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COLUMN ONE : Still Alive: Defying an Epidemic : Are some people immune to AIDS? That's the hope of artist Rob Anderson and others who remain healthy years after acquiring HIV. The question also tantalizes researchers seeking a cure.

September 08, 1993|SHERYL STOLBERG | TIMES MEDICAL WRITER

SAN FRANCISCO — There is a wall of memorabilia in Rob Anderson's art studio--faded family photographs, quirky postcards, esoteric quotes from Eastern philosophy. The wall reveals poignant details of the painter's life. It also tells the story of what it means to be a gay man in San Francisco today.

Sprinkled amid this collection are pictures of the dead--a former boyfriend, elegantly dressed in black tie and carnation, a masseur who advertised "gifted hands," the model who posed for some of Anderson's most beautiful pencil sketches. These pictures, the legacy of AIDS, are hardly shocking here in the epicenter of the epidemic.

The shocker is that the artist's own image is not among them--and may well never be.

On June 20, 1979, when San Francisco's gay community was still swinging with sexual freedom and no one had heard of AIDS, let alone human immunodeficiency virus, Anderson went to a city health clinic and volunteered his blood for hepatitis research. That sample would eventually test positive for HIV.

Fourteen years later, the 40-year-old artist remains healthy.

His relationship with the virus that causes AIDS has been going on longer than the epidemic itself. While dozens of friends and hundreds of acquaintances have died, Anderson's only complaints have been occasional colds or bouts with the flu. He has never taken AZT or other antiviral medicines. His CD4 count--the number of crucial immune cells that are the chief target of HIV--is above 800, well within normal.

"I think I'm going to live much, much longer than this, barring any great disasters," he says calmly. "I don't think AIDS is what's going to kill me off. I'm going for old age."

Many experts who once predicted HIV would kill everyone infected with it are beginning to believe Anderson may be correct. As the epidemic moves into its second decade, more researchers are turning their attention to a tiny group of "healthy positives"--people who for 10 years or longer have not only survived with HIV, but have never taken antivirals and whose immune systems appear to be able to keep the deadly virus in check.

Of course, it is impossible to predict how many healthy positives will remain healthy. Twelve years after AIDS made its appearance in the United States, the disease is still an unfolding story. Because HIV can incubate for 10 years or more without causing symptoms, only time will tell how well this subgroup will fare.

Nonetheless, scientists estimate that 10% of those infected will eventually fall into the healthy positive category, a figure extrapolated from three long-running studies of HIV-positive men. So far, these studies have documented 139 men who clearly fit the profile. Only eight have been infected longer than Anderson, making him one of the nation's earliest documented cases of HIV. None has had the virus more than 15 years.

The blood of these healthy positives is becoming a hot commodity in medical laboratories, where researchers are working furiously to unravel the mystery of what seems to protect them from the ravages of HIV.

It is an unusual twist of science, looking for answers in the healthy rather than the sick. The hope is that the secret--or secrets--can be unlocked and then bottled, so to speak, in the form of a vaccine or drug that could create the same effect in others.

"They are a gold mine of information," said Paul O'Malley, who directs the San Francisco study in which Anderson participates. "My feeling is that these guys are the closest thing we have to a cure right now."

Although diet, exercise and a positive outlook may help, behavioral changes do not appear to be the link. Instead, researchers are pursuing intriguing clues that point toward certain key proteins that shift the balance of the immune system, genes that may enable cells to fight off infection with HIV or infection with a weaker strain of the virus--or a combination of the three.

Or is it, as some suggest, simply that these healthy positives are at the tail end of a very long bell curve, and they too will eventually succumb to HIV--albeit at a slower rate than most?

"That's the big question," said John Phair, an infectious disease specialist at Northwestern University who is studying this group, "and I don't have the answer to it. We don't have enough information to say that these people will not get some clinical problem due to their HIV infection. Whether they'll die of it, I don't know. We just need more time."

*

Rob Anderson is not worried.

It is an unusually sweltering day in San Francisco, and the artist, in blue jeans and casual shirt, palette in hand, is behind his easel. His studio is a room off the kitchen in the faded Victorian he owns in the Potrero district, an eclectic neighborhood of warehouses, refurbished lofts and ramshackle houses. Just a few blocks away is San Francisco Bay--not the ritzy tourist bay, but the workingman's bay of fish companies and shipyards.

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