AIDS Therapy Information

AT 714X Therapy of unknown type administered in Canada at cost of about $900. Have checked with Project Inform, but they have no reports. Signs not good.

AT acupuncture Therapy in which very thin needles are inserted into specific regions beneath the skin with intention of relieving pain or other symptoms. Regions pierced are called "meridians", and practitioners vary the temperature of needle, angle of insertion, speed of insertion and withdrawal, etc. to obtain desired effect. An old Oriental form of treatment, often regarded as respectable and valid by today's medical establishment. Using a procedure called Omura's bidigital O-Ring Test, one group of experimenters has set out to locate acupuncture points for what they called "HIV related weakness." In untreated HIV they found weakness at the point called Spleen 11, located at midthigh above {lymph glands}. Persons using AZT, meanwhile, frequently had "weak responses" at GB 39, a point thought to be involved in {bone marrow} function. An acupoint known as Lung 7 apparently indicated activity of some type of {interleukin}, with signs of {inflammation}.

AT alternative AT According to guidelines of the National Institutes of Health, this term generally points to types of medicine/ medical treatment that supplement biomedicine or allopathic medicine. (The latter is the ordinary kind of medical concept, calling for use of drugs which counteract symptoms and diseases.) Interestingly, in other parts of the world, the situation may be reversed -- "traditional" medicine may predominate and allopathic medicine may be considered "alternative." Here in the U.S., alternative therapies are very likely not approved by the Food and Drug Administration -- may not in fact be supervised by that agency. Some of these therapies seem to be effective to some extent, many of them are not effective at all, and some may be fraudulent. The FDA has what's called a "personal use" policy, which allows HIV- positive persons to import unapproved drugs themselves, and some drugs are available on a compassionate use basis. Details on these plans are available from ACTIS, (800) TRIALS-A. There are "buyers' clubs" in most cities. These sources offer a variety of drugs or other agents thought by proprietors to be helpful to those with HIV. The wise consumer knows that many buyers' club therapies are experimental or speculative only. They might not be effective. 3-93 There's sufficient interest in alternative therapies that the National Institutes of Health have added an Office of Alternative Medicine, Dr. Joe Jacobs M.D., Dir. Activists have criticized relatively small budget allotted to the new Office.

AT Aqua Flora This product, imported to the U.S. by a firm in Long Beach CA and maybe others, appears to be either fraudulent or dangerous. It's said to be a homeopathic (see {homeopathy}) medication -- a concentration of Candida albicans, causative agent of "thrush" or {candidiasis}. The promoter says it is safe, since it's "pH balanced," and they state the product kills "99.99%" of Candida in 7 days. The same document says Aqua Flora is registered with the "Federal Drug Administration" (sic), and claims it can also be used to treat bacterial infection with {Escherichia coli} and {staphylococcus}.

AT ascorbate (ascorbic acid, vitamin C) There are claims, old and recent, that ascorbate is "a known antiviral agent capable of inactivating a broad spectrum of viruses ..." To just whom this is known is unclear. Dr. Linus Pauling has somehow gotten his name associated with ascorbate proponents' work, apparently with voluntary enthusiasm, although with due respect Dr. Pauling's credentials don't derive from biomedical research. At one point Pauling and associates set about proving ascorbic acid's efficacy vs. viral replication and they published a report claiming success in the Proceedings of the National Academy of Sciences. However the NAS and its National Research Council are not the ideal forum for presenting legitimate medical studies for various reasons. Ascorbate in combination with {n-acetylcysteine} is supposed to "confer synergestic suppression of HIV," according to an article in the American Journal of Clinical Nutrition. Finally, there are repeated references to ascorbic acid's {antioxidant} properties, which have been verified but have no telling therapeutic significance.

AT beta carotene This is a nutritive component found in nature, and there's growing evidence that we should have an adequate intake of it. We must discount studies by Dr. Gregg O. Coodley indicating "B.C." at 180 mg/day raised (T-helper cell count}s in subjects. His "trial" involved only 21 persons and any results are meaningless for that reason if for no other. Coodley himself stated that it was not clear whether the findings had any long range significance. Beta carotene is a member of the family of polyphenols called {bioflavonoids}. See also {nutritive supplements 1}.

AT BHT (butylated hydroxytoluene) (6-93) {Synthetic} antioxidant used in fats, oils as a food preservative. It has been said that BHT inactivates a variety of viruses with {lipid}s in their {envelope}s, including {cytomegalovirus} and the Semliki Forest virus. BHT also is said to inactivate the {herpes simplex virus}. (Cytomegalovirus and the herpes virus are two possible cofactors in HIV progression. Both, especially the former, lead to serious illnesses when one's {immune system} is damaged by HIV.) Animal studies show the drug protects sheep against Newcastle disease virus at extremely low doses (100-200 ppm of total diet). The envelope of HIV contains lipids similar to those found in Newcastle virus. Still, there's no more solid evidence of BHT benefits than these at this time. See {antioxidant}.

AT bioflavinoids Bioflavinoids are said to be an {antioxidant}, have {synergism} with Vit. C, prevent abnormal bruising, and improve integrity of the blood system's capillaries. They are members of the chemical family called the polyphenols, and may be found in such nutritive items as {beta carotene}. One source recommends 2-3 grams of bioflavinoids with each meal. Varieties of flavonoids isolated and purified from plants have been evaluated for anti-HIV activity, with tantalizing results -- though we emphasize that test tube studies probably have little actual potential for real world clinical applications. The "flavone" myricetin seems to have some activity against HIV and SIV infection. Less active but fairly selective are gallocatechin and epicatechin. Some activity was shown by catechin. The researchers say that "inhibiting activities of these compounds appear to be directed against gp120. Irreversible interaction with the virus reduced its infectivity and prevented infection ... on the other hand, the compounds ... active against HIV and SIV were also inhibitory to HSV." The same report finds quercetin and epigallocatechin having no anti- HIV/SIV activity. The flavanoids are broken down into subclasses, and the flavans seem generally more effective than flavones and flavanones in selective inhibition of HIV-1, HIV-2 or SIV infection. One bioflavanoid agent, popular with "naturopathic" practitioners, is isolated from the type of plant called Chrysanthemum morifolium. These sources claim to have evaluated the shrub's flavonoid components as inhibitors of HIV replication in H9 cells, with some favorable results. They state that a known flavone, chrysin, was found to be the most promising of the compounds. There is baicalin (BA), from the plant Scutellaria Baicalensis Georgi. It has been used as a traditional Chinese herbal medicine. And now one researcher claims for it some "in vitro" inhibitory effect against HIV-1 infection/ replication.

AT Bioprotect Sold as "full spectrum antioxidant" by {buyers' clubs}. Efficacy not known.

AT biotin This is a vitamin B variant that occurs naturally in the human body, produced by harmless bacteria, and the "good" counterpart to another natural chemical called avidin. There's some question as to whether shortages of biotin occur, even in the presence of HIV. One writer seems certain that they do, and links biotin deficiencies to rashes around the mouth or nose, and to loss of hair. The source advocates dosages of 300 micrograms to 1 mg of the agent daily. Biotin is available naturally to those who eat nuts, whole grains, and certain vegetables. Milk is also a source.

AT blue-green algae Algae is a common vegetation wherever still water is found, but this item is thought to be somewhat special. One source says "BGE" is harvested at mountain lakes, and that it has a certain proportion of nucleic acids, {amino acid}s, minerals, Vitamin B12 and beta carotene, and fatty acids not produced by the human body on its own. Our source claims a variety of benefits for BGE: That it is believed to enhance the functioning of the (immunologically important) thymus; that it helps in the functioning of the {spleen}; even that a compound found in BGE "was shown to have anti-HIV activity but it is not known whether this would be available from oral comsumption of the algae." No matter what, says this source, BGE is regarded as a "super food" with important ingredients, along with the relevant "cofactors." It's found at health food stores and other outlets of the kind.

AT Cancell 2-93 mentioned as possible HIV therapy. Originally developed to work vs. {cancer} by one James Sheridan of Detroit, MI, who claims to be a former "researcher from the MI Cancer Center." Cancell has sometimes been called "Jim's Juice," Enteles, or Entelev. Its efficacy as a drug for use vs. HIV or other disease is totally unproven. Mr. Sheridan says the compound is effective vs. AIDS and also Herpes. For info Call Dr. John Renner, Consumer Health Information Research Institute, (800) 821-6671.

