• People who have AIDS may live longer with the help of acyclovir, an antiviral drug better known for treating herpes. In an ongoing study involving gay and bisexual men with AIDS, researchers found that patients taking acyclovir plus AZT live eight to 15 months longer than those taking just AZT. (AZT by itself generally extends life by about 12 months.) “This is the best news we’ve had about survival with AIDS since AZT became available,” says Dr. Neil Graham, a Johns Hopkins epidemiologist involved with the study. “It’s the first evidence that combination therapy offers survival benefits above and beyond giving just one drug.”
• A fourth AIDS drug has received Food and Drug Administration (FDA) approval. Stavudine (D4T), which interferes with HIV replication in the same manner as the three other AIDS drugs (AZT, ddI and ddC), will be given to patients not helped by those drugs. Bristol-Myers Squibb will sell the drug under the brand name Zerit, which will sell for $6.22 per daily dose. (Some patients have already obtained stavudine through an FDA program that makes promising drugs for life-threatening diseases available before approval.)
• Large-scale clinical trials of two preventive AIDS vaccines have been postponed. Though a committee for the National Institute of Allergies and Infectious Diseases tentatively recommended in April that the trials go ahead, it reconsidered after reports that several volunteers in smaller vaccine trials had become infected with HIV. The volunteers apparently got infected from high-risk behavior (the vaccines themselves can’t cause infection because they consist mainly of protein fragments, not infectious material). Even before the smaller trials started, some scientists were concerned that the vaccines would not protect against all strains and would not confer long-lasting immunity.
• Researchers have discovered one of the steps by which HIV infects cells—and perhaps a way to prevent the infection. After the virus hooks onto a receptor on the surface of a white blood cell, an enzyme on the cell helps the virus get in. By blocking the enzyme, researchers at Boston University School of Medicine prevented the virus from entering cells, at least in test tube experiments. “It’s a totally different approach to intercepting the infective process,” says cell biologist Richard Mandel, one of the researchers. Most AIDS drugs, including AZT, interfere with HIV replication inside infected cells.
• Should home testing kits for AIDS be allowed on the market? The FDA has held a hearing to consider the controversial question. With such a kit, a person smears a few drops of blood on special filter paper at home and mails it to a lab. A week later the person calls a toll-free number for the result and counseling, if necessary, without ever setting foot in a clinic or releasing his or her name.
Proponents think many people who wouldn’t go to clinics might be willing to get tested at home. But representatives of some AIDS clinics worry that people who test positive wouldn’t receive adequate counseling. An informal poll of the FDA drug advisory committee found that most members thought the public health benefits outweighed the risks. Kits would probably sell for $30 to $50 each.
*Alive gave permission to publicly republish this news