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Yeah. Yeah, The streets of San Francisco weeknights at six. On Channel two, there's only 12 In March of this year, we were told that AIDS was virulent. Was lethal attack gay males I V. Drug users and Haitians and had reached epidemic proportions. Researchers complained that though

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aides was epidemic, there was very little money to research acquired immune deficiency syndrome. Well, the money's coming in. Now, if you'd like to talk to a doctor was just received over a million dollars to research AIDS for the next three years. Call us. Our number is

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an area code 4158740222 on open line. Mm. Yeah. Good evening, everybody. I'm Johnny Barnes Selvin, and this is open line Your time to question the experts about issues important to us all. Tonight we're talking about acquired immune deficiency syndrome aids. My guest tonight is

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Dr Paul Volberding. Doctor Volberding is the director of the AIDS Clinic at San Francisco General Hospital. He's the chief of oncology at San Francisco General and is an assistant professor of medicine at the University of California Medical School in San Francisco. Dr. Volberding is here tonight

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to answer any of your questions about AIDS, especially about the funding of researching this lethal syndrome. Thank you very much for coming down tonight. And remember, if you have questions, call us. Our number is 8740 to 2 to the first thing I'd like to know. First

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of all, AIDS is a syndrome. It's not any one disease. It's, uh, you're a group of diseases, right? AIDS stands for the acquired immunodeficiency syndrome, which tells us that we're dealing with a problem that people aren't born with its acquired in adult life and one that

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affects the immune system. This disease results in a wide variety of outcomes for for the person with the disease ranging from cancers to unusual infections. Now you were one of three researchers that held a press conference in March this year, and you were quoted as saying

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that there was really very little money at that point, and perhaps it was because for for researching AIDS and perhaps because of the people who were getting it, that that was the fact. Do you feel that way now? And was it really hard to get this

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million dollar grant? Well, all of us involved in the work see the incredible implications of this disease. First of all, the fact that it is spreading so rapidly and affecting more and more people as time passes. Also, that this disease might tell us a lot about

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other diseases. And so we've been very interested in understanding it for a long time. And yet it seemed as though the research money was taking a long time to come. We're obviously very happy that we have been getting some money. More recently, you're talking about from

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the information that I was I received from your offices and other information I gathered in time, Um, a new organism, something that you think may have come out of Africa. Well, we're not at all sure. We're not sure where it came from. Just talking about the

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nature of the organism. If it is an organism, there's a lot that we still have to learn about this. What about the origins of it? Do you? What do you know of it? Other than the African theory, we think it's a virus, and I would say

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it's a There is some evidence now coming that Africa may have been the source. There's also some evidence that Haiti may have been the source of this. There's probably equal amount of evidence that started right here in the United States. Well, one of the things that

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all of us are reading about daily is the panic involved in this kind of epidemic. People actually asked me tonight when they knew what I was going to do, my show on it if I was going to shake your hand when I greeted you at the

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door and I had never quite thought about not shaking your hand. I mean, there's that kind of feeling about AIDS getting anywhere near it, or anyone that you know has any contact with. It frightens a lot of people. Is there anything that you have to say

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that you can tell people to try to calm down the panic? I think you can shake my hand without fear. I think you can already have too late and shake the hand of any person with AIDS without any fear. We don't think it's easy for this

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disease to spread. All the evidence we have suggests that it requires really direct, intimate contact with a person sexual contact in most cases or exposure to blood products from somebody with a disease. Well, then, in other words, are there any guidelines that I'd like to know

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about? For instance, there are people who have one doctor said that he thought he might have contacted it at, uh, the baths, he called it, Are there any guidelines, anything that you're telling people to be careful about to be aware of? Well, what we tell people

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is that we think this is a sexually transmitted disease for most for most persons with it, and that because of that, we think that it's spread by body secretions. And to decrease your risk of getting the disease, you decrease your exposure to body secretions. So if

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it means in some cases changing sexual practices or using protective devices like condoms, I think that those things are things that we can recommend right now to decrease the risk of getting this disease. Now that you have a million dollars, what direction do you think you're

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going to take with your research? Well, let me first say that I don't have a million dollars is not that much money. When you're researching an epidemic, the money we've gotten. I'm one of the principal investigators. John Ziegler at the V A Hospital in San Francisco

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is the other principal investigator of really a large group of doctors, mostly based at the University of California, who are investigating the therapy of the disease, the nature of the disease and also the epidemiology who gets it. Why? How long does it take that sort of

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thing? So it's a really broad based investigation of the whole disease, and I'm only one of the people that's working on it. What kind of direction are you going to take you? You were You've been involved in Interfere on studies. My primary research is based on

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the therapy of the tumor that we see with AIDS, the Kaposi's sarcoma. I've used both chemotherapy and interferon therapy for the treatment of the cancer that we see. And what kind of success rate do you have in treating Capasa? How do you say it? Kaposi's sarcoma.