AT carnatine (L-carnatine, n-acetyl-l-carnatine) An {amino acid} whose usual function is to help disperse certain fatty acids for use by the body's components. There are claims that carnitine depletion is fairly common in the presence of HIV, and that supplementation would then be called for; but testing of carnitine levels are not practical on a regular clinical basis. Use of carnitine supplements is said to improve lethargy, shortness of breath, heart function, wasting. Further, it's stated that immune function improves as levels of serum {tumor necrosis factor}, triglycerides etc. are restored to a lower (normalized) status. One carnatine advocate presents a suggestion that 250-1500 mg of carnatine supplements may be safely taken up to 3-4 times daily, on an empty stomach.

AT chelating agent Chemical compound that, some sources say, forms complexes by {bind}ing ions. These agents include deferoximine and penacillamine -- used to treat metal poisoning. In chelation, metal is said to {bind} to these agents and be {excrete}d safely.

AT chelation Process whereby a person's blood is treated by a {chelating agent}. The blood is sometimes treated externally and returned to the system, but there is also chelation therapy performed by {IV} administration of a {synthetic} {amino acid} (ethylenediamine tetra-acetic acid, or EDTA) along with {vitamins}, etc. It's heavily promoted as an alternative to heart surgery, for {kidney} disease, arthritis, {parkinsonism}, emphysema, {MS}, gangrene, psoriasis, and other serious conditions including AIDS. Earlier proponents said EDTA works by "pulling calcium out of atherosclerotic plaques," but promoters currently claim procedure pulls {toxic} metals out of body, "reducing the formation of {free radical}s" and enabling areas of {atherosclerosis} to heal. After extensive checking, there's no scientific evidence at hand that either kind of chelation therapy is effective vs. atherosclerosis or any other condition. One Danish study of chelation therapy for intermittent {claudication} found no benefit.

AT choline (phosphatidylcholine, PC) Naturally- occuring substance thought to be a {precursor} of {acetycholine}, increased concentrations of which may be useful in control of {Huntington's disease}, {tardive dyskinesia}, levodopa- induced {dyskinesia}, and certain manifestations of {dementia}. Increased acetycholine levels are hazardous to persons with {parkinsonism}. One proponent of alternative therapies recommends taking 1000 mg of PC twice daily. This is based on the theory that PC has a critical role in cellular function. The source believes PC can help resolve neuropathy, but we cannot locate verification of that. It's of interest that in one European study, PC was tested for possible influence on the proliferation and viability of cells permanently infected with HIV-1. "PC alone, as well as pharmaceutical formulations containing PC, selectively inhibited the growth of productively infected lymphoid cells. The strongest growth inhibition was observed with formulations containing PC, glycerol and triglyceride together."

AT Coenzyme Q10 (Ubiquinone, CoQ10) There have been calls for more investigation of this substance -- a usual component of the human body -- as a potential HIV/AIDS therapy. Ubiquinone has a non- specific antioxidant character, and depressed levels of it seem to play a role in {allergy} development, and thus in autoimmune mechanisms and immunity itself. (One source says it's somewhat like Vitamin K.) Normal bio{synthesis} of CoQ10 in human tissues is a complex process that requires several vitamins and micronutrients, and it's thought that vitamin- deficient people may be deficient in CoQ10 as well. In one very small study, two subjects with symptomatic AIDS are said to have "survived four- five years without any symptoms of adenopathy or infection, on continuous treatment with CoQ10. [Also,] 14 ordinary subjects responded to CoQ10 by increases in the T4/T8 ratios and an increase in blood levels of CoQ10 ..." It's emphasized that this study is found without too much support around it, and is certainly not tantamount to the {clinical trial} that we would like to see. It may be of interest that Ubiquinone is often used against heart problems and for peridontal benefits in Japan. If one wants to supplement CoQ10, we're told that from 90 to 600 mg/ day should be safe.

AT copper (copper sebacate) This is very properly called an "essential trace mineral," used by the human body in its everyday workings. Tiny amounts of both copper and {zinc} are needed by the systems that process oxygen into the blood. There isn't any established "minimum daily requirement" for copper, and there's some question as to whether supplementing it is a good idea at all. Those who take zinc supplements might benefit from very cautious use of copper sebacate, to balance the zinc. The relationship between the two minerals is such that one will cause problems in the other's absence -- or vice versa. Though copper, and the copper/ zinc combination, have {antioxidant} potential, that does not indicate any therapeutic benefits to be had. The decision to supplement copper is basically a personal one.

AT curcumin Substance that gives the seasoning called curry its yellow color, has according to one report shown some anti- HIV properties. Initial report was a casual one from a reputable source, but since its appearance seems to have been inflated somewhat. (Tests sought to establish inhibitors of "{long terminal repeat}" or "LTR" sequence in HIV, vital to virus replication. Curcumin was one of 3 substances found to have some capability in that regard.) Until there's some evidence in its favor, curry probably is not useful as therapy and although not very toxic, very high amounts promote stomach {ulcer}s.

AT detox tea Sold at {buyers' clubs}, efficacy unknown.

AT DMG (Gluconic DMG, N,N-dimethylglycine) This "metabolite" is a derivative of the {amino acid} glycine. It's being sold at {buyers' clubs} and other outlets as an immune modulator or stimulant. A source who works with one of the clubs says "research in non-AIDS populations has shown that DMG can improve both humoral (B-cell) and cell-mediated immunity (T-cell) when administered orally in the dose range of 1-3 mg/kg body weight." Research "at Clemson University" is cited. In fact, "DMG" is just an agent that's used by the body in maintaining the balance of folates and other "support system" chemicals. Elevated levels of DMG are specifically linked to shortages of folates. Mammal experiments have indicated no immune benefits; on the contrary, DMG- treated subjects displayed inferior {interferon} activity. Additionally there are {toxicity} concerns attached to this agent. This doesn't eliminate the possibility that DMG has some therapeutic potential, but blunts the enthusiasm somewhat. We have found apocryphal references to athletes using DMG with the expectation of performance boosts.

AT DMSO (dimethylsulfoxide) Compound is said to be an {antioxidant} and "free radical acceptor" (same thing), used in {topical} application to skin, from which it will penetrate into tissue. Used in sports injuries and other applications, say sources who cite increase in {glutithione} levels when agent is used by those w/ HIV.

AT DNCB 5-93 (dinitrochlorobenzene) A chemical used in the photo finishing industry, DNCB has been around as an "alternative therapy" for some six years. Users dilute it with solvents, then apply to skin. Theory is that DNCB works to restore the {immune} functions of {Langerhans cells}, dendritic cells. Thus the agent is often called a "contact sensitizer" -- it "affects the body," according to AIDS TREATMENT NEWS, "much like poison oak. It penetrates the skin and binds onto protein there, [and makes it] much more likely to stimulate an immune reaction. In a person who has normal immunity, DNCB causes a rash like poison oak. The pure chemical is so strong that it must be diluted almost a thousand times before use." One physician, Dr. Bruce Mills of San Francisco, states that people with AIDS in his care are benefitting from treatment with DNCB. He says he long ago noted effectiveness of the chemical against warts, and he believes that DNCB cleared the warts partly by stimulating T-helper cell development. There's now a chain of at least 14 "underground clinics" dispensing free DNCB to HIV- infected people across the U.S., and many enthusiasts talking about what they sincerely believe to be a valid therapy. Researchers have used DNCB, mixed with acetone, in topical applications with human test subjects. The results are said by some to be promising, but in fact the published account doesn't really indicate any tangible "promise," and even proponents warn against a high likelihood of {toxic} effects. References cited to us that tend to legitimize experimental or other use of DNCB include posters from the 1992 International Conference on AIDS. Others: Stricker RB, J Am Acad Dermat 1993;28: 796-7; Stone OJ, Med Hypothesis 1993;40: 95-6; Marion SA et al, J Acquir Immune Defic Synd 1989;2: 178-86; Madhok R et al, Br Med J (Clin Res Ed) 1986;293: 978-80. Stricker is especially active in this area of endeavor.

