MNSMITH@ECS.UMASS.EDU (Michael Smith) (06/14/89)
AIDS TREATMENT NEWS #80, June 2, 1989
CONTENTS
Cryptosporidiosis: Important Treatment Advance?
Itraconazole: Affordable Fluconazole Substitutes?
San Francisco: Hypericin, Ozone Monitoring Projects Begin
How to Use Hypericin
Cimetidine (Tagamet) As Immunomodulator, Antitumor Agent?
Foscarnet Organizing: New Phone Number
Book Review: Epidemic Politics Under Microscope
Hypericin Survey
CRYPTOSPORIDIOSIS: IMPORTANT TREATMENT ADVANCE?
by John S. James
AIDS TREATMENT NEWS has heard credible rumors that a new
drug used to kill parasites in animals might be effective for
treating cryptosporidiosis, a serious opportunistic infection
which causes severe diarrhea in persons with AIDS.
The drug, diclazuril (trade name Clinacox), kills parasites
and their cysts in chickens, when added to their feed in as lit-
tle as one part per million, or when given as a single dose of 5
mg/kg. We have heard that a few people have used diclazuril in
Africa and in the United States, and that a dose of 200 mg per
day or slightly more may completely eliminate cryptosporidiosis
in many cases, killing both the organism and the cysts in a few
days. However, the drug is not approved anywhere for human use,
and we have not yet confirmed that the 200 mg dose is safe or
effective. And no one is sure how long the treatment may need to
be continued.
We do not know in which countries diclazuril is currently
marketed for agricultural use.
We decided to publish this short article, despite the frag-
mentary information, so that others can help us investigate and
learn more. If you have any information about diclazuril, please
contact John James at AIDS TREATMENT NEWS, 415/255- 0588, or by
mail.
References
No human research has been published. We obtained the fol-
lowing references by computer searches and have not yet seen the
articles.
Animal Pharm World Animal Health News : Number 139, page 18,
October 9, 1987; Number 140, pages 8-9, October 23, 1987; Number
166, page 14, November 4, 1988; Review issue, page 14, January 6,
1989.
Jensen, JF. Comparison of the new coccidiostat diclazuril and an
approved coccidiostat in research with broilers (English transla-
tion of Danish title). Statens Husdyrbrugsforsoeg, number 724,
October 6, 1988.
Kutzner, E and others. Diclazuril, a new anticoccidial agent for
broilers (English translation of German title). Wiener
Tierarztliche Monatsschrift, volume 75 number 11, pages 415- 419,
1988.
Maes, L and others. In vivo action of the anticoccidial diclazu-
ril (Clinacox) on the developmental stages of Eimeria tenella: a
histological study. J. Parasitol volume 74 number 6, pages 931-
938, December 1988
Mathis, GF and others. Anticoccidial efficacy of diclazuril in
chickens. 77th Annual Meeting of the Poultry Science Association,
Inc. Poult Sci 67 (supplement 1), 115, 1988.
Verheyen, A and others. In vivo action of the anticoccidial
diclazuril (Clinacox) on the developmental stages of Eimeria
tenella: an ultrastructural evaluation. J Parasitol, volume 74
number 6, pages 939-949, December 1988.
ITRACONAZOLE: AFFORDABLE FLUCONAZOLE SUBSTITUTE
Fluconazole is a very good antifungal which is taken by
mouth; it is effective for cryptococcal meningitis and many other
fungal infections. It is approved in England, but not in the
United States, apparently because of bureaucratic snafus. Some
people have obtained personal supplies from England, but the drug
is very expensive; maintenance doses for cryptococcal meningitis
can cost almost as much as AZT, and insurance will not pay for
fluconazole because it is not approved.
Another drug, itraconazole (brand name Sporanox) may be
almost as good as fluconazole but much less expensive. Itracona-
zole is used to treat many different fungal diseases. It may be
less effective than fluconazole for cryptococcal meningitis, how-
ever, although it is sometimes used for that condition (see
references, below). Itraconazole is available in Mexico, and it
either is or is soon expected to be available in the UK. We do
not have exact price information, but have heard that treatment
with itraconazole (obtained from Mexico) costs about $1.50 to
$3.00 per day, depending on the dose.
