The Wall Street Journal - Friday, February 5, 1999
Michael Waldholz, Staff Reporter of The Wall Street Journal

Several research reports presented at a major AIDS science conference here this week suggested that scientists may be uncovering a new strategy for fighting HIV, the AIDS virus, by boosting infected people's disease-fighting immune systems. Under this novel strategy, which was the subject of a page-one article last month in The Wall Street Journal, scientists believe it may be possible to remove therapy from some patients, and allow a short-term jump in virus levels to rev up a powerful immune response against HIV.

Researchers here said the new idea, referred to by some scientists as "self-vaccination," may generate an immune response powerful enough to keep low levels of HIV circulating in the bloodstream under control without constant use of the combination-drug therapy that can entail the use of three, four and five medicines taken daily.

Findings from several different research groups are making "a compelling story that the immune system can be educated to a higher level of activity," said Bruce Walker, a researcher at Massachusetts General Hospital in Charlestown, Mass. Dr. Walker added that a new strategy that would intermittently remove drug therapy for short periods of time might be like giving patients "a highly regulated vaccine." In other words, he and others said, researchers would allow a brief burst of virus to ignite a potent immune reaction, much in the way other vaccines stimulate the immune system.

Dr. Walker strongly cautioned, however, that patients and doctors should not attempt their own "self-inoculation" experiments. He noted that most of the emerging data right now are anecdotal. In the next few months, Dr. Walker's research team and scientists elsewhere will be enrolling several dozen HIV-infected patients into formal studies in which therapy will be periodically interrupted.

Several research groups also presented evidence that the thymus gland in the neck can produce new disease fighting immune cells well into adulthood. The findings hint that the brief exposure to the virus when therapy is halted might be teaching new cells from the thymus to become HIV fighting agents, perhaps explaining why the self-inoculation strategy may work for some people.

But not all scientists at the meeting thought the idea was promising or useful. "I think taking people off drugs is crazy," said Joep Lange of the University of Amsterdam. "The last thing we want to do is end therapy, especially if the ultimate goal is to eradicate, and not just control, the virus."
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