What's the latest on AIDS?
At the Vancouver AIDS conference this week, there's been a lot of positive medical news - and a feeling of incredible progress. Do you think we're on the verge of a cure? It often seems like we have a season of hope, followed by one of despair. Is this year any different?
That's a very good question. The virus that causes AIDS is complex and confounding. Over the years, many promising approaches to treatment have fallen by the wayside.
That said, I do believe the latest research offers reason for hope. A new family of drugs, called protease inhibitors, shows a dramatic ability to block an enzyme necessary for the virus to copy itself. Scientists at the Vancouver conference have reported that a cocktail containing these protease inhibitors and other drugs can knock the virus load down to a level not detectable in the blood. Some people with AIDS are feeling healthy for the first time in years and are showing remarkable improvement in their blood work.
But there also are reasons to be skeptical. First, those studies were done in fairly small groups of people, over a period of only 18 months at most. Second, the virus could develop resistance to the treatment. The immune system may not necessarily bounce back. And some people taking the combination therapy weren't helped at all.
Finally, these drugs are very expensive. A year of combined therapy would probably cost about US$10,000 -- far more than most of the 22 million people in the world with HIV can afford.
The data on vaccines have been mixed. So far, about 5 percent of the people enrolled in some 16 trials of vaccines in the United States have become infected. But many public health specialists say a less-than-perfect vaccine could still cut infection rates dramatically. Also, public education about safer sex practices has been very effective in slowing the spread of the virus.
In the United States, the number of people becoming infected appears to be stabilizing -- although at a very high level, especially among African Americans and Latinos. About 1 in 300 Americans is HIV+. Elsewhere in the world, the infection rate continues to climb.
I think the latest discoveries point toward a view of AIDS as eventually becoming a manageable chronic disease, rather than something that can be cured with a shot or a pill. The new combination therapy could bring the virus under control, especially if begun very early in the course of the disease. And some researchers studying long-term survivors are finding some interesting clues for disease management. Dr. Jay Levy, a retrovirologist at the University of California in San Francisco, has found that infected people who stay healthy have especially powerful versions of an immune system cell called CD8+. These cells pump out a molecule he calls CAF, which shuts down the virus's ability to copy itself. Levy suggests finding a way to boost the action of the CD8+ cells, perhaps by using a natural immune-system protein known as interleukin-2.
People I know who have survived AIDS for many years have relied, in part, on herbs, a healthy diet, and a positive mental state. I recommend herbal medicine from the root of Astragalus membranaceous to many patients to help strengthen their immune function. You can find astragalus in health food stores. Follow the dosage on the label. Another immune booster is a mushroom known as maitake, or Grifola frondosa, which is sold in the form of supplements in health food stores.
The ups and downs of immune-related diseases often reflect people's emotional states, which influence immune responses. Sometimes accepting the circumstances of a chronic illness can create significant improvement, through stimulating profound internal relaxation. Psychotherapy, hypnotherapy, and guided imagery all can help strengthen your mind's ability to help your body stay healthy.
Yes, it is a very hopeful time -- and hope itself can be a healing power. The human capacity for healing is tremendous, especially with acceptance and confidence in the power of the body and mind to work together for health.