood transfusions.

In research that was widely publicized during the International AIDS conference last month, Gupta has found evidence of reverse transcriptase activity and viral-like particles in two people, a 66-year-old woman with Pneumocystis carinii pneumonia and her healthy 38-year-old daughter.

But experts pointed out that viral-like particles can be seen under the electron microscope in other diseases, and even in normal human placenta. Howard Temin, a Nobel laureate from the University of Wisconsin, expressed skepticism. He suggested that the viral-like particles might have originated in the laboratory cells Gupta used to grow the virus, not from the patients' blood. He also said there was inadequate evidence that the particles were infectious.

Some patients discussed at the meeting have been ill with a variety of infections while others have no symptoms, according to Dr. Martha Rogers of the CDC.

So far the CDC has evaluated 30 cases. The 30 cases come from 15 states, and all but one of the patients are living, Rogers said. More than half had no reported risk factors for HIV infection, which include blood transfusions, homosexual intercourse or intravenous drug use. There is "no readily apparent linkage, contact, or clustering of . . . cases; they are widely scattered geographically," she said.

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