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COLUMN ONE : Seeking a Cure: Faith, Frustration : Once researchers found the virus that causes AIDS, they were sure they could soon stop the disease. 'Find the bug, find the drug,' they said. A decade later, they are empty-handed and thinking of starting over.

AIDS RESEARCH: WHAT WENT WRONG? The quest for a "magic bullet" is chosen over basic research. First in a series

August 07, 1994|SHERYL STOLBERG | TIMES STAFF WRITER

Bob Gallo's black address book is filled with crossed-out names--the names of the dead.

It has been 10 years since the controversial cancer researcher proudly announced to the world that he had found the virus that causes AIDS, a discovery for which he now shares credit with French scientists. It was a heady time for Gallo, and he was flush with optimism, confident that soon there would be a drug or a vaccine to cripple the galloping plague.

"Find the bug, find the drug," the theory went.

Now, over a glass of lager in the oak-paneled bar of New York's Plaza Hotel, Gallo broods about what might have gone wrong. He contemplates the destructive swath of a disease that, like a familiar enemy, he and countless others have spent too many years trying to outwit.

He did not expect it to be this way.

Villages in Africa are being wiped out. AIDS is racing through Asia, where more than 10 million infections are expected by the year 2000. In the United States, 92 people die of the disease each day.

For the Record
Los Angeles Times Wednesday August 10, 1994 Home Edition Part A Page 3 Column 5 Metro Desk 2 inches; 48 words Type of Material: Correction
AIDS research--A story in Sunday's editions of The Times said that Dr. Harold Varmus, the new director of the National Institutes of Health, had recently ousted Dr. Anthony Fauci as head of the Office of AIDS Research. A spokeswoman for Varmus says Fauci withdrew from the job because keeping it would have required him to give up his other duties.

For Gallo, who trained as a doctor before turning to research, there are faces to these numbers. He recalls having dinner last year with Jesse Dobson, a well-known AIDS activist. Two weeks later, Dobson was dead.

Another name crossed out of the black address book.

"I feel like we should have solved problems sooner," the virologist said somberly. "Would've, should've, could've."

But didn't. Thirteen years after AIDS made its first appearance in this country and a decade after "the bug" was found, just a handful of drugs that directly attack the virus--AZT and three others--are on the market. None of them work very well, and doctors are confused about how to use them. Other new medicines have either been slow to emerge from drug company laboratories or abandoned altogether.

The prospects for a vaccine are equally dim. The wizards of genetic engineering have been unable to work their magic into a shot that prevents AIDS neatly and efficiently. The most promising candidates have flunked laboratory tests, and six volunteers who got the high-tech injections became infected anyway, prompting the government to abandon plans for large-scale studies.

The best hope for a vaccine, many scientists now say, lies with an old-fashioned method that uses a weakened but live form of the human immunodeficiency virus--a method that paradoxically may be too dangerous to test in humans. This formula worked with polio.

But HIV is not that simple. It is a retrovirus, meaning it inserts its own genes into the cells of the person it infects. And it mutates rapidly, raising fears that a vaccine containing live virus could transform itself to infect the person it was supposed to protect.

It is no wonder then that the days of talking about a cure for AIDS are long gone. There isn't a cure in sight.

Instead, as scientists gather in Yokohama, Japan, for the 10th annual International AIDS Conference this week, most use words such as crisis to describe the state of AIDS research.

Among researchers, a consensus has emerged: After 10 years, it is time to go back to the drawing board.

"Over the past decade, ever since the discovery of the virus, there was a great deal of effort put in place to see if we could quickly hit a home run," said virologist David Ho, director of the Aaron Diamond AIDS Research Institute in New York. "I think, in retrospect, that strategy is not going to work, and did not work."

Indeed, the silver bullet Gallo once hoped for has not materialized. And although government and drug company scientists have spent the last decade trying to find one, they have yet to answer some of the most fundamental questions about HIV. Those answers may hold important clues to developing just what everyone wants--better treatments and a vaccine.

"We probably know more about this virus than we do most other viruses," said AIDS researcher Steven Wolinsky of Northwestern University's Medical School. "But many of the basic issues are still begging to be answered."

New York AIDS activist Mark Harrington puts it a bit more bluntly. "We are standing," Harrington said, "at the edge of a scientific black hole."

Researchers do not fully understand how the AIDS virus crosses the body's mucous membranes--the linings of the mouth, vagina and anus--to infect cells. They do not know precisely how HIV spreads inside the body. Nor do they know if certain strains of the virus are more deadly than others, nor why some people die quickly while others live for years.

Also lacking is a good animal model that scientists can use to study AIDS--a monkey, perhaps, or a chimp that could be infected with HIV and would develop the disease just as humans do. However, in Yokohama, UC San Francisco researcher Jay Levy is expected to report that he has solved this problem by using baboons.

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