Subject: Gay Men's Health Center News, Polio Vaccine Date: Nov 20 1987 (223 lines) &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& J O H N J A M E S writes on A I D S &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& copyright 1987 by John S. James; permission granted for non-commercial use. AIDS TREATMENT NEWS Issue Number 45 November 20, 1987 CONTENTS: [items are separated by "*****" for this display] New Optimism On Treatments Newsletter On AIDS Treatments, From Gay Men's Health Crisis News From the Community Research Initiative Polio Vaccine for AIDS Treatment? ***** New Optimism On Treatments by John S. James We have heard from New York physicians treating persons with AIDS and ARC that they are having far fewer deaths this year than last, and fewer serious complications requiring hospitalization, even though they have more patients. And in San Francisco, median survival time after an AIDS diagnosis increased unexpect- edly, from ten months to 14, after staying the same for five years. Meanwhile, the most comprehensive study yet of AIDS out- come found long-term survival much better than expected, and found that the evidence does not show that AIDS is always fatal. Many physicians now see a reasonable chance that AIDS could become usually a manageable disease within the next year or two. No cure is on the horizon at this time, but the hope is that most people could become healthy and remain that way indefinitely, even without a cure. We are preparing a review of this information, probably for the next issue of AIDS Treatment News. ***** Newsletter on AIDS Treatments From Gay Men's Health Crisis The first issue of Treatment Issues, a new monthly newsletter on AIDS treatments edited by Barry Gingell, M.D., is now available without charge from the Gay Men's Health Crisis in New York. Treatment Issues volume 1 number 1 (November 10, 1987) has articles on nutrition and AIDS, a discussion on whether persons with AIDS should receive routine immunizations for influenza and pneumococcal pneumonia, and an update on aerosol and intravenous pentamidine for treating pneumocystis. Treatment Issues is somewhat more conservative than AIDS Treatment News, but still it is full of useful information. For example, the nutrition article recommends lots of protein, including animal protein; for reasons discussed, it recommends against a strictly vegetarian diet. Instead it suggests using certified organically grown meats to avoid unwanted antibiotics, hormones, pesticides, and other chemicals often used in commer- cial meat production. It urges that cured meats (such as bacon, salami, or corned beef) be avoided, because they contain immu- nosuppressive chemicals such as nitrites. It tells where to get good-quality organically grown poultry in New York. A discussion of zinc supplements provides another example of practical information. The article suggests doses, and tells why too much is harmful. The newsletter is written primarily for persons with AIDS or ARC. But it has numerous references to the medical literature for physicians and researchers. To get on the mailing list to receive Treatment Issues without charge, send your name and address to: GMHC, Department of Medical Information, 132 West 24th St., Box 274, New York, NY 10011. ***** News From the Community Research Initiative The Community Research Initiative (CRI), a project of the PWA Coalition in New York, continues to do some of the best work anywhere in furthering AIDS research. (For background on the CRI, see AIDS Treatment News number 38, page 3.) The CRI now has a $300,000 contract with LyphoMed, the manufacturer of pentamidine, to conduct a 200-patient study of aerosol pentamidine. The protocol for this research was revised to support the FDA-approved design used in San Francisco General Hospital, so that the CRI study can contribute toward FDA appro- val of aerosol pentamidine, which will make it more accessible for patients. The CRI has also received $51,000 from People Taking Action Against AIDS, a new fund-raising organization, for a study of egg lecithin lipids (generic AL 721) as an AIDS/ARC treatment. A parallel arm of the study, funded separately, will use an inject- able form of the lipids. Dr. Jeffrey Askenazi will be the prin- cipal investigator in this study, with Dr. Joseph Sonnabend as co-investigator. Study design and funding negotiations are also proceeding for studies on: Ampligen, Erythropoietin, Cryptosporidium Milk- -Immune Globulin, Methionine Enkephalin (MEK), DHPG as CMV pro- phylaxis, and an Antabuse/Imuthiol Monitoring Project. ***** Polio Vaccine for AIDS Treatment? Twelve persons with ARC and one with AIDS have been treated by repeated injections