Læknaneminn


Læknaneminn - 01.04.1997, Page 115

Læknaneminn - 01.04.1997, Page 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.
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