&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& J O H N J A M E S writes on A I D S &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& copyright 1992 by John S. James; permission granted for non-commercial use. AIDS TREATMENT NEWS Issue # 143, January 17, 1992 phone 800/TREAT-1-2, or 415/255-0588 CONTENTS: [items are separated by "*****" for this display] Acyclovir: Maybe Good News -- but Press Confusion Community Research Group, San Diego: Interview with Gary R. Lewis, Ph.D. In Memoriam: Michael Wright Announcements: Tat-Inhibitor Trial: Not Recruiting Now Seattle: New Treatment Hotline Resource List: ACT UP Affiliates, Buyers' Clubs, and PWA Coalitions ***** Acyclovir: Maybe Good News -- but Press Confusion by John S. James Confusing and contradictory press reports, starting in London in late December and later picked up by the world press, suggested that adding acyclovir to standard AIDS treatment with AZT could reduce the AIDS death rate by half. We called a number of parties involved, including Burroughs-Wellcome (the owner of both acyclovir and AZT) and Michael Youle, M. D., one of the designers of and investigators in the study, for clarification. Little hard information is yet available -- for example, although the trial has been stopped, the physicians running the trial had not been unblinded (told which patients were receiving the placebo) as of the time we went to press. The available information is also hard to interpret because a significant number of patients dropped out of the study. Researchers are working rapidly to analyze the trial, so more should be known before too long. Dr. Youle designed an acyclovir study after he saw a report at the 1989 International Conference on AIDS, in Montreal, suggesting that high-dose acyclovir might be useful as prophylaxis for CMV (Metroka and Josefberg, 1989). He approached Burroughs-Wellcome and found that they were already planning a larger acyclovir study. The trial which took place, in Europe and Australia, enrolled a total of 280 patients; they had to have T-helper counts under 150 to enter, and most had counts under 100. Patients received either 800 mg of acyclovir four times a day, or placebo. The original endpoint of the trial was development of CMV; later, mortality was added as another endpoint (for purposes of looking for a statistically significant difference between treatment and placebo groups). The trial was stopped in December 1991 because, in view of the data gathered to that point, it would have been impossible for the trial to show a statistically significant difference in CMV incidence between treatment and placebo groups. (This does not mean that there was no difference, but rather that this particular trial could not determine whether there was a difference or not, which this trial had been designed to do.) This trial administered only acyclovir or placebo, not AZT. The patients were receiving antiretroviral treatment anyway, however, with most taking AZT, and a few taking ddI. No serious toxicity of acyclovir has been seen. This study was designed to look closely at viral culture data, including viral resistance (to AZT and perhaps to other drugs). This data, along with the survival results when they are more fully analyzed, should be the most useful results of this study. History The idea of using acyclovir in HIV treatment, other than for its labeled use as an anti-herpes drug, is not new; AIDS TREATMENT NEWS reported on this use in issue #83, July 14, 1989. Many papers have been published on this use of acyclovir alone, or in combination with AZT, and many physicians have used acyclovir in this way. A number of them have suggested that acyclovir might be beneficial, perhaps by suppressing viruses which are harmful in themselves and which might act as cofactors which could speed the progression of HIV disease. Physicians are divided on this use of acyclovir. The references below show some of the published studies on use of acyclovir in HIV treatment (other than its standard use against certain herpes viruses). This list is not complete, and we have not had time to analyze these papers before writing this article. We include the references to show how much work has been done, and to provide a starting point