Study shows cancer treatment boosts effects of AIDS 'cocktails'

CHICAGO -- Adding a cancer-fighting substance appears to boost the effectiveness of AIDS drug cocktails, government researchers say.

The researchers hope interleukin 2 will translate into better survival rates for AIDS patients. The treatment is still experimental.

The findings appear in this week's Journal of the American Medical Association, an AIDS theme issue published to coincide with the 13th International AIDS Conference, which begins today in Durban, South Africa.

Though potent combinations of AIDS drugs in the past decade have made AIDS more manageable by subduing the virus, they are not a cure. Worried about drug-resistant virus strains, researchers tried adding interleukin-2 to the mix.

Interleukin 2 is a protein that regulates the body's immune response. A synthetic version is produced by Chiron Corp. and is federally approved for the treatment of melanoma and kidney cancer, but not AIDS.

The study -- funded by Chiron and led by Dr. Richard T. Davey Jr. of the National Institute of Allergy and Infectious Diseases -- involved 78 patients on various combinations of antiviral AIDS drugs. About half also got twice-daily injections of interleukin-2 periodically during the two-year study, which ended in 1998.

The AIDS virus was suppressed in almost twice as many of the interleukin patients, 67 percent versus 36 percent.

The researchers also measured levels of CD4 T cells, disease-fighting white blood cells attacked by the AIDS virus. After one year, CD4 levels among the interleukin group climbed an average of 112 percent, compared with 18 percent for the others. The higher the dose, the better the response.

The researchers did not look at survival rates; two larger interleukin studies are examining that.

In an editorial, two Johns Hopkins University doctors said that additional research is needed to determine if the potential benefits of interleukin outweigh the side effects, which may include fever, fatigue and muscle pains.

JAMA's cover usually depicts a renowned work of art, but this issue's is blank, to symbolize ''how much there is yet to do and how much more urgent this task is than ever before,'' wrote Dr. M. Therese Southgate, JAMA's cover section editor.

The latest issue also includes an Italian study showing that drug combinations that have helped stabilize AIDS in adults also improve survival in children; reports suggesting that while the danger of contracting AIDS through U.S. blood donations is extremely low, high-cost testing of single units rather than pooled blood may be needed to further reduce the risk; and a 1994-98 survey of 3,492 young gay or bisexual men in seven large U.S. cities showing that nearly 10 percent of 22-year-olds were HIV-infected.

The issue follows recent disturbing news about a near-tripling of HIV infections among gay and bisexual men in San Francisco and a U.N. report saying that AIDS is expected to wipe out half the teen-agers in some African nations.

The grim picture is told in a devastating account in the journal from an anguished caregiver in Kenya detailing the final days of his 17-year-old AIDS patient, once ''a beautiful young man with stunning eyes,'' now ravaged by intestinal worms, hideous infections and agonizing pain.

''His tear ducts have dried up, his hair fallen out, his bones are brittle. He has no muscle or fat,'' writes Michael K. Elmore-Meegan. ''His fingernails and toenails have fallen out. His skin is blistered and scaly, and scabs cannot form. He can barely move, has no tears to show his pain.

''I whisper to him, and kiss him. He slowly inhales, half closes his eyes,'' then relaxes. ''He is gone,'' Elmore-Meegan writes. ''I held him in my arms and wept.''

On the Net: National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov