Frightening AIDS Data Forecast for Conference

The Fourth International Conference on AIDS opened here Sunday with a prediction from Dr. Lars Olof Kallings, a conference chairman, that new information to be presented about the virus will be “more frightening than we have expected.”

Kallings said his pessimistic assessment was based on his review of the 3,100 papers to be delivered. He said the presentations were likely to include significant new information on the severity and spread of HIV infections without comparable progress on HIV drugs or vaccines.

“I’m afraid that the picture in its entirety that will develop during the four days to come will be frightening,” Kallings, director of Sweden’s National Bacteriological Laboratory, said in his address at the opening ceremony.

Kallings cited in particular early signs of the spread of HIV infections to Asia as well as the increasing numbers of childhood AIDS cases and AIDS-related nervous system disorders.

Dr. Jonathan Mann, director of the World Health Organization’s Global Program on AIDS, estimated that 150,000 new AIDS cases will develop worldwide this year, which is equal to the total number of cases in the world between the mid-1970s and the end of 1987. A total of 96,433 AIDS cases had been reported to the WHO as of June 1--about half the estimated actual number of cases to date in the world.

“HIV has the capacity to create explosive epidemics,” Mann said. As an example he cited data showing that the rate of HIV infection among intravenous drug users in Bangkok, Thailand, had increased from 0% in 1985-86 to 1% in 1987 and nearly 16% during the first three months of 1988.

HIV infections attack the body’s immune system, leaving an infected individual vulnerable to a variety of serious germs and tumors. Acquired immune deficiency syndrome is the most serious health problem caused by the virus.

Some of the few comparatively upbeat disclosures to be considered at the conference are contained in two reports of new data on long-term treatment with AZT, or azidothymidine, the one drug which has been shown to prolong the lives of some AIDS patients.

After 24 months of treatment, 47% of a group of about 100 of the first American AIDS patients started on the drug were still alive, said Dr. David Barry of the Burroughs Welcome Co. in Research Triangle Park, N.C., which manufactures AZT. This compares with an anticipated two-year survival rate of 10% for comparable AIDS patients who had not received AZT, Barry said.

A separate analysis excluded some patients who had to discontinue AZT because of toxic side effects. Among these patients, Barry reported that 68% of the patients were still alive after 18 months of treatment. Patients who received additional drug therapy to prevent the development of an AIDS related lung infection had an even higher survival rate. Their survival rate was 84% over 18 months compared to 62% for patients who did not receive the additional therapy.

“There is a significant added effect for giving these patients prophylaxis for Pneumocystis carinii pneumonia,” Barry said.

Tests in Europe

Another report, based on a European study of 130 patients, evaluated the combination of AZT therapy with a drug primarily used to treat herpes virus infections, called acyclovir.

Nearly one-year of follow-up has been completed. So far 85% of the patients receiving both drugs are still alive compared to about 70% of the patients who received only AZT, reported Professor M. Seligmann of the hospital St.-Louis in Paris. Seligmann cautioned that the “preliminary” results, which reflect nearly a year of follow-up, needed to be interpreted cautiously.

In another development, Dr. Luc Montagnier of the Pasteur Institute in Paris reported the first evidence that a human AIDS virus could cause an AIDS-like disease in a laboratory animal.

Life-threatening fungal infections and low white blood cell counts developed in the brain and lungs of a monkey after it was infected with the variant AIDS virus from West Africa known as HIV-2, Montagnier said. By comparison, chimpanzees have been infected with the original AIDS virus known as HIV-1 but have not become ill.

Proving that a human germ can make a laboratory animal sick is a key part of proving that the germ causes a human disease. “This is one of the most direct proofs that we have,” Montagnier said.

More than 7,000 participants from about 140 countries are attending the meeting at the Stockholm International Fairs conference center.