beth@sphinx.UChicago.UUCP (JB) (10/17/86)
[Defeat is worse than death because you have to live with defeat.]
In the November, 1986 issue of _American_Health_ magazine, there's an
article entitled "Drugs that Suppress Immunity". The last part of the
article discusses AIDS, and I thought it might be of interest:
AIDS is caused by a virus called human T-cell lymphotropic virus type
III (HTLV-III), which attacks a specific kind of T-lymphocyte,
virtually wiping out the body's infection-fighting T4 helper cells.
When the virus gains a foothold, interferon production slows down, the
B-lymphocytes and macrophages stop attacking invaders, and the NK
[natural killer] cells quit mopping up tumor cells and virus-infected
cells. AIDS victims don't die from AIDS, they die from the illnesses
that result from it -- the opportunistic infections and rare cancers
ordinarily seen only in transplant patients whose immune systems have
been suppressed by powerful drugs.
"HTLV-III won't produce AIDS in a healthy person," asserts Washington,
DC, internist Cesar A. Caceres. "HTLV-III produces AIDS only if the
immune system is already damaged." Dr. Caceres and co-author Terry
Krieger, in a controversial article published by _The_Wall_Street_
_Journal_, state, "It appears that most AIDS patients are not healthy
people who got AIDS simply because they had sex with the wrong person.
Rather, they seem to be people who were already sick in the sense of
having a damaged immune system [from drugs]."
Caceres treats a number of AIDS patients in his Washington practice.
Among these patients he noticed "an astonishing record of recreational
drug use." And, significantly, the drug use was not primarily intra-
venous, but oral, and included marijuana, amphetamines, barbiturates,
Quaaludes, LSD, PCP, cocaine, and amyl and butyl nitrites. In going
over the CDC data on risk categories of AIDS victims, Caceres and
Krieger found that drug abuse, not homosexuality, was the most common
risk factor. The authors define drug abuse as using a recreational
drug at least once a week. "We find that at least 79% of AIDS patients
have been drug abusers," Caceres says.
One recreational drug has already been specifically tied to AIDS. In a
1981-82 study of AIDS patients with Kaposi's sarcoma (KS), a cancer of
the blood vessels that is the one most often found among AIDS patients,
Dr. Harry Haverkos of the National Institute of Allergy and Infectious
Diseases found that the most distinguishing factor among the KS sufferers
was their use of large quantities of nitrite inhalants. "Nitrites affect
the blood vessels," he says. "The drug causes vasodilation, which many
homosexuals believe enhances and prolongs sexual stimulation." In his
study, pulished recently in _Sexually_Transmitted_Diseases_, Haverkos
found that nitrites were used by "nearly all" homosexual men with
Kaposi's sarcoma.
"We have enough evidence to warn people not to use drugs," says Nahas
of Columbia. Another researcher likens taking drugs to speeding on the
highway: "Most of the time you can probably get away with it. But if
you do it often enough, eventually there's going to be a cop around."
Note that the key word "controversial" is used to describe Caceres/Krieger's
theory that the immune system must already be damaged for HTLV-III to induce
AIDS. Note also that, at least on the surface, their weighting of drug
abuse as a larger risk factor than homosexuality seems to contradict the
data that Craig Werner supplies us from the CDC:
In article <513@aecom.UUCP> werner@aecom.UUCP (Craig Werner) writes:
> Gay men with no history of drug abuse account for 65% of all
>cases, Gay drug abusers, 8% (total gay = 73%), Heterosexual drug
>abusers, 17%, Hemophiliacs, 1%, Female Sexual Partners of infected men, 1%,
>and Transfusion associated, 2%.
It may be that Caceres/Krieger use a less restrictive definition of drug
abuse (they "define drug abuse as using a recreational drug at least once
a week").
In any case, I thought the article might be of interest, particularly the
tie between poppers and Kaposi's sarcoma. The rest of the article is not
AIDS related, but is quite interesting anyway. I'd recommend getting a
copy of the magazine and reading through it (_American_Health_ is a pretty
swell magazine anyway).
Take care,
JBedhall@randvax.UUCP (Ed Hall) (10/23/86)
Repeat after me:
Correlation does NOT imply causation.
Correlation does NOT imply causation.
Correlation does NOT imply causation.
As Barry Shein so aptly pointed out, the correlation between drug
use and AIDS can be explained by a third factor: life-style.
Many--I dare say a majority--of epidemiological studies are flawed by a
failure to rule out all significant confounding factors. Unfortunately,
it is in the very situation where cooler heads should prevail that
statistical safeguards tend to be forgotten. And, sad to say, some
otherwise brilliant researchers tend to be ignorant when it comes to the
proper use of statistics, leaving it to others to puzzle out just how
meaningful--or meaningless--the results really are.
-Ed Hall
decvax!randvax!edhall
edhall@rand-unix.ARPA