AT EPA (MaxEPA, eicosapentaenoic acid) Advocated as a supplement to the diet, this essential fatty acid falls into the same general class as the docosahexaenoic acids and gamma-linolenic acid (GLA). Be warned that these agents may take the form of fish oil, and shouldn't be used by any diabetic persons except under monitoring by a physician. All the body's tissues, most significantly the cells' walls, have fatty acids as components; these acids are never in short supply when the body is in good health. When the immune system is attacked, though, it's thought that cellular distress occurs, signalled by rashes, seborrheic outbreaks, and other problems that mostly appear on the skin. It's certain that the {lipid} balance of the system is important when HIV is present. There's a lively debate about GLA and EPA as therapeutic agents, though, partly centered on the acids' ability to raise levels of {prostaglandin}, a modulator of immunity.

AT free-form amino acids 4-94 Amid controversy, the Food and Drug Administration is studying the question of regulating these agents. {Amino acid}s are natural substances, and are in fact necessary to almost all human biological processes. It's possible that inadequate levels of them are cause of minor but perceptible failures of the {metabolism} to function as it should, and it's said that bodybuilders find suplementation of amino acids of some benefit. But in 1991, there was an outbreak of eosinophilia myalgia syndrome, an obscure blood/ muscular disorder, which was traced to an amino acid used as dietary supplement. The agent L-tryptophan caused at least 1500 cases of the syndrome and 38 deaths. Soon after that, the FDA felt pressure to take a long hard look at certain supplements. A report under consideration by FDA complains that certain amino acids aren't appropriate as supplements as "they have not been shown to have nutritional value in humans." Added to that, it's very difficult to "identify a safe level of [amino supplement] intake" anyway. Safety of "unrestricted use of particular amino acids in ... supplements cannot be assumed." The most- used amino supplements are L-lysine and L-tryptophan, though L-methionine is also offered in health food stores, {buyers' clubs}, and through ads in bodybuilder magazines (we are told).

AT glucan a {polysaccharide} extracted from mushrooms called "maitake," native to Japan and other areas. 3-93 Reports indicate that powdered maitake or glucan in tablet form stops losses, or incites measurable rises, in {T-cell count}s.

AT glutathione (GSH, GLUT) This {peptide} substance is without question an important part of the human biological process. Since it functions as an {antioxidant}, it is linked to basic energy processes. Also that means that it may be destroyed by oxidation. It serves to transport the important {amino acid} called {cysteine} in {plasma}. To complement this, cysteine is used in the {biosynthesis} of glutathione. There are claims by some sources that GSH tends to inhibit HIV, and they bear examination. What we find is a number of researchers reporting some "{in vitro} suppression" of HIV by the agent. However, this means nothing in practical terms -- any number of non-therapeutics work "in vitro" vs. HIV. Because of the lack of a clear statement on this point in some quarters, glutathione sells well at {buyers' clubs} and health food stores -- to people with HIV whose expectations have been raised. GSH may help in {lymphocyte} activation, and it's been demonstrated in some studies that levels of glutathione are depressed in HIV- infected persons. It's suggested that increasing this agent's level in the body may reduce high levels of {tumor necrosis factor} (TNF), which has been associated with faster HIV replication as well as the {wasting} syndrome of AIDS. Since GSH is produced from cysteine, experiments focus on use of such agents as {OTC} and {n-acetylcysteine} to enhance intracellular GSH levels, in hopes of finding this will somehow reinforce immune system response to HIV/ AIDS. Trials so far have not been conclusive in any respect, however reinforcing the immune system is probably one of our very best hopes against AIDS.

AT glycyrrhizin (GL, glycyrrhizin sulfate, Glyceron, Glycyron) Derived from licorice root -- used in Japan to treat {liver} disease and now being considered in U.S. as possible "complementary therapy." Some lab tests reportedly show this agent capable of inhibiting HIV replication, interference w/ virus- cell {bind}ing and cell-cell {infection}. It's said it also suppressed "clumping" of infected cells, induced {interferon} activity. Same reports claim inactivation of {herpes} simplex/ {herpes zoster} {virus}es, both of which can be, in presence of HIV, serious {OI}'s. Sold at {buyers' clubs}. 2-94 One report circulated by the latter comes from the Clinical Research Institute, Dep't. of Pediatrics, Osaka National Hospital, in Japan. Only 16 subjects were involved, although for a period of 3-7 years. All participants were asymptomatic HIV+ hemophiliacs. They received 150-225 mg of GL. CD4 and CD8 cell counts were noted, as were levels of serum glycyrrhetinic acid and GL, and antibody. In this group, "no ... development to AIDS" was seen, while those in a comparison group showed decreased T-cell counts and in two cases progression to AIDS. At Japan's Kumamoto Univ. Medical School, T. Hattori et al. also had hemophiliac subjects, all HIV+, only three in number. Over a 12 month period, use of GL at 400-1600 mg/day produced various good clinical results, including decreased HIV p24 serum levels. Another source, giving no details, says that "The Chinese Medical Team headed by Dr. Weibai Lu used this remedy treated HIV- infected patients in Tanzania and made three patients converted to serum negative ... " (sic). One importer of GL carefully advises us that it's indicated only for hepatic disorders, skin disease, hair loss, and the like -- no mention of HIV or AIDS. See also {licorice}.

AT heparin (Enoxaparin) This agent is found in nature secreted by leeches of the group Hirudo medicinalis. It's a {protein} having a low molecular weight, and a known anticoagulant (see {coagulation}). For a long time, blood clots or embolisms have been treated by {IV} heparin. In our context, we note that this agent falls into the category called the {sulfated polysaccharide}s, alongside {dextran sulfate} etc. Heparin has demonstrated {in vitro} ability to prevent the entry of HIV particles into CD4-positive T-helper cells. The mechanism of inhibition may, according to one researcher, actually occur after binding of HIV's {envelope} to the CD4 receptor molecules. There's some evidence that heparin {bind}s to HIV's {V3 loop}. In other research, "The addition of as little as 0.05 U of heparin completely inhibited amplification of an HLA-DQa sequence from placental DNA. We conclude that heparin can cause attenuation or inhibition of [HIV] gene amplification." Still, caution: In vitro studies are not a good predictor of results to be had in living models. Studies with heparin and its counterparts are continuing.

AT holistic medicine Considers the person as a complex of systems forming a unity. All systems have to work harmoniously, under the guidance and will of the person involved. Webster's dictionary: "Holism -- the view that an organic or integrated whole has a reality independent of and greater than the sum of its parts." One holistic group, not claiming to speak for others, define their precepts as "Choice, responsibility, integration and faith." Choice comes into play in decisions about nutrition, exercise, exposure to avoidable toxins, etc. Responsibility is called for in making each choice, especially since the immune system, we're learning, is affected each time a choice is made. "Integration" refers to the need to treat not just symptoms but root causes of problems, no matter how indirect. Faith implies the acceptance of a greater intelligence and complex plan that we don't fully grasp, even at our most inspired. The group (Center for Holistic Healing, PO Box 18864, Philadelphia PA 19119) suggest that with faith, we may grow, better learn to hear the messages of the body, and better accept our true selves for sounder health.

AT hyperbaric oxygen Refers to pure oxygen, given at higher than atmospheric pressure, as experimental therapy vs. fatigue associated w/ AIDS. Subjects in informal tests reported more energy, less need for daytime sleep, sometimes gain or stabilization of weight; improvements in {T4:T8} ratio were claimed in some cases.

AT hypericin (HY, Johnswort, St. Johnswort, goat weed, Klamath weed, Hypericum Perforatum, Guttiferae family, amber, ) At one time considered a promising {antiviral}, and still accorded that consideration by some. Agent is derived from St. John's wort plant (goat weed, aka Hypericum triquertrifolium Turra) extracts. Was at one time used as a pediatric antidepressant in Europe. Was involved in Phase I trials ca. 1992, sponsored by VIMRx Pharm. (CT). Produced abnormal {liver} function, {photosensitivity}. Did reduce (at least temporarily) {fever}, {diarrhea}, {wasting}, seemed to decrease {neuropathy}, lower {p24 antigen} levels. There are however reports that any inactivation of HIV by hypericin relies upon presence of light or other factors; and reliable studies pointing to such inactivation have not been seen. Documentation "in favor of" this agent comes from books like "Today's Herbal Health," by Louise Tenney, "Back to Eden," by Jethro Kloss, "Prescription for Nutritional Healing," James F Balch MD and Phyllis A Balch CNC. (The latter merely quotes AIDS TREATMENT NEWS as having said HY "may" inhibit retroviral infections. We were given a list of some 20 citations on HY by one of the agent's supporters. Fourteen of them appeared in a context of less-than-perfect credibility. Otherwise, claims of the agent's antiviral properties rest largely upon studies at New York University Medical School/ the Weizmann Institute of Science, Israel. Summary: Formal studies are needed. We warn of possible side effects involving liver, and photo- (sunlight) sensitivity. Hypericin is readily available at {buyers' clubs} and other outlets.

