Magazine article The Advocate (The national gay & lesbian newsmagazine)

The Hope Whisperer

Magazine article The Advocate (The national gay & lesbian newsmagazine)

The Hope Whisperer

Article excerpt

As the top researchers met in Geneva Earlier this month, an AIDS-weary world Again turned to David Ho for answers

Two years after proposing HIV could be eradicated from the body, David Ho faces many obstacles. Still, he remains optimistic

In 1990 David Ho became the chief executive officer and first employee of the Aaron Diamond AIDS Research Center in New York City. Today, he oversees a staff of 100. In the interim the center has changed the way researchers and the public think about HIV. Ho and his colleagues have shown that contrary to prevailing wisdom, the virus begins to replicate itself massively immediately upon infection. They have been among pioneers of therapy. And most dramatically, as discussed at the 1996 International AIDS Conference in Vancouver, Canada, Ho has posed the theoretical possibility that HIV can be eradicated from the body. As a of the advances made in AIDS treatment that year, Ho was named Time magazine's Man of the Year. The honor was the culmination of more than 15 years on the front line of the AIDS war. As chief medical resident at Cedars-Sinai Medical Center in Los Angeles in 1981, Ho was among first doctors to witness the strange, then-unnamed syndrome that was claiming the lives of gay men and quickly suspected that a virus was the cause.

In an interview in his office prior to his departure for the World AIDS Conference in Geneva, Ho talked to The Advocate about a wide range of topics, including the obstacles to eradication and a vaccine, the rise in unsafe sex among gay men and the continuing impact of his Man of the Year honor.

What do you think the major topics and issues are going to be at the upcoming World AIDS Conference in Geneva?

Well, I'm not expecting major surprises. I expect people to continue to talk about incremental developments in the field. In therapy, for example, I think people will be talking about one regimen versus another and talking about some of the problems that we're facing. People will continue to update us on the declining mortality in the United States and Western Europe. I think the trend will continue even though we all recognize that there are going to be failures that will continue to pop up.

A very different tone from Vancouver then?

To me, Vancouver was just another increment. Some of the developments were blown out of proportion, even some of our work that was featured in that process. We went and gave a very concise, limited talk on some of the theories behind eradication. In some people's minds that got translated into "eradication." That's not appropriate.

What are you going to be talking about in Geneva?

I'm going to talk about the obstacles to viral eradication; that is, the latent pool [of virus] that remains after several years of treatment. We are trying to understand that pool, how big it is, how quickly it's decaying or how slowly it's decaying, whether that pool contains virus that might be different from the other virus [and] to talk about some of the strategies to contend with the remaining virus, how we might be able to induce its activation and therefore its elimination. I'm going to talk about how we could perhaps somehow boost the immune responses in these individuals so that we could perhaps ask the immune responses to substitute for the drugs.

Are you sorry you ever used the word eradication?

I think the first mention of the word came from a meeting titled "HIV Eradication?" in which I did not participate, some weeks preceding the Vancouver meeting. We obviously had been thinking along that line, but we had never dared to use that word. It's interesting that in our field we've been so shy about it until the past couple years. In cancer a cancer cure has been talked about for a long time, and it's OK as an objective. It's taboo in AIDS.

I've heard that you recently suggested that it might be possible to talk about eradicating the virus from the body in 20 years. …

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