Research Initiative Treatment Action (RITA!); Vol 5, No. 3 July 1999
L. Joel Martinez

Dear Readers,

The summer and fall of 1999 would have been the first full season of eradication-a time when the faithful, the true adherents, the believers would finally be rewarded for their persistence and adroit actions. This was the moment when the human immunodeficiency virus, with a long and almost imperceptible sigh, would have flickered out and finally extinguished itself. Many of us would have been eased back into the world, some with fanfare, some unnoticed, but all unimpaired.

Some, like our staff member Paul, had made the careful calculations and marked their mental calendar, "October 3, 1999: Check for eradication!" These hopes of a cure have been questioned all along. More and more scientific evidence has been piling up against the eradication dream.

So it comes as no surprise to report in this issue dark calculations of the long persistence of HIV despite the success of highly active antiretroviral therapy (See "Will Nothing Kill HIV?" on page 5 of this issue). It is not the disappointment. It is the irony of the timing that weighs heavily on the hearts of those of us who wanted to believe, those of us who wanted to overcome our natural skepticism with formulas of half-lifes and steady slopes of arithmetic decay.

The past few years have been an odd combination of Biblical metaphor and scientific dictum. And many of us approached the two with an equally odd combination of fear, skepticism and desire. Unquantifiable viral loads became renewed opportunities; additional CD4 T cells became a new life and suddenly the science converged to make us resurrected Lazaruses. There is nothing wrong with that. It beats the alternative.

What I fear is that we mustn't lose sight of our goal: to find a cure for AIDS.

So, what about these elusive reservoirs, these mysterious sanctuaries, where the virus can continue to express itself imperceptibly and yet undeniably? Antiretroviral therapies may have reached the end of their rope. What more can we ask of them? More mechanisms of action? Fewer side effects? Simpler regimens? These therapies already stop over 99% of viral replication. Is it realistic to expect "intensification" as one of these reviewed articles suggests?

What is needed is novel thinking. Pharmaceutical companies are happy to supply antiviral drugs. Understandably so. But I don't doubt that at the end of the day they too must think about the loved ones they have lost. The challenge is for everyone.

There seems to be a pair of potential Lazaruses here—the patient with a renewed sense of health and the faint flicker of a virus. It is up to us to determine which one of them will ultimately rise.

Very truly yours,

The Center for AIDS:
Hope & Remembrance Project
L. Joel Martinez
Acting Editor

19990710
RI990701

Copyright © 1999 - Research Initiative Treatment Action (RITA!). Reproduced with permission. RITA! is published by The Center for AIDS. Contact Thomas Gegeny, MS, ELS, Editor, RITA! for permission to reproduce RITA!. tom@centerforaids.org. http://www.centerforaids.org

ÆGiS is made possible through unrestricted grants from Roxane Laboratories, Inc., iMetrikus, Inc., the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 1999. This material is designed to support, not replace, the relationship that exists between you and your doctor.

ÆGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1985, 2000. ÆGiS & the Sisters of Saint Elizabeth of Hungary. All materials appearing on ÆGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of ÆGIS and the Sisters of Saint. Elizabeth of Hungary, or the party credited as the provider of the content.