AT hypericum (Phytomax) Product sold at some {buyers' clubs}. See {hypericin}.

AT hyperthermy Treatment of disease by raising body temperature above normal, possibly producing a {fever}. Was once a useful though crude therapy against the STD {syphilis}. AKA hyperthermia but usage shown is preferred. 8-93 Whole-body hyperthermy, raising body "core temperature," being informally tried vs. HIV. Said to have shown some promise in Italy.

AT immuno-tune Product sold at {buyers' clubs}. Efficacy unknown.

AT immunomodulation ther. Therapies such as {DNCB}, {isoprinosine}, and {Imuthiol}. Used in hopes of rebuilding damaged {immune system}.

AT Immunoplex 402 This item is said to be an extract of {thumus} gland taken from young calves. Promoters and enthusiasts provide anecdotal information about a physician who contracted {Hepatitis} B then experienced {remission} after using thymus extracts and multivitamins. They state that a counterpart called Thymodulin has been involved in "convincing" studies in Europe, but the details reveal only a test involving 29 subjects, whose medical problems are listed as {Herpes Zoster}, whooping cough, chicken pox, and infectious {mononucleosis}. None had HIV; another 29 persons served as a control group. The results of the trial are stated in the following terms: "... all patients who received (oral Thymodulin) showed a significant improvement compared to controls." Other notes on Immunoplex 402 speak of remissions of Hepatitis C, {CFS}, lung disease, and {rheumatoid arthritis}. Increases in serum levels of {thymosin} are cited. And the material concludes, "You folks in Texas may have difficulty finding Immunoplex 402. You see, David Kessler, commissioner of the FDA, convinced the Texas Dep't. of Health to sweep (it and some 200 other products) off the shelves of that state's health food stores. Legal proceedings have been brought against Texas and the FDA ... what was the beef with Immunoplex 402? They did not like the name -- thought it was "too suggestive."

AT isoprinosine (inosine pranobex) During the period 1985-87, this agent was a hot item at buyers clubs, and manufacturer Newport Pharmaceuticals (Orange Co., CA) was in hot water with the Food and Drug Administration over allegedly "misleading" claims it had made for isoprinosine's benefits. In a Swedish study with 866 persons enrolled, just two of the 429 who received the drug progressed to AIDS after 24 weeks, and 10 after a year, while 27 of 437 control subjects were symptomatic with AIDS after a year. On closer inspection of the results, though, there were reasons for some skepticism. The agent had apparently had no effect on CD4+ T-cell count, p24 antigemia, or other important immune markers. The persons involved hadn't been followed after the relatively short trial. There were hints of bias on the part of researchers. After a "poster" presentation at the Sixth International Conference on AIDS, interest in isoprinosine apparently waned -- the paper trail we followed seems to disappear as the 90's begin.

AT Monolaurin (Lauricidin) A glycerol ester derived from the laurate class of fatty acid. "Reported" by its proponents "to have activity against Semliki forest virus, 14 human RNA and DNA- enveloped viruses, lipid- containing bacterial viruses and the mammalian herpes simplex virus." It's said that the agent has undergone test- tube evaluation under CDC auspices; we are searching for records of that. In the meantime, it does not bode well that the distributor calls Monolaurin "exciting." Probably for sale at {buyers' clubs}.

AT n-acetylcysteine (Flumucil, NAC) Drug used to treat overdoses of Tylenol (a mild {OTC} analgesic), in Europe for {respiratory} problems. Also said by some sources to inhibit HIV {in vitro} by raising {glutathione} levels in HIV- infected blood cells. Widely available at {buyers' clubs}, scheduled for study by NIH. NAC is very popular due to its {antioxidant} properties.

AT nalidixic acid (NegGram) Promoted as therapy vs. AIDS by a Dr. Yves Jerome, who charges up to $2000 for a course of treatments. Nalidixic acid is a fluoroquinolone- class drug (as are {levofloxacin}, {ofloxacin}, and {ciprofloxacin}. These drugs are recent introductions, mostly for therapy vs. {TB}, {MAC}. They have no record of anti- HIV activity even {in vitro} and could benefit those w/ HIV only to the extent that TB and MAC could be {cofactor}s in basic HIV infection, replication. No {efficacy} seen otherwise.

AT OmegaSyn A nutritional supplement sold in health food stores and at {buyers' clubs}, containing "activated essential fatty acids." A fact sheet issued by the manufacturer solemnly presents a "protocol for using OmegaSyn as a dietary supplement for AIDS and ARC Patients with Fatigue," prefaced by charts delineating "quality of life" changes for some 18 people with symptomatic AIDS who took part in a double- blind study under unspecified circumstances. They do not say just how they evaluated "quality of life," which would be of interest. OmegaSyn is basically supposed to assist in {prostaglandin} formation and thus confer benefit upon the cardiovascular system. The consequent (claimed) effect of lessened fatigue is an incidental which is maximized in the sales literature.

AT Ondrox Multi-{antioxidant} formula said to be an effective HIV therapy, but {efficacy} has not been confirmed as of 2-93. Maker states that antioxidants critical to {immune} function. Main ingredient is {glutathione}. It is true that levels of this substance are decreased in the presence of HIV and associated diseases.

AT Oorganik-15 Said to be a "blend of naturally occurring vegetable culture methyl donors and acceptors ... essential in the formation of vitamins, hormones, enzymes, neurotransmitters, and antibodies." Claims have not been verified.

AT OTC 9-93 (oxothiazolidine carboxylate, Procysteine) (IND) Listed by one source as an antiviral in Ph. I trials vs. AIDS via prevention of "{inflammation}- induced replication" of HIV, but is basically an {immunomodulator}. Is thought to function by raising cell- cell {glutathione} levels. Seems safe, well tolerated. [Listed in this section because it is in use as an "alternative therapy" prior to completion of investigational testing.] 11-93 In Phase II/ III trials. See {cysteine precursors}.

AT oxidation AT 2-93 Therapy based upon the premise that HIV is a {lipid} {envelope} {virus} that can be rapidly oxidized by an "oxide radical." Sources claim there's a significant body of evidence that "peroxidation" of {lymphocyt}e {membrane}s reduces {viral} replication activity. Various oxidative agents may be used, based upon condition of person being treated. The healthier he or she is, the more aggressively he/she may be "oxidized," his or her "viral load" reduced. Oxidative agents may be given {oral}ly, {topical}ly, or {IV}. Proponents say oxidative therapy may also induce {alpha interferon}, a positive effect. Some oxidation therapy aims to stimulate {thymus} processes for improved {T-cell} response. Some such therapy involves administration of {IV} hydrogen peroxide solution, followed by one day of {chelation}. Reference is also made to chelation as a means of "shutting off" oxidation treatment lest its continuation endanger the patient. The validity of oxidation therapy's premise has not been fully established, nor has its {efficacy}, however some of the technical information used by its supporters is correct. To further muddy the waters, there's a totally different concept, {antioxidant} therapy, competing for attention. The two ideas are not the same.

AT ozone AT Promoted as a means of reducing HIV's activity. In fact, ozone is O(3), the same agent that causes environmental {degeneration} of rubber, and it is by nature {toxic}. At least one company is circulating reports that this therapy worked vs. SIV in Canadian tests and that it's been "used and proven countless times in Europe," but they have no black- and- white proof from reputable sources. 9-93 A film called "Ozone and the Politics of Medicine" has stirred controversy; {FDA} condemns ozone therapy as fraud.

