October 15, 2011 (Vol. 31, No. 18)
The UNAIDS Report (2010) estimated that 33.3 million people worldwide were living with HIV/AIDS. Sub-Saharan Africa accounts for 22.5 million of these individuals, while 1.5 million people with the disease live in North America.
For those who can afford or have access to AIDS drugs, four classes of antiretrovirals are available: nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, and fusion inhibitors.
But in 1986 when the nation’s first AIDS hospital opened, just 20,000 cases of AIDS had been diagnosed in the U.S. and antiviral therapies were only in the investigative stages.
The Institute for Immunological Disorders is discussed in more detail in this month’s GEN 30th Anniversary Flashback. It offered some real hope for those who were suffering from a condition that was then essentially considered a death sentence. The fact that this was the first healthcare center to focus on a rapidly emerging and still largely understood disease was big news.
Unfortunately, due to financial losses and marketing difficulties, the institute closed in 1987.
—John Sterling, Editor in Chief
“As Seen in GEN”—Flashback Volume 6, Number 9, October 1986
Houston Opens Nation’s First AIDS Hospital
By John Sterling
The first hospital completely devoted to AIDS research and treatment opened its doors last month in Houston, Texas. The Institute for Immunological Disorders, with 150 hospital beds, will treat AIDS patients with a number of experimental drugs, including azidothymidine, or AZT.
The Institute was created through an academic affiliation agreement between the University of Texas System and American Medical International, Inc., a Los Angeles, CA-based private healthcare company with $2.6 billion in annual revenues. AMI owns and operates over 170 acute care and psychiatric hospitals, ambulatory centers and other facilities. A former acute care hospital, Citizens General, has been converted into the new Institute.
Under terms of the agreement, the University of Texas Cancer Center M.D. Anderson Hospital and Tumor Institute and the University of Texas Health Science Center at Houston will direct the medical and research activities at the AIDS facility. AMI’s role, in addition to providing the hospital, is to equip and staff it, according to the agreement.
Over 20,000 Cases
Over 20,000 individuals in the U.S. have been diagnosed as having AIDS, and AIDS experts predict that the number of cases will reach 179,000 by 1991.
Currently, the hospital treats 30 inpatients at a cost of $1,050 per patient per day. One hundred and twenty outpatients paid $500 for their initial evaluation and about $250 for each subsequent visit.
“The opportunities the Institute offers for AIDS diagnosis, research and treatment can’t be calculated,” said Dr. Peter W. A. Mansell, the Institute’s medical director. “A totally dedicated hospital may be just what we need to make progress with this disease.”
The Institute is exploring the efficacy of experimental antiviral and immunorestorative drugs on AIDS patients. As a result, a multi-faceted treatment approach is being taken. Immune modulators such as azimexon, copovithane, recombinant interleukin-2 (IL-2), glucan and Imreg 1 are being evaluated, and future treatments with ampligen, isoprinosine and bone marrow transplants are planned.
Antiviral agents under investigation include sodium suramin and ribavirin; ampligen and AZT are scheduled for use soon. Alpha interferon with and without low dose vinblastine, and low dose infusion chemotherapy with bleomycin/vinblastine are being employed against Kaposi’s sarcoma and other malignancies; future treatments will include beta and gamma interferons, AZT, and ribavirin.
Potential therapies for the various opportunistic infections associated with AIDS (such as Pneumocystis pneumonia, cytomegalovirus and toxoplasmosis) and the neuropsychiatric complications of AIDS are also being looked at. Miscellaneous studies on the nutritional requirements of AIDS patients and on the use of prophylactic antibiotics are being carried out as well.
The Institute assigns each patient a social worker and also maintains an outpatient program. Although the first individuals to enter the Institute were from the Southwest, there are no geographic barriers to admission. As their primary criterion for patient admission, the Institute’s officials determine whether a given individual might benefit from the particular experimental protocol under way at the facility.
“People are already lining up to get in,” an AMI spokesman, Mick Taylor, told GEN. Taylor added that there were plans to expand the scope of the Institute’s services by eventually treating a whole range of immunological disorders in addition to AIDS. These would include multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus, and myasthenia gravis.
Such plans might be considered overly ambitious by Terrence A. Curley, the Institute’s executive director. He told GEN that he already sees a need to develop the Institute’s immunology and virology laboratories further and to expand the clinical labs just to treat the AIDS patients. He wondered how well the requirements of the Institute had been costed out.
“It appears that the capital commitment will be larger than was anticipated,” Curley said.