Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, August 17, 1993 TAG: 9308170141
SECTION: NATIONAL/INTERNATIONAL PAGE: A-1 EDITION: METRO
SOURCE: NANCY McVICAR FORT LAUDERDALE SUN-SENTINEL
DATELINE: LENGTH: Medium
Christi's life is in jeopardy from the human immunodeficiency virus that causes AIDS.
Amy is healthy, but she's fighting the disease just as hard as her sister.
She is trying to save Christi's life, or at the very least prolong it, by giving her sister part of her own immune system.
The 26-year-old south Florida women have been recruited by the National Institutes of Health in Bethesda, Md., for a study to determine whether a healthy twin can give an infected twin a longer life.
Doctors are trying to reconstitute Christi's immune system using infection-fighting cells donated by Amy. If it works, the technology might allow other family members to donate components of their immune systems to lengthen the lives of people they love.
"I'm so grateful for her, for what she's doing," Christi said. "I want to live as long as I can for my kids. I want to see my children graduate. I want to be around to see my grandchildren."
"I love her and I'll do anything that will make her live a day longer," Amy said.
Preliminary reports on the study made public in June at the IXth International AIDS Conference in Berlin showed the method is safe and carries almost no side effects or dangers to either participating twin.
Researchers hook Amy up to a machine that removes some of her infection-fighting white blood cells, called CD4 cells or T-cells. Over the next week and a half, the cells are grown and multiplied in the laboratory in a fetal calf serum, then infused into Christi.
"My T-cells were as low as 227," said Christi, who lives in Miami and must fly to Bethesda for the treatments and monitoring every week. "Then I was put on AZT and DDC and that therapy raised it to 435 before my first infusion of Amy's cells. I've had two infusions and now my count is up to 726. It just keeps climbing."
Doctors use T-cell counts as one measure of the strength of the body's immune system. People with fewer than 200 are classified as having AIDS. Normal T-cell counts range from about 800 to 1,200.
"T-cells, or CD4s, are so important because they have a unique quality. They not only fight off infections, they assist other cells in fighting infection," said Dr. Patrick Cadigan, Christi's North Miami Beach doctor.
"When they're diminished because the HIV is killing them, that's when you come down with all these opportunistic infections that people with AIDS are susceptible to," Cadigan said.
Cadigan not only treats Christi, and also has given injections of a special dye called KLH to Amy. The dye is a marker that allows NIH doctors to track Amy's CD4 cells in Christi's body.
Christi's progress during the study has been phenomenal, he said.
"It's unbelievable. Her T-cells have doubled. We're not sure it's going to hold or continue, but because it's an identical match with her twin sister, we would expect they will last as long in her as they would in Amy."
Amy's body replenishes its lost cells over time, but the donation process can be painful and time-consuming and requires her to make frequent trips to Bethesda.
"I'll do anything for my sister, anything that will advance AIDS research," she said.
Christi's diagnosis was devastating for Amy.
"I was very angry at first, then I was sad, then angry again, grieving as if she was going to die because that's what it is, it's a death sentence," said Amy, a licensed practical nurse.
Christi, a single mother, was in school learning typing and other clerical skills to better support her two sons, ages 8 and 2, when she received information about AIDS and how to prevent it.
"They said if you've had unprotected sex in the last five years, you need to get tested," Christi said. "I went to my doctor and he didn't want to test me. He said I wasn't in a high-risk group."
Christi said she had only two sex partners - her children's father, and then after he left, a new boyfriend.
But she insisted on a test, and it came back positive.
"I didn't get it from the drinking water, and I wasn't promiscuous. And we don't do drugs, we do food," said Christi. "We're large women."
Both twins work for Community Research Initiative, a community-based AIDS research project based in south Miami. Amy is a research assistant.
After her diagnosis, Christi got a job at CRI as a clerical worker. It was her boss, Rick Siclari, who saw the announcement from the NIH on the twins study and told her about it.
"I talked it over with Amy and she said I should call them," Christi said.
The NIH scientists have asked Christi to participate in a study on an AIDS-fighting drug called Interleukin-2 at the conclusion of the current one, which continues for only a few weeks more.
Amy doesn't want her to do it, because while the drug boosts the immune system, it also initially causes the HIV virus to grow or become more active.
But Christi has agreed to do it:
"They say I will feel like I have the flu, and it can increase the activity of the virus, but I feel I have to do whatever it takes to fight this, and what I do may help other people."
by CNB