AT PCM-4 For sale at {buyers clubs}, this agent is claimed to function as a "natural, non-toxic" immunomodulator for people with HIV. The "P" in the product name refers to a polypeptide (protein) extract, called Polymega. Proponents claim this component has been "studied in people with cancer. The study showed significant increases in T and B lymphocytes and increased immunoglobulins. Another study on people with cancer [in weakened, underweight condition] showed weight gain, increased lymphocytes, hemoglobulin, and total protein ... "Another study," the source goes on, "showed an increased production of gamma interferon, which has shown benefit in improving CD4 counts." The substance, by the way, is derived from porcine, or pig, spleen. The "CM-4" component is concentrated {Eleutherococcus} senticosus, a Siberian ginseng. Our source tells us it may "improve appetite, weight gain, increase lymphocyte activity (including T cells), and enhance healing time in individuals with cancer." Just as relevant, it's stated that "PCM-4 is being studied in Uganda and Tanzania in people with HIV, however the results from these trials should be interpreted with caution due to the lack of reliable and standardized laboratory equipment available in these countries." That conceded, the source states that "the laboratory results from six individuals in the Uganda study showed remarkable increases in absolute CD4 counts as well as percentages of CD4 to total lymphocytes." Cost of using PCM-4 regularly is around $100 a month. Proponents hint the agent may be of benefit against {Sjogren's} Syndrome and {CFS}.

AT pyridoxine Vitamin B6. See {Nutritive Supplements}.

AT Reiki "Fine tuning of body w/ laying on of hands in a particular pattern to channel body energy for relief of stress/ tension, treatment of debilitating illness." See also {Shiatsu}.

AT shark cartilage (Cartilade) 1-93 Under various names, this stuff is being sold for extremely high prices at {buyers' clubs}. Our researcher has seen no proof of effectiveness against any disease, though as a sidelight it's noted that agents extracted from cartilage of chickens have been tried vs. {rheumatoid arthritis}, a notorious {autoimmune} disorder. Results of those experiments were mildly affirmative. The reader is asked not to confuse apples with oranges in this case, however. One study of this agent has been furnished to us: "The opportunity to work with advanced cancer patients using [shark cartilage] was offered by the Ernesto Contreras Hospital in Tijuana, Mexico ... [the] women received 15 gm daily rectally administered as a retention enema and 15 gms daily ... administered into the vaginal body cavity." The man was given two 15 gram retention enemas daily. "Location of administration was designed to expedite rapid absorption." Typical results: "At 7 weeks tumor size had diminished 40% ... pain was materially reduced ... catheter was removed ... death was expected ... her recovery is proceeding ... after 11 weeks the tumor size was reduced to 3" by 3" ..." No information more exact than that sort of thing is provided. Summary: No way.

AT Shiatsu An oriental technique using palm, thumb, and finger pressure to achieve (claimed) healing results. A practitioner touches the energetic pathways (or "meridians") of the body and specific points along these lines "to help balance the energy in the body. All of us, at various times, have too much energy in one area (excess) and not enough in others (deficiency). If these excesses and deficiencies persist then disease will arise. "Shiatsu works," our source continues, "by freeing areas of stagnation and excess and by filling areas of deficiency to bring about a balanced ... flow of qi (vital energy) in the body. This balancing of energy allows the body to return to its normal homeostatic state, and healing can begin. In a typical Shiatsu session, we're told, a client's Hara (abdominal region) is gently palpated, feeling for areas of excess and deficiency. "The energetic pulses are then taken to further access any imbalances. These diagnostic means are then used to formulate a Shiatsu Treatment designed specifically for that client's energetic needs." No specific proof is given for claims that Shiatsu is effective for treating the "imbalances" that are said to cause many AIDS and HIV- related symptoms. The technique is supposedly able to help resolve "stress, insomnia, fatigue, nausea, diarrhea, headache, lack of appetite, myopathies, neuropathies and the emotional effects of these symptoms."

AT thioctic acid (Thioctacid, lipoic acid, pyruvate oxidation factor) Said to be a pivotal nutrient and "catalyst" required by both plants and animals, this agent is advanced as a means of resolving chemical or mineral hypersensitivity, and it's also used to protect the {liver}. Literature provided to us says that taking thioctic acid might result in lower- than- normal {SGOT} or {SGPT} test results, so one should warn one's physician in advance of the test(s) that one's using the agent. It's stated that "research indicates ... effectiveness of Thioctic for ... diabetic neuropathy [or] peripheral neuropathy ... [but] there is no data on the effect of Thioctic on HIV related neuropathy." Still, "the implications of the above information would seem to indicate a strong effectiveness." (It is, in fact, not very emphatic information, with mostly just a discussion of the liver's handling of toxins.) We're told that thioctic acid is is most useful "in combination with thiamine, preferably the fat soluble derivative such as the Allithiamines naturally present in garlic. This molecular conjugate appears to have an essential role in the breakdown of alpha-keto acids and in the transfer of pyruvic acid into the krebs cycle (the utilisation of energy out of matter." Having reviewed the literature we were given on this agent, we were about to move on, but were curious and checked some other files first. We found some early- stage studies noting that certain antioxidants may indirectly block HIV reverse transcription. Authors of one study found that alpha-lipoic acid has some functionality in this regard in test tube experiments. Still, the precaution: So called "in vitro" tests are not accurate potential is known.

AT Viroxan A fake HIV "treatment" administered in southern California. Currently involved in a large lawsuit vs. the parties who provided it to several persons with HIV/AIDS who developed blood clots, swelling, various other conditions.

AT zinc As nutrient, is an effective {antioxidant}. But in 2-94 a study finds high doses of dietary zinc are connected with faster progression to AIDS. Anecdote from our medical consultant tells of one person whose symptoms indicated -- simultaneously -- {anemia} and {leukopenia}. Physician was temporarily at a loss, but then asked if the person had been taking zinc supplements. Answer was affirmative. Excess zinc taken in had displaced normal level of systemic copper, needed for manufacture of both white and red blood cells. Body chemistry was corrected by infusion, complaint was resolved.

CD abscess Localized collection of {exudate} (pus), in {tissue} which may be swollen or subject to {inflammation}. Causes are various.

CD acanthamoebiasis Infection by an {opportunistic} {parasite}, Acanthamoeba castellani, which ordinarily inhabits moist soil, water. May cause one type of {meningoencephalitis}. In presence of HIV, may be an {OI}.

CD acidosis Condition in which {acid}ity of body {tissues} and fluids is unusually high. This could be due to a failure of {metabolism} whereby the balance between acidic and {alkaline} components is not maintained.

CD acromegaly {Chronic} disease usually caused by excessive {secretion} of the {pituitary gland}'s growth {hormone}. May result in enlargement of certain parts of skeleton -- nose, ears, jaw, fingers/ toes.

CD active infection An {infection} that is producing injurious effects. Contrast {dormant}, {latent}, {silent infection}.

CD acute infection {infection} with sudden onset, severe symptoms or both.

CD adaptational disease Condition caused by bodily defense mechanisms, i.e., high blood pressure due to excess {adrenaline} levels.

CD addiction State of craving for anything (including certain substances that cause {habituation} but also including other stimulating experiences or items) that escapes user's control. An addicted person cannot function normally. There are means of curing addictions, none of them fast or easy, but they offer a return to reality and the safety of restored control over one's life.

CD Addison's Disease Characterized by {chronic} weakness, low blood pressure due to inadequate activity of {cortex} of {adrenal gland}. Can be controlled w/ {cortisone}.

CD adenocarcinoma Malignant tumor ({cancer}) derived from a {gland} or glandular {tissue}, or a tumor of which gland- derived cells form gland- like structures. Many or arguably most cancers of {kidney}, breast, {colon}, {pancreas}, fall into this category.

CD adenopathy Enlargement of {gland}s, especially {lymph glands}.

CD adenovirus Group of {DNA}- containing {virus}es originally identified in human adenoid tissue, sometimes present in {latent} {infection}s in healthy persons. May cause symptoms like common cold. Can cause upper {respiratory} tract infection and {conjunctivitis} as {OI}'s in presence of HIV.

CD adhesion An abnormal fibrous {tissue} which binds two separate parts of body together.

CD agammaglobulinemia Near- total absence of {immunoglobulin} {antibody}.