to others who may want to look deeper into the use of acyclovir in HIV treatment. What should be done now? One possibility is to use a relatively new statistical method called meta-analysis to combine the information from the existing studies of long- term acyclovir use in HIV treatment. The advantage of this approach is that no new study has to be done; therefore the meta-analysis can be completed much more rapidly and less expensively than the large- scale, multicenter trial which would be necessary to obtain similarly definitive results from a single study. A meta-analysis could be particularly important if (as we suspect may be the case) acyclovir is indeed beneficial in HIV treatment, and has not been given due credit simply because each separate study, seen by itself, is not definitive. Technical Articles Brockmeyer NH, Kreuzfelder E, Mertins L, Daecke C, and Goos M. Zidovudine therapy of asymptomatic HIV1-infected patients and combined zidovudine-acyclovir therapy of HIV1-infected patients with oral hairy leukoplakia [letter]. J. Invest. Dermatol. April 1989; volume 92, number 4, page 647. Chavanet P, Aho S, Mallet J, and others. Randomized trial of placebo versus high dosage acyclovir in HIV patients (English translation of title). V International Conference on AIDS [abstract # T. B. P. 304], Montreal, June 4-9, 1989. Chavanet P, Mallet J, Waldner A, and others. A double-blind randomized placebo trial on very high doses of acyclovir in weakly symptomatic HIV patients. Cancer Detect. Prev. 1990; volume 14, number 6, pages 669-673. Collier A, Coombs R, Bozette S, and others. Virologic and clinical response to combination zidovudine (AZT) and acyclovir (ACV) in AIDS-related complex (ARC). Twenty-Ninth Interscience Conference on Antimicrobial Agents and Chemotherapy [abstract # 30], Houston, September 17-20, 1989. Coombs RW, Collier AC, Chaloupka K, and Corey L. Decreased HIV plasma titer in response to combined low-dose zidovudine and acyclovir therapy in CDC class IVA patients. VI International Conference on AIDS [abstract Th.B. 24], San Francisco, June 20- 23, 1990. Fiddian AP. Preliminary report of a multicentre study of zidovudine plus or minus acyclovir in patients with acquired immune deficiency syndrome or acquired immune deficiency syndrome-related complex. J. Infect. January 1989; 18 Supplement 1, pages 79-80. Hollander H, Lifson AR, Maha MA and others. A phase I study evaluating combination zidovudine and acyclovir in asymptomatic HIV-infected men: Virologic and immunologic effects. IV International Conference on AIDS [abstract # 3135], Stockholm, June 12-16, 1988. Hollander H, Lifson AR, Maha M, Blum R, Rutherford GW, and Nusinoff-Lehrmann S. Phase I study of low-dose zidovudine and acyclovir in asymptomatic human immunodeficiency virus seropositive individuals. American Journal of Medicine. December 1989; volume 87, number 6, pages 628-632. Hollander H, Moore M, Nusinoff-Lehrmann S, Barnhart J, and Lifson A. One year follow-up of zidovudine plus acyclovir in asymptomatic HIV-seropositives. V International Conference on AIDS [abstract # M. B. O. 50], Montreal, June 4-9, 1989. Holmberg SD, Gerber AR, Stewart JA, Lee FK, O'Malley PM, and Nahmias AJ. Herpesviruses as co-facators in AIDS [letter]. Lancet. September 24, 1988; pages 746-747. Lifson AR, Hollander H, Maha MA and others. A phase I study of combination zidovudine and acyclovir in asymptomatic HIV- infected men: Safety and toxicity. IV International Conference on AIDS [abstract # 3134], Stockholm, June 12-16, 1988. Metroka CE and Josefberg H. Possible usefulness of high dose acyclovir as prophylaxis for CMV. V International Conference on AIDS [abstract # M. B. P. 126], Montreal, June 4-9, 1989. Mulder J, De Wolf P, Coutinho RA, Goudsmit J, and Lange JMA. Long term treatment with zidovudine (+/- acyclovir) of asymptomatic HIV-I infected subjects. VI International Conference on AIDS [abstract # S. B. 449], San Francisco, June 20-23, 1990. Surbone A, Yarchoan R, McAtee N, and others. Treatment of the acquired immunodeficiency syndrome (AIDS) and AIDS-related complex with a regimen of 3'-azido-2',3'-dideoxythymidine (azidothymidine or zidovudine) and acyclovir. A pilot study. Annals of Internal Medicine. April 1988; volume 