Gloom in the Palais Des Congres

By Jamie Murphy.

When the first international conference on AIDS met in Atlanta 14 months ago, an air of optimism prevailed. In a remarkably short time, scientists had not only identified the virus responsible for the disease but devised a blood test that could determine if a person had ever been infected. Would a vaccine come next? The atmosphere at the second annual AIDS congress, held last week at the cavernous Palais des Congres in Paris, was considerably more subdued. Although the world's leading AIDS experts were among the more than 2,500 doctors and scientists in attendance, they bore few encouraging tidings. Speaker after speaker acknowledged that neither a vaccine nor a cure is in sight for acquired immunodeficiency syndrome, the deadly disease that destroys the body's ability to combat infection. Moreover, they said, AIDS is still spreading and poses a threat around the globe. Among the findings reported:

If present trends continue, predicted James Curran, director of the AIDS program at the Centers for Disease Control in Atlanta, there will be 300,000 cases of AIDS worldwide in 1991. Representatives of the World Health Organization estimated that 5 million to 10 million people now harbor the AIDS virus. Most of them do not show symptoms of the disease, but all are capable of transmitting the virus to others.

Nowhere is AIDS more widespread than in Africa, where WHO estimates that 50,000 people already suffer from the disease and that at least 1 million more are infected with the virus. Said Bila Kapita, an AIDS expert from Kinshasa, Zaire: "Today we know that AIDS is almost everywhere in Africa, especially central Africa. The question is, Why does Africa seem to be such a hot spot?" No answer was forthcoming. In Africa, AIDS strikes men and women in nearly equal numbers and, Kapita said, seems to be primarily spread by heterosexual contact.

Laurence Lasky, a scientist at Genentech, Inc. of South San Francisco, announced that the firm has used genetic engineering to produce antibodies that neutralize the AIDS virus in a test tube. Lasky did not venture to guess if these antibodies can be formed in a human body, and the necessary tests could take months or years. To complicate matters, Robert Gallo of the National Cancer Institute reported that samples of virus isolated from the brains of AIDS victims inexplicably differ from the form of virus that commonly attacks the T cells of the immune system.

While reports of promising anti-AIDS drugs surface frequently, several scientists noted, test results have so far been disappointing. Suramin, highly touted last year, has proved ineffective, if not actually harmful. Eager for any hopeful note, some reporters at the conference seized upon and overplayed a report by Dr. Anthony Fauci of the National Institutes of Health. Fauci revealed that one of his AIDS patients had regained his health and returned to work after treatment that included a bone-marrow transplant from his identical twin. Whether the patient has been permanently cured remains in doubt, and two other victims who received the same therapy have not improved. Fauci himself pointedly refrained from characterizing the procedure as a success, saying, "This is not a breakthrough, (just) a small but important building block of knowledge."

Epidemiologist Warren Winkelstein of the University of California, Berkeley, offered some slight encouragement, suggesting that public education campaigns have slowed the spread of the infection. While the number of AIDS cases is still increasing among homosexual men in San Francisco, he said, the rate of new infections declined from an 18% increase each year between 1982 and 1984 to only about a 4% rise last year. Winkelstein attributes the drop to "safe sex" practices like using condoms. Similar declines have been recorded among gay men and intravenous drug users in Baltimore. Said Dr. Frank Polk of the Johns Hopkins School of Hygiene and Public Health: "Even IV drug abusers are changing their habits. I never would have believed it, but they're being cleaner. They're buying more needles and sharing less."

As the experts read their reports in Paris, AIDS continued to make news in the U.S. In an interview with the Los Angeles Times last week, President Reagan suggested that Americans could avoid the risk of contracting AIDS from transfusions by storing their own blood for emergency use. Although all donor blood in the U.S. is screened for AIDS contamination, one undisputed case of transfusion-borne infection was reported two weeks ago. A donor gave blood so soon after the homosexual encounter that infected him that his body had not yet produced the antibodies the test is designed to detect.

Two other AIDS developments in the U.S. last week riled civil rights and homosexual groups. Despite the lack of any evidence that AIDS can be transmitted by casual contact, the Justice Department ruled that an employer who genuinely fears a spread of contagion can fire an AIDS victim without violating his federal civil rights. Snapped a staff attorney for the American Civil Liberties Union: "The decision is nothing more than a pretext for discrimination." And in California, an initiative that could prohibit AIDS victims from attending or teaching school and working in restaurants was certified for placement on the November ballot. The measure was put forward by followers of the perennial presidential candidate Lyndon LaRouche.

At week's end, both in the U.S. and abroad, the need for a medical answer to the AIDS crisis was becoming more and more urgent. As the Paris meeting concluded, Molecular Biologist Flossie Wong-Staal of the National Cancer Institute tried to sound optimistic. "I think things are going on the right track and the right time schedule. The science is going very fast." Unfortunately, she conceded, "the disease is going faster."

With reporting by Christine Gorman/Paris