CD AIDS Acquired Immunodeficiency Syndrome. A system of disorders arising from lack of a properly functioning {Immune System}. Identified in 1981, it is believed to result from {infection} by {HIV}, Human Immunodeficiency Virus. HIV is thought to have originated in Africa, where it still runs rampant among the population. After HIV has damaged a person's natural immunity to a given point, he or she will begin showing {symptom}s of diseases, most of which would not have caused much or any impact on a non- infected human body. Also, the person with AIDS will develop {intractable disease} or forms of illness that only temporarily or partially heal -- even if given very "aggressive" medical care. AIDS is deadly. It is killing close to 2,000 adults and adolescents each month in the U.S. alone. Medical science is exerting every effort to find a cure for AIDS, needless to say, but in the meantime, there are things we can all do to help prevent new cases and care for those now infected. To do so, we need knowledge, and that is the purpose of this document. If you're not aware of how AIDS works and how we may work against it, please check the listings {HIV -- the Basics}, {AIDS -- the Basics}.

CD AIDS Related Complex (ARC) Obsolete term previously used to describe any syndrome or illness common to {symptomatic} AIDS. There are however still published references extant which use the term but are otherwise accurate.

CD allergy An immediate or delayed {immune system} reaction caused by the presence of foreign {antigen}, called in this context "allergens." Those with HIV disease seem to experience faster disease progression in presence of any concurrent allergy. This is not mere coincidence, as the same bodily mechanisms are involved in the two cases. See {basophil}.

CD alopecia Temporary hair loss resulting from use of certain therapies.

CD ALS (amyotrophic lateral sclerosis, Lou Gehrig's Disease) {Degenerative} disorder of the {CNS}, involves major {motor} pathway. Nerve cells in {spinal cord} and {brain} that control muscles disintegrate. Cause is unknown, some 10% of cases thought hereditary. Disease usually begins in middle or late adult life. Those affected develop progressive weakness, {spasticity}, muscle {atrophy}, paralysis, death. No known treatment. 5-93 Researchers say familial ALS can be traced to chromosome 21, in which they saw several different {genetic} mutations in the gene for {superoxide dismutase}, each leading to switching of an {amino acid} in a key part of the {enzyme}.

CD Alzheimer's Disease Symptoms: premature senility, is a physical disease affecting {brain}. {Degenerative} and not treatable. Those working with elderly must understand that fear of contracting this illness is very great among this group. Older individuals sometimes mistake simple forgetfulness for early symptoms of this disorder, need reassurance. Some late- stage neurological AIDS syndromes mimic Alzheimers, but no parallel exists to our present knowledge.

CD amebiasis Infection caused by a {parasite} called Entamoeba histolytica, which lives in large {intestine}.

CD anaphylactic shock A {systemic} reaction in a susceptible person upon exposure to an {antigen} such as wasp venom or {penicillin}, after previous allergic or other sensitization. The sensitization would be evident esp. by {respiratory} symptoms, fainting, itching, rash, swelling of face, tongue, throat, etc. Sudden decline in blood pressure, dizziness or confusion. This reaction is often {severe} and sometimes fatal. Call medical help or take person to emergency room.

CD anemia Condition marked too little {hemoglobin} in {red blood cells} -- whose function it is to distribute oxygen to body. (May also be caused by too few blood cells as percent of blood volume.) Typically {present}s as pallor, weakness. Specifically causes heart/ blood circulatory system stress and {tissue} {hypoxia} due to low oxygen level in blood. Sometimes loosely called "low blood count." See {hematocrit}, {hemoglobin}. (anemia of chronic disease) (ACD) Progressive {anemia} affecting PWA's and others with {chronic} conditions. It's thought that up to 85% of those w/ AIDS will experience "ACD" during lifetime. Affected person will have lowered levels of {erythropoietin}, a substance that usually stimulates {RBC} production in {bone marrow}. May be traced to use of drugs ({AZT}, {Dapsone}, {pyrimethamine}) or nutritional shortfalls -- iron, {folic acid} and vitamin B12* may be deficient in system. Some {OI}'s ({MAC}, {CMV}, {KS}) encourage ACD in {GI} tract. Diagnosis via {CBC}. If anemia is due to inadequate iron or other nutrients, this can be corrected by iron supplementation, vit. B12, etc. Transfusions may be needed. If anemia is caused by AZT, may lower dosage, and {recombinant} {erythropoietin} may be given to help production of RBC's. (*See {Nutritive Supplements 1}.)

CD ano-genital warts Raised bumps, corrugations, or protruding pieces of skin in {anal} or {genital} areas. Cause is {human papillomavirus} (HPV). May spread on body or from one person to another through sexual contact. In presence of HIV, much more serious and difficult to control.

CD anorexia Lack of desire for food, common to HIV disease but sometimes due to other factors. If produced solely by a psychological problem is called "anorexia nervosa," and is distinguished from simple lack of hunger. See also {wasting}.

CD aphasia Difficulty in speaking coherently, i.e., after apoplectic episode or {stroke}.

CD aplastic anemia Condition of {bone marrow} failure that can be fatal if left untreated. See also {anemia}.

CD apnea Temporary stoppage of breathing, usually because of excess accumulation of oxygen or insufficient amount of carbon dioxide in brain. Many persons have a very mild form of apnea which occurs during sleep, causes no harm. It's possible for apnea to cause death.

CD Aran-Duchenne Disease Muscular {atrophy}, progressively leading to extreme {wasting}. A severe form of {Muscular dystrophy}.

CD ARC AIDS-related complex. Term obsolete. See {CDC case definitions}.

CD arrhythmia Disturbed or irregular rhythm of heartbeat.

CD ARV AIDS related {retrovirus}. See {HTLV-3}.

CD aspergillosis {Infection} of {lungs} and sinuses, caused by the {fungus} Aspergillus fumigatus. Can spread through blood to other organs. Symptoms include cough, difficulty breathing/ chest pain, fever, {diaphoresis}. May if unchecked cause {inflammatory} {lesion}s of skin, ear, eye cavity (orbit), nasal sinuses, and sometimes bones, {meninges}, heart, {kidney}s, {spleen}. If this infection reaches brain, it may cause {dementia}. Therapy via {amphotericin B} 0.5-1.5 mg/kg body wt. {qd} {IV}; in some cases ongoing therapy needed. Experimental use of {itraconazole} shows some promise. In presence of HIV, may be an {OI}.

CD asthma {Spasm} or narrowing of the airways in {lungs}, results in wheezing and shortness of breath. May be hereditary, or triggered by hay fever, food, {allergy}, exercise, emotional stress, or introduction of a drug into system. Part of the complex called "chronic obstructive airway disease." Asthma can caus wheezing and shallow breathing at rest; when triggered, it may cause labored or {distress}ed breathing. This condition may be treated with bronchodilators, agents which use {steroid}al properties to help airways achieve full {dilation}. As with any other steroid- type medication, these anti-asthma drugs must be used with great care.

CD ataxia Loss of muscle control leads to jerky or uncoordinated movements.

CD atherosclerosis {Degenerative} disease in which arterial blood flow is restricted, due to presence of fatty materials on {artery} inner walls.

CD bacillary angiomatosis (peliosis hepatitis) A {bacterial infection}, generally caused by Rochalimaea henselae, whose symptoms may include {lessions} resembling the plaques and nodules characteristic of {KS} -- physicians have been warned about that point in a JAMA article 2-94. Diagnosis is difficult, requiring {biopsy} of lesion; sample exam under electron microscope, also blood sample for possible {antibody}. Cats have been implicated as carriers of this disease as well as toxoplasmosis. Bacillary angiomatosis may yield to treatment with {Erythromycin} 500 mg {PO} or other strategies. (CDC-B)

CD bacteremia Generally, refers to blood poisoning by {bacteria}. See also {septicemia}.

CD bacterial infection As opposed to infection by {virus} or certain other agents, but doesn't exclude those caused by {parasite}s by any means. Unlike the virus, {bacteria} are environmentally common. An example of this is the pneumo{coccus} organism, which may cause pneumonia; it's a form of bacteria. the disease.

CD bacterial vaginosis As implied, {bacterial infection}. One uggested therapy is via metronidazole (Flagyl) 0.5 gm bid {PO}, 7 days; but if person is in 1st trimester of pregnancy, substitute other therapy.

CD Basal Cell Carcinoma Most common type of skin {cancer}. Forms in lowermost layer, grows slowly. Easily detected, can be cured when treated promptly.

CD benign tumor Abnormal swelling or growth, usually free of {cancer}, and harmless.

