The Role of Drugs in AIDS

1/10/93 Ms. No. T1867

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to identify either HIV-carriers that develop AIDS only when they use drugs or
to identify HIV-free drug users that develop AIDS indicator diseases.
Drug use necessary for AIDS in HIV carriers.
(i) The incidence of AIDS diseases among 297 HIV-positive,
asymptomatic drug users over 16 months was three times higher in those
who persisted than in those who stopped injecting drugs (60).
(ii) The T-cell count of 65 HIV-infected drug users from New York
dropped over 9 months in proportion with drug injection, on average 35%,
compared to controls who had stopped (61).
(iii) (a) A causal link between nitrite inhalants and Kaposi's sarcoma
and pneumocystis pneumonia in homosexuals was first suggested in 1982 by
the CDC (9) and other investigators (8, 10). In view of this the sale of nitrite
inhalants decreased and was banned by the U.S. Congress in 1988 (Public Law
100-690) (62). At the same time the incidence of Kaposi's sarcoma among
AIDS patients decreased from a high of 35% in 1983 (63) to a low of 10% in
1990 (4). (b) Among drug users a 10-fold higher preference for nitrites (64)
correlates with a 20-fold higher incidence of Kaposi's sarcoma in
homosexuals compared to heterosexuals (18). (c) Male homosexuals with
Kaposi's sarcoma have used nitrite inhalants twice as often as those with
other AIDS (53). These correlations indicate that nitrites are necessary and
possibly sufficient for Kaposi's sarcoma.
(iv) AZT was used as AIDS prophylaxis in a controlled study of HIVpositive 25-45 year-old male homosexuals and intravenous drug users for one
year with the following results (58). A group of 453 on 500 mg AZT per day
developed 11, and a group of 457 on 1500 mg AZT per day developed 14 AIDS
cases. The placebo group of 428 developed 33 AIDS cases. For the presumed
savings of 22 and 19 AIDS cases, 19 cases of anemia, neutropenia and severe