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Screening sites pushed pending AIDS therapy.

Screening sites pushed pending AIDS therapy

State and Federal agencies continue to mobilize resources toward alternate site blood screening for AIDS as researchers press to find some form of cure or vaccine.

At this writing, the Centers for Disease Control had disbursed nearly $10 million for screening centers through a series of state grants. More than 500 new sites are now in operation throughout the country, under the direction of local health officials. Private organizations such as the Red Cross are also supporting screening centers, but authorities say government programs are by far the more prevalent.

Washington observers expect support for existing centers will continue. But at press time they noted that funding faced ongoing budget wrangling in Congress.

"If anything, there may be fewer sites available until the money issue is resolved,' Russ Havlak, the CDC's alternate site overseer, reported. "Not every state has funds remaining. They'll try to keep everything open, but it may not be possible in all cases.'

As of mid-November, the Senate had approved more than $200 million to fight AIDS, including an additional $10 million for alternate site screening. The House set aside approximately $190 million, but did not specifically earmark funds for alternate sites.

Officials say screening and other precautions will remain a key until discovery of some treatment, which many researchers believe could be at least two years away. "The first prong of attack has to be promoting public information on what can be done to prevent AIDS,' Dr. George Galasso, a leading researcher with the National Institutes of Health, explains. "That has to be our first line of defense.'

To date, the Food and Drug Administration has licensed five manufacturers to market kits detecting antibodies to HTLV-III. The companies are Abbott Laboratories, Du Pont/Biotech, Electro-Nucleonics, Litton Bionetics, and Travenol-Genentech.

FDA regulators plan to stay out of the picture until researchers present a treatment compound as a candidate for testing in humans. However, some analysts express hope for applications of drugs the agency has already approved.

A team of three French physicians recently reported a promising improvement in two AIDS patients treated with cyclosporine (one later died). Until now, the drug has been prescribed to suppress the body's immune system and keep it from rejecting transplanted organs--ausage almost the reverse of the French experiment. The FDA approved cyclosporine for transplant patients in 1983.

The French reported that the drug increased the patients' T-4 lymphocytes, which are attacked by the AIDS virus. U.S. officials, however, remain skeptical. One FDA insider explained: "Doctors here could legally prescribe cyclosporine for AIDS, but the consensus among Government scientists is that the announcement in France was very premature. Only two out of six patients showed improvement, and the research has yet to be analyzed by an independent scientific organization. We believe anyone using cyclosporine for this purpose should be very, very careful.'

In this country, research into a weapon against AIDS has been broad-brushed. Some scientists are analyzing antigens to induce the virus antibody, while others work to develop a vaccine such as those for smallpox and polio.

Government physicians say at least five compounds have shown effectiveness as an antiviral in animals. But they are cautious in assessing which approaches may prove most successful.

According to NIH's Dr. Galasso, "We're basically just trying to do everything we know how to do, using all the methods and technologies that have proven successful in other areas of disease research.' He notes that NIH has formed a special selection committee "to make sure that everything gets covered one way or another. We'll look at everything, including the cyclosporine experiments.' To date, NIH has doled out roughly $60 million for AIDS research across the country.

One group of scientists who received a $90,000 NIH grant is currently testing a new AIDS vaccine in chimpanzees. Dr. Gordon Dreesman and his colleagues at the Southwestern Foundation for Biomedical Research, San Antonio, Tex., used genetic engineering to produce two synthetic peptides, a sequence of 18 amino acids that match a portion of the virus. Dr. Dreesman reports that in experiments with rabbits, the substance helps create a protective coating around the AIDS virus, isolating it from healthy cells.

The team has gone on to test the vaccine on chimpanzees, whose immune systems more closely resemble those of human beings. "We can now take a chimp, inoculate it with the peptides, and challenge it with the AIDS virus [obtained from human blood plasma],' Dr. Dreesman explains. "Then we can see whether they work to prevent infection.'

Scientists say they will know results of current tests in six to eight months. If successful, the vaccine could be available to AIDS victims in about two years.

Some authorities question whether drug companies really want to invest in an AIDS vaccine. As Dr. Galasso observes, "The reality we have to face is that these are profit-motivated companies. An AIDS drug could cost millions of dollars to bring to market. Firms might not be interested if they're not sure they can get their money back. If you have a potential total of, say, 50,000 cases, the return might not be there.'

The NIH official adds that the threat of professional liability may scare some companies away. "Anytime you deal with a biological problem, someone is going to get sued. Something is bound to go wrong sometime, and with the jury awards we've seen, the results can be very damaging.'

Still, Washington officials remain cautiously optimistic that an answer to AIDS will surface, possibly within two years. As one FDA spokesman observed, "It could come today, it could come in two years, it may never come. In this situation you can't really tell when or where something will pop up. But at this point, it looks like two years is our best guess.'

In the meantime, health officials are trying to calm fears over the epidemic that has killed over half of its more than 14,500 reported victims.

Dr. James Mason, acting assistant secretary of health, U.S. Public Health Service, states: "I cannot deny that AIDS is a terrifying public health problem. But I can say with assurance that AIDS is not easy to catch. It is not spread by casual contact with risk group members or AIDS patients.

"In health care workers, who have the closest contact with very ill, often hospitalized AIDS patients, not one has developed AIDS or become seropositive as a result of contact with the patient. Of 1,472 health care workers tested for antibodies to the virus, only 18 have had positive test results. Of these 18, all but three belonged to risk groups [homosexual or bisexual men, IV drug users, and blood transfusion recipients]. We believe these workers suffered needlestick injuries, and we strongly urge people handling needles to observe the precautions we have published.'
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Title Annotation:current AIDS research
Publication:Medical Laboratory Observer
Date:Dec 1, 1985
Previous Article:The big swing toward pay for performance.
Next Article:The impact of DRGs after year 2: consolidating the changes.

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