The Washington Blade; Friday, March 20, 1998
Lisa Keen

While the report, which appeared in this month's issue of Nature Medicine, drew considerable media attention, the news was not entirely startling. Gallo and colleagues reported three years ago that they believed a hormone produced in early pregnancy had powerful abilities to shrink Kaposi's sarcoma lesions. The hormone then was identified as Human Chorionic Gonadotropin (HCG).

In the latest report, Gallo's team says it believes that another substance also found in the urine of women in the first trimester of pregnancy does even more. The substance, a protein which the team is calling HAF (which stands for HCG-Associated Factor), reportedly diminished HIV replication in test tube experiments and shrank KS lesions in mice.

Gallo told reporters he believes it will take at least two years to develop these findings into a drug that can be tested on humans.

Quick test results might help, even if wrong

The U.S. Centers for Disease Control and Prevention recommended last week that, at least in some cases, health care providers should advise people who test positive for HIV infection that test result even before it is confirmed through a more reliable confirmatory test.

In the March 27 Morbidity and Mortality Weekly Report, the CDC notes that it was making the recommendation based on a 1995 study of almost 700,000 people who sought HIV antibody testing. That study found that 25 percent of people who tested positive did not return to the test site to learn the results of their tests.

Because a "rapid test" tool can provide "preliminary" results as quickly as within 10 minutes, CDC recommended that anyone testing positive on that test should be notified immediately and told to return for the confirmatory results. One consequence of this recommendation, however, noted CDC, is that some people will get an initial report that they have HIV infection when they don't. Out of the 44,383 people who tested positive on the initial "rapid" test, noted CDC, 8,301 (or 18 percent) were not really infected with HIV.

More data on usefulness of triple-drug therapy

A study in last week's New England Journal of Medicine gave strong confirmation that triple-drug therapies, especially those including a protease inhibitor, are most likely responsible for the recent drops in the numbers of people succumbing to AIDS each month and that such therapies should be the "standard of care" for people with advanced HIV disease.

In the study, researchers led by Northwestern University Medical School in Chicago analyzed the records of 1,255 patients with relatively advanced HIV disease (CD4 counts below 100) between 1994 and 1997. They found that while mortality rates from AIDS were fairly constant in 1994 and 1995 (about 29.4 deaths per 100 "person-years"), they declined "markedly" to 16.7 deaths per 100 person-years in 1996 and to 11.8 deaths per 100 person-years in 1997, when triple-drug therapies involving protease inhibitors were in wide use.

While those taking combinations which included only nucleoside analogs recorded death rates of 15.6 deaths per 100 person-years in 1996 and 1997, those taking combinations with protease inhibitors recorded death rates of 10.6 deaths per 100 person-years during those two years.

"In conclusion," noted the researchers, "the routine use of increasingly intensive antiretroviral therapies has resulted directly in dramatic declines in morbidity and mortality among HIV-infected patients with advanced immune depletion. "Our data suggest that an intensive combination drug therapy regiment that includes a protease inhibitor should be considered the standard of care for patients with advanced HIV infection."

In brief ...

RESTORING THE SYSTEM: A study in the March issue of the Journal of Clinical Investigation suggests that daily injections of interleukin II in "ultra low doses" for several months "can restore in part" the immune systems of people with AIDS in fighting off opportunistic infections. The study, which involved only eight patients, was led by researchers at Roswell Park Cancer Institute in Buffalo, N.Y.

ONE-STOP WON'T STOP: A study of the effectiveness of one-time HIV counseling for adolescents in preventing the spread of HIV and other sexually transmitted diseases found the one-stop effort does not work in convincing sexually active youth to use condoms. The study, which involved 149 patients at an urban clinic for adolescents, was conducted by the George Washington University in Washington, D.C., and published in the March issue of the Archives of Pediatric and Adolescent Medicine.

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