San Francisco Chronicle - The Voice of the West, 901 Mission Street, San Francisco, CA 94119 - Thursday, 20 March 1997, Page A15.
David Perlman, Chronicle Science Editor

A major theme of the ninth annual "AIDS Update Conference" focused on groups of people who aren't yet getting the message:

-- Ethnic minorities in inner cities with little or no access to health care.

-- Youngsters barely out of adolescence too immature or ignorant to heed warnings of sexually transmitted diseases.

-- Women, a population in which rates of infection by HIV, the AIDS virus, continue rising ominously.

Experts at the conference called for making HIV testing available to everyone, and Mayor Willie Brown urged drug companies to donate the lifesaving medications to those who cannot afford them.

To Dr. Marcus A. Conant, one of the physicians who pioneered testing AIDS treatments when the epidemic first hit in 1981, the good news today seems to say, in his words, "We now have the drug cocktails that can actually stop this disease."

But in his keynote address to the meeting at Civic Auditorium, Conant, who runs the largest AIDS treatment clinic in the Bay Area, also sounded a warning to those not as well versed on AIDS prevention:

"We're finding increasing numbers of people who think they're HIV-negative, who think they're safe, and then when their partner's condom breaks, as condoms do, they become another link in the epidemic. These are the people we must reach," he said.

That lesson was not lost on Brown, who, in a welcoming speech to an audience of more than 500, spoke glowingly of the numbers of young men in San Francisco now returning to work in apparent health from their regular use of drug "cocktails" based on combinations of the protease inhibitors and older AIDS drugs.

"People's lives are being extended," Brown said. "But you're now on the threshold of a whole new set of problems generated by success, because the drugs are terribly expensive, and a whole forgotten class of people are not getting them, including people of color."

To meet that issue, Brown called on the drug manufacturers -- "our corporate brothers," he called them -- to donate the new medications to those who can't afford them. And he urged federal and state legislators to provide special tax breaks for pharmaceutical companies willing to expand their programs of access to free AIDS drugs.

In his detailed progress report on the AIDS epidemic from its early days of despair to its current new hopefulness, Conant noted that the protease inhibitors can now reduce the quantity the of AIDS virus in the bloodstream of HIV-infected people to undetectable levels. Those extremely low levels, he said, have now been sustained in many people for two years or more.

And although no one can yet say that the virus has been completely cleared from people using the drugs, "the data suggests to me that the viral load in many people is, in fact, zero," Conant said.

And if indeed the new drugs prove they can wipe out the virus in every human cell where it is known to lurk, then patients' immune systems should recover completely, and their bodies should never develop resistance to the drugs, Conant said.

With that kind of progress now nearing reality, major social issues posed by the epidemic become more urgent than ever, he said. His prescription:

HIV testing is not yet being offered to everyone, and it must be. The new drugs must be available to everyone who needs them, and patients taking the drugs must be educated to comply with the complex drug-taking regimens that are required. Prevention through more widespread and effective "safe sex" education must be strengthened.

"This disaster of AIDS can be stopped with the therapies we have today," Conant insisted.

The conference -- with educational workshops, a film festival and small discussion groups -- continues through tomorrow.
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