Just out., September 02, 1994, Page 15, Image 15

ju s t o u t ▼ M p to m b c r 2, 1M4 ▼ 15
K eys to S urvival
Staying healthy with HIV means getting good treatment early
by Subhuti Dharmananda, Ph.D.
he concept has been developed in the
popular press— and in the minds of
millions—that becoming infected with
HIV means that a person will neces­
sarily die of AIDS. In reaction to this
impression, a few individuals have sought to
demonstrate that HIV is not the cause of AIDS,
thus trying to break the necessary connection
between a positive HIV test result and the devel­
opment of AIDS. But the assumption, in that
unlikely scenario, is that AIDS is a necessarily
fatal disease.
Thus far, most scientific evidence supports the
contention that HIV is the primary factor leading
to development of AIDS. But, at this time, there is
no convincing evidence that HIV infection or
AIDS is necessarily fatal. To the contrary, there is
growing evidence that potential survival time
under the influence of HIV is not much less than
when HIV is absent. This assertion may seem odd
when one knows so many people who have died
from complications of AIDS, but support for this
view is growing. HIV infection is increasingly
being described as a chronic or manageable dis­
ease.
PHOTO BY LINDA KUEWER
In the United States, to the best of our knowl­
edge, the spread of HIV began in 1978. We are An acupuncture session at the Institute fo r Traditional Medicine
thus in the 16th year of HI V-related disease in this
country. By repeated surveys and evaluations, it
has been determined that there are now about 1 what similar to the effects of aging— it is almost
ments, are reasonable methods of therapy that are
million people in the United States infected with
as if the aging process (as it affects the internal
relatively inviting, once a person learns of them.
HIV. According to medical records, about 205,000
organs, endocrine system, and immune functions)
There may be poor management o f the thera­
people died from complications of AIDS from
is speeded up by the infection. Just as one can
pies. This can occur because the medical doctor or
1981 until the end of 1993. Thus, up to this point,
recover from illness more quickly and more com­
team involved is inadequately trained or moti­
about 1.2 million people in the United States have
pletely in youth than in old age, so, too, one can
vated, or because the individual with the HIV
recover health from HIV’s negative impact more
been infected, and about one in six (16 percent)
infection does not follow recommended proto­
quickly when treatment is started early. In a recent
have died. The current (early 1994) toll of the
cols or lacks the will to survive through adversity.
survey of over 2,600 gay and bisexual men, more
disease is some 60,000 deaths per year, or about
Lifestyle factors with negative impact make
than half did not know their serostatus. Of those
one in sixteen (6 percent) of those infected. Most
health and survival difficult. Diet, exercise, smok­
who knew they were HIV positive, one-third did
of the individuals who have succumbed are those
ing and other behaviors that either enhance or
not pursue standard health care options, such as
who were infected early in the epidemic and
detract from health can have a large impact on the
finding
a
doctor
to
work
with
them
on
their
HIV
progression of any disease. For example, in the
received little treatment (or poor treatment) dur­
condition, getting regular testing to determine
ing the time they were infected.
non-HIV population, cigarette smoking is associ­
their
health
status,
or
beginning
antiviral
therapy
ated with a substantial decline in average life
Treatment for HIV and AIDS was essentially
if their CD4 counts were in the appropriate range.
span; the impact on the HIV population is be­
absent for the entire first half of this 16-year
One
deterrent
to
early
intervention
has
been
a
fear
lieved to be slightly greater. As much as half of the
period. The opportunistic infection pneumocystis
of interaction with the medical system. Yet, health-
cancers that occur among people in the United
carinii pneumonia was fatal in more than half of
promoting approaches, such as ingesting herbs
States not infected by HIV can be traced to lifestyle
all occurrences in 1986, yet it is rarely fatal today,
and nutritional supplements in convenient form,
factors— exposure to carcinogens is only part of
just eight years later. There were virtually no
and receiving acupuncture and massage treat-
the problem— several behaviors lead to reduced
treatments with nutritional supplements, with
Chinese medicine, with DNCB, DHEA, IL-12, or
other substances that have since been tried and
been shown to be promising (there is still very
little treatment with these), and there were no
nucleosides (e.g., AZT, ddl, ddC) and little or no
prophylactic therapy. Those who died prior to
1988 were basically untreated for the disease, and
There is hope it’s ju st not coming through
many of those who have died in the six years since
were treated too late or treated inadequately to
on the right channel
have a life-saving effect. In other words, death
from complications of AIDS has largely been the
any people anxiously awaited the re­
nosed as HIV positive. Projections indicate that
result of lack of treatment or a long delay in
sults
of
the
recent
international
confer­
there
are between 6,000 and 10,000 individuals
beginning therapies that are helpful. The same
ence on HIV disease and AIDS. Ac­
in the state of Oregon who are HIV positive.
situation existed earlier with other diseases—
cording
to
the
news
coming
out
of
that
confer­
In July, over 150 HIV/AIDS leaders and
such as early-onset diabetes—that were almost
ence, there is relatively little data that shows
activists gathered in Dallas, Texas, to address the
always fatal until the disease was understood and
promi
se
in
this
epidemic.
