The Italian AIDS Epidemic Supports The Chemical AIDS Theory. Daniele Mandrioli
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1 The Italian AIDS Epidemic Supports The Chemical AIDS Theory Daniele Mandrioli
2 EPIDEMIOLOGY France Population: AIDS Incidence: 16/million Germany Population: AIDS Incidence: 4/million
3 EPIDEMIOLOGY Spain Population: AIDS Incidence: 33/million United Kingdom Population: AIDS Incidence: 14/million
4 EPIDEMIOLOGY Incidence of AIDS cases (cases x inhabitants) among IV Drug Abusers in EU ( )
5 Italy Population: AIDS Incidence: 19/million EPIDEMIOLOGY Reported AIDS cases, cases corrected (reported late), deaths and lethality in Italy
6 Evolution of the AIDS epidemic among the different Risk Groups EPIDEMIOLOGY
7 HEROIN MEDICAL CONSEQUENCES OF CHRONIC HEROIN INJECTION USE INCLUDE SCARREDAND/OR COLLAPSED VEINS, BACTERIAL INFECTIONS OF THE BLOOD VESSELS AND HEART VALVES, ABSCESSES (BOILS) AND OTHER SOFT-TISSUE INFECTIONS, AND LIVER OR KIDNEY DISEASE. LUNG COMPLICATIONS (INCLUDING VARIOUS TYPES OF PNEUMONIA AND TUBERCULOSIS) MAY RESULT FROM THE POOR HEALTH CONDITION OF THE ABUSER AS WELL AS FROM HEROIN S DEPRESSING EFFECTS ON RESPIRATION. MANY OF THE ADDITIVES IN STREET HEROIN MAY INCLUDE SUBSTANCES THAT DO NOT READILY DISSOLVE AND RESULT IN CLOGGING THE BLOOD VESSELS THAT LEAD TO THE LUNGS, LIVER, KIDNEYS, OR BRAIN. THIS CAN CAUSE INFECTION OR EVEN DEATH OF SMALL PATCHES OF CELLS IN VITAL ORGANS. HEROIN ABUSE DURING PREGNANCY AND ITS MANY ASSOCIATED ENVIRONMENTAL FACTORS (E.G., LACK OF PRENATAL CARE) HAVE BEEN ASSOCIATED WITH ADVERSE CONSEQUENCES INCLUDING LOW BIRTH WEIGHT, AN IMPORTANT RISK FACTOR FOR LATER DEVELOPMENTAL DELAY
8 (IM)PURE HEROIN
9 FONTS Parlament Report on Drug Addiction in Italy DPA, Dipartimento Politiche Antidroga Narcotics Control Bureau by the Italian Government Drug Addiction Services Report Italian Ministry of Health AIDS Cases and HIV Infections Report Italian National Health Service
10 Population treated by the Drug Addiction Services (SerT) HEROIN M/F ratio in the population treated by the SerT
11 Primary Drug of Abuse SerT treated population (percent distribution) Today HEROIN Intravenous Drug Abuse SerT treated population (percent distribution) Today
12 AIDS CASES Semestral Incidence HEROIN HEROIN ABUSERS Incidence of heroin abusers that need to be treated (estimation, confidence 95%)
13 Deaths for acute drug intoxication in Italy and Europe HEROIN Death for acute drug intoxication in Italy (M/F)
14 HIV Test: tested patients, new and old positive tests Results as percentage of the patients treated by the SerT HEROIN A I D S HIV+ Prevalence in Tested Patients YEAR HIV C A SE S R E P O R T E D Age of the Sert treated patients
15 AIDS CASES Semestral Incidence HEROIN PEAK HIV+ TESTS: PREVALENCE AND INCIDENCE AMONG DRUG ABUSERS Percentage of the SerT Population NO PEAK
16 Anti-Retroviral Therapy Use in Pre-AIDS Patients Total THERAPY Evolution of the AIDS epidemic among the different Risk Groups Risk Groups
17 POPPERS ANIMAL RESEARCH RAISES THE POSSIBILITY THAT THERE MAY BE A LINK BETWEEN ABUSE OF NITRITE INHALANTS AND THE DEVELOPMENT AND PROGRESSION OF INFECTIOUS DISEASES AND TUMORS. THE RESEARCH INDICATES THAT INHALING NITRITES DEPLETES MANY CELLS IN THE IMMUNE SYSTEM AND IMPAIRS IMMUNE SYSTEM MECHANISMS THAT FIGHT INFECTIOUS DISEASES. A RECENT STUDY FOUND THAT EVEN A RELATIVELY SMALL NUMBER OF EXPOSURES TO BUTYL NITRITE CAN PRODUCE DRAMATIC INCREASES IN TUMOR INCIDENCE AND GROWTH RATES IN ANIMALS. nitrite inhalant
18 DIAGNOSIS Revised Surveillance Case Definition for AIDS (in Italy). CIRCOLARE MINISTERO DELLA SANITA' 29th of April 1994, n. 9 - (in Gazzetta Ufficiale, 13 th of May 1994, n. 110)
