Future brighter for AIDS patients

by Bei Hu

Patty B., a former Twin Cities nurse, has to take 32 pills daily to hold back the HIV virus and the accompanied inflammation that have invaded her body. Although AIDS still eludes a cure, Patty and many others who have tested HIV-positive in the 1990s no longer have to face immediate doom from the virus.
At a scientific symposium sponsored by the University’s International Center for Antiviral Research and Epidemiology on Thursday, Patty joined Hank Balfour, a University laboratory medicine and pathology professor, to showcase the encouraging developments of AIDS and HIV research in Minnesota.
A yet-to-be-published study showing that a combination of three anti-HIV drugs can prolong life and improve physical conditions of patients with advanced AIDS competed for attention with another project published today in Science magazine. The latter issue showed that an effective combination of anti-HIV drugs can reduce the virus in human tissue.
The new study involved more than 1,300 late-stage AIDS patients. At the beginning of the research, all the subjects had a T-cell count under 50 — far below the normal level of 800 to 1,000 T-cells and the 200 level used to define full-blown AIDS. The T-cell count is a commonly used barometer for the body’s ability to fight the virus.
This is the first study regarding the treatment of patients with such a low T-cell count.
“Back in 1993 when this study started, there were people who actually thought no treatment was acceptable because this was a hopeless situation,” Balfour said.
But Balfour and his colleagues overturned this conviction. They observed that both the two-drug and the three-drug therapies clearly benefited the patients by the study’s conclusion in 1996.
“The average length of time that people survived was twice as long as it had been predicted, for everybody,” said Balfour.
Minnesota scientists have taken part in 48 regional and national investigations on AIDS and HIV treatments in the past 10 years through the Center and the AIDS Clinical Trial Unit, which is funded by the National Institutes of Health.
Several of the studies involved more than 1,000 subjects. Researchers tested about 20 different drugs in several different combinations to see which method provides the most effective treatment for patients.
Results of the studies have confirmed that a combination of three anti-HIV drugs generally work better than double-drug therapies, while two drugs used together prove more effective than any singular medication.
Although newly marketed inhibiting drugs are gaining popularity, Minnesota researchers have concluded that AZT, one of the earliest anti-HIV drugs approved for use in the United States, can independently prevent HIV-infection from progressing into full-blown AIDS. Even in cases when multiple drugs are applied, the combination does not have to include any protease (enzyme) inhibitor, Balfour said.
In an attempt to address the financial issue of AIDS and HIV treatments, Minnesota researchers have proposed the use of two-drug instead of three-drug combinations in patients whose conditions have stabilized. This move could save patients several thousands dollars every year.
In a recent study of nine HIV-infected Minnesotans who have been in clinical trials for anti-virus drugs for the past 10 years, researchers found two drugs were able to reduce the virus amount in eight of the patients’ plasma to undetectable levels.
This is good news for patients who are paying $8,000 to $10,000 a year for a three-drug therapy program. Once a study is completed, the patients must find their own way to pay for treatment if they want to continue the therapy. Although Patty said she has adequate insurance, many patients do not.
As for Patty, who has been in four clinical drug trials since 1991, the future has brightened again. Forced to quit her job in 1994 because of severe AIDS symptoms, she is actually considering a return to the workforce.