Vegas joins study of HIV medicine

Las Vegas has been selected as one of 50 cities in North America to conduct the first large-scale human tests on a vaccine to prevent infection by the virus that causes AIDS.

VaxGen Inc. of Brisbane, Calif., began talking to representatives of University Medical Center's Wellness Center in October and signed contracts last month to conduct the three-year study, which is scheduled to begin March 1 in Las Vegas.

About 5,000 volunteers will be selected from among the 50 cities for the study of the human immunodeficiency virus (HIV) vaccine.

The vaccine, called AIDSVAX, is made from neither a live nor killed HIV virus. It is composed of a copy of the protein from the surface of HIV.

"This is quite a feather for us to pull," said Dr. Dennis Fuller, one of the principal investigators in the Las Vegas study.

Fuller will conduct the study with Dr. Jerry Cade, a noted AIDS specialist in Las Vegas, and Dr. Jim Christensen. The Clark County Health District also will assist in screening potential volunteers.

Cade said 150 high-risk people who are not HIV-positive will be selected for the study in Las Vegas. These will include male homosexuals, women whose partners are HIV-positive and women who have had multiple sex partners and have had at least one sexually transmitted disease.

Cade said 100 people will receive the vaccine and 50 will be given a placebo. The study will be double-blinded, with neither the physicians nor the volunteers knowing who is receiving the vaccine.

Nicole Lynch, director of communications with VaxGen, said Las Vegas was chosen because of its large gay population and metropolitan status.

According to the latest Health District statistics compiled through December, 3,030 AIDS cases have been reported in Clark County since the disease was documented in the early 1980s. Of those patients, 1,450 have died.

For the same period, there were 2,046 reported cases of HIV infections, and 41 of those individuals have died.

Metro Police also has been keeping track of HIV-infected prostitutes since 1988. To date, 274 have been diagnosed as HIV-positive.

An HIV vaccine, if successful, would be used only to inoculate people so they don't become infected with the HIV virus. It would not be effective in treating people who are already HIV positive or who have AIDS.

For HIV-positive individuals, daily doses of antiretroviral drugs in a "cocktail" combination will still have to be taken for the rest of their lives.

In 1995, HIV-positive individuals began taking, on average, a three-drug cocktail combination from three categories of anti-retroviral agents -- non-nucleoside reverse transcriptase inhibitors, nucleoside analogues and protease inhibitors.

In many cases, these cocktails may include between 10 and 15 pills that must be taken at different intervals every day. Potential side effects could be headaches, fever, nausea, vomiting, diarrhea and muscle pain.

The drugs are designed to interrupt the reproduction cycle of the HIV virus.

When a person becomes infected, the HIV virus enters the body's T-lymphocytes (T-cells) and takes over the cells' DNA to reproduce. A normal person usually has between 500 and 1,500 T-cells per milliliter of blood.

A person's immune system is able to fight this takeover for seven to 10 years, but when the T-cell count gets down to 100 to 200 cells per milliliter of blood, symptoms of AIDS often develop.

AIDS, according to Michael Collins, an AIDS-certified registered nurse with the Wellness Center at 2300 S. Rancho Drive, Suite 205, is considered an old term today.

The condition is more accurately called "HIV disease" because the low T-cell count can trigger a variety of diseases, including pneumonia, cancer, kidney failure, yeast infections in women and skin lesions.

With the body's immune system unable to fight any one or more of these diseases, an infected individual will eventually die.

Anti-retroviral drugs, through their ability to interrupt the reproduction of the HIV virus, have enabled HIV-positive people to delay developing a form of HIV disease.

The price per person runs from $16,000 to $24,000 a year for the drugs. Most HIV-positive people can't afford these prices and rely on Medicaid and the federal AIDS Drug Assistance Program (ADAP) to pay for their drugs. A few people who go back to work may be able to receive coverage through their employer's insurance.

Aside from the cost, HIV-positive individuals also must constantly reshuffle the combination of drugs because their systems become immune to them.

"I take 13 pills a day," said Greylin Young, 40, who was diagnosed as being HIV positive in 1986. "I have more energy now. When I first found out I was infected, I thought I was going to die. But now I feel that I have a little more chance to achieve things in life. Birthdays are a big thing for me now -- because it means I survived another year."

But the drugs also have caused severe side effects for Young. He's constantly tired and has reoccurring bouts with diarrhea. The medications also make him vomit at times, and his weakened immune system caused kidney problems. He undergoes dialysis 3 1/2 hours a day, three times a week.

"There are times when my friends want to go to the movies, and I tell them I can't because I have to go home and take my medications," Young said of his limited lifestyle.

Chris Reynolds, 32, said the first thing he does is get a flu shot every year. He also tries to avoid being around people who are sick, and he is careful of what over-the-counter drugs he takes so they won't interact with his HIV medications.

"There are days I can't get out of bed," Reynolds said. "I feel tired. I get mood swings. And with the medications I'm taking now, I get vivid nightmares. I've had viral meningitis and hepatitis B three different times. I was in the hospital once and found out I had five different infections."

What bothers Reynolds today is that many young people think AIDS has been cured because of the anti-retroviral drugs. They engage in unprotected sex and feel they can take one pill if they get infected with the HIV virus.

"They don't know that some people take up to 18 pills a day and have all the side effects," Reynolds said. "The hardest thing is knowing that you will have to deal with this for the rest of your life."

The U.N. AIDS Program in November reported that the number of people testing positive with the HIV virus has risen by 5.8 million to 33.4 million worldwide. About 3 million of these people, the report said, were between age 15 and 24.

AIDS, to date, is estimated to have claimed nearly 12 million lives. Experts predict that 50 million people will be infected by the year 2000, and by 2010 about 40 million people will have died.

"AIDS, the epidemic, is not dead," Collins said. "It's still the number one threat to life for some groups of our population. The medications curb the virus. They are not a cure -- just essential to our patients' lives.

"As you bring out new drugs, the virus will eventually develop a resistance. I see the development of a vaccine for people who don't have HIV as the way to protect people from getting it -- much like the tuberculosis vaccine today."

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