HEALTH

Progress in AIDS Research the cause of the deadly syndrome may have been found

By L. Krivitskiy, M.D.

Ever since the AIDS epidemic started in the late 70's, everyone interested in fighting this apparently new disease has been asking the same questions: "What causes this deadly syndrome? What makes someone's previously healthy immune system to break down? Is AIDS infectious or non-infectious? If the disease is infectious, what is the agent responsible? The new theories appeared in the medical literature suspecting or implicating different viruses, recreational drugs such as nitrites, multiple sexually transmitted diseases, sexual promiscuity and so forth as possible causes of AIDS. The opinion that AIDS may not be infectious or acquired after all has been expressed. All these theories so far have turned out to be blind alleys and the number of AIDS victims continued to grow in this country and abroad.

In the last 6 months, the choice of possible culprits has narrowed to a class of human viruses as new to medical science as AIDS itself. These are retroviruses, discovered about 20 years ago in animals and since shown to cause cancer, mostly leukemia in certain

animals. Three years ago the first human retrovirus, called "human T-cell leukemia virus" has been found in some patients with malignant blood diseases. In September, 1983, the world's leading virologists have reported that 83% of

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AIDS victims showed evidence of exposure to human T-cell leukemia. virus. Considering that human T-cell leukemia virus is infrequent in nature, this is a very high percentage.

And, from France, with the second largest number of AIDS cases after the U.S., came news of yet another retrovirus that seems to be clearly linked to at least two factors found in most AIDS victims sexual promiscuity and multiple lymph nodes swelling. This "lymphadenopathy virus" (LAV) discovered by a team of Paris researchers and clinicians was initially found in four promiscious homosexual men. Dr. Luc Montagnier, leading French virologist, reported that evidence of LAV infection has now been found in 63% of 47 patients with lymphadenopathy (lymph nodes swelling) syndrome, but in less than 2% of controls. Evidence of LAV also has been found in 20% of 40 patients with full-blown AIDS and in 17% of 40 healthy homosexual men. The virus itself, Dr. Montagnier said, has also been isolated from two patients with full-blown AIDS. "We are not saying we have discovered the cause of AIDS," Dr. Montagnier told Medical World News magazine. "The disease, in its fully developed form is a complex one and could have many causes, including environmental and genetic factors as

well as other viruses. What we do seem to have found, though, is a virus

that has never been described before and that is in probability the most likely cause of the lymph node swelling found in promiscuous homosexual men." If lymph node swelling is a kind of AIDS-related complex, then LAV becomes a major source in the cause of AIDS. According to some reports, up to 10% of promiscuous gay men with multiple lymph node swelling do end up developing full-blown AIDS.

But human T-cell leukemia virus is a prime suspect in the hunt for an AIDS agent: It requires intimate (cell-to-cell)

contact for transmission as would occur in sexual intercourse. It infects chiefly the subset of T-cells that "help" the immune response and it's these "helper" T-cells that are so dramatically reduced in most AIDS patients. In most recent reports, some investigators have suggested that human T-cell leukemia virus can make the cells it infects produce a surface molecule so similar to the individual's "self" antigens, that the virus-

infected cells escape destruction and removal by the body's usually discriminating immune system. Lymphadenopathy virus, Dr. Montagnier points out, is quite different in its appearance from human T-cell leukemia virus. But the idea of the French

team is that a viral infection human T-cell leukemia virus, LAV or an as-yet-undiscovered virus triggers the process that culminates in AIDS.

The organism's first attack, this hypothesis goes, affects only a tiny proportion of the victim's T-cells and there are no signs or symptoms of disease. But if the victim is exposed to second, third and subsequent attacks, enough target cells eventually will be infected to swamp the body's entire immune system. This would open it to attack by any

number of outside invaders other viruses, bacteria, "foreign" cells in semen and the like, or even "inside" invasion by lurking cancer or infectious cells. Retrovirsuses are rare, so this would explain why only individuals whose lifestyles or circumstances expose them to multiple attack by a virus would 'be most likely to get AIDS. If the hypothesis is correct, by the time the disease is well-advanced, the original virus would be eliminated from the body, together with the cells it destroyed, making its detection difficult if not impossible.

So the search continues. But the spotlight is now focused on a retrovirus, whatever its national pedigree and what is exciting is that these rare and very unusual retroviruses suddenly popped up at around the same time in about the same propor-

tions of patient groups in two countries an ocean apart and in labs using different methods of detection.

The discovery of a human retrovirus coinciding with the sudden. appearance of a new lethal epidemic must surely be more than an epidemiological artifact.

It is possible now to screen one's immune system, especially the T-lymphocyte function by exposing the individual to certain substances commonly encountered in nature. This is done by. intradermal injection of several such substances.

If the T-lymphocyte function is intact, a very

definite reaction on the place of injection will follow. This, coupled with normal blood count, gives a good presumptive evidence of normally functioning immune system and very low probability of developing AIDS. On the other hand, if any abnormality is detected during this screening, the individual would be advised to have more complicated studies of Tand B-lymphocyte function performed, which is possible now in one of the local laboratories in Columbus.

U. of M Study

Will Report On The Impact Of AIDS

The University of Michigan Psychosocial Impact of AIDS Project is a research study designed to estimate the social and psychological impact of AIDS on the gay male community. The project is being conducted by the School of Public Health and the Institute for Social Research of the University of Michigan. It is one of three studies in the nation, funded by the National Institute of Mental Health, to study psychosocial aspects of AIDS.

Why this study is being done.

Uncertainty about what is causing AIDS,

lack of effective treatment, high mortality, and increasing incidence rates have combined to produce considerable anxiety in the gay community. Patients. with AIDS are reported to be coping with isolation. and public hostility, as well as with a lifethreatening illness. For every AIDS patient, there are tens of thousands of individuals coping with the threat of this disease. This study is an attempt to measure and describe the responses of the gay community to this threat. Fundamental to any scientific study of this sort is the development of

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