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People argue about how it's pronounced, but Kaposi's sarcoma response to chemotherapy, various drugs and with interferon. We've seen some very encouraging response. About 50% of the people that we treat with interfere on have some beneficial results from it. I see. I've been told that there are

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two types of Kaposi's sarcoma. Can you tell us what they are and who's most likely to get them? Well, the primary type of Kaposi's sarcoma that we see with AIDS, we think, is caused by the failure of the immune system. And the only other time that

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we see Kaposi's sarcoma in the United States is in the very elderly males and that in their in their cases, it behaves itself and doesn't usually cause any problems with immune deficiency syndrome. It tends to progress rather rapidly. How far do you think you're gonna get

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in three years just to give us an idea? Roughly. Do you think that you're going to make a lot of headway with the I'm really encouraged by what we've done already? I think we have done probably more than any other center in the country and studying

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the basic problems that AIDS represents. I think we'll make some great progress in three years whether or not we'll come up with the cause of the disease here in San Francisco or not. I can't say obviously, but we certainly hope will make a good deal of

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progress. Okay, we have a call on line two. Good evening, caller. You're on open line. Yes, thank you. I have a question. Recently, I've read in the newspaper similarities between symptoms of AIDS and also symptoms that are being suffered by veterans who than it has been

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exposed to Agent Orange. I'd like to know if there has what kind of research is being done in terms of a chemical cause. And if you could explain that similarity and then I also have a follow up question, if I may. Okay. Thank you. Go ahead.

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Well, there's really no evidence at this time that there is a single chemical cause of this disease. One of the things we were interested early on was whether one of the drugs that's used as in recreation may have been the basis of the disease. And there's

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no evidence of that, Really, all of the evidence makes that look like this is an infectious disease rather than a chemical. So I'd say there's really no evidence that this could be caused by something like Agent Orange. Mhm. The follow up question I have is what

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sort of safeguards are there in terms of the possible escape of genetic viruses from experimental laboratories that are currently doing experimentation in the country. Well, it's a good question. There are a number of laboratories doing research with viruses in the country, a number of them here

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in the Bay Area. On the other hand, there is no known virus that causes anything like this disease, either in animals or man. So yes, the point that it could come out of the laboratory, whether this came out of the laboratory or whether it's a mutation

00:10:01.060 - 00:10:15.170

in the natural world, we really can't say. Obviously, we still don't even know that it's a virus. When we do find the cause of it, I think we can then track back and ask questions like that, whether it resembles viruses, that people are doing research within

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laboratories. Thanks a lot, thank you very much. People are really quite concerned with the fact that people who need transfusions are going to be very susceptible through blood transfusions to contracting AIDS. Is there any test that you're working on to test the blood before it is

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given the investigators, the investigators that Irwin Memorial Blood Bank in San Francisco have been very active in this research in looking for tests. We call them surrogate test because we don't have a diagnostic test for AIDS. Their tests that might be abnormal in the blood of

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a person with AIDS, even though they don't always mean that you have AIDS. And we've been looking for a number of these of these markers of AIDS with varying success so far that research is really just starting. I should think that would be a very important

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part of your your research. Okay, let's take another call. We have a call on line one. Go ahead, caller. You're on the air. Yes, Why has it is the federal and state government being asked to fund this research when it affects a relatively few people overall?

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And the more prevalent diseases such as lung and breast cancer are not state and federally funded? Well, it's an important question. The it's true that AIDS in San Francisco is only affected about 270 people. But remember that we're dealing with a disease that's doubling its numbers

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every six months and that it appears to have an incubation period of at least two years, so we can start projecting at this point that within the next two years we'll have thousands of cases here in San Francisco. And if we don't find the cause of

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this, if it continues to spread at that rate, it could easily overwhelm some of the other diseases that do receive regular research funding. I think the public health implications of this disease are only started to become. The public has only started to become aware of them.

