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Recently a Kenyan scientist, Mr Charles Mbakaya, claimed
success in file search for an AIDS drug. He stated that the AIDS was not “all
about sex” and added that there was “the nutrition angle to think about”. He
drew parallels to South Africa President Thabo Mbeki’s assertion that “Africa
should not wholly believe the Western view about medicine.”
From a
purely political point of view, Mbeki’s standpoint is admirable to some,
given the harsh history Africa has had with the West. However, this should
not mean that HIV does not cause AIDS. In any case, last week it was reported
that Mbeki now accepts the negative impact that the pandemic is having on
South African society and the country’s image abroad, and pledged to reaffirm
the official government position in support of the scientifically
demonstrated link between HIV infection and AIDS.
Mbeki’s
position notwithstanding, HIV does exist. And it is the cause of AIDS. AIDS
stands for Acquired Immune Deficiency Syndrome. A patient is described as
having AIDS when the immune system is so damaged that he has less than 200
CD4+ cells or gets opportunistic infections.
There is
an “official” list of these infections, the most common being pneumocystis
carinii pneumonia, a lung infection. There is also Karposi’s sarcoma, a skin
cancer, Cytomegalovirus, an infection that usually affects the eyes, Candida,
a fungal infection, Toxoplasmosis, a protozoal infection of the brain, and in
over 50 per cent of the AIDS cases in Kenya, Tuberculosis, a bacterial
infection that attacks the lungs, and can cause meningitis.
It is
important to make clear the fact that there is no cure, neither is there any
vaccination for HIV/AIDS.
AIDS is fatal. But while
there is no cure, there are several forms of anti-retroviral medicines that if
taken in the right combinations, do delay the progression of HIV infection to
AIDS
Dr
Martin Markowitz, Clinical Director at the Aaron Diamonds AIDS Research
Centre in New York, says that these drugs have to be prescribed by trained
medical personnel and the patient’s progress monitored if the drugs are to
work.
Dr Markowitz
was on an award-winning team that led to the development of Highly Active
Anti-Retroviral Treatment. He has also been treating AIDS patients since 1981
and is involved in some of the most cutting edge AIDS-related research.
The
research data presented by Mbakaya is preliminary and should therefore not be
used for developing AIDS treatment policy before being subjected to a
rigorous review process with the normal well-established protocol for
clinical trials.
Such a
study should be published in a reputable journal, as that would require it to
be peer-reviewed on a stringent basis by virologists, pharmacists,
biochemists and clinicians.
Even if
this study has been published, the inherent weaknesses of the data presented
still need to be addressed.
Indeed
the immune system is adversely affected by even moderate degrees of zinc
deficiency. Severe zinc deficiency results in severely depressed immune
function and frequent infections.
Zinc is
required for the development and activation of T-lymphocytes, a kind of white
blood cell that helps fight infection. When zinc supplements are given to
individuals with low zinc levels, the numbers of T-cell lymphocytes
circulating in the blood increase and the ability of lymphocytes to fight
infection improves. These are well known facts.
Dr
Francis Kajumo, a Kenyan born researcher at the Albert Einstein School of
Medicine in New York, US, and a director at the Kenya AIDS Watch Institute,
says: “While there is a scientific basis to the claim that zinc boosts the
immune system on a general basis, so do other chemicals and substances. None
of them have been effective in reducing viral load on even a short term
because this virus attacks the immune system itself and unless a zinc
anti-viral effect and/or a negative interaction between zinc and the virus is
proven any claims of a zinc-laden supplement reducing viral load in patients
have no real basis”.
Kajumo
adds: “Just boosting the immune system may just increase fresh host targets
for the virus to replicate in, and by laws of attrition, the body fails to
produce enough immune cells to destroy the virus than those that are killed
and infected with HIV and so we have an increase in viral load.”
Questions
have also been raised about Mbakaya’s study: who was eligible to participate
in their trials? What criteria were used in selecting participants? What were
their initial viral loads? What were the negative controls used? Were any
efforts made to determine whether participants were on a zinc deficient diet
prior to commencement of the study? Was the “double-blind method used?
The
researcher should be willing to allow access to the patients them- selves to
peers to verify that there has actually been a reduction of viral loads.
Kajumo quotes the US’ National Institutes of Health guidelines.
“It is
also very important to know what the amount of zinc given was in these
supplements, because too much can cause toxicity and cause loss of immune
function.”
There is
a certain health risk to too much zinc. Zinc toxicity has been seen in both
acute and chronic forms. Intakes of 150 to 450 mg of zinc per day have been
associated with low copper status, altered iron function, reduced immune
function, and reduced levels of high-density lipoproteins (the good
cholesterol).
One case
report cited severe nausea and vomiting within 30 minutes after the person
ingested four grams of zinc gluconate (570 mg elemental zinc). Turning to the
nutrition aspect, “if as Mbeki believes, nutrition is responsible for AIDS in
Africa, why are Kenyans and South Africans in the middle and upper middle
classes dying of AIDS?
Don’t
they have the best diets and are nutritionally educated?
The rich
in Africa should not be dying of AIDS on this basis. Studies show that poor,
malnourished children in India, Africa, South America, and Southeast Asia
experience shorter courses of infectious diarrhea after taking zinc
supplements. Zinc supplements are often given to help heal skin ulcers or
bedsores, but they do not increase rates of wound healing when zinc levels
are normal.
In any
case the cost of anti-retrovirals is now less than Sh6,000 per month, down
over 95 per cent a year ago. The proposed cost of the zinc nutrition
supplement is Sh300 for three sachets a day which translates to Sh9,000 a
month, one half more than the cost of proven, properly tested medicine.
As much
as HIV/AIDS has become an industry, now is not the time to challenge the “HIV
causes AIDS” theory, not when it has become the single biggest killer of
human beings on earth.
Inasmuch
as there is much to be done in terms of national response to the AIDS
pandemic, we must recognise the steps we have made in recent times. We have
maintained the prevalence of AIDS at 14 per cent with positive signs of greater
lower prevalence in the near future. This has been due to the concern and
involvement of Kenyans and friends of Kenya.
A way
forward would be a massive national de-stigmatisation and screening effort.
Later supported by the availability of affordable anti-retroviral treatment
for those infected. This is the most productive and sustainable solution.
Considering
the enormous suffering caused to individuals, families and communities, it is
extremely cruel and irresponsible to give HIV/AIDS patients false hopes
regarding new treatment unless and until such treatment has been evaluated
and found beneficial and efficacious in the hands of several experts.
Kenya
AIDS
Watch Institute.
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