Medicine: AIDS: A Spreading Scourge

In a desperate search for something, anything, to arrest the disease, AIDS patients are traveling the world. Hudson had reportedly gone to Paris to seek treatment with an experimental antiviral preparation called HPA-23, which was discovered at the city's famed Pasteur Institute. French experiments with this and other new drugs have made Paris something of a Lourdes, attracting dozens of AIDS patients from the U.S. and elsewhere. Some patients have flown to Mexico to be treated with other drugs supposedly effective against AIDS but not approved for use in the U.S. Some sufferers have spent small fortunes on obscure rejuvenating treatments in Switzerland and sheep-gland injections in Rumania, or have turned to holistic healers, megavitamin therapists, even voodoo doctors and spiritualists. Doctors caution AIDS patients about quackery but understand why their advice is often ignored. Says Dr. Michael Lange, an infectious-disease specialist at St. Lukes-Roosevelt Hospital in Manhattan: "If I were told that I was going to die from AIDS in two years, I would seek help wherever I could find it."

The greatest and perhaps the only real hope for AIDS patients lies in half a dozen experimental drugs now being tested in the U.S. and abroad. In general, the drugs fall into two categories: those that attack the AIDS virus directly, generally by interfering with its replication, and those that are aimed at rebuilding the immune system. The Pasteur Institute's HPA-23, which may be available for study in the U.S. this fall, prevents the virus from reproducing by blocking the transcription of its genetic code. In limited studies, HPA-23 has indeed been shown to reduce the amount of virus present in some patients' blood. But it is by no means clear that it alleviates their illness. What is more, the drug can have potentially serious side effects, including blood-clotting problems. Acknowledges Dr. Willy Rozenbaum, a leading French investigator: "This is not a miracle drug."

U.S. researchers at a handful of medical centers around the country are testing another antiviral preparation, called Suramin, which was originally used to combat African sleeping sickness. Like HPA-23, the drug appears to stop the proliferation of the AIDS virus, but it does not necessarily improve the patient's condition. Other antiviral substances, including Ribavirin and Foscarnet, now being studied in Sweden and Canada, are in even earlier stages of investigation.

To revitalize the weakened immune systems of AIDS patients, researchers have in some cases tried bone-marrow transplants and infusions of interferons and interleukin-2, another substance produced naturally by white blood cells. But such efforts, like those aimed at arresting the virus, have failed to influence the course of the disease. The answer, says Dr. Anthony Fauci, an immunologist at the National Institute of Allergy and Infectious Diseases, "may lie in a two-pronged approach to suppress the replication of the virus at the same time that we are enhancing the immune response." This strategy, Fauci and other researchers think, will probably involve the use of several drugs in combination.