CD BIV Bovine immunodeficiency virus. 3-94 The prospect of an immune deficiency disorder affecting cows is relatively new. A herd of the animals near Cheshire, England has reportedly shown such symptoms as nerve degeneration, weight loss, ulcers in mouth, and respiratory infections; it's confirmed that at least two of eight bovines has immunodeficiency disease. BIV is not able to grow in human cell cultures, and although two humans in the U.S. have sustained "needle stick" injuries with BIV- tainted blood they were not infected.

CD blastomycosis {Infectious} disease caused by a {fungal} {parasite}, usually in {lungs}. Can spread to skin, bone, or other {tissues}. "North American blastomycosis" caused by B. dermatitidis, is aka Gilchrists's disease, "South American blastomycosis" by B. Brasiliensis. Both should clear if treated w/ {Amphotericin B}.

CD blepharospasm Uncontrollable closure of eyelids. Seen in a variety of movement- related disorders including {parkinsonism}.

CD Bowen's Disease Sometimes seen in HIV+ males. Usual ther.: 5% 5-fluoroucil cream 2x daily.

CD bradykinesia Often used interchangeably with akinesia, a difficulty in initiating or continuing movement. Possible symptom of {parkinsonism}.

CD bronchiectasis Condition involving dilation of {bronchi}. Pus may form in the airways, tending to induce coughing up of {exudate}- like sputum. Blood may be coughed up. Caused by {recurrent} {inflammation}/ {infection} of airways, onset varies from {congenital} to early childhood/ young adulthood. Exact cause varies; {cystic fibrosis} (about 50% all cases), lung {infection} ({fungal}, {TB}, {abscess}es), {body fluids} deficiency, alpha- 1 antitrypsin deficiency w/ cigarette smoking, {rheumatic} disease. May result from {immune system} disord's. Diag. via {x-ray}, therapy usually {antibiotic}s, possible need for surgery. Has been known to occur in PWA's.

CD bronchitis Inflammation of {bronchi}, commonly marked by presence of unwanted fluid in {lungs}. Coughing is a natural means of helping lungs expel this fluid. May {present} as {fever}, fatigue, preliminary signs of {anorexia}, weight loss. Often treated w/ {antibiotic}s, may range from mild to very persistent or life- threatening.

CD Burkitt's lymphoma Malignant growth ({cancer}) affects {lymph glands}, causes {lesion}s of jaw, which may in turn lead to destruction of bone structure. {Epstein-Barr virus} is believed to be causative agent. An {opportunistic disease}. Initially reported from central Africa. (CDC-C)

CD cachexia General poor health, malnutrition. May imply weight loss due to anxiety, malnutrition, {wasting} due to {chronic} disease, etc.

CD campylobacteriosis (campylobacter jejuni) {Bacterial infection}, may be treated w/ {Ciprofloxacin} 500 mg {PO} {bid}.

CD cancer Large group of disease conditions characterized by uncontrolled growth and spread of abnormal {cell}s, termed "{malignant}." Prognosis varies, depending upon type of cancer and many other factors.

CD canker sore An {ulcer}ation, common to mouth. Very localized and painful, {symptomatic treatment}s available at drugstores, should heal rapidly.

CD carcinoma {Malignant} form of skin {cancer} or {tumor} that arises in {tissues} that cover or line such organs as skin, {intestine}s, {uterus}, {lungs}, breast, etc.

CD carcinoma in situ An early, curable stage of {cancer} in which the tumor has not spread beyond a defined superficial site.

CD cat-scratch fever {Infection} w/ swollen {lymph glands}, persistent {fever}, slow-healing wounds. Caused, literally, by scratch of cat. (Not to be confused with possible cat transmission of {toxoplasmosis}, {bacillary angiomatosis}.)

CD cervical cancer (invasive cervical cancer) 2-93 The CDC has added invasive cervical {cancer} to its list of conditions that define AIDS. Although it is not peculiar to HIV- positive women, conditions leading to it seem to be more common to the latter population. Regular pap smears are recommemded as a means of early detection of this condition, and should be part of regular gynecological care. {Pathogen} is not known, but this cancer is usually preceded by {cervical dysplasia}. See also {invasive cancer}. (CDC-C)

CD cervical dysplasia An abnormality in the size, shape, or organization of the cells lining the cervix, or womb, that can be detected by a {Pap smear}. If not detected, cervical dysplasia may progress to a more severe {lesion}; thus, any abnormal finding should prompt further examination.

CD chancre Manifestation of {STD} which is caused by hemophilus ducreyi {bacteria}, highly contagious in nature. Chancres are preceded by appearance of pimple- like growth on {genital} skin. Growth will eventually burst, leaving a pus- filled, infectious, and painful venereal {ulcer}, the chancre. Chancres differ from growths seen in {syphilis} in that they lack firm "{indurated} margins." Chancroid condition is suspected as a route of HIV transmission.

CD chlamydia {Infection} group that may cause {conjunctivitis}, urethritis ({inflammation} of urethra), and a wide variety of other diseases. Causative organisms usually thought to be {gram- negative bacteria}, though they are of a size comparable to {virus}es and are all in fact "obligate" {parasites}, according to one source. Chlamidia infection may and should be specified, i.e., C. trachomatis affects the eye, etc. May appear as a venereal disease independently of AIDS but may be an AIDS {OI}.

CD chlamydia trachomatis (lymphogranuloma venereum) {bacterial infection} of eye. Possible therapy would be {doxycycline} 100 mg {bid} {PO} or {erythromycin} 500 mg {qid} {PO}.

CD cholangitis Condition involving bile duct {inflammation}. See {microsporidiosis}.

CD chorea A dysfunction that {present}s as jerky, irregular movements of the extremeties, trunk; sometimes lip, facial muscles also. Common to several diseases, chorea is noted in persons with {Huntington's disease}, Sydenham's chorea. Also noted as reversible side effect of {dopaminergic} therapy in those w/ {parkinsonism}.

CD choroidretinitis (Aka choroiditis) Inflamation of {choroid}, causing blurred vision or loss of same, however is painless. Sometimes caused by {toxoplasmosis}, {tuberculosis}, {syphilis}. In pres. of HIV, an {OI}.

CD Christmas disease Form of {hemophilia} in which deficiency of clotting factor IX is noted. (Most hemophilia involves lack of {factor VIII}.)

CD CIDP (chronic idiopathic demyelinating polyneuropathy) Form of generalized (poly-) {neuropathy}, a disorder of {CNS}. It's marked by {degeneration} of {myelin}. CIDP is not one of the neuropathies commonly associated with progression of HIV. Its cause is not known for certain, and therapy is mostly speculative, often not successful.

CD CIN Cervical intraepithelial lesion. A condition revealed by {Pap smear} that necessitates further evaluation.

CD claudication Cramp- like pains in legs due to insufficient blood circulation to muscles. Often associated with hardening of leg {arteries}.

CD colitis Inflammation of {colon}.

CD collagen disease Any disease affecting {connective tissue}s of body. Includes rheumatic fever, {lupus}, {rheumatoid arthritis}, others. Certain {autoimmune} disorders affect the collagen.

CD coma Unconsciousness, with movement & mental processes {acute}ly impaired. A person in deep coma can't be aroused by external stimuli.

CD condyloma Caused by {human papilloma virus}, presents as venereal wart, an {infection} regarded as a general {STD}. However, {immune} suppression in PWA's may cause more widespread involvement. {Remission} then recurrence common. Therapies include laser surgery, {cryotherapy}, or {topical} drug application. In PWA's, an {OI}.

CD congestion Disruption of function in parts of body by swelling of the lining {tissues} and blockage of normal channels of blood or air flow. Perhaps most commonly seen in lung disorders such as bronchitis, in which a fluid with the consistency of {mucous} is brought forth in an area inside the lung which would otherwise be clear so as to process incoming air.

CD constipation Inability to expel {feces}. Is a side effect of some drugs, sometimes due to certain level of {dehydration}, may be a symptom of disease. A temporary instance of this condition may be cleared by an {OTC} laxative, but persistent or {chronic} constipation calls for medical attention.

CD constrict To cut off flow.

CD cotton wool patches Term describing "fuzzy- edged" white spots in internal layer of {retina} (back lining of eye). Indicate areas of blocked blood supply.

