AIDS: Disease, Research Efforts Advance

By Silberner, Joanne | Science News, April 27, 1985 | Go to article overview

AIDS: Disease, Research Efforts Advance


Silberner, Joanne, Science News


What emerged from last week's international AIDS conference in Atlanta is a grim picture of a disease that remains one step ahead of the researchers seeking ways to stop it. The meeting focused on work in progress--some of which was so new that the rawness of the data led to conflicting interpretations about the liner details of the disease.

But there was agreement on most points, among them that acquired immune deficiency syndrome is continuing to increase exponentially and to gain a foothold in more risk groups, and that it is transmitted primarily through intimate contact. Results of treatments are beginning to trickle in, but proven therapies and vaccines are still down the road.

The numbers are chilling. there will be as many cases diagnosed in the next year as have occurred since 1978, when an increased incidence of opportunistic infections among homosexual men was first noticed, predicted James W. Curran, head of infectious diseases at the Centers for Disease Control (CDC) in Atlanta. So far, 9,760 AIDS victims have been diagnosed in the United States; 4,760 have died.

The test used to screen donated blood for antibodies to the AIDS-associated virus, which indicates a history of infection, has been used to screen several groups of people. Extrapolating from this and other data, Curran estimated that from 300,000 to 1 million people have been infected with the virus. What will happen to them remains an open questions; anywhere from 5 to 20 percent could go on to develop symptons, he said. There is a spectrum to the syndrome--some people are infected and have no signs of the disease, and some have "pre-AIDS" or AIDS-related complex (ARC), a collection of symptoms that isn't quite full-blown AIDS.

"Clinical AIDS is a very small fraction of the seropostive [antibody-postive] population," Jerome Groopman, a Harvard Medical School hematologist and oncologist who is studying AIDS, told SCIENCE NEWS at the meeting. "What determines the clinical outcome after infection is unclear." A CDC and San Francisco Department of Public Health study found that two-thirds of 362 homesexual men who were AIDS-antibody-free in the late 1970s had developed the antibodies by 1984. And no one knows how many people who have been infected are contagious, Groopman said.

Paul Volberding of the University of California at San Francisco (UCSF), head of the AIDS clinic at San Francisco General Hospital, estimated that five to 10 times as many people have ARC as have AIDS.

In 1981, UCSF began a study of homosexual men with one of the symptoms of ARC, swollen lymph nodes or lymphadenopathy. After one year, there were no cases of AIDS in this group, but by the end of the thid year of 14 of 200 men had it. Other research, noted study participant Donald I. Abrams of UCSF, shows that anywhere from 3 to 26 percent of men with lymphadenopathy go on to develop AIDS.

Women are victims of AIDS as well. In Africa, where the disease is believed to have originated, as many women as men have AIDS, presumably as a result of heterosexual transmission. In Haiti, Port-au-Prince and Cornell University researchers reported at the meeting, the incidence in women is on the increase. In 1982, 7 of 49 cases, or 14 percent, were women; by 1984 the numbers had increased to 30 of 93, or 32 percent. As has been the case with homosexual transmission, there is a correlation with the number of sexual partners.

robert R. Redfield of the Walter Reed Army Hospital in Washington, D.C., has been studying AIDS incidence in military personnel with no known risk factors. While noting that his subjects may have been reluctant to admit to homosexuality or intravenous drug abuse, which would put them into known risk groups, he said that five of seven wives of men with AIDS or ARC had virus or antibodieS.

Though an increase in heterosexual transmission is inevitable, Curran said, "it is likely that heterosexual spread of infection will not be as rapid as among gay men and drug users. …

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