San Francisco Chronicle - Friday, March 26, 1999
Carl T. Hall, Chronicle Science Writer

Small-scale clinical studies have been yielding encouraging results recently, the researchers said, particularly when the experimental immune boosters follow anti-viral drug treatments.

The state-of-the-art approach now coming into focus is to "first lower the amount of virus, then immunize" the patient for lasting resistance to disease, said Dr. Ronald Moss, executive director of medical and scientific affairs at the Immune Response Corp. in San Diego.

He and other researchers summarized the latest findings yesterday during the 11th annual National HIV/AIDS Update Conference, under way this week at Bill Graham Civic Auditorium.

One or more of the immune- based therapies -- such as interleukin-2, Remune and GM-CSF -- could turn out to be the key missing ingredient needed to make the so- called multidrug cocktails truly effective.

None has proved itself in large- scale clinical tests, and there have been frequent problems of side effects. Experts warn that the complex interactions between the human immune system and the AIDS virus make predictions impossible.

But Kevin Frost, director of clinical research at the American Foundation for AIDS research, said immunology and AIDS has only recently become a research priority. For 15 years, he noted, AIDS researchers have concentrated almost exclusively at figuring out how HIV replicates and trying to stop it.

Reviewing recent results with interleukin-2, Dr. James Kahn of the University of California at San Francisco said researchers are seeing "tremendous potential" for long- term recovery of immune function. Test subjects given interleukin-2, along with anti-viral drugs, showed a persistent benefit lasting nearly two years in some cases.

The treatment appears to boost the immune system as a whole, Kahn said, as opposed to simply stimulating a specific type of disease-fighting cell. Also, people with detectable amounts of HIV in their blood, despite taking anti-viral drugs, seem to get "enhanced viral repression."

Remune, a modified form of HIV, appears to help some test subjects fight off multiple subtypes of the AIDS virus, Moss said. The therapy, given by intravenous injection every three months, seems to make disease-fighting immune cells capable of recognizing certain parts of the AIDS virus that generally do not change when HIV mutates.

Dr. Stan Deresinski of Stanford University said that GM-CSF, a synthetic form of a natural disease- fighting molecule, may be used as an adjunct to anti-viral treatment to clear the virus from hard-to-reach hiding places in the body.
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