Path: utzoo!utgpu!news-server.csri.toronto.edu!cs.utexas.edu!swrinde!elroy.jpl.nasa.gov!ucla-cs!usenet
From: turner@lance.tis.llnl.gov (Michael Turner)
Newsgroups: sci.med.aids
Subject: Re: Being Alive Newsletter - February 1991 - Part 2/2
Message-ID: <1991Mar1.191128.14350@cs.ucla.edu>
Date: 1 Mar 91 18:53:30 GMT
References: <1991Mar1.103442.26897@cs.ucla.edu>
Sender: news@ncis.tis.llnl.gov
Organization: University of California, Berkeley
Lines: 56
Approved: phil@wubios.wustl.edu
Note: non-commercial reproduction.
Nntp-Posting-Host: squid.cs.ucla.edu
Archive-Number: 3045

In article <1991Mar1.103442.26897@cs.ucla.edu> gilbert@tce.COM (Gilbert Cornilliet) writes:
>
>COMMON SKIN DISEASES IN HIV INFECTION
>by Alan Cantwell, Jr., MD
>
>[extensive deletion]
>No discussion of HIV-associated skin disease would be complete without 
>mention of Kaposi's sarcoma (KS). KS is the most dreaded skin disease 
>because, by definition, a KS diagnosis means AIDS. To the untrained eye, 
>there are various red and purple lesions which can resemble KS. Thus, a skin 
>biopsy should be done to confirm a suspected KS diagnosis.
>[more deleted]
>It should be noted that AZT does not necessarily prevent the development of 
>KS. Interestingly, my longest surviving AIDS patient is a Black man with 
>extensive KS lesions of the legs for over 5 1/2 years. He has never had AZT, 
>interferon, or chemotherapy, although he has received some local radiation to 
>some lesions. He claims that stress definitely aggravates his KS lesions, and 
>he works hard to minimize it in his life.
>
>The cause of KS is not known....Most AIDS patients do 
>not die from KS, but rather from opportunistic infections of more serious 
>nature.
>[more deleted]

I read recently that the links between KS and HIV infection are increasingly
weak--that KS shows up in many HIV- gay and bisexual men who are not in the
usual "risk group" (Italian men) for this otherwise-rare disease.  I don't
have the report on hand.  I recall that it was printed in the S.F. Chronicle,
and was based on data released by CDC with Robert Gallo's imprimatur (but
with no comment from him.)

This is interesting in that AIDS was first known informally as "gay cancer"
on the basis of widespread KS diagnoses in the early 80s.  Dr. Gallo, who
had nearly his whole career as a virologist invested in the theory of viral
causes for cancer, now has his career invested in the theory of viral causes
for AIDS.  For him to now release data suggesting that the original trail-
marker for the HIV/AIDS connection was not a valid one is *very* interesting.
That AZT is "not necessarily" (maybe not at all? what does he mean?) effective
in preventing KS seems to further weaken the connection.

Obviously, this should be confirmed by someone with more credentials in
AIDS epidemiology, but it would seem that the "definition" (in part, that
"KS means AIDS") should be reviewed.  Is KS really an HIV-related disease?
Or is it due to other immunosuppressive cofactors that just happen to
correlate closely with risk for HIV infection?

Another disturbing thing: since KS was one of the first diseases linked to
HIV, epidemiological data about KS is among the oldest data we have.  For
this break in the HIV causal link to KS to be so long in coming is suspicious.
Gallo's bias (viral causes for cancer) is obvious.  Could this bias have
delayed the announcement?  By years, perhaps?  The virtual CDC monopoly on
AIDS epidemiology data makes it that much harder to say.  Perhaps this
data should be put in the public domain.
---
Michael Turner
turner@tis.llnl.gov