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It's a very serious disease. Thank you very much for your question. We have another call on line three. Good evening, caller. You're on open line. Yeah. My question is about the information given about a I mean, you know, being aware of the disease, you watch one

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news program in another news program and they more or less, I'll give you the same information. But there are those that tend to right give you a little bit of different statistics like one new said. One new station said that the 99.9 of people do not

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have homosexual people do not have a job. So I guess Does that leave the other 9% who are very how should I say, you know, without trying to, you know, I just wish there would be more information given a concise information rather than you know, you

00:13:03.160 - 00:13:17.160

put one news on they say one thing you put another news on. They say something else. Isn't there a pamphlet or something that you know we can get through the mail or something about this? Yeah. There. There are good sources of information, and it's true that

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that some of the information that you hear is confusing. It reflects sometimes the confusion that we have about this because it's it's such a new disease. We'll show you hear something else. Yeah, well, you know, I mean, they don't know that much about it, they say,

00:13:33.640 - 00:13:46.990

but isn't there at least a little leeway they can give us at the end of the show? I'm going to give you a couple of phone numbers. One is for Dr Volberding Clinic, and one is for the Kaposi's Sarcoma Research and Education Foundation. If you call

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there, you can ask them to please send you some information. And I'm sure that that will help clarify a lot of it for you and pull you out of some of the confusion, but I'm afraid that the answer to a lot of the questions is still

00:13:57.970 - 00:14:17.520

we don't know. But there is something you do know about about the the gay population that is at greatest risk for Capasa. I wish I could post Sarko. I wish I could say that. In fact, what we know about it is that the early cases tended

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to occur, be seen in people who are very sexually active as the disease. What does that mean for someone like the gentleman who's calling? I think at this point, very sexually act. At this point, it doesn't mean very much because as the disease has spread through

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the community, I think at this point it doesn't require as many contacts as we saw originally to have a chance of coming across this disease. I think we do know a lot about AIDS, though, and I think more and more of the evidence is that it's

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not easy to catch the disease and that probably whether or not you get it after being exposed to it depends on your own immune system and that it may very well be the case that you will only get AIDS if your immune system is already compromised.

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I see you were saying that the incubation period is, uh, sometimes up to two years, sometimes beyond that. 6 to 36 months is what I read and you probably wrote what I read. Um, is there any way that those who think they might be carrying the

00:15:15.950 - 00:15:35.990

infection could find out? You could have your clinics flooded. Well, we have a screening clinic where we see people mostly on referral, who are concerned that they might have this disease. There really is no single test that we can do to diagnose AIDS until the person

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gets one of the serious manifestations of it. There is no single blood test. And for most people that are concerned, the best thing we can do is to outline how we think the disease has spread. How we think people can reduce their risk of getting the

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disease. So you're you're stressing prevention were really stressing prevention. We're stressing knowledge awareness of the disease and prevention. Alright. We're going to have to go to a break right now. Please stay with us. We'll be right back right after this message. Welcome back. to open line.

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I'd like to remind you that our number here is 8740222 And we're talking about acquired immune deficiency syndrome AIDS. We have a colour online for Good evening, caller. You're on open line. Good evening, Johnny. Um, two quick questions. One, if one is to come down with

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age and is to break out of your immune system as I call it, doesn't hit you real hard right there. And it makes you ill. Or does it pick up gradually over the months And then the second question to, uh, the gay parade being a week

00:16:41.420 - 00:16:58.320

from today, I want to know his personal opinion on whether or not he thinks that there will be a lot of cases growing up in around six months from next week's date because they say that every six months after cases will be doubling. Mm. Well, the

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first question, really, I think highlights the questions of symptoms. What are the symptoms of AIDS? And the symptoms can vary a lot. They can vary all the way from no symptoms at all. Someone simply noticing the tumors of Kaposi's sarcoma on the skin to people who

00:17:16.880 - 00:17:37.780

have very high fevers, sweating at night, very profuse sweating at night and unexplained weight loss and diarrhoea. All of those symptoms are not uncommon in people with AIDS. You have to be aware that these symptoms usually go on a long period of time. So just having

