AIDS experts caution against hype in news of treatment breakthroughs

VANCOUVER, British Columbia (AP) — Top AIDS officials cautioned Sunday that overly optimistic reports of breakthroughs in AIDS treatment will raise impossibly high hopes among AIDS sufferers around the world.
The warning came as 15,000 people attended the opening session of the 11th International Conference on AIDS in a mood of euphoric hope that AIDS has been brought under control at last.
A variety of new drug treatments show promise — at least in short-term use — of holding the AIDS virus in check. The development may mean that an HIV infection, while perhaps not curable, is not necessarily a death sentence anymore.
However, many worry that the treatments will not hold up when given for many years. The virus, which has outsmarted so many strategies in the past, also could evolve ways to elude the new approaches as well.
“There is hope, but let’s not exaggerate,” said Dr. Peter Piot, head of the U.N. AIDS program. “Let’s not switch from very dark pessimism to hype and over-optimism so we will all have a hangover within six months or a year.”
The cheerful aura at the international meeting comes in dramatic contrast to earlier gatherings, such as the one two years ago in Yokohama, Japan, where gloom prevailed. This time, pharmaceutical companies handed out glowing reports of promising findings and researchers spoke of perfecting a cocktail of AIDS drugs to wipe out all traces of the virus.
The meeting’s organizers cautioned that while the preliminary findings are a welcome change, they do not represent a cure — although some AIDS experts have begun to talk about just that possibility.
“We don’t want the pendulum to swing so far over that we have again the state of very unrealistic expectations that will leave people bitterly disappointed,” said Dr. Martin T. Schechter of the University of British Columbia, the conference co-chairman.
In all, nine AIDS drugs are on the U.S. market, five of them introduced this year. The most important are three in a new class called protease inhibitors, which block one step in HIV’s reproductive cycle. When combined with two older AIDS drugs, the virus appears to stop reproducing.
People have been taking various three-drug combinations for about 18 months, and in many — but not all — HIV disappears from the bloodstream.
Dr. Michael V. O’Shaughnessy, another conference organizer, advised skepticism in judging the reports of these combinations, which will be presented at the meeting.
“Keep the hyperbole in perspective,” he asked reporters. “There will be a lot of overstatement of results.”
Even if the new treatments work as well as researchers hope, Piot noted they are likely to be little use to most of the world’s HIV-infected people, who cannot afford to pay $10,000 or $15,000 a year for treatment.
According to U.N. figures, 21 million people are living with HIV, 90 percent of them in developing countries. Every day, 8,500 more people — including 1,000 children — become infected.
“What keeps me awake at night,” said Piot, “is the growing AIDS care gap — especially between the developed and developing world.”
Unlike in the United States and other industrialized nations, where AIDS spreads mostly through homosexual sex and dirty needles, AIDS in poorer countries is largely a heterosexual disease.
Piot, however, said the first hints have appeared showing that poorer countries can stem the spread of the disease through diligent condom education campaigns. He noted the number of new HIV infections has fallen in both Uganda and Thailand, which have serious HIV epidemics.
Despite what he called “solid grounds for hope,” Piot said the AIDS “epidemic remains huge, unstable and mostly invisible.”