Taking His Own Medicine

By Ed Magnuson

Most animals have little to fear from the lethal AIDS virus. That is good for them but not for human beings, since other species are of little use to medical researchers seeking treatments and vaccines for the deadly disease. The limited value of research on baboons and chimpanzees, among other beasts, creates an urgency to move swiftly to tests on humans. Last week, after months of rumors within the scientific community, it was confirmed that this dramatic leap has been taken in vaccine research. In a letter in the British journal Nature, Dr. Daniel Zagury, an AIDS investigator at the Pierre and Marie Curie University in Paris, described a bold experiment: he had inoculated himself in November with a potential AIDS vaccine.

"This is an important first step," said Dr. Robert Gallo, a leading AIDS researcher at the National Institutes of Health in Bethesda, Md. "It's very noble that he did it on himself first." Yet Zagury dismissed any notion of heroism and seemed embarrassed by the attention. "If I began on myself," he told a reporter from France's Le Matin, "it is simply a question of a scientist's ethics."

Actually the personal risk to Zagury was probably quite small. The vaccine he used, based on the work of NIH Immunologist Bernard Moss, contained only a tiny portion of genetic material from the AIDS virus. This material was inserted into the genes of a larger, harmless virus, which served as a carrier. (The larger virus was vaccinia, once commonly used to prevent smallpox.) When tested in baboons and a chimp for one year, this hybrid stimulated the animals to produce antibodies not only to vaccinia but to the AIDS virus, with no apparent side effects.

! How would it work in humans? A few weeks after Zagury scraped his skin enough to let the experimental substance enter his bloodstream, tests showed that his body had produced two types of immune response: antibodies to the AIDS virus, plus specialized blood cells capable of defending against incipient AIDS infection. In laboratory tests, these defender cells were effective not only against the strain of virus from which the vaccine was made, but against a second strain as well. This finding was especially significant since the AIDS virus has innumerable strains.

The acid test for the vaccine, of course, would be for Zagury to inject himself with live AIDS virus to see if he is truly protected. But that, he admits, "would be crazy." The next best thing is to test the vaccine in people who, because of their life-style or environment, have a high risk of being exposed to AIDS. Zagury took a step in this direction late last November when, with approval from the government in Kinshasa, he gave his experimental vaccine to eight healthy volunteers in Zaire, a country where AIDS is rampant. If they remain free of the infection and experience no side effects, a wider test might be warranted.

In the U.S., meanwhile, a number of research teams are eager to conduct their own human trials of experimental vaccines. Bristol-Myers, for example, plans to seek approval from the Food and Drug Administration within the next month for tests of a preparation similar to Zagury's. Such tests would only be the first step in a process that will probably take years. "You're dealing with a very sneaky virus," observes Jeffrey Laurence, an AIDS researcher at New York Hospital-Cornell Medical Center. "It's going to be a long haul."

Of more immediate relevance to current AIDS patients was the FDA's astonishingly swift approval last week of the drug azidothymidine (AZT). The prescription drug, which will be marketed by Burroughs Wellcome under the name Retrovir, is the only substance proven to reduce the symptoms and prolong the lives of some AIDS patients. But the drug falls far short of being a cure, costs an estimated $7,000 for one year's dose and has severe side effects. Some AZT patients require at least biweekly blood transfusions to combat anemia, and at least one-third of them may develop bone-marrow suppression. For most AIDS victims, however, these complications seem worth risking, considering the present alternative.

With reporting by Andrea Dorfman/New York and William Dowell/Paris