00:17:37.790 - 00:17:57.060

a fever one day isn't enough to necessarily worry that you have AIDS. The second question about the gay parade is an important one. There are thousands of people coming to the city who will likely have sexual contacts here in San Francisco. It's our feeling, though, that

00:17:57.540 - 00:18:16.110

bye promoting prevention measures as we as we have in public education as a department of public Health, is in the bathhouses and other other places of of congregation that we can decrease the risk to the visitors of getting this disease enough that I think the parade

00:18:16.110 - 00:18:29.720

definitely should go on. I don't expect we're going to see a big increase in the number of cases. Okay, have the number of cases decreased coming into your office or you're just Of course, if the incubation period is up to 36 months, you're going to be

00:18:29.720 - 00:18:45.020

seeing infections that are happening now or just a while back for some time to come. Sure, the education. And continue to increase the number of you're seeing a continued increase. Okay, we have another caller. Let's take the call. It's online too. Good evening, caller. You're on

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open line. Yes. I have two related questions with regard to the comment made earlier about the use of condoms. First of all, um, our condoms effective in protection against viral agents and with regard to AIDS. But you're not sure of the agent? The infectious agent. How

00:19:08.140 - 00:19:28.450

can you suggest that condoms might be effective in decreasing the risk? Well, two questions The first, really, Is this a viral disease? And as I hope, I can emphasize that we really don't yet know that this is a viral disease. And yet all evidence suggests that

00:19:28.450 - 00:19:50.980

it is whether or not condoms protect against viruses is, to some extent debatable. Although most people feel that it does prevent present an effective barrier against the spread of most viruses such as hepatitis B. Okay, but it's not necessarily going to be the only protection once

00:19:50.980 - 00:20:07.360

you take No, I would expect that as we learn more about this disease that we'll be able to make some very definite recommendations about the risk of transmissibility. At this point, you're only giving advice that you think will be effect. We're trying, far as you can

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advice based on what we do know. Okay, Good. We have another call on line one. Good evening, caller. You're on open line. Yes, Screaming. Doctor, I have a question for you. Okay. Regarding the practice in the medical community of treating social diseases with of antibiotics and

00:20:28.450 - 00:20:43.220

that is very common for syphilis, gonorrhea and other diseases that are easily transmitted, especially in the gay community and at the end of the society at large. I want to find out from you how you feel about this being a potential trigger for AIDS in the

00:20:43.220 - 00:21:02.500

gay community, the over treatment of antibiotic spite of medical profession for gays, which is very common practice. And if there is any correlation in your in your mind to that by suppressing the immune system and triggering that to occur. Good question. We really were concerned about

00:21:02.500 - 00:21:21.610

that early on when we noticed that gay men were the most likely to get this disease that raised questions about recreational drugs, sexually transmitted diseases or in fact, the therapy of some of those sexually transmitted diseases. One of the drugs that were most interested in was

00:21:21.610 - 00:21:37.180

fragile. A drug that's been used for the treatment of parasites. And yet, as we've seen more and more cases, there doesn't seem to be any certain any particular pattern of the infections they've had or the drugs that were used to treat those infections. And we, in

00:21:37.180 - 00:21:53.890

fact, have seen a number of patients who haven't had any sexually transmitted disease, especially the heterosexuals who have gotten AIDS. So I think at this point, the evidence of a drug like that having an effect is pretty minimal. Okay, Thank you for your call. And we

00:21:53.890 - 00:22:09.800

have another caller. The call is online for good evening, caller. You're an open line. Yes. Johnny, can you hear me? Clearly? Yes. We can hear you. Go ahead. Well, my question is, I'm over 16. Well, over 60 and I'm afraid I turn the TV down completely.

00:22:09.800 - 00:22:26.840

Should I have done that? That's right. And I'm afraid I don't know the sentence that they and then physically quite strong. But, you know, like anyone else and brainwashed to the extent I'm not even talking to anyone, and I closed myself off from people with this.