108, number 4, pages 534-540. Walger PP, Baumgart G, Wilke G, Kupfer U, Schwaaf A, and Dorst KG. Effectiveness of low-dose-combination therapy with azidothymidine (zidovudine) and acyclovir in AIDS- and ARC- patients. V International Conference on AIDS [abstract # W. B. P. 318], Montreal, June 4-9, 1989. Weber R, Bonetti A, Luthy R, Putzi R, Spacey B, and Siegenthaler W. Effect of combination of zidovudine and interferon-alpha compared with zidovudine and acyclovir on HIV-antigenaemia in asymptomatic patients. V International Conference on AIDS [abstract # W. B. P. 321], Montreal, June 4- 9, 1989. Webster A, Lee CA, Cook DG, and others. Cytomegalovirus infection and progression towards AIDS in haemophiliacs with human immunodeficiency virus infection. Lancet. July 8, 1989; pages 63-66. ***** Community Research Group, San Diego: Interview with Gary R. Lewis, Ph.D. by John S. James Last month we visited the San Diego Community Research Group, which has rapidly established a successful clinical-trials program, and is now developing a nonprofit clinic to provide primary care for persons without insurance. Since these programs may offer useful examples for other efforts, we interviewed Gary R. Lewis, Ph.D., president and CEO of the organization. [Our comments within Dr. Lewis' replies are in brackets.] JJ: How did the Community Research Group (CRG) begin? GL: In August of 1989 a group of eight or nine people, headed by Terry Dearstone, Ed.D., met and decided that San Diego needed a community-based research organization. So they called AmFAR [the American Foundation for AIDS Research, in New York and Los Angeles] and asked how to become one of the groups in AmFAR's Community-Based Clinical Trials Network. AmFAR told them and sent them an application for a seed grant. They submitted the grant that fall, and in February 1990 were notified that they were awarded a grant of $25,000. They received the money in March. They did a nationwide search for an administrative person to head the new organization, and hired me in April to start the organization. Clinical Trials JJ: What trials have been conducted by the CRG -- either completed trials, or ones currently underway? GL: We had a rifabutin prophylaxis trial which was ended last week [after data showed that rifabutin is effective for prophylaxis of MAC]; this study should continue on open label [with all the volunteers offered the drug]. A separate trial of rifabutin in treatment of MAC is still going. We completed an early study with Viagene, a local biotechnology company which is developing a therapeutic vaccine for HIV. We recruited the 20 volunteers they needed for skin biopsies, to develop methods for laboratory testing of whether or not the vaccine is likely to work, when they do the genetic manipulation and splicing. Now they've asked for those people to come back for an additional one to three visits for more blood work, to develop what are called "target cells." In animals they have had very encouraging responses to what they are doing, and they are hoping to start phase I tests in the fall of this year. [Note: Viagene, located in San Diego, was in the news last April, when Green Cross, a pharmaceutical company in Osaka, Japan, invested up to $40 million in Viagene's AIDS research. According to an article in the April 26, 1991 Los Angeles Times, the company hopes that the treatment "could help the immune system destroy HIV-infected cells." San Diego is a major center of the biotechnology industry in the United States.] We are also doing a toxoplasmosis prophylaxis study using two different doses of pyrimethamine. There is no placebo in this study. And we are also testing itraconazole vs. fluconazole for treating cryptococcal meningitis. [For ethical reasons, this test is being done with patients who are less seriously ill, so they are not at immediate risk if the experimental therapy fails.] We have just started a study of Intron-A [alpha interferon], to see if the combination of AZT and interferon reduces disease progression when compared to AZT alone. We are also running a clarithromycin study, which is now closed to enrollment. We were the only community-based site to be doing this study; the other sites were in the ACTG [AIDS Clinical Trials Group