by Claus Köhnlein
January 22, 2006
As an "AIDS doctor" following the chemical-AIDS hypothesis you are in a tough
place. What I mean is that you are always with one leg in prison, since you
know the guidelines for therapy, and if you don't follow these guidelines and
something happens (some/any disease appears), you easily can face legal action.
And it is difficult to simply say, "Forget about your HIV diagnosis, just get the treatment for the disease which is diagnosed", since we don't know, for example, whether a cerebral toxoplasmosis is more efficiently treated with a protease inhibitor than with antibiotics. The same is true for generalized mycosis and other AIDS-defining conditions, *because there are no controlled studies.* (more on this in future columns).
So I will start by explaining how I first began to put myself in such an awkward position, and earned the title of a dissident AIDS doctor.
I saw my first AIDS patient in 1990 when I was part of the oncology unit at Kiel University. The patient was a strong, 35 year old man and he was suffering from a lymphoma. Because of a pos. EBV-test, he was said to suffer from Burkitt-Lymphoma. At that time our hospital started HIV antibody testing. The test happened to to be positive in this patient, and instantly the diagnosis changed from EBV related lymphoma to HIV-induced lymphoma and the patient was an AIDS patient from that moment on. I learned that he needed another treatment because AZT was tested in a controlled trial, and shown to be effective. Indeed the lymphoma disappeared, along with the patient, two years later. He died of PCP under bone marrow suppression.
At that time I did not know there was a controversy about the causation of AIDS. My criticism was only on an epidemiological basis. I said something like, "for me that's not a new epidemic, it's just an epidemic of testing, and consequently giving old diseases a new name. I didn't get many new friends with that idea.
A few months later, a 28 years old female was admitted to the hospital almost dying, breathless with fluid in the pleura. She had been on holiday in Sri Lanka and came back with high fever and severe headache, and because of that she was admitted at the Institute for Tropical Diseases in Hamburg. There she got lots of antibiotics because of the unknown fever. She deteriorated and was put on cortisone under the suggestion of some autoimmune disease. She recovered for some weeks and than deteriorated again and was admitted to our hospital because my chief at that time was a highly estimated Lupus erythematodes specialist. The woman was almost dying had lost a lot of weight and you cold easily call her an AIDS patient.
We started a whole bunch of diagnostic procedures and found nothing, not even HIV. But after a while we got a result from an Institute where we had sent some bone marrow of the patient and they found Histoplasma capsulatum in the bone marrow. We were excited - a treatable disease. We placed the patient on intravenous antimycotics and she recovered completely.
We repeated the discussion of several months previous. That's an AIDS patient, I said. It's an AIDS defining condition. It's not, said the other side. She is HIV negative, so she cannot have AIDS because AIDS is caused by HIV. At that moment I had a certain epiphany as I realized fully the insidiousness of the tautological definition.
HIV- antibody positive plus one of 27 old diseases (histoplasmosis, tuberculosis, lymphoma,cervical cancer etc...) is the new disease AIDS. But the same disease without HIV is simply the old condition.