of killed-virus polio vaccine three to seven times per week. All have show major improvement or com- plete remission of symptoms, usually within two months, and T- cell counts have also improved. Results of one case have been published (FN Pitts and AD Allen, Clinical Immunology and Immuno- pathology 43, 277-280 (1987). A report on the next four cases is in press, and a complete report will be published later. The physicians tried polio vaccine because they had already had good results with one case of acute lymphocytic leukemia, believed to be caused by a retrovirus related to HIV. In this case, a child who was not expected to live was given the vaccine for several years, and tested for eight years to confirm the rem- ission of the leukemia. He has now been healthy for 20 years after the treatment began. That child's physician had tried the vaccine in desperation, after learning that new leukemia cases decreased in areas which had a polio outbreak. This decrease suggested that there might be a cross immunity between polio and the retrovirus--perhaps because mammals had evolved an ability to produce antibodies to a certain groups of disease-causing organisms when exposed to only one of them. The first HIV patient was a physician with KS, thrush, fatigue, weight loss of 60 pounds, and a T-4 count of 40. Improvements started within six weeks; by ten weeks the KS, thrush, and most of the other symptoms had disappeared. He still had severe mental depression, however, and stopped the treatment in favor of another experimental therapy, and was lost to follow-up. The next four patients treated were gay men with ARC; an article on this phase of the study will appear in Clinical Immu- nology and Immunopathology. Three of these patients started with relatively high T-cell counts averaging over 400; their symptoms resolved completely within two to seven months. The fourth did not have an initial T-cell count available; his lymphadenopathy resolved completely, but some fatigue remained after 11 months of treatment. The killed-virus (Salk) polio vaccine used is believed to be entirely safe, and is commonly used for persons with immune defi- ciencies who cannot use the Sabin live-virus vaccine. However, there has been some controversy about whether persons with AIDS or ARC should receive any immunization, because of fear that increasing activation of the immune system could stimulate the growth of HIV. Last week we spoke with Dr. Pitts, one of the authors of the paper cited above; he is convinced that the bene- fits far outweigh any risk. He has now treated 12 persons with ARC, and every one treated long enough to evaluate has shown resolution of symptoms. They are able to work and entirely healthy. T-cells have increased by at least 67 percent, and sometimes much more. The polio vaccine trial has met skepticism from some immu- nologists, who say that polio immunization would not work for AIDS because it is a different virus. Immunologists are currently emphasizing the specificity of the immune response. Dr. Pitts points out that although the polio virus and HIV are in different families and reproduce differently, they are similar in structure in some ways. And there are many examples of common antibodies among different viruses, going all the way back to the first vaccination, which used cowpox virus to prevent smallpox. Dr. Pitts is board certified in both psychiatry and pedia- trics. He has studied the effects of viruses in the brain's lim- bic system (which controls mood)--including possible viral causes of depression. He became interested in retroviral diseases because the child whose case is described above is his son. The polio vaccine trial has IRB (institutional review board) approval to enroll 100 patients; since only 12 are enrolled so far, places are open for others. Dr. Pitts will consider persons with AIDS as well as ARC for the study. Only one person with AIDS has been treated so far, however, and it is not known whether the vaccine will be effective if the illness is very far advanced. Dr. Pitts is also recruiting physicians to work with him in testing this treatment. Physicians could of course use the treatment anywhere. Physicians or patients interested in the study can contact Ferris N. Pitts, Jr., M.D., Professor of Psychiatry and Behavioral Science, University of Southern California Medical School, 7500 E. Hellman Avenue, Rosemead, CA 91770. Phone (818) 571-4866, and ask for Claudia, a registered nurse who is working full time on this project. ***** [Obsolete subscription information has been removed. See the latest issues for up-to-date information. -- sysop] &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& End of display