of the U. S. National Institute of Allergy and Infectious Diseases]. According to Abbott, they are pleased with the community-based method of doing research. They were able to accrue very rapidly and obtain good data. One nutritional study which is now finished tested the Vivonex brand elemental nutritional supplement, for Norwich Eaton. We saw very good results with that. We had over 25 people in that study. Some had their diarrhea lessen, they gained weight, they went from not being able to keep anything down to being able to drink this liquid and gain weight on it, and later they went back to eating regular food. HIV Educational Classes JJ: Your brochure mentions classes organized by the CRG for persons with AIDS or HIV. GL: We've put about 2,000 people through our "Fightback" class ["a nine-hour AIDS survival course ...designed to teach people who have tested HIV+ the information they need to know, to enhance their chances for survival"]. We are beginning a formal evaluation of the program; but just from peoples' responses we can tell that it made a big difference for them. We have almost finished development of a self-contained program that we can mail to anybody, including audio tape, a video tape, a workbook, everything in one package. We expect it will cost about $25 or $30 for the whole package; then people can use it alone or with others wherever they are. Anyone can call us for more information [phone number below]. We also give the OPTIONS program, a choice-making stress reduction program. And we are also negotiating to be the fiscal sponsor of RISE, a stress-reduction program presented at the international AIDS conferences in San Francisco (June 1990) and Florence (June 1991). Future Plans GL: The Community Research Group is in the process of establishing a nonprofit clinic. We want to be able to support primary care using research dollars, for persons who have no insurance or other payer. We're looking at bringing in people with only Medicaid, or county medical, or nothing, and be able to subsidize 80 cents on the dollar with research and fund raising. We hope to take some of the load off the physicians who otherwise could be inundated by patients who do not have any way to pay for healthcare. At this time we are looking for space for the clinic; we do have the funding to begin. We hope to have something in operation by summer or fall at the latest. We are not designating ourselves exclusively as an AIDS agency; we are dealing with life-threatening diseases. We have found that the community-based approach is a very valuable way to do research. It would be unfortunate to lose this approach when there is a cure for AIDS. So we will attempt to establish ourselves for the long run. Right now we are working almost exclusively with AIDS, but in the future we may branch out to research in cancer, Alzheimer's, extreme hypertension, and other life-threatening diseases, and provide the services to these populations as well. Nuts and Bolts JJ: You mentioned the importance of getting legal advice for a community-based group. GL: We have retained a major San Diego law firm to represent us. What's most important is that any time I have a question- -about a contract, or a document from a pharmaceutical company, or whatever -- I can fax it to our attorney, and he immediately faxes back an answer about it. This way I know that I'm not putting us in any kind of jeopardy. We also hired a business consultant to do a complete evaluation of the program, and do a strategic planning meeting for our board and myself, to present the findings and suggest ways to improve and strengthen the organization. In addition, we are audited every year. It costs between two and three thousand dollars. But it alleviates any questions in somebody's mind. For More Information For more information about the San Diego Community Research Group, or any of its programs, call them at 619/291-AIDS, or write to: San Diego Community Research Group, 3800 Ray St., San Diego, CA 92104. ***** In Memoriam: Michael Wright Michael Wright, who made immense contributions to AIDS treatment activism in San Francisco and elsewhere, died on January 14. His influence was not only through specific projects, including greatly increasing patient