[Letter to Tim Westboreland from Spencer Cox]

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DEC 10 ' 2 1:55

PAGE. 0101

December 10, 1992

Board of irectors
John LX Bacci
Ross Blecaer
Phyllis Danilow
Donald Hall
Donald Kotler MD
Rcben Levy. E,q.
Stephen Zifler
Medical Director
Joseph A Sonnabend, MBBCh, MRCP
Scientific Advisory Committee
isinaid Armstrong. Mi)
Se Buimovci-Ktn. MD
T D >eterich, Mi)
Ste r. MD
ruj K ler. MD
lPaci ange, Md. tRCP o te
ijidlyn Ph.D.. lccr,?ii D..,.at A Sonnahend. MBBCh. MIRCP, Stein, MBS (h
cd T. Valentine. MD
Phlvsician's Advisory Committee
James F. Braan. DO
Richard A. Elion. MD
Arthur Englard, MD
How, ard Grossman. MD
Karl R. Hoffman. MU)
Donald Kotler, MD
"iadd Lazrarus. MD
Thomas Markoski. MD
Winiam Siroty. ML
Joseph A Sonnabend. MBBCh. MRCP
National Advisor Council
Donald Abrarns. M f)
Michael Bar
Jon Engbretson
Roben Huff
Mathilde Knm. Ph D.
Kiki Moa.on
Richard Peto. Ph.D
Peter Scalc s

Mr. Tim Westmoreland
1364 G Street, SE
Iiltli Illll II! illll I!!11 1111 III!! 1111!1111 II 1111 i111 1111
Washington, DC 20003
5571095.0492.022
Dear Mr. Westmoreland:
I am writing at the suggestion of Larry Kramer, with reference to the need
for basic biomedical research into interactions between HIV and the
immune system, and the pathogenesis of AIDS. I write both as an HIVinfected constituent, and as the Public Affairs Associate for the
Community Research Initiative on AIDS (CRIA), a non-profit,
community-based AIDS research center in Manhattan.
During the Presidential transition process, many AIDS advocates have
proposed some form of "Manhattan Project," with the goal of identifying
effective treatments and, ideally, a cure for AIDS. While such a project
is obviously gratifying to consider, it is important to recognize that there
are serious scientific limitations on our ability to rationally identify,
prioritize and test new therapies for HIV infection. These limitations have
important implications for the goals and structures of any such targeted
treatment research program.
Modern molecular immunology is approximately twenty-five years old;
our grasp of the complexity of the various immune responses is,
unfortunately, correspondingly infantile. The early pathogenic model, in
which HIV is latent for a long period, and then becomes "act've,"
infecting and subsequently killing CD4+ lymphocytes, is now recognized
as an inadequate oversimplification of this disease.
HIV seems to interact with the immune system at the most complex
possible levels, leaving no aspect of the immune function undisturbed.
Since the earliest research on the epidemic, there has been a significant
body of evidence indicating that B-cell malfunction, cytokine
disregulation, autoimmunity and co-infection all play some part in disease
progression, however as yet we do not understand the specific roles that
these abnormalities play in the development of AIDS.
-ommunity Research Initiative on AIDS
New York, NY 10001 Phone: [phone] Fax: [phone]

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