Anyone considering using fluconazole or itraconazole should
also consider the more conventional options. Amphotericin B
(AMB), which is readily available, is probably at least as effec-
tive as fluconazole. Its drawbacks are that it must be given
intravenously, it can cause unpleasant side effects, and some
patients cannot tolerate it at all.
If AMB cannot be used, a patient may be able to qualify for
a trial of fluconazole, or for compassionate use, in which case
the drug will probably be free. Physicians only who want to find
out how to enroll their patients should call the developer,
Pfiser Inc., at 203/441-4112.
If these options do not work, then for more information
about obtaining fluconazole or itraconazole from abroad, patients
can call the PWA Health Group, 212/532-0280.
References
De Gans, J and others. Itraconazole as maintenance treatment for
cryptococcal meningitis in the acquired immune deficiency syn-
drome. British Medical Journal 296/6618 (339), 1988.
Dismukes, WE. Azole antifungal drugs: old and new. Annals of
Internal Medicine volume 109 number 3, pages 177-179, August 1,
1988.
Dupont, B. Attack and maintenance cure of cryptococcal meningitis
in AIDS patients. (English translation of French title.) Med.
Mal. Infect., volume 18, special issue 215, pages 737-741.
Saag, MS and Dismukes, WE. Azole antifungal agents: emphasis on
new triazoles. Antimicrobial Agents and Chemotherapy volume 32
number 1, pages 1-8, January 1988.
Tucker, RM and others. Treatment of mycoses with itraconazole.
Annals of the New York Academy of Sciences number 544, pages
451-470, 1988.
Wishart, JM. The influence of food on the pharmacokinetics of
itraconazole in patients with superficial fungal infection. Jour-
nal of the American Academy of Dermatology volume 17 number 2
part 1, pages 220-223, August 1987.
SAN FRANCISCO: HYPERICIN, OZONE MONITORING PROJECTS BEGIN
San Francisco area community groups have begun two small,
prospective monitoring studies to collect reliable information
about potential AIDS/HIV treatments which have come into use by
patients but are not being studied in formal clinical trials.
"Monitoring" studies do not give treatment to anyone; they
only collect data. Therefore they are much easier to set up and
administer than the large-scale, randomized trials favored by
large institutions. "Prospective" means that these monitoring
studies are designed in advance, allowing clean, uniform data
gathering: the same blood tests for every patient, on the same
schedule and at the same lab; uniform physical examinations, med-
ical history interviews, and patient diary forms; and an overall
study design approved in advance by a scientific committee. If
successful, these studies can serve as precedents for rapid,
community-controlled research projects to get reliable data for
patients and physicians, as soon as new treatments come into use.
THE HYPERICIN STUDY
We have previously reported on hypericin, an antiretroviral
found in St. John's wort, a plant long used in herbal medicine
(see AIDS TREATMENT NEWS #63, 74, 75, 77, and 78). While main-
stream researchers are synthesizing the chemical, running animal
studies, and negotiating for FDA permission to begin "phase I"
human trials this year or next, probably hundreds of people are
already using herbal extracts. We are hearing anecdotal reports
of benefits, but this information is inherently limited because
of unknown self-selection biases, and because different blood
tests and different labs were used.
The new monitoring study, formally approved May 22 by San
Francisco's Community Research Alliance (CRA; for background on
this community-based research organization, see AIDS TREATMENT
NEWS issue # 70, December 1, 1988), is for people who have not
used hypericin in the last six months, but plan to start using a
standardized herbal extract. (Standardized extracts are those
which have been chemically tested during their manufacture and
adjusted to contain a uniform strength of an active ingredient in
every batch. Examples of St. John's wort extracts standardized
for hypericin content are Yerba Prima tablets, Psychotonin tinc-
ture, and Hyperforat tincture.)
The study will last four months. "Baseline" testing (before
treatment begins) includes P24 antigen, T-cell subsets, CMI, Beta
2 microglobulin, CBC, ESR, and SMA 25, as well as a physical
examination and medical history. Blood tests are given monthly;
the last visit includes a second physical exam. A total of five
monthly visits is required.
All tests are paid for by the CRA. At this time, the CRA has
enough money to enroll 30 patients. More will be enrolled if the
money can be raised.