access to the critical antibiotic clarithromycin, but also through personal leadership which guided and welcomed a new generation of activists. Michael also was a major channel for communication among treatment activists in different cities. On the evening of January 14, more than 50 people gathered at ACT UP/Golden Gate in San Francisco, for a spontaneous memorial service for Michael. Others met in New York and elsewhere. The following is from a statement by one of Michael's closest friends and associates which was distributed at the San Francisco meeting. Michael Wright by G'dali Braverman It was the week after the VIth International Conference on AIDS and 150 men and women packed a second floor room in the Women's Building for an ACT UP/San Francisco meeting. There were twice as many first timers at that meeting than there were old members. I perched myself on the bar off in the back of the room and watched the evening unfold. There amongst the new faces were a set of sparkling green eyes. Those eyes fixed themselves on me that evening, and they are burned into my memory today as they will be until the day that I die. Michael picked me that night to be his conduit into a new life as an AIDS activist. That choice changed my life and the lives of People with AIDS/HIV on this globe; not because of my knowledge or influence, but because of Michael's eagerness to take my knowledge and influence places where I could never have reached. Today I have lost my first and closest ally and friend in San Francisco. The AIDS community has lost a man who over the course of one and a half years has made an impact on AIDS treatment access and research that few would have thought possible from a relative newcomer to AIDS activism. Michael Wright was a cofounder of ACT UP/Golden Gate, an organization that he was both proud of and frustrated with. His investment of time, energy, and love into that organization over the course of its first year has unquestionably served to bring credibility and respect to ACT UP nationally amongst researchers, elected officials, activists, and people with AIDS/HIV. Because of his work on opportunistic infections, the lives of thousands of people will be extended and improved.... Last night I went to visit Michael in the hospital and he told me that he was worried about me. What a control queen! He knew he was dying, but he wanted to make sure that I assessed my life and not his death. Before I left Michael, he told me that he had no regrets. I wish that resolution should be true for all of us as we continue to fight AIDS on our own behalf and on behalf of Michael and the few that have gone before him, that fought with the same spirit, for all of us still living through this horrible war. Note: A memorial service for Michael Wright will be held February 1 at 2:00 at the Metropolitan Community Church, 150 Eureka Street, San Francisco. Contributions in his name can be sent to either ACT UP/Golden Gate, P. O. Box 519, San Francisco, CA 94114, or to Project Inform, 1965 Market Street, Suite 220, San Francisco, CA 94103-1012. ***** Announcements ** Tat-Inhibitor Trial: Not Recruiting Now In AIDS TREATMENT NEWS #141, December 20, 1991, we mentioned that a phase I trial of the Hoffmann-La Roche "tat inhibitor" drug RO 24-7429 was ongoing at Johns Hopkins University. That trial is now on hold, as it has completed the three lowest doses of the dose escalation. It was planned in advance (before the trial was started) that safety data would be evaluated after the three lowest doses had been tested, and then a decision would be made as to where to go from there. As this issue went to press Johns Hopkins called to tell us that they had been receiving many calls about this trial, and had to tell people that it is not recruiting at this time. As of January 15 the protocol for the continuation of the trial has not been written, so they do not expect any study to be open soon. Note: In our December 20 issue we picked tat inhibitors as the most important experimental HIV treatment to watch for 1992; that is still our belief. But what is important is this class of drugs. RO 24-7429 is the first member of this class to reach human testing, but at this time it is impossible to know whether or not this