Læknaneminn - 01.04.1997, Blaðsíða 115

The drug-AIDS hypothesis *
users. Kaposi’s sarcoma as an AIDS diagnosis is 20
times more common among homosexuals who use
nitrite inhalants than among AIDS patients who are
intravenous drug users, or hemophiliacs 36, 13°.
According to the drug hypothesis Kaposi’s sarcoma is
a nitrite-specific AIDS disease. Indeed, male homosex-
uals are 58-times more likely to use nirite inhalants as
sexual and mental stimulants than heterosexuals 75 (see
3.). Due to their carcinogenic potential, nitrites were
originally proposed as causes of Kaposi’s sarcoma 215'217.
The fact that up to 32% of Kaposi’s sarcomas of homo-
sexual men can be diagnosed as pulmonary Kaposi’s
sarcoma 234'235, lends additional support to the nitrite-
Kaposi’s sarcoma hypothesis, because the lungs are the
primary site of exposure to nitrite inhalants. Meduri et
al. point out that the ”pulmonary involvement by the
neoplasma has been an unusual clinical finding” in the
Kaposi’s sarcomas of male homosexuals compared to all
”classic” Kaposi’s sarcomas 236. This agrees with the
fact that ”aggressive and life-threatening” Kaposi’s sar-
coma, particularly pulmonary Kaposi’s sarcoma, is
exclusively observed in male homosexuals 235-238.
Pulmonary Kaposi’s sarcoma had never been observed
by Moritz Kaposi, nor by anyone else prior to the
AIDS epidemic 239.
Moreover, it appears that the nitrite-induced AIDS-
Kaposi’s sarcoma and the classic, spontaneous Kaposi’s
sarcomas are entirely different cancers under the same
name. The ”HIV-associated” Kaposi’s sarcomas
observed in male homosexuals are "aggressive and life-
threatening” 237, often located in the lung and fatal
within 8-10 months after diagnosis 234-236’238. The clas-
sic ”indolent and chronic” Kaposi’s sarcomas are only
diagnosed on the skin of the lower extremities and hard-
ly progress over many years 16,236,24°. Nevertheless, the
distinction between classic and AIDS-Kaposi’s sarcoma
is rarely ever emphasized and may have escaped many
observers due to the ”difficulty in pre-mortem diagnosis”,
and because "pulmonary Kaposi’s sarcoma was indis-
tinguishable from opportunistic pneumonia...” 238.
The immunotoxicity and cytotoxicity of nitrites also
explains the proclivity of male homosexual nitrite users
for pneumonia, which is the most common AIDS dis-
ease in the US and Europe 26, 130 (Table 1). The
cytotoxic effects of nitrites are compounded by the
immunotoxins and cytotoxins of cigarette smoke. For
example, in two groups of otherwise matched HIV-
positive male homosexuals, cigarette smokers devel-
oped pneumonia rwice as often as non-smokers over a
period of 9 months 133.
2) High mortality and speciftc diseases of intravenous
drug users. High mortality and tuberculosis, pneumo-
nia, mouth infections, immunodeficiency, lym-
phadenopathy, candidiasis, fever, weight loss and
dementia are each characteristic of intravenous drug
users 26,86,120,122,124,123 (see 3.) and AIDS patients.
A recent review article has tried to resolve the “con-
fusion [that] may arise as to the aetiology of specific
symptoms” from intravenous drug use and from HIV,
“since they may mimic each other” 40. But, after con-
firming that drug use causes lymphadenopathy, diar-
rhea, dementia, epileptic seizures, impotence, tubercu-
losis and other clinical features by itself, the article fails
to resolve the confusion (see 3.). Since it lacks drug-
free HlV-infected patients with the specific diseases of
intravenous drug users, the confusion remained. In
other words, the article confirmed, despite its intent,
once more that AIDS diseases of intravenous drug
users are drug diseases.
Because of drug-induced diseases intravenous drug
users only reach a very low average age. A German
study found the average age at death of intravenous
drug users was 29.6 years for HlV-free and 31.5 years
for HlV-positive addicts in 1995 3'2. American studies
show that both HlV-positive and negative intravenous
drug users die between the ages of 25 and 48 years 41,
and from the same AIDS-defming and other diseases in
1988 86. The average age at death of amphetamine
addicts was also determined to be about 30 years lls.
Thus drugs, not HIV, determine the specific diseases
and high mortality of intravenous drug users.
3) Low birth weight and mental retardation ofAIDS
babies. Low birth weight, mental retardation and
immunodeficiency for lack of B-cells are specific AIDS
diseases of AIDS babies 224.
According to the drug hypothesis these are drug dis-
eases because 80% of American/European babies with
AIDS are born to mothers who were intravenous drug
users during pregnancy 2S’51.2<)5,233_ Moreover, HlV-free
“crack babies” of drug-addicted mothers have exactly
the same diseases as HlV-positive infants 241 (see 6.8.).
The remaining 20% are due to congenital diseases such
as hemophilia, and infant morbidity and mortality due
to poverty 26.
LÆKNANEMINN
H3 1. tbl. 1997, 50. árg.