END OF THE MAGIC ERA : Q&A; : More Issues Than Answers Are Surrounding HIV

Magic Johnson’s announcement Thursday that he is retiring from professional basketball because he tested positive for the human immunodeficiency virus (HIV) is a complex situation. What follows are some questions and answers to help explain the issues.

Question: What causes AIDS, the acquired immune deficiency syndrome?

Answer: AIDS is caused by a virus known as human immunodeficiency virus, or HIV. Unlike the viruses that cause colds and flu, HIV does not leave the body after attacking the cells. HIV permanently combines its genetic material with the genetic material of the body’s host cells. Then it uses those cells to make copies of itself. Each cell becomes, in effect, a little virus factory.

Q: Does Johnson have AIDS?

A: He has tested HIV positive, but Johnson said he does not yet have fully developed AIDS.

Q: If Johnson does not have fully developed AIDS, why doesn’t he continue playing for the Lakers?

A: Johnson’s physician, Michael Mellman, said the sport is too physically demanding. Experts said that there is no evidence that a well-trained athlete who is HIV infected but whose immune system has not yet begun to deteriorate, would be greatly impacted by physical activity. Because NBA players sometimes get hurt and bleed, there is a remote chance of exposing someone to infected blood, although no case has been documented.

Q: Is there any indication that NBA officials, not wanting a player suffering from HIV in the league, pressured Johnson to retire?

A: Although NBA Commissioner David Stern attended Johnson’s news conference, it is not known why Magic decided to make his announcement.

Q: How did Johnson contract the virus?

A: Neither Johnson nor his physician offered any explanation. But Johnson seemed to imply that he acquired it through heterosexual activity.

Q: How did Johnson find out he was HIV positive?

A: Johnson said he found out the final results of his test Wednesday. Mellman said Johnson was tested for an insurance policy.

Q: Which cells does HIV attack?

A: Its primary targets are the T-helper cells, critical parts of the body’s immune system. Once these cells are destroyed, the delicate balance of the body’s immune system is upset and it cannot protect the body against disease. But HIV also can infect other cells in the body, including those in the brain. This is why some people with AIDS also suffer neurological problems such as memory loss, partial paralysis and mental disorders known as dementia.

Q: What is Johnson’s T-cell count, which would indicate the extent of damage to his immune system?

A: The information was not disclosed by Johnson or his physician.

Q: How long does it take before an infected person gets sick?

A: Sometimes only a few months, but more often several years. The virus can remain silent in the body for 10 years or longer--and a person can look and feel perfectly healthy. Scientists do not know what triggers the disease, but eventually the virus begins to wear away at the immune system.

Q: What are some symptoms?

A: They include fatigue, fever, night sweats, unexplained weight loss, swollen lymph glands, shingles, diarrhea or yeast infections. As the disease progresses, the person also might develop rare cancers or a serious respiratory infection known as pneumocystis carinii pneumonia.

Q: Has Johnson suffered from any of the symptoms above?

A: In October of 1985, Johnson was temporarily sidelined from basketball because he suffered from shingles.

Q: How is AIDS transmitted?

A: The virus is passed through unprotected (meaning, without a condom) anal and vaginal sexual intercourse. It also is transmitted by intravenous drug abusers who use--and then share--hypodermic needles. It can be passed by a woman to her fetus during pregnancy, and through breast milk. Previously, it also was transmitted through blood transfusions, but transfusion blood now is tested for the virus. The virus cannot be passed through casual contact with others, or through the air.

Q: Is Johnson’s wife of two months, Cookie Kelly, infected?

A: Johnson said at the news conference that she tested negative for HIV.

Q: Does an infected person transmit the virus every time he or she has sexual intercourse?

A: No. There are multiple factors that go into the efficiency of transmission, including such elements as open sores and genital ulcers. Also, the levels of the virus vary in the semen.

Q: What drugs are available to treat AIDS?

A: Two drugs have been approved to treat the underlying viral condition, AZT or zidovudine, and DDI, also known as dideoxyinosine or didanosine. The drugs seem to prolong and improve the quality of the lives of individuals who already have AIDS. While the information on DDI is still preliminary, AZT is known to delay symptoms in infected people who are not sick yet, and slow the progress of the disease in those with early symptoms. Both AZT and DDI have serious side effects. AZT can produce some serious side effects in people with fully developed AIDS. But it appears to be less toxic in those who do not yet have symptoms or who only show early signs of the virus.

Q: What else can be done?

A: In addition to taking AZT, medical authorities also have recommended preventive measures for infected persons who do not have symptoms but whose immune systems show some damage. A test can determine whether the number of T-helper cells has dropped to dangerous levels. Doctors suggest taking “aerosol pentamidine” to prevent pneumocystis carinii pneumonia, which can be fatal.

Q: Is all this beneficial to the patient?

A: Yes, because the new drugs help AIDS patients live longer. But the downside to living longer is that they are developing other equally serious conditions, such as lymphoma, a kind of cancer.

Q: Are any unapproved drugs available to treat AIDS or AIDS conditions?

A: Yes. If they qualify, some individuals can participate in formal clinical trials--human studies--of experimental drugs conducted by government-funded researchers. Also, the federal government has approved what it calls an expanded access to experimental drugs. Finally, the federal FDA sometimes allows access to experimental drugs through a special category known as “Treatment IND (for investigational new drug.)

Q: What medication is Johnson taking?

A: His physician said no medications have been administered yet. Doctors are still determining what treatment will work best.

Q: Are scientists researching other new drugs to treat AIDS?

A: Yes. Dozens of drugs are being tested, both to treat the underlying viral condition and the various diseases caused by AIDS. Anabolic steroids are being used in some patients because the drug builds muscle mass, which could help stop the deterioration of the body.

Q: Will there ever be a cure for AIDS?

A: Probably not--not if you define cure as a so-called “magic bullet” that will destroy the AIDS virus completely. However, most researchers are convinced that, someday drugs will be available to control AIDS the same way doctors now control such diseases as diabetes or high blood pressure. Those conditions are incurable, but can be successfully controlled with drugs. Individuals suffering from those diseases can live full and relatively normal lives. Researchers believe that someday the same will be true of people with HIV.

Q: Will Johnson play on the U.S. Olympic basketball team that is made up of NBA players?

A: He is not expected to play.

Q: If not, who will replace him?

A: No decision has been made.

Q: Have any other NBA players contracted HIV or AIDS?

A: Not that is known.

Q: Any other professional athletes?

A: At least four athletes have died from AIDS--football player Jerry Smith, decathlete Thomas Waddell, boxer Esteban DeJesus and stock car driver Tim Richmond.

Understanding AIDS Here are some definitions :

HIV: The human immunodeficiency virus is the organism that causes AIDS. The virus is passed through the exchange of bodily fluids, during sex with an infected partner, by way of a blood transfusion or in the process of sharing contaminated IV needles. Mothers who are infected can pass along the virus to their babies during birth or while nursing. ARC: AIDS Related Complex is a term that is not officially used by the Centers for Disease Control or most doctors but it refers to a variety of symptoms, such as recurrent fevers, fungal infections or unexplained weight loss, which are found in some persons infected with HIV but who do not yet have full-blown AIDS. AIDS: Acquired Immunodeficiency Syndrome is the full manifestation of infection with HIV. As the immune system breaks down, patients become suspectible to unusual infections and malignancies. The time between when a person is infected and gets full-blown AIDS is, on average, 10 years. After developing AIDS, a person may live for several years.