[Letter to Bonnie Mathieson from Jon Cohen]

TO: BONNIE MATHIESON
FROM: JON COHEN
July 7, 1992
Bonnie--
Thanks again for all of your help. I couldn't reach my editor right away, bu
here's the last draft I sent in of the sidebar on the MACS. The final versio
should read pretty much the same. Note that I marked the footnote with a
'+.-- JC
AIDS research in the United States seems
to be undergoing a sea-change, as researchers
shift their focus from what causes disease to
what causes immunity--the factors that
distinguish people who have been exposed to
HIV but are not getting sick (see main
story). But this research interest is so new
that there is little in the way of large
studies to back it up. Now, however large
immunological studies in four groups of
''unique individuals'' are on the tarmac and
set for takeoff at the Multicenter AIDS
Cohort Study (MACS).
The MACS is the flagship AIDS
epidemiological project in the U.S., an
NIAID-funded effort with a $10 million annual
budget that, since 1985, has been following
nearly 5,000 gay men to track the natural
history of HIV infection. Recently, however,
the scientific leaders of the four different
MACS sites--Baltimore, Chicago, Los Angeles,
and Pittsburgh+--decided to send their
studies off in a new direction. On 8 June
they formalized plans to look closely at
their cohorts of more than:
* 250 uninfected men who reported having
unprotected, anally receptive sex with
several partners (some of the partners were
known to be HIV-infected).c
* 40 rapid progressors who developed
AIDS within five years of a documented
infection.
* 50 infected men who have remained free
of AIDS-related diseases for over three
years, despite having fewer than 200 CD4
cells. (The loss of these critical white