DECEMBER 23, 1994 GAY PEOPLE'S CHRONICLE

HEALTH WATCH

Where is the virus?

by John Carey, M.D.

One of the arguments used by people who don't think HIV is the cause of AIDS is that although HIV antibodies can be found in people who later go on to develop AIDS, it is very hard to find the virus itself. When scientists were able to find the virus, it was often found in small amounts. So how could a virus which is found in such small amounts be causing such havoc on the immune system?

Well, it now appears that there are two answers to this question. The first answer is that early in the epidemic, the techniques used to look for the virus were not very good at detecting it. The second answer is that early on in HIV infection, the blood is the wrong place to look.

So how do people look at how much HIV there is in a person? The earliest techniques involved growing HIV from a sample of blood. This is a very expensive and timeconsuming approach. Later, people looked for a building block of the virus, a molecule called p24 antigen, in the blood of people with HIV infection. A limitation of this approach was that it only measured virus when it was activity replicating, and we know that some of the virus is just sitting quietly in cells doing nothing, some of the time.

Scientists have developed tests that measure both active and dormant virus in the blood with techniques that look at how much RNA or genetic material there is in a given sample. There are two such techniques, rt PCR and b-DNA, currently being evaluated in clinical trials. While it is clear that each test has its advantages and disadvantages, it is not clear which test will turn out to be more useful.

Studies with people who have had HIV infection for a long time-more than seven years and have not progressed, have shown that these individuals have lower levels of virus or viral burden' than people who progress more quickly. One study of people with advanced HIV disease has shown that decreasing viral burden is associated with better outcome. It should be remembered that these tests are not available to be ordered by your doctor to help you monitor your HIV

disease, but are being evaluated to determine how useful they are in context of AIDS treatment trials.

One thing that complicates the interpretation of these tests is that early on in HIV disease, it seems that most of the infected cells are not in the bloodstream, but instead are in the lymph nodes. The lymph nodes can be thought of as the police stations of your body's immune system. They are where the various component cells of the immune system: the B cells that make antibodies; the macrophages that carry messages and are the first to encounter foreign material; and the T cells, the directors of the immune system; get together to decide what kind of creature is attacking the body and what kind of response is required.

Work by Dr. Anthony Fauci and colleagues at the National Institues of Health has shown that early on, most of the virus and viral replication is occurring in these lymph nodes. With time, there is destruction of the lymph nodes. This results in more virus being found in the bloodstream and more clinically apparent HIV disease.

An important question that comes from this work is, are we able, with currently available therapy, to decrease the viral burden in the blood or lymph nodes, especially in people with early HIV infection?

Protocol 275, which is being conducted at the Case Western Reserve AIDS Clinical Trials Unit in Cleveland, and other sites around the country, is trying to answer these questions. This is a trial which will compare AZT to ddl, and to the combination of AZT and ddl, for patients who have not been treated with anti-viral drugs and have CD4 cell counts of more than 550. The study will look at the effect of these medications on viral load and immune responsiveness in blood and tissue. For more information call Margret Culter at 216-844-8175.

John Carey has cared for people with AIDS since 1983. He is medical director of the Special Immunology Unit at University Hospitals of Cleveland, an outpatient unit for people with HIV/AIDS.

BORDERS

BOOKS AND MUSIC

Presents...

30121 DETROIT ROAD WESTLAKE 892-7667

Borders Gay/Lesbian Book Group

TUESDAY, DECEMBER 27 7:00 P.M.

This month the group will discuss Edmund White's The Beautiful Room is Empty. Borders offers a twenty

percent discount on books purchased for book discussion groups. Call or sign up at the main information desk so that

we may reserve a copy of the book for you. January's discussion will be on Elizabeth Lapovsky Kennedy's Boots of Leather, Slippers of Gold.

Cafe'

BILLY'S

Delf

North Coast

NEW YEARS EVE

RESERVATIONS SUGGESTED SPECIAL MENU $14.95 per person

Soup, Salad, Entree, Dessert 6:00 PM12 Midnight

NEW YEARS DAY BRUNCH

IT100 Clifton

SPECIAL MENU

$4.95

9:00 AM-3:00 PM

Breakfast Available Upon Request

281-7722

BODYMIND THERAPY IN A SAFE SETTING

HELLERWORK

by

JUDY HARLAN

Certified Practitioner

The revolutionary therapy that uses the language and release of the body to heal the problems of the body and the mind through deep tissue massage dialogue

movement re-education

AFFIRMATIONS

HOWARD R. FRADKIN

PhD, CCDC II, Psychologist

A Center For Psychotherapy &

Certified Chemical Dependency Counselor

KATE KITCHEN

MSW, LISW

Clinical Sodal Worker

DON LAUFERSWEILER

MS, CCDC III, LPCC

Certified Chemical Dependency Counselor Licensed Professional Clinical Counselor

SADIE MICHAEL

MSW, LISW

Clinical Social Worker

Growth

SPECIALIZATIONS INCLUDE:

Individual, Group, and Relationship Psychotherapy Affirmative Gay and Lesbian Psychotherapy AIDS Related Concerns Women's Issues

Substance Abuse/Addiction Counseling

Incest Survivors/Sexual Abuse Hypnotherapy

Adult Children of Alcoholics Healing the Child Within Dual Diagnosis Counseling Domestic Violence

Collapsed Stance

Released Stance

Braden, Harlan

& Associates

595-1015

614/445 / 8277

VITTY Columbus, OH 43206

918 South Front Street

Tour the nation

THE MODEM NATION

Call by modem today

You are cordially invited to join the Citizens of The Modem Nation.... Cleveland's premiere on-line service.

(216) 498-4200 14400 V.32 (216) 498-4220 28800 V.FC

"We're All Part of The Modem Nation 24 High Speed Lines, 24 hours

OUR LITTLE GIFT TO YOU!

20% off retail products AND a free hair moisturizing or strengthening treatment at the time of your haircare service appoint-

ment.

SAVE $5 or MORE

DEC

Chaz

HAIRCARE

&SPA

13429 Detroit Avenue, Lakewood • 521-1199

9