Note: Ten patients per month will be enrolled in this obser-
vational study. If you are interested in volunteering, call the
Community Research Alliance at 415/626-2145. If more than ten
qualify for the study, ten will be chosen by a lottery; those not
chosen the first month will be considered again at later months.
The first ten may be able to start by late June. However, no
starting date can be guaranteed, and there will probably be more
volunteers than can be accepted.
It is very important that people who enter this study have
not used hypericin in the previous six months. Otherwise, bene-
fits may have already occurred before the first physical exam and
blood test, and therefore the study would miss them and mislead-
ingly underestimate the value of the treatment.
All other treatments (AZT, etc.) are OK, however, either
before or during the study. One of the rules of a monitoring
study is that it does not ask people to change the treatments
they would be using anyway. These must be reported to the
researchers, of course.
The Community Research Alliance is also looking for
volunteers for office work, etc. If you can help, call the number
above.
Ozone Study
Ozone is being studied as an AIDS/HIV treatment in Germany,
but aside from a small trial for AIDS-related diarrhea at the
Veterans Administration Hospital in San Francisco, there are no
government or corporate clinical trials in the United States.
Recently, however, a group of ten persons with AIDS or HIV
jointly purchased an ozone machine for their own use, and before
beginning the treatment they organized their own monitoring
study, with the help of research nurse Leland Traiman. Mr. Trai-
man runs mainstream AIDS clinical trials professionally, and he
volunteered to help coordinate the patients' ozone trial.
This eight-month study includes the same blood tests as the
hypericin protocol described above. (These tests are becoming a
core subset of uniform blood work and data collection forms, to
be used in many prospective monitoring studies.) Laboratory work,
medical history, and physical exams were given before treatment
started, to obtain baseline values; eight additional appointments
were scheduled over the next eight months. The baseline and two
other blood drawings have already occurred; the fourth blood draw
is scheduled for the end of May.
At this time, the ozone trial is not officially sponsored by
any organization; it belongs entirely to the people in the study.
When they obtained the ozone machine, the Community Research
Alliance was newly organized and not ready to approve and admin-
ister a study. But the patients were ready to start, and of
course they did not want to wait for a study. So the Healing
Alternatives Foundation (the San Francisco buyers' club) donated
$2500. for initial blood work; without that support at a critical
time, the baseline values could not have been obtained and the
study would have been lost. The entire trial will cost about
$10,000, almost all of it for lab work, as Mr. Traiman's time is
volunteer. Money from an anonymous benefactor, from AIDS TREAT-
MENT NEWS, and from Mr. Traiman himself has kept the study going
so far.
Recently the Berkeley Gay Men's Health Collective offered to
assist, by housing the ozone monitoring project in the Berkeley
Free Clinic building.
After seven weeks of ozone treatment, no dramatic changes
have been found. At three weeks, lymphocyte counts had improved
substantially for many of the patients; other blood work showed
no meaningful change. By the seventh week, however, these counts
had returned to close to their baseline values. At this time
there is no evidence of any benefit, or of any harm, from the
ozone treatment.
The lack of early results does not discourage Mr. Traiman.
"There are no conclusive results so far; it's too early to
tell... I don't believe or disbelieve that ozone is an effective
therapy. I've heard some strong positive anecdotal reports, and I
want to learn if there is any scientific basis behind them."
A New Model for Community Response?
One of the most successful responses to the AIDS epidemic so
far has been the "San Francisco model", close cooperation between
public agencies and private, mostly volunteer organizations, in
providing prevention education and services to those who are ill.
However, this model has traditionally not included any involve-
ment with research.
The ozone and hypericin studies suggest a new, additional
model for the years ahead. Small but well-conducted research stu-
dies are within the capabilities of grassroots organizations. The
key test of the success of these projects is whether they produce
information which is credible to front-line AIDS physicians, and
useful to patients and physicians alike in making treatment deci-
sions. Community groups responsive first and foremost to
patients' interests can move much faster than Federal or cor-
porate bureaucracies ever will; if they can generate solid treat-
ment information, they will make a major contribution to saving
lives and improving quality of life.
