In the first of the new studies, researchers at New York’s Aaron Diamond AIDS Research Center put nine volunteers on a three-drug regimen within 90 days after they contracted HIV. The virus was flourishing in the patients before they started treatment. But after several weeks on AZT, 3TC and the protease inhibitor ritonavir, none of them had any detectable HIV in his blood. The researchers have now followed the volunteers for periods of three to 10 months, and blood tests have yet to turn up any sign of virus. HIV may still be holed up in their lymph nodes and other tissues. But if the drug regimen can keep the virus from replicating until all the infected cells have died and been replaced, it will have reversed the disease process.
The second study is larger, and its participants started out sicker. Working out of four medical centers, researchers led by Dr. Roy Gulick of New York University have treated 97 advanced AIDS patients with different drug regimens for up to 11 months. Last week Gulick reported that six of the seven patients who have spent 48 weeks on a three-drug cocktail (AZT, 3TC and the protease inhibitor indinavir) are now producing virus-free blood samples. The next step, as in the first study, is to test other tissues, and to see if the remission lasts. At some point the researchers will try taking successful patients off the drugs.
For all the scientific excitement, controlling the AIDS pandemic is still a distant hope. Getting patients to stick to a complicated, 15-pill-a-day drug regimen is no small feat. If the new drug combinations don’t prove curative, the variants of HIV that survive them would be highly resistant. And even if they do prove curative, few sufferers will benefit any time soon. Some 90 percent of the world’s 22 million infected people live in developing countries where virtually no one has $15,000 a year to spend on medication. Last year alone, a million people died from AIDS worldwide and cases increased by 19 percent. The infection rate is down in the United States – an estimated 40,000 Americans contracted HIV last year – but that’s an exception. India is now approaching 5 million infections, and China is a huge and vulnerable target. ““We have to avoid the idea that we’ve arrived,’’ warns Dr. Scott Hammer of Deaconess Hospital in Boston. Amen. But at least there’s cause for hope.