particular chemical will pass the safety and other tests required for a useful drug. RO 24-7429 appears to have been chosen for early development in part because it was already on the shelf at Hoffmann-La Roche (probably as a leftover from the development of Valium years ago). It is vitally important that other potential drugs (including existing drugs, for which safety and pharmacology are already well known) also be tested for anti-tat activity. ** Seattle: New Treatment Hotline The Seattle Treatment Education Project (STEP) has established a toll-free phone line to make HIV treatment information more accessible. The number is 800/869-7837, and phones will be staffed Monday through Friday, from 1:00 to 5:00 Pacific Time. STEP's regular line (206/329-4857) will also continue to be operative. STEP has plans to acquire a computer BBS number in the near future. ***** Resource List, January 1992: ACT UP Affiliates, Buyers' Clubs, and PWA Coalitions Compiled by Laura Thomas and Denny Smith The identification codes used below are "A" for AIDS activist groups, "B" for buyers' clubs, and "C" for PWA coalitions. We only listed numbers which could be verified. Many of these organizations, and their phone numbers, are in flux. To locate new ACT UP affiliates, interested persons should call ACT UP Network at 816/753-3505. For new PWA coalitions, call the National Association of People With AIDS (NAPWA) in Washington, D. C. at 202/898-0414. ALABAMA Birmingham AIDS Task Force of Alabama 205/326-0628 C Huntsville AIDS Action Coalition 205/533-2437 C ARIZONA Phoenix ACT UP/Phoenix 602/433-4966 A Tucson PAACT Buyer's Club/ PWA Coalition 602/322-9808 B & C CALIFORNIA Long Beach ACT UP/Long Beach 213/435-4346 A Long Beach Being Alive Long Beach 213/495-3422 C Los Angeles LA Buyers' Club 310/854-6230 B Los Angeles ACT UP/Los Angeles 213/669-7301 A Los Angeles Being Alive Los Angeles 213/667-3262 C Orange County ACT UP/Orange County 714/744-6878 A Palm Desert Desert Buyers' Club 619/568-1725 B Redondo Beach Being Alive South Bay 213/544-2702 C San Diego Alliance 7 Buyers' Club 619/281-5360 B San Diego Being Alive San Diego 619/291-1400 C San Francisco Healing Alternatives 415/626-2316 B San Francisco ACT UP/Golden Gate 415/252-9200 A San Francisco ACT UP/San Francisco 415/563-0724 A San Mateo San Mateo AIDS Network 415/573-2588 C West Hollywood Being Alive 213/667-3262 C COLORADO Boulder Boulder Buyers' Club 303/444-7647 B Denver ACT UP/Denver 303/830-0730 A Denver PWA Coalition Colorado 303/837-8214 C CONNECTICUT Bethel AIDS Project Greater Danbury 203/778-2437 C Milford PWA Coalition Connecticut 203/249-6160 C DISTRICT OF COLUMBIA ACT UP/DC 202/328-2437 A Carl Vogel Foundation 202/289-4898 B & C DC Buyers' Club (DCBC) 202/232-5494 B Lifelink 202/898-0372 C Oppression Under Target (OUT!) 202/234-3614 A The Positive Woman 202/898-0372 C FLORIDA Broward County PWA Coalition 305/784-0314 C Clearwater PWA Coalition Pinellas 813/449-2437 C Coconut Grove Cure AIDS Now 305/856-8378 C Dade County PWA Coalition 305/573-6010 C Ft. Lauderdale PWA Health Alliance 800/447-9242 B Jacksonville PWA Coalition 904/398-9292 C Miami ACT UP/Miami 305/787-1131 A Miami Body Positive 305/576-1111 C Oakland Park PWA Health Alliance 305/568-3001 B Orlando Trans AIDS Support Services 407/351-1759 C Palm Beach PWA Coalition 407/845-0800 C Sarasota AIDS Manasota 813/954-6011 B & C Tampa Bay PWA Coalition Tampa Bay 813/238-2887 C Tampa DACCO 813/223-4648 C GEORGIA Atlanta ACT UP/Atlanta 404/874-6782 A Atlanta NAPWA Atlanta 404/874-7926 C Atlanta Atlanta Buyers' Club 404/874-4845 B ILLINOIS Chicago ACT UP/Chicago 312/509-6802 A Chicago ACT UP/Windy City 312/509-6363 A Chicago Chicago Buyers' Club 312/935-7380 B INDIANA Indianapolis PWA Coalition 317/637-2720 C IOWA Davenport Quad Cities AIDS Coalition 319/324-8638 C KANSAS Kansas City ACT UP/Kansas City 816/753-5930 A Topeka Positive Action Coalition 913/232-3796 C Wichita ACT UP/Wichita 316/269-1183 A LOUISIANA New Orleans PWA Coalition 504/945-4000 C MAINE Portland PWA Coalition 207/773-8500 C MARYLAND Baltimore ACT UP/Baltimore 301/837-5203 A Baltimore AIDS Action Baltimore 301/837-2437 A & B Baltimore PWA Coalition 301/625-1677 C Glen Arden New Day 301/773-6964 C MASSACHUSETTS Boston ACT UP/Boston 