These small studies which combine the work of professionals,
activists, and other volunteers are also relevant to public pol-
icy in a time of scarce resources. Monitoring studies cost very
little to run. If they produce useful treatment information, they
should pay for themselves many times over, by reducing the need
for hospitalization and other treatment, by keeping people pro-
ductively employed instead of ill, and by developing very low
cost treatment options (such as hypericin herbal extracts) which
other U.S. research institutions seldom or never do.
HOW TO USE HYPERICIN
by John S. James
AIDS TREATMENT NEWS has published several articles and
updates on hypericin, an antiviral available in extracts of the
St. John's wort plant (see AIDS TREATMENT NEWS numbers 79, 77,
75, 74, and 63). Almost all the reports we are hearing from users
are good, a fact not always reflected in our articles, as we have
felt obligated to publish reports of side effects or possible
dangers immediately, but have not hurried into print with the
reports of benefits. Few people who have told us about their use
of hypericin have failed to report benefits, usually objective
improvements in symptoms, blood-test results, or both, often
entirely unexpected. However, we have only received about 25
reports overall, and it is possible that we have seen a biased
picture because persons who did not see any effects may not have
bothered to contact us. We hope that the survey elsewhere in this
issue will help to correct such bias. And the upcoming prospec-
tive monitoring study by San Francisco's Community Research Alli-
ance (also described in this issue) should obtain better informa-
tion than any survey could.
There has also been confusion about how to use hypericin. We
have reported several different dosage regimens, and different
brands. AIDS TREATMENT NEWS has a policy against making its own
treatment recommendations; but we have closely followed the use
of hypericin herbal extracts, and since little information is
available, we decided to summarize the picture as we see it.
The following three standardized extracts contain signifi-
cant amounts of hypericin: Yerba Prima St. John's wort tablets,
Psychotonin tincture, or Hyperforat tincture. "Standardized"
means that the concentration should be uniform from batch to
batch.
Of the three, the Yerba Prima tablets are much less expen-
sive than the other two, which must be imported from Germany. As
far as we know, the tablets are just as good.
AIDS TREATMENT NEWS had a chemist test several brands, as we
previously reported. Two other products, St. John's wort tinc-
tures from Herb Pharm and from Jarrow Formulas, were found to
contain comparable amounts of hypericin. These products are not
standardized for hypericin content, however, so the concentration
may vary.
Not acceptable are products which have not been indepen-
dently tested. As there are no standards for herbal products in
the United States, a product can be labeled "St. John's wort" no
matter how little St. John's wort or hypericin it contains. Even
some European extracts may have ten times less hypericin as the
products we named above. We could not test everything, however,
and other products we do not know about may also be good.
Also not acceptable are teas made from dried St. John's
wort, which is sold in health-food stores. As previously
reported, we have heard of little or no benefits from these teas,
and one report of possible harm.
Hypericin may be especially effective for persons who are
also using AZT.
What about the dose? For the Yerba Prima tablets, with which
we are most familiar, the usual dose is two or three of the 250
mg, 0.14 percent hypericin tablets per day. Some people are using
as many as six tablets every day. (The dose recommended on the
bottle is two.) There are also intermittent schedules being
tried, in which the tablets are not used every day.
Absorption and blood-level studies are now being done, with
hypericin being administered intravenously, intramuscularly, and
orally. Dose recommendations may change in the future. AIDS
TREATMENT NEWS will report information as it develops.
The most important safety precaution, in our view, is to
have liver function tests (often included in a blood-chemistry
panel) within several weeks of starting hypericin. In a handful
of cases, persons using hypericin have been found to have
elevated transaminase values, and their physicians had them stop
all treatments which might have been responsible. While no one is
sure that St. John's wort caused the problem, it would be unsafe
to take risks until more is known.
Another precaution is to avoid exposure to sunlight or
ultraviolet light. Photosensitivity (abnormal sensitivity to sun-
light) due to St. John's wort extracts has been so rare in humans
that there is debate about whether it happens at all. But again
it seems better to err on the side of safety.
Drowsiness has been reported when people have used large
doses of hypericin-containing extracts.
