AIDS vaccine still elusive, but optimism creeps in

The patient's inoculation was as routine as any Dr. Robert Johnston had seen. Roll up the sleeve, a cotton swab of alcohol on the upper arm and a "this shouldn't hurt much."

What was in the syringe, though, was anything but typical: a genetically engineered Venezuela equine encephalitis bug laden with pieces of HIV, the virus that causes AIDS.

As nasty as that shot sounds, the biotechnology brew injected into the volunteer's body that July day was not infectious -- it was designed to save lives. In fact, Johnston's research at the University of North Carolina is just one of the latest AIDS vaccine experiments that are moving from the laboratory to human tests.

An increasing number of human experiments, spurred by biotechnology breakthroughs, has added a new word -- optimism -- to a research field noted more for its failures than its successes over the last two decades.

"I'm certainly more optimistic than just a couple of years ago," said Dr. Robert Gallo, who 20 years ago co-discovered the virus that causes AIDS. "We can see the light at the end of tunnel."

Gallo, who heads the Institute for Human Virology at the University of Maryland, expects to begin testing his own experimental vaccine on humans soon.

Most AIDS researchers agree that vaccines will be the only effective way to control a pandemic that has killed 28 million people and infected 42 million more, most of them in Africa.

Unfortunately, most also agree that things will get worse before they get better. Some five million people were infected last year and another 3.1 million died.

"I tend to stay away from the word 'optimism,"' said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease. "I see things happening that make me feel better about the process. But I don't want to give an impression that this is a new dawn in America. We still have a long way to go."

AIDS is notoriously wily in beating the body's immune system and so far has survived every drug thrown at it. In February, VaxGen Inc. reported that the world's most advanced human vaccine experiment -- involving 5,000 volunteers -- had flopped.

Nonetheless, a gathering two weeks ago in New York at the AIDS Vaccine conference was palpably more upbeat and better attended than years past, attendees said.

"There's cause for optimism," said Dr. Laurence Peiperl, an AIDS researcher at the University of California, San Francisco. "There are more interesting products going into clinical trials."

About two dozen potential vaccines are being tested by 12,000 human volunteers in experiments around the world. Several more human experiments are about to start.

Fauci's federal institute has budgeted $456 million for HIV vaccine research in fiscal 2004 -- up from $413.6 million in 2003 and $182 million in 1999. Last Monday, it awarded $81 million in contracts to four biotechnology companies for vaccine development.