NotAIDS! Essay
December 22, 2006 (updated May 22, 2009)
UPDATE: New evidence indicates that KS may be related to intestinal parasites. More to come on this story.
Why did the U.S. National Institutes of Health (NIH) and Centers for Disease Control (CDC) look for a singular agent underlying uncommonly occurring illnesses afflicting 5 Los Angeles gay men, and 12 other men in New York and San Francisco, in 1981?

It was 1981 when Dr. Michael Gottlieb reported five patients to the Centers for Disease Control (CDC) because each had an uncommonly intensive infection.

The men had Pneumocystis Carini pneumonia (incorrectly identified as PCP, now known to be Pneumocystis Jiroveci); they also suffered from cytomegalovirus (CMV) infections, and intestinal and/or oral Candida Albicans overgrowth. Kaposi's Sarcoma lesions were reported at other clinics, in New York and San Francisco, and noted on the page following Dr. Gottlieb's report.

Dr. Gottlieb's Los Angeles report, and the KS "outbreak" in NYC and San Francisco, spurred a race among epidemiologists at the CDC and NIH - and simultaneiously at the Pasteur Institute - to find a cause celebre, a 'bug' that was making gay folk sick, even though the reasons for these illnesses caused by the mens' immunocompromised state was plainly attributable to behavioral causes.

The late seventies were characterized by a mentality of free-flowing sex, love, drugs, and rock and roll, and sex. In the late seventies and early eighties, there were thousands of other gay men who were dealing with irritable bowel syndrome (IBS) - caused by parasites and candida overgrowth, sometimes severe or entrenched enough to cause wasting and other so-called "rare" illneses.

Dr. Michael Gottlieb described these infections in his 1981 report to the CDC on five patients of his Los Angeles office. What is not in the report is the setting of this medical drama about to unfold on center stage for the next 30 years.

Intravenous drug use, exotic pills, 8 or 12 hour sex parties, and the many sacrificed meals and lost nights of sleep set up an environment favorable to mycobacteria (CMV), fungal organisms (Candida, PCP), and viral antigens like Kaposi's sarcoma, a human herpes virus. All of these organisms are present in a majority of humans but don't typically manifest in illness, under the immune system's capable control.

Some of the sexual activites gay men enjoy, like rimming, are unfortunately high-risk for parasites, which commonly travel the fecal-oral route. In Africa, due to the lack of water filtration systems, this route is quite common. Less than half of the sub-Saharan population has access to clean drinking water.

Research has repeatedly shown that parasitic infections over time damages the immune system, restricts absorption of nutrients from food, and settle in organs beyond the digestive tract, in the lungs for example. It is notable that pneumocystis pneumonia is a fungal parasite.

Candida overgrowth, another fungal infection, occurs routinely in the intestines post-antibiotics. It is no surprise, then, that IBS was common. In the gilded age of gay liberation, sex was carefree; it was as easy to find antibiotic pills as it was to get laid, if you caught something from your midnight snack.

Despite the wild sex parties of the time, these "CDC five" who are the subject of Dr. Gottlieb's infamous report, hadn't had direct sexual contact with each other - an interesting sidebar despite the "sex kills" mentality coming out of the AIDS madness.

One wonders if there were 5 straight people, not having had direct sexual contact with each other, presenting with pneumonia, CMV and IBS candida overgrowth, would they have not been reported to the CDC, and might we never have had AIDS?

The fact is that the only "unusual" thing about these men is that they preferred sex with men - note the wording in the CDC report: "all active homosexuals." (When the CDC refers to heterosexuals, are they qualified by their "active" sex life?)

Statistics indicate that around 60% of the general population would test positive for the CMV bacteria. As stated, all of the other offending organisms also are common but not commonly fatal. Therefore, a diagnosis of immunodeficiency is a no-brainer, but a prognosis of "eat well" and "get some rest" was apparently not exciting enough for the public health establishment, and certainly too boring for the career epidemioligist.

As anyone knows, when the body gets run down, illness is likely to follow. It is a known fact that protracted parasitic infections cause AIDS symptoms. So there is in fact nothing unusual at all about these five men getting sick given each of their behaviors leading to their illness.

Kaposi's sarcoma (KS) that afflicted other cohorts of men from New York and San Francisco was also blamed on the imaginary "AIDS virus," but a 1990 study concluded that KS had nothing to do with HIV.

"Differences in clinical findings, CD4+ and CD8+ cell counts, and P24 antibody and antigen levels indicate that the occurrence of KS may be independent of HIV induced severe immunodeficiency."²

Research shows that KS was and is directly attributable to the the hepatitis B vaccine. An experimental formulation of the hepatitis B vaccine was administered to thousands of gay men in New York, San Francisco, between 1979 and 1981 - the year a "gay related immune deficiency" syndrome called GRID was described in the media, later to become known as AIDS.

When all the facts are considered, the response of the CDC was fatefully overwrought in 1981. The sexual proclivities of gay men became a hot topic and maybe was titillating to certain repressed NIH / CDC epedemiologists. But beyond some gay men's choice of recreational activity, and the reaction of overzealous government employees and entrepreneurial medical workers like Robert Gallo who saw dollar signs in other people's suffering, not much else was unusual about some guys getting sick from partying and playing too much.

Nope, there was nothing unusual at all about what was to become AIDS, and what would curse generations of gay men, and consign them and later, sub Saharan Africa to the longest running pharmaceutical and human surveillance experiment in history.

The dose of trimethoprim sulfa is too high. It was the dose that we were taught to give, but we recognized fairly early, probably by '83 at least, that this was too high a dose...because it was toxic, yes. People got too sick on this high dose.

Early in the epidemic, people with KS had a better prognosis than later, after the first couple, three years of the epidemic. This was because the oncologists were just blasting the KS patients with chemotherapy and further depressing their immune system, and so their life expectancy went down.

So there was this dip in the life expectancy of KS patients. In fact, the early response, despite what the dermatologists and oncologists may say, was to overtreat these patients with chemotherapy. This hurt patients in terms of their life expectancy, because they were treated aggressively for their visible KS lesions.¹

- Dr. Stephen Follansbee

See page 2 of the MMWR report on the New York and San Francisco KS outbreak.Essay by Kirk Cordell, ©2006.

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