One conservative strategy for using hypericin would be to
continue it only if there are clear benefits. In most of the
reports we have heard, unmistakable improvements in symptoms
and/or blood work were seen within a few weeks. One approach to
risk reduction would be to accept the probably small risks of the
treatment provided that there is clear benefits to balance the
risk, but to discontinue use if there was no evidence that it was
helping.
CIMETIDINE (TAGAMET) AS IMMUNOMODULATOR, ANTITUMOR TREATMENT?
by Denny Smith
Cimetidine (Tagamet), commonly used to treat stomach ulcers
and one of the most widely prescribed drugs in the U.S., has
shown immune enhancing and antitumor activity in recent studies.
In its original use, cimetidine worked by blocking the receptors
on stomach cells which control digestive acid secretions.
Cimetidine has also been shown to be useful for controlling
herpes simplex and herpes zoster outbreaks, as well as chronic
Epstein-Barr infection. (Cimetidine can slow the metabolism of
other drugs, leading to increased concentrations of them in the
bloodstream. This is important for drug interactions/half-life
considerations.)
The results of the current studies demonstrated variously
that cimetidine appeared to increase in vitro the proliferation
and potency of lymphocytes, probably by stimulating interleukin-2
production; increased the median survival time of patients with
gastric cancer and possibly lung cancer as well; enhanced natural
killer activity in patients with leukemia; and reduced T8-
suppressor cell activity in patients with hypogammaglobulinemia.
The most interesting research relating to HIV was done at the
University of Essen in West Germany. 1200 mg of cimetidine was
given daily to 33 patients with ARC for five months. All of the
participants showed improvement of symptoms, such as decreased
fevers, diarrhea and lymph node size, and increased body weight
and sensitivity to skin antigen tests. Significant increases in
several immune functions were noticed, including elevated T-
helper cell counts. These effects were reversible when cimetidine
was stopped, and reproducible when resumed.
We spoke with S. Jeanne Bramhall, M.D. who conducted her own
informal cimetidine monitoring project with five patients in
Seattle. All five patients experienced relief from a number of
AIDS or ARC symptoms, apparently after several weeks of Tagamet,
300 mg three times daily. Here is a brief summary of the results:
Patient 1: After three weeks on Tagamet and imipramine, her
fatigue, night sweats and lymphadenopathy disappeared completely.
These symptoms returned when the patient stopped the Tagamet, and
disappeared again when she resumed. Her T-cell ratio returned to
normal and the symptoms did not recur when she discontinued the
Tagamet after a second three-month trial. This patient has since
been lost to follow-up.
Patient 2: Experienced relief of disseminated herpes lesions
and thrush after two weeks of Tagamet, and after three months a
diagnosed Kaposi's sarcoma lesion in his mouth vanished. His T-
cell ratio was improving after eight months, and he had added
amitriptyline, acyclovir and ketoconazole to his medications. He
also wanted to start AZT, but was apprehensive about the poten-
tial for cimetidine to increase the toxicity of certain drugs. To
avoid this he replaced Tagamet with ranitidine (Zantac), a
related drug which studies found somewhat as active as an immu-
nomodulator but less likely to potentiate the toxicity of other
drugs. After switching he suffered several bouts with a per-
sistent staph infection and two episodes of PCP. He was also lost
to follow-up.
Patient 3: Started Tagamet after hospitalization for pneumo-
cystis. He noticed increased energy levels and diminished oral
thrush and enrolled in a local AZT study. After three months the
AZT had caused anemia severe enough to warrant a transfusion
(bone marrow toxicity is not unusual with AZT but perhaps the
potential for toxicity was enhanced with Tagamet). He elected to
discontinue both medications and after a month the anemia was
corrected. He now takes no medication other than Chinese herbs,
but seven months after the Tagamet he has seen four KS lesions
subside and has gained 25 pounds.
Patient 4: After a month on Tagamet, his persistent leuko-
plakia, intermittent fevers and diarrhea all subsided. After five
months, he discontinued the Tagamet and megavitamins, thinking
that they were causing a recurrence of diarrhea. At the time he
was lost to follow-up, he was not on any medication and had
remained symptom-free.
Patient 5: Fatigue decreased dramatically after one week on
Tagamet, but oral thrush persisted until he increased the dose to
400 mg three times a day for a week. He discontinued Tagamet and
continues to be in good health.
