As an HIV vaccine breakthrough in Thailand stirs interest and hope, a pioneering AIDS researcher at the University of Miami Medical School says she is preparing to start human trials for a new vaccine that would fight the deadly virus.

While the Thai experiment is the first to prevent infection by the HIV virus that creates AIDS, Dr. Margaret Fischl of UM is working on a vaccine that would be given to patients already infected with HIV to help boost their immune systems to fight off the disease. Both vaccines are years away.

If successful, the Fischl vaccine could replace the two- and three-drug ``cocktails'' of antiretroviral drugs now used to improve and prolong the lives of people with HIV. That approach is expensive and also produces numerous side effects.

Fischl is one of the world's most respected AIDS researchers. In 1987, she was instrumental in developing AZT, a breakthrough that provided the first effective antiviral medicine that stopped AIDS from killing nearly all of its victims. It is still in use today along with many newer drugs, and AIDS deaths have plummetted.

Her new vaccine, being developed in conjunction with a major out-of-state biotech firm, has been successful in treating HIV in small mammals up to the size of rhesus monkeys. It should be ready for human trials by about January, she said.

``The goal is to use the vaccine as the mainstay of treatment, so infected people would no longer need HAART (highly active antiretroviral therapy), with its expense and side effects,'' Fischl said. ``With this, they would take a shot every year to boost their systems and keep them in shape.''

ENCOURAGING NEWS

Alan Bernstein, executive director of the New York-based Global HIV Vaccine Enterprise, which is not involved in Fischl's study, called news of Fischl's vaccine trial ``great news for people who already have HIV.''

``Obviously, the vaccine in the Thai trial would not help people who already have HIV'' because it's given to uninfected people to prevent HIV, he said. ``So this vaccine would be very complementary.''

Also, he said, people who control HIV with antiretroviral drugs are never cured and must stay on the drugs for life. And he said new research suggests that such people are developing signs of premature aging, such as arthritis and early dementia.

Since a therapeutic vaccine would be aimed more directly at the HIV virus, it might have fewer toxic side effects, he said. It, too, would not be a cure.

Fischl and the biotech firm, which she cannot yet name, have been working on the new vaccine for years. She said more details will be released soon. It has been successful ``in vitro'' in the lab and has worked well in trials with six rhesus monkeys who had been infected with the HIV virus, she said.

``We know the vaccine works all the way up to the monkey model. We know its safety profile already,'' Fischl said. By about January, she said, it should be ready for its first trials in humans. About 30 volunteers would be recruited at several universities.

TREATING HUMANS

Human trials are very sensitive, she said.

``I feel very strongly that when you do a study in humans, even if you have volunteers lined up around the block, you move slowly. You give a dose to the first patient, and you wait to make sure there are no side effects. Then you give it to the second patient.''

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