The Living Daylights

Some people with HIV don't get sick for years and years and years. Their lives might contain the clues for the cure.

But according to the Clinic Study's data, some 5 to 8 percent of people who test positive will, like Rob Anderson, remain immunologically intact for nearly two decades after infection. And "at this point, with HIV the closest we can get to someone who's cured is these long-term nonprogressors," O'Malley says. "They have the ability to keep their virus in check."

The question, of course, is this: For how long? Forever?

When she calls into radio talk shows, which she does on occasion, she calls herself Ellen. Usually what makes her reach for the phone is something someone says about AIDS -- about how people don't live too long with the virus, or about how Magic Johnson sure looks good despite his infection. When she calls, she doesn't use her real name, and it's not surprising: Almost no one in her life, including her two children, knows she has been HIV-positive since early 1984.

On this weekday morning, Ellen is wearing a sunflowered jumpsuit, the yellow flowers bright on a blue background. Her long, thick, wavy hair spills down her back and over her shoulders. She is a homemaker, she says, and she talks about her HIV status with the ease and practice of someone long grown accustomed to it -- every six months, Ellen has been coming to the Clinic Study to talk to interviewers about her life and to have blood drawn and tested. She wasn't part of the original cohort, obviously, since she is not a gay or bisexual man, but when she heard about the study she called up and asked to be allowed to participate. They opened the doors and let her in.

"I found out in 1991," Ellen says. She and her husband applied for life insurance; they had been married for seven years. Part of the application was an HIV test. He was negative; she was not. She thought back on her life. Her boyfriend, in 1984, had been an IV drug user -- she remembered her own flulike illness around that time, in mid-March, swollen lymph glands and a fever. Many phone calls later, she tracked him down abroad. She asked him to get tested; "I called him two weeks later. His test was positive," she says.

In 1991, when she first found out, "I woke up every morning thinking, 'Another day with HIV.' I would be jealous of people on the street. I was so jealous of other people. I never thought there would come a day when I didn't think, first thing, HIV."

It took about two years, she says. "It was like a roller coaster. First of all I was always terrified of death before. I was always afraid of death," she says. "When I found out, I thought I would die in a very short time. I knew I had had it for seven years. I'm not afraid of death anymore -- but yet I've also realized I'm not going to die."

Since her first illness, 12 years ago, the flulike bout, she has had no symptoms. And since then, "I've been doing the T-cells count," she says. T cells help the body fight infection, and because HIV attacks the body's immune system, the number of T cells in a cubic millimeter of blood is one indication of the severity of HIV infection; in 1993, the Centers for Disease Control changed the definition of AIDS to include anyone with T cells below 200. Ellen's haven't ever approached that number. "The lowest they've been is 540," she says. "Usually they fluctuate from 700 to 1,100."

She hasn't taken any of the antiretroviral drugs -- like AZT or the new protease inhibitors, which prohibit the replication of HIV-infected cells -- and she tries to take care of herself physically. And, as a homemaker, she says, she thinks she has less stress in her life than she would if she had a job. "I'm trying to relieve stress in my life -- just remembering some things aren't that important to get all stressed out about."

And she believes she will not die from HIV infection. "My genetic makeup for some reason is dealing with HIV, and there's no reason for me to think that won't last the rest of my life."

"That's the bottom line," she says. "I believe everything else you do that's positive only helps."

Inside our bodies exist worlds we know nothing about, groves of bones and blood, unrecognizable, perhaps, to an eye accustomed to the outside. It is tempting to believe that the mind directs it all -- to believe that the mind, with its senses and thoughts, can direct the course of any action, or any disease. But throughout the AIDS plague, there have been countless thousands who told themselves they would survive only to find that their best hopes and desires were for naught. In Western medicine, at least, the search for the reason behind why some people with HIV do not progress to AIDS and death, or move toward that end so much more slowly than others, has focused on empirical data, the kinds of things measurable in laboratories. And so far, there have been no easy answers. But there are answers, nonetheless. Or at least, there are the beginnings of answers.

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