AIDS Treatment New, no. 183

TMP-SMX: High Treatment Dose
Can Cause Hyperkalemia
A study by physicians at the Brookdale Hospital Medical Center in Brooklyn, New York, measured serum potassium levels in 25 patients who were given high-dose TMPSMX for treatment of pneumocystis, compared with 26
patients not given that drug. They concluded that highdose TMP-SMX could result in life-threatening hyperkalemia, particularly 7 to 10 days after the start of treatment,
and that serum potassium levels should be monitored
closely. (Note: this study looked at the high doses used to
treat pneumocystis - not the much lower doses used for
prophylaxis.)
[Greenberg S, Reiser IW, Chou SY, and Porush JG.
Trimethoprim-sulfamethoxazole induces reversible
hyperkalemia. Annals of Internal Medicine. August 15,
1993; volume 119, number 4, pages 291-295. The following article starting on page 296, by different authors, looks
at a possible cause, involving effects of the drug on the
kidney.]
Lymphoma: EBV Test
May Help in Diagnosis
A research test (not now available commercially) found
Epstein-Barr virus DNA in the cerebrospinal fluid from 17
of 17 patients who were diagnosed at autopsy with primary
CNS lymphoma - but in only 1 of 68 HIV-positive
patients without detectable lymphoma at autopsy. The
authors concluded that the test was 100 percent sensitive
and 98.5 percent specific for AIDS-associated primary
CNS lymphoma.
[Cinque P, Brytting M, Vago L, Castagna A, Parravicini
C, and Zanchetta N. Epstein-Barr virus DNA in cerebrospinal fluid from patients with AIDS-related primary
lymphoma of the central nervous system. The Lancet.
August 14, 1993; volume 342, pages 398-401.]
Resources
September Scientific American:
Special Issue on the Immune System
A special issue of Scientific American, "Life, Death,
and the Immune System," now on the newsstands, provides an excellent tutorial and background on how the
immune system works. It is especially helpful for giving

the background information needed to understand technical discussions of AIDS - including the technical terms,

such as "T cells," "B cells," "stem cells," "MHC molecules," "cytokines," etc. Besides several general chapters
on the immune system and its development, there are
chapters on AIDS, autoimmune diseases, and allergies.
The AIDS chapter has little treatment information, but
much background ontheories of what happens inthe body
during HIV infection.
The reading level is more advanced than that of AIDS
Treatment News, and readers will need some familiarity
with the material to understand the articles without assistance. For those without such background, the issue could
be a useful "textbook" for a short course on AIDS and the
immune system, led by an instructor. Organizations could
provide a service by setting up such a course for their
clients.
AIDS Treatment in Prison: Booklet
Useful for Non-Prisoners, Too
The Treatment Education Program of AIDS Project
Los Angeles has published a 46-page booklet, Be Good to
Yourself: A Self-Care Manual for Inmates Living with
HIV. It focuses on what can be done with treatments
which are likely to be accessible to prisoners. These
approaches are therefore accessible to most people without difficulty.
Chapters include acupressure, stress reduction, exercise, massage, nutritional supplements (which some prisons allow), AIDS prevention information, and a resource
list for prisoners. This book does not include Western
medicine in prison, or the related issues of access and
standards of care.
"Many of these treatments originated in Oriental medicine or other forms of traditional therapy. They were not
specifically designed for HIV infection, but to strengthen
natural defenses. Most of them have not been formally
tested as a treatment for HIV disease, mainly because
traditional medicine is largely neglected by scientists and
physicians in charge of AIDS research in Western countries. For this reason, no warranty or endorsement is made
as to the success of any of these treatments. This information should be considered as source material only." (From
the Introduction.)
For a copy, write to: Treatment Education Program,
AIDS Project Los Angeles, 6721 Romaine Street, Los
Angeles, CA 90038.

AIDS Treatment News #183

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