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TIME: Almanac 1993
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TIME Almanac 1993.iso
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1992-08-28
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MEDICINE, Page 62The Body Wins Round 1
Research offers hope that the AIDS virus can be beaten
For the past decade, AIDS researchers have focused on the last
phase of the infection. Their main question: Why do people with
the AIDS virus, or HIV, succumb to cancers, opportunistic
infections and nerve disorders? During the past two years,
however, a small number of immunologists and virologists have
started asking a different, and potentially more useful,
question: Why do so many people with the virus live in such good
health for so long -- in some cases for more than 12 years?
Two groups of scientists from UCLA and the University of
Alabama believe they have found the beginning of an answer. In
independent studies published last week in the New England
Journal of Medicine, the researchers demonstrated for the first
time that the body launches a massive and effective
counterattack on the virus soon after the infection begins. If
doctors can figure out how to reproduce that early, powerful
immune response, they might be able to develop better medical
treatments that would postpone -- or prevent -- the later,
debilitating stages of the disease.
The researchers required tenacity -- and more than a bit
of luck. After all, to study someone at the beginning of a
relatively silent phase of the HIV infection, they had to find
people who did not yet realize they had contracted the virus.
It turns out that at least a third of HIV-infected people
develop a fever or a severe sore throat within a few weeks to
months after first exposure. Such signs, which usually clear up
on their own, can easily be misdiagnosed as a bad flu or
mononucleosis. Researchers realized the tip-off would come when
they tested the patients and found HIV instead of influenza
viruses or other disease-causing agents. By hanging out in
hospital emergency rooms and talking to colleagues, the
researchers identified seven young homosexual men -- three in
Alabama, four in California -- suffering from a primary HIV
infection.
Using advanced laboratory tests that had been developed
only in the past few years, both sets of scientists discovered
an explosive growth of virus in the men's bloodstreams. (Half
of the men were able to pinpoint exactly when they became
infected, and in each case it was during unprotected sex.) Each
liter of the men's blood contained as many as 10 million
infectious viruses. "This is the first time anyone has reported
such high levels of infectious virus early on," says Dr. Eric
Daar, a specialist in infectious disease and one of the leaders
of the UCLA study. "We've never seen these levels before except
in people with severe AIDS."
Within days after the viral burst, the researchers
measured a rapid increase in the bloodstream of the number of
anti-HIV antibodies. These Y-shaped bits of protein sought out
the virus and targeted it for destruction. Once the antibody
attack reached full scale in the seven test subjects, the level
of HIV in the bloodstream dropped precipitously. In the majority
of cases, the researchers could detect little or no virus two
to three weeks later. "In other words, the normal immune system
can shut down the AIDS virus," says Dr. Stephen Clark, who
organized the study at the University of Alabama. Now
researchers must figure out exactly how the body puts together
this early effective defense -- and how the virus manages, years
later, to circumvent it.
By Christine Gorman