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-- Copyright Information --

-- Copyright Information --
1998 SIRS, Inc. -- SIRS Researcher Winter 1998
Title: AIDS and Immunity
Author: Laurie Garrett
Source: Newsday (Long Island, N.Y.)
Publication Date: July 7, 1998 Page Number(s): C1+

---------------------------

NEWSDAY
(Long Island, N.Y.)
July 7, 1998, pp. C1+

Copyright 1998, Newsday, Inc./Laurie Garrett. Reprinted by
permission.

AIDS AND IMMUNITY
Battling the Perfect Immune System Killer
by Laurie Garrett
Staff Correspondent

GENEVA--"It's hard to tell if the glass is half full or half empty," Ilana Fogelman said, shrugging her shoulders.

She was speaking of her Food and Drug Administration research on the immune responses of AIDS patients who have been taking the powerful triple-drug combination therapy called HAART.

Pointing to her work, posted on a wall at the 12th World Conference on AIDS here, she knitted her brow and then concluded, "We'll have to do some more research."

An estimated 1 million people worldwide are now taking the toxic combination of one protease inhibitor drug with two older drugs to fight their HIV infections. It is now known that while HAART (highly active anti-retroviral therapy) can bring the infection to undetectable levels in the blood, HIV remains undefeated, hidden in the body.

Now there is strong interest in--and debate about--restoring the immune system. Can the ravaged systems of AIDS patients be reconstituted to take up the fight?

In every conceivable way, HIV has adapted to become the perfect immune system killer.

Dr. Rolph Zinkernagel of Zurich University aptly describes how HIV works as "immunopathology."

The virus enters the body by infecting immune system cells, the germ-ingesting white blood cells called macrophages, which carry them like Trojan horses straight into enemy territory: the lymph nodes.

"It's all a continuum from macrophage--the entire HIV process," says Dr. Jan Orenstein of George Washington University.

Transported to the lymph nodes, HIV can latch onto the first lymphocyte (lymph cell) it sees that has a CD4 receptor--usually a CD4 T cell (T cells help other immune system cells make antibodies and a variety of chemicals to attack an invader). Using CD4 and other receptors on the cell's surface, the virus enters the cell, making its way to the nucleus. And then HIV, which is an RNA virus, makes a mirror image of its genes, in the form of DNA. Since all human genes are made of DNA, this mirror switch allow

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