Science often seems to offer little hope to HIVers in poorer countries or those unable to tolerate current regimens. But Robert Gallo, MD, director of the University of Maryland’s Institute of Human Virology, is out to change all that. Pursuing research by the University of Paris’ Daniel Zagury, Gallo and his team are working with Zagury and others in Italy, Israel, France and the United States to open up a new avenue of treatment: a therapeutic vaccine that will suppress both interferon-alpha (an between-cell chemical messenger) and HIV tat (a protein released by the virus).

Research has shown that both of these chemicals not only inhibit T-cell proliferation but promote the expansion of immunosuppressive CD8 cells, thus undermining the immune system’s ability to control HIV. Pilot studies using the vaccine in about 70 people at various disease stages have found a significant reduction in the level of both chemicals, as well as a modest drop in viral load.

Although Gallo and Zagury don’t think the vaccine will work as well as HAART in decreasing high viral loads, they predict that early use might stabilize CD4 counts and improve immune function, postponing the need for antiretrovirals. The treatment could also be a last-ditch option for those whose drugs have failed. And since the vaccine would be inexpensive and probably only needed a few times a year, it might be the first therapy available to the 95 percent of the world’s PWAs for whom five-figure HAART is out of reach. A U.S. trial should begin by early 1999. Stay tuned.