Healthy twins get AIDS vaccine before transplants to brothers


FLORENCE, Italy -- The number of crucial immune-system cells in a man with AIDS has doubled in the three months since he received a bone-marrow transplant from his healthy brother, who had been given an experimental AIDS vaccine to boost his immune system, researchers at the U.S. National Institutes of Health said yesterday.

Described for the first time at yesterday's session of the Seventh International Conference on AIDS, the procedure was one of several exotic approaches to treatment outlined at a meeting that has seen no announcements of major treatment advances.

The transplant was completed in March. A transplant on a second patient with acquired immune deficiency syndrome was performed last week, and a third is scheduled for August. The patients, all of whom had identical twin brothers, first underwent weeks of treatment with AZT and alpha-interferon, powerful drugs that affect the human immunodeficiency virus and the immune system.

Meanwhile, their healthy twin brothers were injected with the experimental AIDS vaccine gp160 in hopes that the cells in their immune systems would make antibodies against HIV. After establishing that the donors were making antibodies, their bone marrow was transplanted into their ailing brothers.

The results of the first transplant were, the presentation said, "a significant improvement." The patient's CD4 count -- a crucial measure of the strength of the immune system -- has doubled.

The use of bone-marrow transplants for AIDS treatment has been controversial since doctors at the Johns Hopkins Hospital in Baltimore performed a similar procedure on AIDS patients three years ago, with no apparent success.

The NIH approach differs in that the donor is vaccinated, the patient's immune system is not deliberately destroyed before the transplant, and AZT and alpha-interferon therapy are used.

Scientists know that such an approach would be impractical on a large scale both because of its cost and because few AIDS patients have identical twins, but they hope that such exotic treatments will reveal ways to restore the virus-ravaged immune system.

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