617/492-2887 A Boston PWA Coalition Boston 617/695-9117 C Boston Positive Directions 617/262-3456 C Hyannis Cape Cod AIDS Council 508/778-5111 C Provincetown ACT UP/Provincetown 508/487-2063 A Provincetown Provincetown Positive 508/487-3998 C MICHIGAN Ann Arbor ACT UP/Ann Arbor 313/665-1797 A Detroit Friends Alliance 313/836-2800 C Grand Rapids PWA Coalition Western Michigan 616/363- 7689 C Grand Rapids Grand Rapids AIDS Resource Cntr 616/459-9177 C MINNESOTA Minneapolis ACT UP/Minnesota 612/823-8526 A Minneapolis The Aliveness Project 612/822-7946 B & C MISSISSIPPI Jackson PWA/HIV Project 601/353-7611 C NEW HAMPSHIRE Newmarket Positive Action 603/659-8442 C NEW JERSEY Bergenfield PWA Coalition 201/944-6670 C Collingswood PWA Coalition S. N. J. 609/854-7578 C Fort Lee PWA Coalition N. J. 201/944-6670 C NEW MEXICO Albuquerque NMAPLA 505/266-0342 C Santa Fe Rural AIDS Network 505/986-8337 C NEW YORK Binghamton PWA Coalition Binghamton 607/724-0758 C Buffalo Niagara Frontier AIDS Alliance 716/852-6778 C Long Island ACT UP/Long Island 516/338-4662 A Long Island PWA Coalition 516/756-2354 C New York City ACT UP/New York 212/564-AIDS A New York City PWA Health Group 212/255-0520 B New York City PWA Coalition New York 212/532-0290 C New York City NY AIDS Coalition 212/675-7750 C NORTH CAROLINA Research Triangle ACT UP/Research Triangle 919/990-1197 A OHIO Columbus ACT UP/Columbus 614/251-2841 A Wooster ACT UP/Wooster 216/287-4133 A OKLAHOMA Oklahoma City AIDS Support Program 405/525-6277 C OREGON Portland ACT UP/Columbia-Williamette 503/239-7545 A PENNSYLVANIA Philadelphia ACT UP/Philadelphia 215/925-7121 A Philadelphia We The People 215/545-6868 B & C Pittsburgh Cry Out! 412/683-9741 A RHODE ISLAND Providence Lifeline PWA Coalition 401/421-5344 C TENNESSEE Nashville NAPWA Nashville 615/385-1510 C TEXAS Austin ACT UP/Austin 512/477-AIDS A Austin PWA Coalition 512/448-4357 C Dallas Dallas Buyers' Club 214/826-7455 B Dallas PWA Coalition 214/941-0523 C Houston ACT UP/Houston 713/433-2924 A Houston PWA Coalition 713/522-5428 C UTAH Salt Lake City PWA Coalition Utah 801/359-9619 C VERMONT Brattleboro Vermont PWA Coalition 802/257-9277 C WASHINGTON Seattle ACT UP/Seattle 206/726-1678 A WEST VIRGINIA Morgantown Friends Who Care 304/599-6726 C WISCONSIN Milwaukee ACT UP/Milwaukee 414/769-8708 A Milwaukee PLWA of Milwaukee 414/273-1991 C WYOMING Casper Wyoming AIDS Project 307/237-7833 C ***** AIDS TREATMENT NEWS Published twice monthly Subscription and Editorial Office: P. O. Box 411256 San Francisco, CA 94141 800/TREAT-1-2 toll-free U. S. and Canada 415/255-0588 regular office number 415/255-4659 fax Editor and Publisher: John S. James Medical Reporters: John S. James Michelle Roland Denny Smith Reader Services, Business, and Marketing: Thom Fontaine Keith Griffith Laura Thomas Tadd Tobias Rae Trewartha Statement of Purpose: AIDS TREATMENT NEWS reports on experimental and standard treatments, especially those available now. We interview physicians, scientists, other health professionals, and persons with AIDS or HIV; we also collect information from meetings and conferences, medical journals, and computer databases. Long-term survivors have usually tried many different treatments, and found combinations which work for them. AIDS Treatment News does not recommend particular therapies, but seeks to increase the options available. Subscription Information: Call 800/TREAT-1-2 Businesses, Institutions, Professionals: $230/year. Nonprofit organizations: $115/year. Individuals: $100/year, or $60 for six months. Special discount for persons with financial difficulties: $45/year, or $24 for six months. If you cannot afford a subscription, please write or call. Outside North, Central, or South America, add air mail postage: $20/year, $10 for six months. Back issues available. Fax subscriptions, bulk rates, and multiple subscriptions are available; contact our office for details. Please send U. S. funds: personal check or bank draft, international postal money order, or travelers checks. VISA, Mastercard, and purchase orders also accepted. ISSN # 1052-4207 Copyright 1992 by John S. James. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used. &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& End of display