AIDS Treatment New, no. 183

Announcements
AZT Muscle Problems:
L-Carnitine Study Recruiting
The Neuromuscular Diseases Section of the U.S. National Institute of Neurological Disorders and Stroke
(NINDS) is now recruiting for a study of high-dose Lcarnitine as a possible treatment or preventive for AZTrelated muscle problems. Patients may be eligible if they
are using AZT and experiencing either fatigue, decreased
endurance, or weakness; these can be symptoms of AZTinduced muscle toxicity. [Note: persons with HIV and
nerve or muscle disorders, whether or not they are taking
AZT, may be eligible for a separate NINDS study of a
different treatment; for more information, see the announcement below.]
This six-month study is being conducted at the National
Institutes of Health campus in Bethesda, Maryland, near
Washington D.C. All expenses are paid, except for the cost
of travel for the first trip to Bethesda to see if you qualify
for the study. (Lodging is paid for this first trip, and all
expenses are paid for later trips.) No insurance company
will be billed, and all information will be kept confidential.
There are no T-helper count requirements for this study.
All test results (including physical examination, laboratory tests, EKG, echocardiogram, and muscle biopsy) will
be forwarded for the patient's clinical care.
This is a placebo-controlled study. At the end of the
study, if the treatment is determined to be effective, it will
be provided.
Background
L-carnitine is an essential nutrient, which is found
especially in muscle tissue. Deficiencies can cause muscle
and heart problems. A study published last year found low
levels in 72 percent of AIDS patients who were using
AZT.' Another study2 gave a high dose of L-carnitine for
two weeks to AIDS patients treated with AZT, and found
improved results of certain blood tests. The goal of the
NINDS study is to see if correcting an L-carnitine deficiency (if there is one) could relieve AZT-related muscle
problems.
Carnitine is sold in health-food stores and buyers' clubs.
But be sure to use only L-carnitine (not DL-carnitine,
which at one time was the only kind available there). DL
carnitine consists of a mixture of equal parts of L-carnitine
and D-carnitine. Only L-carnitine is active; and some
people suspect that D-carnitine might be harmful.

Better yet, if you can get your physician to prescribe Lcarnitine, you can be assured of getting the highest quality.

Some physicians will be reluctant, because this use (for
AZT-related muscle problems) is experimental and unproven at this time.
References
1. De Simone C, Tzantzoglou S, Jirillo E, Marzo A,
Vullo V, and Martinelli EA. L-carnitine deficiency in
AIDS patients. AIDS. February 1992; volume 6, number 2,
pages 203-205.
2. De Simone C, Tzantzoglou S, Famularo G, and others.
High dose L-carnitine improves immunologic and metabolic parameters in AIDS patients. Immunopharmacology
andl Immunotoxicology. January 1993; volume 15, number
1, pages 1-12.
For More Information
For more information, call Edward J. Cupler, M.D., at
NINDS, 301/496-9979.
HIV-Related Nerve or Muscle Problems
- IVIG Study Recruiting
A separate study of HIV-related muscle and nerve problems is also being conducted at the Neuromuscular Diseases Section of NINDS. This study is for patients with
"inflammatory myopathy and HIV-associated demyelinating neuropathy... We will evaluate patients with neuropathic symptoms of numbness, distorted sensation, or
weakness starting distally and progressing proximally."
This study is testing high-dose IVIG (intravenous immune globulin) to treat these conditions. There are no Thelper count requirements. It does not matter whether the
patient is taking AZT or other antivirals.
For More Information
For more information, call Edward J. Cupler, M.D., at
NINDS, 301/496-9979.
New York: Community-Based
Aspirin Study Recruiting
A study of aspirin as a potential treatment for AIDS,
conducted by the Community Research Initiative on AIDS
(CRIA) in New York City, is now recruiting. The hope is
that reducing HIV-related inflammation might result in
lower viral burden. The principal investigator is Donald
Kotler, M.D., Director of Gastrointestinal Immunology at
New York's St. Luke's Roosevelt Hospital Center.
The study will administer high-dose aspirin (4 grams,
equivalent to about 12 ordinary [325 mg] aspirin tablets per

day), plus 3 grams of Sucralfate as a buffer to help prevent
stomach irritation, for eight weeks. Volunteers will be
randomly assigned either to receive the aspirin, or to

AIDS Treatment News #183

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