Two professionals dedicated to working with AIDS patients on a daily basis are researching different aspects of AIDS to better understand the underlying cause of the disease and the effectiveness of treatments.

Dr. Lawrence Kingsley, faculty member of the department of infectious disease for the School of Public Health through the University of Pittsburgh, is working with the Pitt Men's Study, a study of over 2,000 gay men, to try and determine why certain patients with the HIV infection develop AIDS.

With funding from the AIDS Program of the National Institute of Allergy and Infectious Disease and the National Cancer Institute, a Multi-Center AIDS Cohort Study (MACS) has been established in four different cities Baltimore, Chicago, Los Angeles and Pittsburgh -- to investigate populations of gay men.

"The reason we are focusing upon gay men is because these people are in a major risk group for acquiring AIDS," he said, adding 25 percent of the men in the study are infected with the AIDS virus.

Likewise, Dr. M. Elaine Eyster, chief of the hematology division at the University's Hershey Medical Center and director of the clinical AIDS Unit, along with colleagues at Hershey is participating in research studies involving hemophiliacs who have AIDS.

Funded through the National Institute of Allergy and Infectious Disease, scientists in Hershey's 16-year-old hemophiliac program are researching various treatments to determine hemophiliac AIDS patients' response to specific drugs, including AZT. Another study funded by the National Cancer Institute, is tracking why certain hemophiliac patients infected with the AIDS virus are resistant to the development of AIDS.

Most of the patients at Hershey come from about 30 counties throughout Pennsylvania.

"As physicians we take care of the patients. We can't select what symptoms they have," Eyster said.

She said the most rewarding part of the job is helping people deal with the stresses involved with the infection.

"We give them hope through therapy," she said.

Eyster said in the early 1980s before the AIDS virus was identified, blood banks were contaminated with the AIDS virus. If a hemophiliac received a blood transfusion between 1980 and 1985, when blood donations were not screened, he or she could have been inadvertently infected with the HIV virus.

"What our studies have shown is that well over 50 percent of our patients are infected with the virus," she said.

Because persons with hemophilia receive blood transfusions from pools of about 5,000 blood donors, hemophiliacs in the early 1980s were at a high risk of exposure to the AIDS virus.

"Patients may be exposed to a couple thousand people and possibly up to a million (through transfusions)," she said.

After eight years of infection, 26 percent of hemophiliac patients throughout the country infected with the HIV virus have developed AIDS. Eyster said more than half of the (80 to 90) people participating in the study are known to be infected. Hershey has about 250 hemophiliac patients and just about all of them are participating in one study or another.

"We basically see these patients on a regular basis," Eyster said, adding some patients have been followed since birth.

"In hemophiliacs you see a lot of patients who have illnesses which prove to be fatal and AIDS is one of them. I think what keeps us doing this is the realization we are going somewhere. There is always hope, especially with advances with this problem."

Kingsely is also dedicated to his work. Although many may express hesitation about working with AIDS patients, he said he does not hesitate about working with these patients because AIDS is a major public health challenge.

"It is a very exciting and necessary place to be at this time," he said.

Kingsley said because 75 percent of the men in the Pitt Men's Study are not infected, participants have mixed feelings and an extreme pressure exists not to become infected.

"A fear certainly exists because all people in the study have had personal acquaintances who have developed AIDS and died," Kingsley said.

Many of the individuals infected with HIV for five years or longer experience no symptoms of the disease, feel good and have a positive attitude about the future, Kingsley said. On the other hand, some patients infected with the virus suffer several clinical problems.

"There is a major impact on being a gay man in the late 80s. The psychological effects of adjusting to a new lifestyle are difficult," Kingsley said referring to the impact of AIDS on the gay community.

The Pitt Men's Study is an extension of a pilot study conducted in 1982 on about 100 gay men-in the area surrounding Pittsburgh. This was when experts knew of the disease but did not call it AIDS, he said.

The Pitt Men's Study originally started as a study in the tri-state area of Ohio, Pennsylvania and West Virginia with a special interest in Allegheny County. The study has expanded its screening activities throughout Pennsylvania, reaching into the central and northern regions, but a majority of the participants are within a 100 miles of the study, Kingsley said.

Kingsley and the researchers applied for a grant in 1994 and the study became a part of MACS. Today the joint studies in the four cities are studying over 5,000 gay men.

Treatments patients receive often depend upon individual differences of the patients.

Eyster said before she administers a treatment, "We sit down with each person who may need the protocol and determine if it will benefit him or her."

Many patients are anxious to be treated. However some patients are not interested or do not qualify because they are too sick.

"It really depends upon the patient, you can't generalize," she said.

"Physicians are here to help people. Whether or not you cure the patient you help them to deal with the problem the best you can," she said.

Eyster said patients at Hershey with more severe cases of hemophilia are seen every three to six months while those with less severe cases are seen about once a year. Those with the AIDS virus are monitored every month or whenever problems arise.

By giving AZT to patients with hemophilia, Eyster said she and researchers hope to determine whether the drug will help minimize symptoms in hemophiliac patients with AIDS. The drug is extremely toxic so it would not be beneficial to prescribe AZT if patients' symptoms will only worsen due to the effects of the drug, she said.

Ampligen, a mismatched doublestranded RNA, is administered to persons who are very late in the infection to see if the drug in high doses will work to resist the infection in patients. The drug looks like the AIDS virus and tricks the immune system in order to eradicate the the virus from the host, Eyster said.

Patients who participate in such studies not only help researchers learn more about what they're studying, it sometimes benefits the patient.

Kingsley said in exchange for participation in the Pitt Men's Study, patients receive benefits such as free testing screening and counseling.