SEARCHLIGHTSummer/Fall ’98 QUARTERLY NEWS FROM AIDS RESEARCH ALLIANCE The National Leader in Fast-Track AIDS Research AIDS RESEARCH A L L I A N C E Board of Directors Kenneth C. “Cam” Davis Financial Advisor Sanford C. Bernstein & Co. Chair H. Smith Richardson, III Vice-Chair What’s News— Chuck Williams Chuck Williams & Associates Treasurer * * * * * * Tim Engel Senior V. P. of Production Clinical Research People & Developments Walt Disney Feature Animation Secretary Daniel Bowers, M.D. Pacific Oaks Medical Group VaxGen, Inc. has selected AIDS RES E A R C H AIDS RESEARCH Alliance received national press Nancy Bresler Alliance to participate in the world's first large-scale coverage of our first inoculation of a volunteer in Sandy Bresler Talent Agent study of a preventative AIDS vaccine, AIDSVAX™. VaxGen, Inc.’s preventative AIDS vaccine study. Bresler, Kelly & Associates Bruce Cochran, Atty. A total of 5,000 HIV-negative people at risk for sex- Television, radio, and newspaper reporters wit- Tim Corrigan ually-transmitted HIV infection will be enrolled at nessed and photographed the injection, which was Executive V.P. Bates Worldwide approximately 40 sites throughout North America followed by a large press conference. Steve Martin, Friley Davidson Entrepreneur in this 3 year, double-blind, placebo controlled mayor of West Hollywood, and West Hollywood city David Hart, M.D. st u d y . councilman Sal Guarriello were also on hand to Wilbert Jordan, M.D. Director, Oasis Clinic (Coverage Begins on Page 4) lend their support. & AIDS Programs King/Drew Medical Center * * * Arnold Kassoy * * * Partner The Holiday Card Campaign is now underway for Manatt, Phelps & Phillips Virco, N.V. has selected AIDS RESEARCH Alliance Matt Redman to participate in a study that will determine the 8th consecutive year. We are offering 4 new McCown-Redman Design and inspiring selections—"Guardian Angel" (a Robert Winters, M.D. whether anti-HIV drug choices made with prior Chief Executive Officer knowledge of the drug resistance properties of drawing by Amy Dakos), "Still Window" (a collage Gregory S. Britt by Louella Hill), "Candle" (a photo by A r m o n d Director of Clinical Research patients' virus can improve the patients' responses Stephen J. Brown, M.D. Ba g d a s a r i a n ), and "Unknown Angel" (a photo by Medical Director to their medications. We are currently enrolling George C. Fareed, M.D. this open-label, randomized trial that will take Jayme Thornton)—in addition to a popular design Medical and Scientific Advisory Committee place in 20 centers nationwide. that we have retained from last year ("City Star"). Harvey Abrams, M.D. Bisher Akil, M.D. (Article on Page 13) H. Aaron Aronow, M.D. (Article on Page 3) Victor Beer, M.D. Aron Bick, M.D. * * * Joseph Church, M.D. * * * Gary Cohan, M.D. AIDS RESEARCH Alliance's Institutional Review Richard Cooper, M.D. Four AIDS RESEARCH Alliance staff members con- George Fareed, M.D. Erik Fleishman, D.O. verged upon the 12th World AIDS Conference in Board (a.k.a. IRB), which ensures the highest stan- Parkash Gill, M.D. Jonathan Goldsmith, M.D. dards of ethical treatment of study participants, has Michael Gottlieb, M.D. Geneva, Switzerland this summer to uncover areas Edward Grant, M.D. expanded its membership and undergone a David Hardy, M.D. of HIV/AIDS science now ripe for clinical investi- Scott Hitt, M.D. change in leadership. Three new members have John James gation. In this issue, we provide extensive coverage A. Kay Kalousek, D.O. Mark Katz, M.D. of major advances in our understanding of been elected to serve on the IRB, and S t e p h e n Peter Kraus, M.D. James Lee, D.O. Fefferman, M.F.C.C. was voted in as chairman. Albert Lerner, M.D. HIV/AIDS as presented at the conference. Aliza Lifshitz, M.D. We extend our gratitude to his predecessor, Fa t h e r Thomas Lockner, M.D. * * * Thomas Magee, M.D. Douglas Glassman, for 5 years of dedicated service Steven Miles, M.D. Michael Moret, M.D. Frequently, clinical trial results for anti-HIV drugs Phillip A. Musikanth, M.D. as a member, and later chairman, of the IRB. Gregg Olsen, M.D. fail to reflect the probable outcome for the average Amit Patel, M.D. (Article on Page 11) Henry Poscher, Ph.D. patient that uses these drugs after they receive FDA Eugene Rogolsky, M.D. Peter Ruane, M.D. approval. This has implications for how communi- * * * Jesse Sanders, M.D. Karen Sandler, D.O. E Anthony Scarsella, M.D. ty members should interpret clinical trial results Circle of Hope, AIDS R SEARCH Alliance's major Michael Scolaro, M.D. Elyse Singer, M.D. and potentially for how future studies should be donor campaign, kicked off with a bang in '98, Brian Smith, D.C. Brian