Dr. Bramhall is not a researcher and did not have access to
substantial funds or resources. But her anecdotal results should
be a springboard for more and larger studies. She points out that
cimetidine is relatively a very safe drug and is available now to
people with HIV and their physicians. Our thanks to Dr. Bramhall
for her work and to Jonathan Lax and Jim Tavitian for helpful
information. We hope to find more information on this potential
treatment at the V International AIDS Conference in Montreal.
References
Brockmeyer, NH and others. Immunomodulatory properties of
cimetidine in ARC patients. Clinical Immunology and Immunopathol-
ogy, number 48, pages 50-60, 1988
Tonnesen, H and others. Effect of cimetidine on survival after
gastric cancer. The Lancet, October 29, pages 990-991, 1988.
Gifford, RRM and Tilberg, AF. Histamine type-2 antagonist immune
modulation II. Cimetidine and ranitidine increase interleukin-2
production. Surgery, volume 102, number 2, pages 242-247, August,
1987.
Allen, JI and others. Cimetidine modulates natural killer cell
function of patients with chronic lymphocytic leukemia. Journal
of Laboratory Clinical Medicine, volume 109, number 4, pages
396-401, April 1987.
White, WB and Ballow, M. Modulation of suppressor-cell activity
by cimetidine in patients with common variable hypogammaglobu-
linemia. The New England Journal of Medicine, volume 312, number
4, pages 198-202, January 24, 1985.
Armitage, JO and Sidner, RD. Antitumour effect of cimetidine? The
Lancet, pages 882-883, April 21, 1979.
FOSCARNET ORGANIZING: NEW PHONE NUMBER
On December 16, 1988 AIDS TREATMENT NEWS published a San
Francisco phone number as a contact for organizing to make fos-
carnet an available treatment option in the United States. The
number belonged to Terry Sutton, who died on April 11 without
receiving the drug (see "Terry Sutton, 1955 - 1989", AIDS TREAT-
MENT NEWS #77).
The new contact number for foscarnet organizing is 415/431-
6088.
Note: In our talks with U.S. physicians who are experienced with
foscarnet, they have emphasized that it is not a miracle drug for
CMV, or as an HIV treatment; most prefer ganciclovir for CMV.
Physicians are much more concerned that foscarnet is no longer
available through compassionate use for treating acyclovir-
resistant herpes, for which it seems clearly better than anything
else available.
BOOK REVIEW: EPIDEMIC POLITICS UNDER MICROSCOPE
by Denny Smith
AIDS: Cultural Analysis/Cultural Activism, edited by Douglas
Crimp, is an excellent anthology published by MIT Press last year
and available in its second printing this year. Fourteen essays
examine the culture of contempt and disinformation which has
shaped the character of AIDS in America. Four essays recommended
in particular are: "AIDS, Homophobia, and Biomedical Discourse:
An Epidemic of Signification", by Paula A. Treichler; "AIDS and
Syphilis: The Iconography of Disease", by Sander L. Gilman; "Is
the Rectum a Grave?", by Leo Bersani; and "How to Have Promiscu-
ity in an Epidemic", by the editor.
Treichler writes: "The 'free-floating' iconography of
disease attaches itself to various illnesses (real or imagined)
in different societies and at different moments in history.
Disease is thus restricted to a specific set of images, thereby
forming a visual boundary, a limit to the idea (or fear) of
disease. . . the 'taming' of syphilis and other STDs with the
introduction of antibiotics in the 1940s left our culture with a
series of images of mortally infected and infecting people
suffering a morally repugnant disease--without a sufficiently
powerful disease to function as the referent of these images. . .
AIDS appeared then as the perfect referent."
In the following passage Douglas Crimp quotes Senator Jesse
Helms in the right-wing lawmaker's effort to foment support for
an amendment to deny Federal funds for gay safe sex education.
" . . . about 10 days ago I went down to the White House and
I visited with the President. I said, 'Mr. President, I don't
want to ruin your day, but I feel obliged to hand you this and
let you look at what is being distributed under the pretense of
AIDS educational material . . .'
"The President opened the book, looked at a couple of pages
and shook his head, and hit his desk with his fist."
