Bruce Walker, an immunology researcher and AIDS treatment specialist from Massachusetts General found himself on the cover of the Wall Street Journal this week when the respected financial journal reported the results of his 8-patient study, which appeared in the September 28 issue of Nature.
The study, though small, has big research ramifications. Dr. Walker's group treated a group of very recently infected HIV patients with drugs. The drugs were stopped when the virus was held in check, and the immune system of the patients developed a vigorous response. In most of the eight patients, the virus remained under control-without benefit of medication.
The research confirms that vaccines are possible against AIDS--since vaccines work by stimulating the body's own defenses, as does the treatment approach taken by Dr. Walker's research. The study also confirms that treatment is possible by fortifying the immune system rather than just suppressing the virus.
There are caveats. First, the patients in the study have been controlling the HIV virus on their own for less than a year. No one knows how long the freshly bolstered immune systems can fight the virus. Also, the subjects in the study were very newly infected patients, in most cases infected for less than a month. Few individuals discover their viral status so soon after contracting HIV and the technique has not worked with patients infected for months or years. And finally, the study group was small with no control group so no one knows if the results can be replicated on a large scale.
For patients the study can have a variety of meanings. The study's authors are afraid that as news of their success is spread, some patients may decide to stop taking their medications, assuming they can bolster their own immune systems. In a world where many patients suffering from HIV infection are poor, can't read or do not speak English as a first language, an on-again, off-again regimen is hard for health care workers to explain--let alone a patient to follow. The news that it's okay to stop taking medications may reach these patients; they may stop their medications and thereby undermine their own health.
Unless the scientists in Dr. Walker's research group are able to transform the information from the study into a reliable therapy, the technique of assisting the HIV individual's own immune system into suppressing the disease will be helpful to only those patients lucky enough to participate in the original study.