Newsmaker: NIAID's Anthony Fauci Looks at the Latest Research

DR. ANTHONY FAUCI: The presence of any level of virus takes even normal cells and induces aberrant signals which doesn't allow them to function normally. But there's enough virus expression going on to measure the subtle effects of small amounts of virus expression. And it's really a very, very fascinating thing, and it goes everything from what we had seen functionally of the evolution of resistance over time. Why are you evolving resistance? Because there's a very small amount of virus replication going on.

So all of these things are now starting to accumulate in the sense of our understanding the very subtle effects and impact of virus itself on an immune system at the time that the immune system is relatively intact as opposed to being devastated by large amounts of virus.

GEORGE STRAIT: And the two-word question, so what?

DR. ANTHONY FAUCI: So what? What it tells us is that the principle of getting virus to as low as you possibly can still holds. But from 1996 -- the famous eradication time -- until now, we've realized that you can't really just hammer people more and more to try to get the virus to below the detectable level. So that gets us to think again about, at the time you get as much mileage as you can out of the anti-retrovirals, what about things like therapeutic immunizations, like immune enhancers, like things that can get the body to exercise its own defenses.

Now, again, you say, gee, okay, what else is new? But the fact is you remember the field went through phases. We didn't have anti-virals. Then anti-virals were only the answer. Then the therapeutic [unintelligible] said, forget about anti-virals, let's do immunological enhancement. And now in 2002, we're saying, as is usually the case when people of good will disagree, it's probably a combination of both.

Special coverage from the XIV International AIDS Conference provided by kaisernetwork.org, a free service of the Kaiser Family Foundation.