People
who
are
thought
growing
crisis of new infections occurring in gay
a rational treatment developed.
to be infected now number in the millions world­
men, bisexuals and lesbians. This conference
wide.
In
the
United
States,
more
than
one-third
was sponsored by the American Association of
or those who receive adequate treatment, and
of women infected have not received access to
Physicians for Human Rights. A report was pre­
especially those who receive it early enough
anti-HIV
drugs
such
as
ACT.
Forty
percent
of
sented
on the high rate of new infections among
in the disease process, the prospects of stay­
gay and bisexual men, particularly youth and
ing healthy with HIV and living long with HIV are infected women have not even been given anti­
biotics
to
fight
off
pneumocystis
carinii
pneumo­
men
of color.
quite good. While there will always be a few who
nia. HIV/AIDS is growing at an alarming rate
The two main factors that keep coming up
will succumb to any disease (even common flu is
among
the
elderly
in
the
United
States.
Globally,
from
the long-term survivors of HIV disease and
the cause of death for thousands each year who are
hundreds of thousands of children are orphaned
AIDS are early diagnosis and immune enhance­
not infected by HIV), there is well-founded hope
after
their
parents
die
from
the
complications
of
ment
therapies. With that in mind, the following
for most of those now living with the virus. The
AIDS.
three articles outline accessibility challenges for
main reasons why AIDS can still prove fatal, with
In
Oregon,
a
recent
report
shows
766
new
youth and men of color, as well as offering real
our current state of knowledge, are:
AIDS
cases
and
over
500
people
newly
diag-
hope to people who are HIV positive.
The majority wait too late to begin treatment.
• » ■~ ♦ *
The effects ¿fH lY infraipn’pve/jím c árc^rfié-,
I I « ♦
T
T he S tate of HIV D isease and AIDS
,
M
F
immune functions that allow cancers to develop.
Cancers characteristic of HIV disease, such as
Kaposi’s sarcoma and lymphoma, are likely to be
influenced similarly. Travel has become a poten­
tial problem for those with HIV— sitting for hours
in a plane can expose one to pathogens, and
separation from one’s medical providers and health
programs, as well as from supportive individuals
and a familiar environment, can take a toll. An­
noying problems of exposure to new germs or
parasites that affect many travelers become criti­
cal problems for those with HIV.
Genetic factors. One’s genetic background
can have an influence not only on basic life span
but on susceptibility to developing various life-
threatening diseases. Such genetic factors, unlike
the other factors mentioned above, cannot be
controlled at present.
s reported in a recent retrospective study of
a group of individuals known to have been
infected by HIV at least since 1978 (be­
cause their blood samples had been retained as
part of a hepatitis study) and traced by medical
researchers, many remain alive 15 years later, this
being the group who lived with the infection for
the most years without any treatment. For those
who were infected later than that, and who have
obtained treatment, one may well expect about
half (or more) will be alive 20 years later, based on
the impact of drugs that have already been tested
for a few years. Newer treatments are likely to
improve the outlook. Most AIDS-related deaths
have occurred in those 30 to 50 years old. As
treatment improves— and if measures preventing
spread of the disease are successful— those fig­
ures will soon be changed to 40 to 60 years old,
and perhaps older.
Further, researchers are confident that more
effective treatments will be discovered in the next
few years that will greatly enhance the outcome.
For example, promising trials are now being con­
ducted with a vaccine that can be administered
after HIV infection which can aid the immune
system in attacking HIV. There have been some
cases of seroconversion— that is, transition from
being HIV positive to HIV negative— in indi­
viduals pursuing either natural therapies or very
aggressive medical therapies. New forms of AZT
and other nucleosides are being tested which are
expected to show improved effects and fewer
side-effects. Despite disappointing reports from
the Berlin Conference in 1993 and the British-
French study of early intervention with AZT,
other studies have demonstrated delays of devel­
opment of AIDS and longer survival from the use
of existing drug therapies.
A
t the Institute for Traditional Medicine, we
have noted the rapid progress in the field
of natural therapies. The Immune Enhance­
ment Program operated by ITM in Portland has
made many improvements in the therapeutics
offered since it began in October 1992: Herb
dosage has been increased, new formulations
added, improved understanding of HIV progres­
sion has led to better selection of herb formulas,
and there arc more methods of administration
offered (tablets, granules, topical treatments, re­
tention enema). In addition, nutritional supple­
ments have been provided, information about
diet and exercise have been collated and pre­
sented, and massage therapy now accompanies
acupuncture treatments. Meetings of clinicians
to discuss new methods of therapy are held
regularly. Formal clinical studies conducted at
this site, starting with an evaluation of DNCB
and continuing with hormone-modulators and
interleukins, enhance medical monitoring of the
participants and offer the best possible treatment
A
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