As many as one in
300 HIV patients never get sick and never suffer damage
to their immune systems, and AIDS experts said on Wednesday
they want to know why.
Most have gone
unnoticed by the top researchers because they are well, do
not need treatment, and do not want attention, said Bruce
Walker of the Harvard Medical School. But Walker and
colleagues want to study these so-called elite
patients in the hope that their cases can help in the
search for a vaccine or treatments.
"What in the heck
is going on in people that successfully control this
virus?" Walker asked at a news conference held at the 16th
International Conference on AIDS. "If we can figure out how
people are doing that, we can try to replicate it."
So far Walker and
colleagues have not been able to find out why certain
people can live for 15 years and longer with the virus and
never get ill. The AIDS virus usually kills patients
within two years if they are not treated. Some even
appear to have weak immune responses, he noted. "Is it
just that these people got infected with a wimpy virus? The
answer to that is no," Walker said.
"Some of the
people know who infected them," he added, and in those
cases the person who infected the "elite" patients always
went on to become ill.
A few years into
the AIDS epidemic, researchers identified people who
were called "long-term nonprogressors." These were patients
infected with HIV who did not become ill. Many have become
ill as the years have gone by and required treatment.
Walker said a few
of the long-term nonprogressors were now classified as
elite patients. But the difference is that the elite status
is clearly defined by how much virus they have
circulating in their blood. Loreen Willenberg, of
Diamond Springs, Calif., is a newly designated elite. Now
52 and healthy, she said she became infected in 1992.
"I dreamed that I
was HIV-positive," Willenberg told the news
conference. "I was really going through a very bad flu." She
sought testing and after getting an inconclusive result was
later declared HIV-positive.
HIV patients are
not immediately put on drugs that can keep them healthy
but wait until the virus reaches a certain level in the
blood or until the virus kills a certain number of
immune system cells, called CD4 T-cells.
landscape designer, never got to that point.
"I am in perfect
health. I think I have had maybe only one cold in the
past 14 years," she said.
tracked down 200 elite patients and has now joined up with
other prominent AIDS researchers to find at least 1,000
elites in North America and as many as possible
globally. Based on research done so far, Walker
estimates there are 2,000 of them in the United States.
His team wants to
take blood and DNA samples to see what might be
different about them. Confidentiality is promised. The
recently published map of the human genome will make
this possible. They will compare key genetic sequences
of the elite patients to genetic readouts from healthy
people and from other HIV patients. Maybe a few genetic
variations can explain what is happening, Walker