00:22:26.850 - 00:22:44.480

Let me be more direct with this. The common with male and female people who are on the street quite often and who come in contact like they're forced to be the only female prostitutes would be more like susceptible to catching that age than people saw. A

00:22:44.480 - 00:23:06.010

bit of a cover of guard against it. It doesn't extend about I'm sorry being direct like that because I don't want to offend anyone. Sure, that's quite all right. Go ahead. Well, I think how you approach your your sexual practice probably doesn't have any real influence

00:23:06.020 - 00:23:25.920

if you're in contact with somebody who has the virus. If it is caused by a virus and it's spreading it, then you are at some risk to get that agent, no matter what your your purpose or or motives in that practice. If I answered, I think

00:23:25.920 - 00:23:46.500

his question probably is he more likely to come into contact with one of the diseases that make up the syndrome. If he's in contact with someone who is very sexual, very sexually active, yes, I'd have to say yes. Probably. Yeah. Okay. Thank you for your call.

00:23:46.500 - 00:24:04.330

We have another caller on line two. Good evening, caller. You're on open line. Yes. I was wondering if you think AIDS is transmitted by body fluids. Could you get it from saliva from kissing someone? Well, we don't think so. There's no evidence of that, at least

00:24:04.330 - 00:24:21.810

at this point. On the other hand, the virus that's probably the best model for AIDS is hepatitis B virus, and that virus is present to some extent in the saliva. So we think it's at least a potential risk. We advise our patients and people who are

00:24:21.810 - 00:24:38.630

concerned about AIDS to as much as possible minimize their exposure to saliva. I was reading one of the articles I was reading before the show was about a mother who has probably gotten aids from her child and Haitian. Um, and I was thinking about that when

00:24:38.630 - 00:24:51.450

I think about the amount of drooling my one year old does. Um, that would be a question if you're getting it from body fluids. Could she have gotten that through the saliva? Or is that I was I was curious as to how the mother in this

00:24:51.450 - 00:25:10.320

medical journal article that I was reading had gotten aids from her child. The articles have been mostly the other way around of Children getting it with the mother who has it and whether that's in utero or during delivery or in breast milk after delivery is not

00:25:10.320 - 00:25:27.210

known at this point. Okay, we have a call on line three. Good evening, caller. You're on open line. Okay? I have a couple of questions. My first question is, I'm a dental hygienist in the area here, and I know AIDS is transmitted by secretion. I worked

00:25:27.220 - 00:25:46.710

with the mucus membranes, and I know you can catch hepatitis B through the blood secretion. Yeah, you're fingers. For instance, If you have any cuts or lacerations or whatever you can, you know, absorb it through your skin. That was my first question. Um, I know if

00:25:46.720 - 00:26:05.870

someone has hepatitis here to wear gloves, but it was a regular thing. We don't wear gloves. Uh huh. What can you suggest? It's a It's an important question. One that when they were asked, more and more, the risk of dental workers to hepatitis B is very

00:26:05.870 - 00:26:21.620

high. They have one of the highest risks because of their exposure to saliva and blood and because they're handling sharp instruments. Mm. Clear that through the medical history. But like AIDS, you don't know whether or not the person has it. I don't know if there had

00:26:21.620 - 00:26:37.370

been any. Any final recommendations about dental hygiene is and Dennis, but I know that more and more dental groups are recommending the use the routine use of gloves for any patient contact at this point because of the possibility of transmission both of hepatitis and of of

00:26:37.370 - 00:26:53.840

aids. Okay, I'm going to take a moment here to give you some information because we're just about out of time. And for those of you who would like to get further information, you can call the AIDS clinic at San Francisco San Francisco General Hospital. Um, the

00:26:53.840 - 00:27:12.460

number there is an area code 415821883 Oh, and also, if you'd like further, that's the AIDS clinic. So if you have any worries about anything that you notice about yourself or is it symptomology symptoms symptoms, that's easier. Then please call the clinic there. If you'd like

00:27:12.460 - 00:27:30.810

to have some basic information, something in writing. Then do call the Kaposi's Sarcoma Research and Education Foundation. The number There is also an area code 4158644376 Do we have time for another call? I'm afraid we don't have time for another call. We're all out of time.

00:27:30.810 - 00:28:01.080

And I'd like to thank you very, very much for coming down and answering questions for us about acquired immune deficiency syndrome. And I'd like to thank you all for watching. I'm Johnny Barnes. Selvin. See you again next week. Good night. Mhm. Mhm! Mhm, Mhm. Mhm. Yeah,

00:28:02.040 - 00:28:22.850

yeah. Mm. Mhm. Mm. Mhm. Mhm.