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MIXED SIGNALS ON HIV COCKTAILS; DRUG COMBOS NOT A CURE-ALL IN AIDS FIGHT.

Byline: Jenifer Hanrahan Daily News Staff Writer

For a few fleeting weeks last winter, Felice Jones' story sounded as promising as Magic Johnson's.

A powerful combination of AIDS drugs - the much-heralded ``cocktail'' that combines protease inhibitors with at least two other HIV medications - had reduced the virus in her body to undetectable levels, the same way it seems to have disappeared from the basketball legend's system.

But then drug therapy stopped working. After a few hopeful weeks, the crafty virus was again raging in her blood.

``People were thinking with the cocktail this was the end of the AIDS epidemic,'' said Jones, a 37-year-old actress and AIDS educator. ``The public thinks it's not something you have to worry about. And that's real dangerous. These drugs are failing.''

Today is the 15th annual World AIDS Day. Public health agencies, physicians and activists like Jones want to impart a message they believe is getting lost in upbeat news reports about declining AIDS deaths: The AIDS epidemic is not over.

In fact, some reports paint a gloomier picture than ever. Worldwide, HIV infections are soaring. UNAIDS, a United Nations agency, estimates 30 million people are infected with HIV.

About 16,000 people are infected daily, one in every 100 sexually active adults under age 49 worldwide has HIV and, among those infected, only one in 10 knows it, the report issued last week said.

Advice ignored

Jones, who found out she was HIV positive 14 years ago, lectures frequently about AIDS and its prevention at schools and colleges. But lately, she feels her pleas to practice safe sex are being ignored.

``I have people asking me if I am on the same cure as Magic Johnson,'' said Jones, who lives with her husband in Thousand Oaks. ``Magic Johnson is not cured. There was no detection of the virus in his blood. It doesn't mean it's not in his lymph glands or one of his other organs. It doesn't mean he's not infected. It doesn't mean that he can go on and have children now.''

The source of the misunderstanding may be news reports last year that compared the treatment of AIDS to diabetes.

Researchers announced a new drug combination could reduce the amount of the HIV virus in the blood to undetectable levels, bringing a fresh sense of optimism that AIDS could be transformed from a terminal illness to a chronic, manageable disease.

In Los Angeles County, deaths from AIDS plunged nearly 60 percent during the first half of this year compared with the same period last year.

But declining mortality rates do not tell the whole story.

``The treatment of HIV is not an easy, routine thing,'' said Dr. Michelle Roland, who treats AIDS patients at San Francisco General Hospital. ``A cocktail is something that's pleasurable, and these drugs are not pleasurable.''

Despite the advances in treatment, up to one-third of patients don't improve on the combination, according to several clinical studies.

Some people, especially drug addicts and the homeless, have trouble sticking to the strict regimen of dozens of pills. Some pills need to be taken with food, some without, at precise times every day. The drugs are also costly. Estimates range from $12,000 to $24,000 a year.

The combination therapy causes side effects such as nausea, headaches, diarrhea and mouth ulcers.

Wrong combination

For others, the drugs do not work at all. At San Francisco General Hospital, a study of 136 patients who took a protease inhibitor combined with two or more HIV drugs found that the therapy failed to suppress the virus in 53 percent of the patients.

Physicians believe this may be because many of the patients in the study added the protease inhibitors to older drug combinations that were already failing. It led physicians to believe that the ``cocktail'' will have more success on newly diagnosed patients who begin the triple-combination therapy at the outset of the HIV diagnosis.

``To say AIDS can be treated like hypertension or diabetes is an outright lie,'' said Dr. Cary Savitch, an assistant professor of medicine at UCLA and a specialist in infectious diseases. ``It's deceiving the public, the patients, and we're deceiving ourselves. It's a myth we're near a vaccine. It's a myth we're near a cure.''

Still, for the lucky and diligent, the new treatment lifted them out of an abyss of hopelessness.

When taken properly, the drugs have the potential to extend life for years or even decades, doctors say.

Evelyn Jackson-McCarty, 35, tested positive for HIV in 1991. The first drugs prescribed for her made her so sick she stopped taking them at the end of 1995.

Her health started to decline. She was lethargic, losing weight and severely depressed.

She considered suicide. She waited to die.

``I thought the medicine was worse than the disease,'' said the Arleta woman. ``I was told if I didn't take it, I was going to die, so I thought I was going to die.''

But the doctors tinkered with the combination. Now taking 10 pills a day, she says she experiences few side effects.

Since February, the virus has been undetectable in her blood. Her T cell count crept back up from below 200 - full-blown AIDS - to nearly 300 and holding steady.

From bad to better

Jackson-McCarty sees the doctor a couple of times a month. She takes her medication religiously. She works out every day and has regained her physical strength so fully she will enter a local body-building contest next month.

``I feel better right now than I ever did in my life,'' she said. ``HIV made me want to take care of myself, to be stronger and healthier and have confidence.''

But Jones believes Jackson-McCarty should be prepared for the virus to reappear.

The medication's benefits have been temporary for everyone Jones knows who tried the triple-combination therapy, which was available for several years in clinical trials before FDA approval.

For Jones, the side effects left her homebound, sick with severe intestinal pain, diarrhea and a constant urge to urinate.

The drugs also exacerbated her diabetes, a condition she had before her HIV-positive diagnosis in 1983.

Because they made her so ill, she starting missing dosages.

Finally, a few months ago, she stopped taking the medications altogether, switching back to the older AZT.

It wasn't a difficult choice, she said.

``It's disappointing,'' she said. ``But psychologically, I couldn't do it anymore. I couldn't wake up every morning and take something that made me feel terrible.

``There are people willing to suffer in order to prolong their life. I would rather enjoy every moment I have today, even if it means a shorter life span.''

CAPTION(S):

3 Photos

Photo: (1--Cover--Color) On WORLD AIDS DAY ...

IS A CURE ON THE HORIZON?

Cover design by Cesar Quebral

(2) The much-heralded AIDS cocktails only worked temporarily for actress Felice Jones.

David Sprague/Daily News

(3) Evelyn Jackson-McCarty's HIV is undetectable since she went on a new treatment regimen, giving her the strength to work on body building.

John McCoy/Daily News
COPYRIGHT 1997 Daily News
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1997, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

Article Details
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Title Annotation:L.A. LIFE
Publication:Daily News (Los Angeles, CA)
Article Type:Statistical Data Included
Date:Dec 1, 1997
Words:1173
Previous Article:AIDS QUILT ON CYBERVIEW.
Next Article:MCCARTHY WANTS CUSTOMIZED SCRIPT FOR MOVIE DEBUT.


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