It was just another routine case," says Dr. Mahlon Johnson. In 1992, as the Vanderbilt University neuropathologist was removing the brain of a man who had died of AIDS, his hand suddenly slipped. The bloody scalpel sliced through his glove and deep into his left thumb. Because of that "freaky little slip of the scalpel," as Johnson ruefully characterizes it, he endured seven "nerve-racking" months. He took several HIV tests--all were negative. Then the result that he had been dreading came in: he was HIV positive.

At the time, most doctors with HIV-positive patients held off using powerful but highly toxic AIDS drugs during the early, "latency" period of the disease, when the virus was thought to be somewhat dormant. But Johnson was aware of new studies suggesting that the virus was in fact extremely active during this period, engaged in a winner-take-all struggle with the immune system.

Looking for what he calls "the loophole in the death sentence," Johnson became one of the first to confront the virus early with the most potent arsenal medicine had to offer. He regularly dosed himself with combinations of AZT, DDI and interleukin-2 (two antiretrovirals and an immune enhancer), enduring nausea and developing a rash as a result. For the past few years, doctors have been unable to detect any virus in his blood, although antibodies remain.

Has he been cured? "It seems unlikely," Johnson says. He points to the case of a patient who underwent similar successful therapy but in whom the virus became detectable again when he stopped his drug treatment. Johnson remains realistic but optimistic. In the battle against AIDS, he says, "we've switched from certain death to uncertain life. We used to ask, 'How soon will I die?' Now we ask, 'How long can I live?'"

Whatever the outcome, Johnson strongly advocates early, massive drug intervention--a point he emphasizes in his recent book, Working on a Miracle. Indeed, he has recommended the same treatment for a young HIV-positive widow he is seeing, and they are now both taking protease inhibitors. Though the virus is still detectable in her blood, her immune-cell count has risen dramatically.

--Reported by Dick Thompson/Washington