Læknaneminn - 01.04.1997, Blaðsíða 108
Peter Duesberg and David Rasnick
Attending an AIDS Clinic: Utilization of Prescribed,
Unorthodox, and Investigational Treatments” describes
even higher drug use by 189 HlV-positives from San
Francisco of which 94% were male homosexuals and
2% were intravenous drug users 19°. In telephone
interviews 96% of these people reported prescription
drugs, 67% over-the-counter drugs, 31% investiga-
tional drugs, 29% recreadonal drugs, and 29% “alter-
native” drugs. An average of 2.3 medications were
taken simultaneously by healthy HlV-positives and 5.6
medications were taken simultaneously by those with
AIDS symptoms. The authors of the study “conclude
that use of polypharmacy among some AIDS clinic
patients is common, could create an increased risk for
adverse drug reactions, and may affect clinical drug tri-
als.”
Larry Kramer, the HlV-positive playwright and
founder of the gay activist organization Act-Up, has
described his own anti-HIV/AIDS polypharmacy
under the title “Checking in, my chart” 19‘. Following
the advice of several AIDS luminaries such as Anthony
Fauci, David Ho, Joseph Sonnabend, Alvin Friedman-
Kien and others, Kramer composed his own polyphar-
macy of 19 drugs for an annual price tag of $19,000
15°. This chart includes: “AZT (AIDS), acyclovir [gen-
ital herpes], Zantac, colchicine [mitosis blocker], pro-
pranolol, spironolactone, myphyston [liver cirrhosis
and hepatitis], Eucerin, Moisturel, Retin-A, mycolog,
flucinonide, sulfacet-r, Nizoral [fungal dermatitis],
Hisminal and Humbid [bronchitis], and Shaklee vita-
mins, zinc, NAC” and a “turquoise stone which a for-
tune teller, many years ago, advised” ‘91. Before devel-
oping AIDS and medical drug addiction, Kramer
offered a client’s eye-view of homosexual life-style,
including a long list of the 56 most popular recreation-
al drugs in his novel Faggots 6,n.
The polypharmacy of the AIDS patient and activist
Peter Di Giulio from San Francisco, who suffers from
weight loss, chronic diarrhea, skin ailments, and neu-
ropathy, even exceeds that of Larry Kramer. At an
annual cost of just over $41,000 “Di Giulio has no
choice but to organize his life around his medications”:
the DNA chain terminators d4T, 3TC (for HIV),
Cytovene (for cytomegalovirus) and Zovirax (for her-
pes), the protease inhibitor Crixivan, the antifungals
Diflucan and Septra (for PCP), anti-mycobacterials
Biaxin and Myambutol, the anti-diarrheal Lomotil,
Valium for anxiety, and an assortment of ten vitamins
and supplements 192.
The polypharmacy of adult HlV-positives even
extends to children. The treatments prescribed to an
American group of 20 boys and 22 girls serve as an
example. These children were originally diagnosed as
HlV-positive only at 7 years of age, but were HIV-pos-
itive from birth due to perinatally acquired HIV ’93. At
the time of HIV diagnosis, 5 of 42 (12%) were also
diagnosed with some AIDS-defining diseases. Yet all
but 2 of the children were treated with anti-HIV/AIDS
drugs. At an average of 11 years of age the following
medications were administered to the children:
Most of the children are receiving multiple chronic
medications, with 90.5% (38 of 42) receiving anti-
retroviral therapy, 78.6% (33 of 42) receiving PCP
prophylaxis, 33.3% (14 of 42) receiving fungal pro-
phylaxis, and 23.8% (10 of 42) receiving herpesvirus
prophylaxis. Among the children receiving antiretrovi-
ral therapy, 78.9% (30 of 38) are receiving zidovudine
[AZT]. Other medications frequently prescribed
include meter dose inhalers for reactive airway disease
in 33.3% (14 of 42) of patients and nutritional sup-
plements for failure to thrive and wasting syndrome in
52.4% (22 of 42) of patients. Only 2 of the 42 chil-
dren in the cohort are not receiving any medications,
with 4 receiving one medication, 14 receiving two, 10
receiving between 3 and 5, and 12 receiving between 6
and 12 different medications daily. Sixty-two percent
(26 of 42) of the children receive monthly intravenous
infusions of immunoglobulin 193.
4.3. Diseases caused by AZT and other anti-HIV med-
icines. AZT functions as an analog of natural thymi-
dine (T). If AZT is incorporated instead of T into a
growing DNA chain, DNA synthesis terminates for
lack of a 3’OH end, and the cell dies (see Fig. 3). A
standard daily prescription of 0.5 g AZT corresponds
to about 10 21 molecules per body, or 10 7 per human
cell, enough to kill most growing cells, especially the
fastest growing ones - the immune cells, red cells and
epithelial cells - by terminating DNA synthesis l59,194.
Stopping the regeneration of these cells over several
days causes anemia, nausea, lymphocytopenia, hepati-
tis, and wasting disease 26,152,195,196. AZT also prevents
mitochondrial DNA synthesis in non-proliferating
cells. Specifically, non-renewal of mitochondrial DNA
causes muscle atrophy, hepatitis, and dementia 26,U7,159,
LÆKNANEMINN
106 1. tbl. 1997, 50. árg.