Terry, M.D. designed and analyzed. The article, " C l i n i c a l adding 27 new members to the program. We are James Thommes, M.D. Daniel White, M.D. Trials to Clinical Reality", on page 23 discusses grateful to all those who have contributed to our Herbert Wiesinger, M.D. Kevin W. Williams, M.D. these issues in depth. mission of finding a cure for AIDS. Ronald Wing, M.D. Founders In Memorium * * * * * * Paul Rothman, D.O. Matthew Rushton 2 SEARCHLIGHT quarterly news from AIDS RESEARCH Alliance The growing complexity of the epidemic— A National Leader in Fast-Track AIDS Research It’s a multi-factorial disease (stupid) AIDS RESEARCH Alliance is a national leader in cutting- edge AIDS research dedicated to finding more effective, better-tolerated treatments for HIV, and a cure for everal years ago, there were members of the scientific community who repeated the AIDS. AIDS RESEARCH Alliance recognizes that aggres- sive science is the only hope for saving the lives of the S mantra “it’s the virus, stupid”. This oft-quoted catch phrase served to imply millions of people infected with HIV worldwide. that 100% of the pathogenesis of HIV disease could be attributed directly to the virus (i.e. remove the virus, cure the patient). EXECUTIVE EDITOR Gregory S. Britt EDITOR Numerous scientific presentations at the XII World AIDS Conference held recently Andrew Korotzer, Ph.D. in Geneva, Switzerland served as a poignant reminder that HIV disease is a highly MEDICAL EDITORS complex multi-factorial disease. Data were presented demonstrating that total sup- George C. Fareed, M.D. pression of the virus does not result in rapid immune restoration. While the virus Stephen J. Brown, M.D. may be the igniter of the gradual depletion of the immune system, it is far from the EDITORIAL CONSULTANT Michael Slattery only factor as the disease progresses. Our basic assumptions of how the virus behaves have been revised. The virologists have finally acknowledged that they may CONTRIBUTORS TO THIS ISSUE Andrew Korotzer, Ph.D. need the assistance of the immunologists (and other specialists) in order to win the Gregory S. Britt war against AIDS. Michael Slattery Stephen J. Brown, M.D. Karen J. Wellenkamp Beware of the person with simple solutions to a complex problem (or of the person PRODUCTION COORDINATOR with an elixir that cures “all that ails you”). Despite the numerous proponents of Karen J. Wellenkamp the simplest solution always being the best solution, it has been shown repeatedly SUBSCRIPTION COORDINATOR throughout history that highly complex problems typically require complex solutions. Carlo Danielson The ultimate solution to the AIDS epidemic will be no different. ART DIRECTOR Chris Davies The real news presented in Geneva were the advances made in the areas of basic ART PRODUCTION Mad Macs Communications science—which have served to better inform our future strategies for blocking HIV’s DIGITAL PRE-PRESS STUDIO entry into the cell, fighting viral resistance, and rebuilding the immune system. Fontographics However, the details of these advances didn’t make it into the mainstream media AIDS RESEARCH ALLIANCE because the complexities cannot be reduced to a savory headline. MEDICAL EXECUTIVE COMMITTEE Robert Winters, M.D., Chair Peter Anton, M.D. The only “stupid” scientists working in AIDS research are the ones who have the Daniel Bowers, M.D. arrogance to assert that they have all the answers. I will happily indulge their James Corti, R.N. George C. Fareed, M.D. arrogance the day that they present us with the cure. Until then, the rest of us will David Hart, M.D. continue to feel our way around in the dark attempting to shed as much light in as Wilbert Jordan, M.D. many places as possible until we find a definitive solution to this epidemic. Ian McGowan, MB, D. Phil, MRCP Michael K. Wensley, M.D. Se a r c h l i g h t is published quarterly for the HIV community by AIDS RESEARCH Alliance, a California nonprofit corpora- tion which is solely responsible for its content. Noncommercial reproduction is encouraged provided the appropriate credit is given. Circulation: 16,000. Copyright© 1998 AIDS RESE A R C H Alliance. All rights reserved. Gregory S. Britt Chief Executive Officer AIDS RESEARCH Alliance 621A North San Vicente Blvd. West Hollywood, CA 90069 Telephone: (310) 358-2423 Fax: (310) 358-2431 @ PRINTED BY ACUPRINT ON RECYCLED PAPER S U M M E R / F A L L ’ 9 8 S E A R C H L I G H T NEW C L I N I C A L T R I A L S 3 Treatment based on prior knowledge of viral drug res i s t a n c e — VI R C O ’ s Antivi ro g ra m ™ An open-label, randomized trial to determine w he t h e r the Antiv i ro g ra m ™ (“immediate phenotyping”) can lead to improved treatment c ho i c e s .