Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.
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The San Francisco Examiner - Wednesday, Feb. 12, 1997
Lisa M. Krieger of the Examiner Staff
Nature has proved it is possible to protect against HIV infection. Now, the challenge is to mimic this effect in the test tube.
The Saturday symposium, entitled "Host Genes and Resistance to HIV Infection and AIDS," will open with a presentation on genetic susceptibility and resistance to human infectious diseases by Dr. Arno Motulsky of the University of Washington in Seattle.
Also featured will be:
*Dr. Richard Kaslow of the University of Alabama at Birmingham, who has found that certain combinations of genes are associated with slow disease progression, while others correlate with rapid progression.
*Dr. Francis Plummer of the University of Manitoba, Canada, who will update his work on HIV-exposed, but negative, prostitutes in Kenya.
*Dr. Edward Berger of the National Institutes of Health, whose lab identified the first HIV co-receptor, called fusin, and who has since discovered that different HIV strains use different receptors to enter and infect immune cells.
*Dr. Richard Koup of the Aaron Diamond AIDS Research Center in New York, who is studying high-risk gay men with mutant forms of genes that encode another HIV co-receptor, called CCR5.
*Miles Cloyd of the University of Texas Medical Branch in Galveston, who will describe a type of HIV resistance not related to mutations.
One man's experience
The research could answer a question that has long troubled men like San Franciscan Frank Kronberg, a 51-year-old technician at a UC-Berkeley astrophysics lab who was exposed to HIV but not infected.
His former partner, Tim, never wore condoms because "he thought condoms were for girls," Kronberg recalled.
One morning in 1984, against Kronberg's wishes, Tim had sex with him without a condom.
"I felt terrible and angry and desolate. I just felt cold. We broke up . . . and I was sure that I had been infected," Kronberg said.
Tim then died of AIDS. Kronberg assumed that was his fate, too.
But his HIV test came back negative.
"I was stunned," he said. "I didn't really believe that I was uninfected."
Last fall, he received a telephone call from Paul O'Malley, lead investigator at the San Francisco City Clinic Study, which for more than 15 years has stored and studied blood samples of high-risk gay men.
The news: Kronberg carries a genetic quirk that renders him immune to HIV. From his parents, he had inherited a "defective" version of gene that produces the CCR5 protein receptor, needed by HIV to enter the cell. Rather than being normal, his gene contains two mutations - and thus infection through CCR5 cannot occur.
"All I could I think of was my mother and father," he says.
His blood has since been shipped off to a New York-based lab for further research. Scientists say that his genetic quirk - and that of several other San Francisco men also discovered in O'Malley's study - could offer major insights into how to block HIV without harming health.
Researchers estimate that perhaps 1 percent of the white population carries this inborn protective mutation. They speculate that, perhaps centuries ago, the defect protected against some other viral invader and thus gained a toehold in the population. HIV immunity has also been observed in rare cases among African Americans, although a mechanism other than CCR5 appears to be at work.
Kronberg, although relieved, still feels moments of ambivalence.
"Anyone who states that they are not infected is often the object of mistrust and envy," he said. "You must realize that every gay man in San Francisco has had numerous friends die terrible, agonizing deaths from HIV.
"Why a few gay men have not been visited personally by this terrible plague is something that many other gay men cannot comprehend."
He also remains cautious. He is not convinced that the genetic defect offers complete protection. Also, he doesn't want to risk getting, or giving, a multitude of other sexually transmitted diseases.
Two years ago, Kronberg attended a conference of Holocaust survivors to better understand the experience of survival.
"I want to be one of those people. I want to learn how to be one of those survivors," he said.
"I don't know why "the blood of the lamb' has been on my door," he said. "I would like to think that I have been given this extra time to learn about being human . . . I wish it was not such as hard lesson to learn. I wish that we, in general, and I, in particular, could go down some other path - some less rocky, less painful path of lessons learned."
HIV transmission study
UC's Center for AIDS Prevention Studies has launched a study to examine the risk of HIV transmission in gay male couples. It will be the first study to assess reports of sexual behavior from both men in the couple, according to investigator Colleen Hoff.
Previously published studies have reported that a large proportion of HIV transmission occurring among gay men is a result of unsafe sex within "primary" or "boyfriend" relationships. Some men report that their relationship provides them a false sense of security from HIV transmission.
On Feb. 14, study representatives will set up a table in the Castro District - at 17th and Market streets - to start recruiting couples. Participants will be asked to be available for a brief phone interview once a week for three months. For information, call (415) 597-4988.
Date
reported / Cases / Deaths
S.F. 1/1 23,841 16,604
Calif. 1/1 97,690 63,063
U.S. 1/1 548,102 343,000
WHO(rprtd) 1/1 8,400,000 6,400,000
Figures are cumulative since June 1981.
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