AIDS (Acquired Immune Deficiency Syndrome) is a fatal immune deficiency disorder for which neither the cause nor the cure is certainly known. The disease seriously impairs immunity, leaving patients highly vulnerable to attack from opportunistic organisms, particularly P. carinii pneumonia (PCP); and to such malignancies as lymphoma and Kaposi’s sarcoma, a once-rare form of cancer that attacks the endothelial cells fining the blood vessels.
AIDS is steeped in controversy. The cause is conventionally considered to be the HIV retrovirus; but Dr. Peter Duesberg, of the University of California at Berkeley, heads a growing number of scientists and physicians who question the theory. Dr. Duesberg, who helped pioneer the field of retroviruses, argues that HIV is too inactive, infects too few cells, and is too difficult to find in AIDS patients to be responsible for the immune damage that results. As a med student it was always interesting if a man could get HIV from a kissing. John has proved that in his extensive guide on HIV RNA testing.
He observes that there are nearly 5,000 documented AIDS cases worldwide where HIV is not present, a discrepancy that has been covered up by reclassifying them as idiopathic CD-4 lymphocytopenia (ICL), although their symptoms and opportunistic infections are the same as for AIDS.41 Alternative explanations for the immune deficiencies of AIDS patients include chronic consumption of drugs such as cocaine, amyl nitrates (“poppers”), AZT, and other immunosuppressive drugs; multiple, repeated venereal diseases leading to immune-system collapse; radiation exposure; and other viral and parasitic pathogens. Even the toxic benzene lubricants used by homosexual men have been proposed as culprits.
Other researchers accept the viral theory but dispute the popular African green-monkey theory of its origins. Dr. Leonard Horowitz, a Harvard public-health researcher, traces the AIDS virus to National Cancer Institute laboratories, where researchers in the 1960s deliberately mixed viral genes from different animals to produce leukemia, sarcoma, general wasting, and death, producing the “cancer models” used to begin human vaccine trials. Still other researchers blame the spread of AIDS on contaminated vaccines; for example, those given in Africa for smallpox. Such contamination hasn’t yet been proven for a human vaccine, but contamination of a fowlpox vaccine with a retrovirus was reported in the Economist in November of 1997. The discovery confirmed that retroviruses are able to reproduce by inserting their genes not only into an animal host but into another virus.
Drug Treatment
The first prescription medicine approved for the treatment of AIDS was the antiviral drug zidovudine (“AZT”). Originally developed for treating cancer, AZT slows replication of HIV but doesn’t specifically target the virus, doesn’t cure active AIDS, and can’t restore an AIDS patient’s immune system once destroyed. It also has many unwanted side effects, including nausea, insomnia, severe headaches, muscle pain, and reduction in white blood cells. Suppression of the growth of bone-marrow cells results in a lack of red blood cells, producing anemia, and in a lack of white blood cells, increasing susceptibility to infection. Liver damage has also been documented. As many as half of all AIDS patients can’t take AZT because of these side effects; and cost of the drug is prohibitive, running around $7,000 or $8,000 per patient per year.
AZT has also been used preventatively, since it seems to delay the development of AIDS in people who have the virus but have no symptoms—a category believed to include several hundred thousand Americans. The problem with using the drug preventatively is that HIV progressively develops a resistance to it. If people who are well take it for several years, it may be of no use to them once they begin to get ill; and they will have had to undergo AZT’s side effects and risks in the meantime. Risks include cancer; high doses of AZT have been linked to vaginal cancer in rats. For people who already have AIDS, this may be of small consequence, since their life expectancy is typically only a year or two after their first hospitalization. But for people who are infected with the virus but are asymptomatic, the ill effects of the disease may not be felt for years. Cancer could affect them before AIDS does. And under Dr. Duesberg’s theory, they might never even develop the disease.
In December of 1995, the FDA approved Hoffman-LaRoche’s Saquinavir, the first of a new category of AIDS drug known as protease inhibitors. In March of 1996, two more protease inhibitors were approved, Merck’s Indinavir and Abbott’s Ritonavir. Protease inhibitors are reported to stop HIV from replicating and, in some cases, to substantially reduce the total viral load. But these drugs, too, can have serious side effects, although Indinavir seems to have the least; and the cumulative price tag is estimated at more than $40,000 for the drugs and another $20,000 to $40,000 for lab and doctor fees. In 1997, researchers reported that the drugs weren’t as effective as had been hoped, and that the AIDS virus seems to be becoming resistant to them.
A range of other drugs that kill HIV is also used to treat AIDS, including DDI (didanosine), pentamidine, ddC, d4T, and 3TC; but these drugs too can have serious side effects. Other drugs are used by AIDS patients to treat the opportunistic infections and malignancies resulting from their immune deficiency.
There is no vaccine effective against HIV and no drug that specifically targets it. Development of an effective AIDS vaccine, if possible at all, is thought to be more than a decade away.