19 DIAGNOSIS - Candidiasis of bronchi, trachea, or lungs; - Mycobacterium avium complex or M. kansasii, - Candidiasis esophageal; disseminated or extrapulmonary; - Cervical cancer, invasive; - Mycobacterium tuberculosis pulmonary; - Coccidiodomycosis, disseminated or - Mycobacterium tuberculosis extrapulmonary; extrapulmonary; - Mycobacterium, other species or unidentified - Cryptococcosis, extrapolmonary; species, disseminated or extrapulmonary; - Cryptosporidiosis, chronic intestinal (greater than - Pneumocystis carinii pneumonia; 1 month's duration); - Pneumonia, recurrent; - Cytomegalovirus (other than liver, spleen, or - Progressive multifocal leukoencephalopathy; nodes) - Salmonella septicemia, recurrent; - Cytomegalovirus retinitis; - Toxoplasmosis of brain; - Encephalopathy, HIV-related; - Wasting syndrome due to HIV; - Herpes simplex: chronic ulcer(s) (greater than 1 - CD4+ T- lymphocyte count of less than 200 cells/ month's duration); or bronchitis, pneumonitis, or ul*; esophagitis; - Karnofsky Index of 50 or lower*. - Histoplasmosis, disseminated or extrapulmonary - Isosporiasis, chronic intestinal (greater than 1 month's duration) - Kaposi's sarcoma HIV+ - Lymphoma, Burkitt's; - Lymphoma, immunoblastic; *since 2001 (DECRETO MINISTERIALE 7/5/2001) - Lymphoma, primary, of brain;
20 DIAGNOSIS Candidiasis of bronchi, trachea, or lung Cryptococcosis, extrapolmonary Cryptosporidiosis, intestinal (diarrhea more than 1 month's duration) Cytomegalovirus lungs or CNS Herpes simplex: chronic ulcer(s) or bronchitis, pneumonitis, or esophagitis Kaposi's sarcoma in a patient older than 60 Lymphoma, primary, of brain in a patient younger then 60 Atypical mycobacteriosisisseminated or extrapulmonary Pneumocystis carinii pneumonia; Progressive multifocal leukoencephalopathy Toxoplasmosis of brain HIV - Vs apple HIGH DOSE OR LONG-TERM CORTYCOSTEROID THERAPY OR OTHER IMMUNESUPPRESSIVE OR CYTOTOXIC THERAPY during the three months preceeding the beginninig of the opportunistic disease;. Lymphocytic leukemia;. Multiple myeloma;. Hodgkin's disease;. Non-Hodgkin lymphoma oppure altri tumori maligni di tessuti linforeticolari o istioetici or other malignant tumors of the lymphoreticular systems;. acquired immunodeficiency atyical syndrome for an HIV infection, as the ones with hypogammaglobulinemia or genetic immunodeficiency syndrome;
21 This is an excerpt from the Retrovir (zidovudine) Prescribing Information available on the FDA site. WARNING: RISK OF HEMATOLOGICAL TOXICITY, MYOPATHY, LACTIC ACIDOSIS AZT RETROVIR (zidovudine) has been associated with hematologic toxicity including neutropenia and severe anemia, particularly in patients with advanced HIV-1 disease [see Warnings and Precautions (5.1)]. Prolonged use of RETROVIR has been associated with symptomatic myopathy [see Warnings and Precautions (5.2)]. Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues alone or in combination, including RETROVIR and other antiretrovirals. Suspend treatment if clinical or laboratory findings suggestive of lactic acidosis or pronounced hepatotoxicity occur [see Warnings and Precautions (5.3)] Myopathy Myopathy and myositis with pathological changes, similar to that produced by HIV-1 disease, have been associated with prolonged use of RETROVIR. 5.3) RETROVIR- Prescribing Information NDA ].
22 ABACAVIR This is an excerpt from the Ziagen (Abacavir Sulfate) Prescribing Information available on the FDA site. Ziagen is a NRTI (Nucleoside Reverse Transcriptase Inhibitor). Ziagen does not cure HIV infection or AIDS. Ziagen has not been studied long enough to know if it will help you live longer or have fewer of the medical problems that are associated with HIV infection or AIDS ZIAGEN- Prescribing Information, section Medication Guide NDA
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