The book in question was "precisely the sort of safe sex
education material that has been proven to work, developed by the
organization (Gay Men's Health Crisis) that has produced the
greatest amount of safe sex education material of any in the
country, including of course, the Federal government . . . when
we see how compromised any efforts at responding to AIDS will be
when conducted by the state, we are forced to recognize that all
productive practices concerning AIDS will remain at the grass-
roots level."
HYPERICIN SURVEY
If you have used hypericin (St. John's wort extracts), or
know anyone who has, whether or not any results were seen, you
can help with this survey. All identifying information will be
kept confidential. Please complete this questionnaire even if you
have already told us about your use of the treatment.
Use the back of this sheet, or use additional paper, when-
ever necessary. Please print or type.
A. Initials of person using hypericin: (Optional--you may omit
this information. If you provide it, we will keep it confidential.
We are requesting it to help us avoid counting the same person
more than once.)
First initial _____
Last initial _____
State of residence (or country if not U.S.) _____
B. Hypericin preparation used (circle one or more):
Yerba Prima tablets
Psychotonin tincture
Hyperforat tincture
Jarrow Formulas tincture
Herb Pharm tincture
Other (please specify) _______________
C. What daily dose was used? (Specify tablets, drops, or other.
Explain on back if necessary.) _____
D. How long was it used, in weeks? _____ (Explain on back if
necessary.)
E. Benefits which you believe might have been due to
hypericin: (Use back of sheet if needed.)
F. Side effects or harm which you believe might have been
due to hypericin: (Use back of sheet if needed.)
G. Symptoms or conditions which failed to improve while you
used hypericin: (Use back of sheet if needed.)
H. P24 antigen levels, if available:
Before starting hypericin (include date of blood drawing) _____
After using hypericin (include number of weeks of treatment
use at time of blood drawing) _____
I. T-helper cell counts, if available:
Before starting hypericin (include date of blood drawing) _____
After using hypericin (include number of weeks of treatment
use at time of blood drawing) _____
J. Other treatments:
AZT (circle one: yes / no). Dose: _____
Other antivirals (please specify, and give dose):
_______________
Other treatments we should know about (please list):
K. Optional: If we can contact you in case we have any further
questions, please give us your name and phone number:
L. In your own words, what do you think of hypericin? Also, use
this space to tell us anything else we should know.
STATEMENT OF PURPOSE
AIDS TREATMENT NEWS reports on experimental and complemen-
tary treatments, especially those available now. It collects
information from medical journals, and from interviews with
scientists physicians, and other health practitioners, and per-
sons with AIDS or ARC.
Long-term survivors have usually tried many different treat-
ments, and found combinations which work for them. AIDS TREATMENT
NEWS does not recommend particular therapies, but seeks to
increase the options available.
We also examine the ethical and public-policy issues around
AIDS treatment research.
HOW TO SUBSCRIBE TO AIDS TREATMENT NEWS
Send $100. per year for 26 issues ($150. for businesses and
organizations), or $30. reduced rate for persons with AIDS or ARC
who cannot afford the regular rate, to: ATN Publications, P.O.
Box 411256, San Francisco, CA 94141. A six-month subscription (13
issues) is $55. ($80. for businesses or organizations), or $16.
reduced rate. For subscription information and a sample issue,
call (415) 255-0588.
For the complete set of over 70 back issues, send $75. ($18. for
persons with AIDS or ARC) to the above address. The back issues
include information on hypericin, dextran sulfate, foscarnet,
passive immunotherapy, DTC (Imuthiol), naltrexone, DHEA, len-
tinan, propolis, coenzyme Q, monolaurin, egg lecithin lipids, fu
zheng herbal therapy, DNCB, aerosol pentamidine, fluconazole,
ganciclovir (DHPG) and other experimental or complementary treat-
ments.
To protect your privacy, we mail first class without mentioning
AIDS on the envelope, and we keep our subscriber list confiden-
tial.
Outside North America, add $20. per year for airmail postage, and
$18. airmail for back issues. Outside U.S.A., send U.S. funds by
International Postal Money Order, or by travelers checks, or by
drafts or checks on U.S. banks.
Copyright 1989 by John S. James. Permission granted for non-
commercial reproduction.