CD Creutzfeldt-Jakob Name of rare, transmissible {viral} {encephalopathy}. {Present}s as apparent {brain} {degeneration}, {wasting}, tremor, erratic movement. Usually fatal. See also {prion diseases}.

CD Crohn's disease A disease that causes {inflammation} of small {intestine}, though any other part of {GI} system may be involved. {Present}s as repeated episodes of pain in abdomen (usually lower right side), poss. {fever}, {diarrhea}, {anorexia} and weight loss. Causes thickening of bowel wall and may produce {abscess}es or obstruction of intestine. Can be misdiagnosed as appendicitis. In presence of HIV, an {OI}.

CD Cushing's {Syndrome}, symptoms include high blood pressure, high blood/ {urine} sugar levels, weight gain. Often associated with use of {steroid}s. Person affected will appear swollen about upper body and/ or face.

CD cyst Growth resembling or consisting of sac, containing fluid or blood.

CD cystic fibrosis Hereditary illness found in 1 in 2500 newborns, most of whom die before age 30. A defective copy of "CFTR" {gene} deprives those affected of normal channel by which chloride (component of salt) can pass in and out of {cells}. Salt accumulates in cells lining {lungs} & digestive tissue.

CD cytopathy Rather vague term refers to diseased/ dysfunctional cells.

CD cytopenia Deficiency in one or more of the various kinds of blood {cells}. Defects result in pancytopenia, erythropenia, neutropenia, lymphopenia, thrombocytopenia, eosinopenia.

CD debilitation Having noticeably lessened or impaired energy, or experiencing weakness.

CD dehydration Loss of water content from body or tissues. Can occur in a severe and sudden manner in those with {diarhhea}. Also may occur due to inability to swallow due to {coma}, {debilitation}, drowsiness -- or from lack of salt. Can be {exacerbated} by vomiting. May produce dizziness, disorientation, delirium, {shock} or even death in rare cases, i.e., if one is already in acutely ill condition or if the pt. is a child.

CD delirium Fragmented pattern of consciousness marked by anxiety, inattentiveness, restlessness, disordered perception of time, space. If extreme, may extend into hallucination. In the most extreme cases, persons may injure selves, be unable to sleep, unable to recognize familiar persons or objects or react appropriately. Occurs in some {bacterial infections}, possibly due to action of {toxin}s on parts of {brain}. May be seen in any HIV- related disease that affects {brain}, {CNS} ({AIDS dementia} in particular but also possibly in severe {toxoplasmosis}, etc.). Sedatives may be used to prevent self- injury, etc., but therapy involves treatment of cause.

CD demyelinization Loss of the {tissue} which covers nerve {axon}s or fibers. The tissue is called {myelin}, and may be thought of as a form of electrical insulation, as signals carried by inner fibers are electrical in nature.) Seen in {multiple sclerosis}, other disease or {trauma}.

CD dependence A state close to {addiction}, or actual condition of addiction. May be physical, psychological, or both. More serious than {habituation}.

CD deradenitis Inflammation affecting {lymph glands}. May produce swelling of neck.

CD dermatitis {Inflammation} of skin.

CD diabetes Technically, any disease which causes a frequent need to {excrete} {urine}, but most often takes the form of {diabetes mellitus}.

CD diabetes mellitus a disease of the {metabolism}, in which body cannot assimilate sugar properly. This is due to the body's relative lack of, or abnormal functioning of, {insulin} -- a {hormone} {secrete}d by {pancreas}, responsible for blood sugar levels. May be called simply "diabetes." If treated and monitored properly, this potentially dangerous disease seldom causes major problems.

CD diaphoresis Night sweats. If severe, a person may need to arise and change bedsheets, nightclothes frequently for comfort. Diaphoresis is common in HIV disease, and sometimes but not always is a warning of the development of {infection} or worsening of disease.

CD diarrhea Liquid bowel movements, sometimes subsequent to stomach pain, "cramps." Those with HIV disease should regard appearance of diarrhea as a likely sign of some form of illness setting in. It is true that drug side FX, diet or change of diet, as well as stress factors, can produce diarrhea, and caffeine and alcohol encourage its development. Increased intake of fluids and smaller, more frequent meals may help resolve diarrhea, and intake of high- fiber or fatty foods may be of benefit. Reduction of use of dairy products sometimes recommended. Over- counter medicine such as Lomotil or Imodium, etc. may be used for temporary control. However, if the problem is not readily resolved, suspect {OI} or reaction to intake of {antibiotic}s, consult physician. Diarrhea or {fever} above 38.5 deg. C lasting more than one month are considered (CDC-B) markers.

CD DUNHL (Diffuse Undifferentiated Non-Hodgkin's Lymphoma) Rare {lymphoma} affecting {B-cells} that's difficult to distinguish from another cancer, {Burkitt's lymphoma}. 1-93 Its relationship to AIDS is uncertain and is being investigated. DUNHL pt.'s exhibit generalized {lymphadenopathy} and enlarged {spleen}s. This disease is usually fatal.

CD dysarthria Difficulty in pronouncing words when no other speech imediments or irregularities are noted.

CD dysentery {Inflammation} of large bowel, {present}ing as cramps, pain.

CD dyskinesia Condition producing involuntary momement of a part of body, often tongue or lips, cause uncertain. See {tardive dyskinesia}. Does appear to relate to {dopaminergic} system, may relate to altered sensitivity of {neurotransmitter} receptor sites at brain. (levodopa-induced dyskinesia) Abnormal, involuntary body movements, probably result of {dopamine} treatment for prolonged periods.

CD dysplasia Impaired growth processes. May refer to abnormally- developed {tissue}s or altered shape or organization of {cells}.

CD dyspnea Shortness of breath.

CD dystonia {Motor}/ postural disorder producing {spasm}odic twisting or jerking movements, typically in area of neck, shoulders. May be caused by damage to {basal ganglia} of brain. If confined to muscles of neck, onset during middle life, may be called {spasm}odic torticollis. No known therapy.

CD dystropy 1. abnormal development. 2. defective nutrition. 3. {degeneration}, as seen in {muscular dystrophy}.

CD ecchymosis A bruise, or purple discoloration of skin indicating {hemorrhage} beneath.

CD ecthyma Skin disease, similar to but more serious than {impetigo}, spreads down into tissues, involves {ulceration}. More {refractory} than impetigo.

CD ectopic pregnancy A pregnancy that occurs outside of the uterus.

CD edema Accumulation of excess amounts of fluid in some part of body.

CD Ehrlichiosis 11-93 {Bacterial infection} assoc'd. w/ {febrile} illness, {cytopenia}. Caused by Ehrlichia chaffeensis, relatively rare, identified in W. hemisphere ca. Ô86. Has appeared once in presence of HIV, in which case it mimicked {PCP} or pancytopenia as possible AZT side effect. Ehrlichiosis will usually clear after administration of {tetracycline}. Has been suggested this condition be added to list of possibly life- threatening {OI}s related to AIDS.

CD empyrema Condition where portion of body is filled with {exudate}.

CD encephalitis {Inflammation} of {brain}, caused usually by {viral} factors, otherwise {bacterial} or secondary to {infection} by {parasite}, {present}ing as {fever}, {headache}, neck pain, nausea, unclear thinking. May affect {CNS}, producing weakness, {coma}, paralysis. Can be the result of drug reactions or other influences. May be linked to meningitis, an {inflammation} of membranes called meninges covering brain. Treatment might include {antibiotics} for {infection}, {steroid}s to reduce brain swelling, other therapy for fever or headache, bed rest. Many HIV- linked opportunistic diseases, such as {toxoplasmosis}, include possibility of encephalitis. In presence of HIV, an {OI}.

CD encephalopathy A disorder affecting Brain, having various causes. (CDC-C) if HIV- related. See {PML}, {AIDS dementia}.

CD endocarditis (subacute bacterial endocarditis) {Bacterial infection} of heart valves, sometimes {secondary} to respiratory infection, possibly affecting nasal area. Symptoms: Weakness, low- grade fever, {diaphoresis}, weight loss, chills, aches. Somewhat more common among PWAs than general population.

CD endometritis {Inflammation} of {uterus}' lining.

CD entereocolitis {Inflammation} of small/ large {intestine}.

CD enteritis {Inflammation} of {intestinal} tract.

CD enuresis Passage of {urine} during sleep.

CD eosinophilia Abnormally high level of {eosinophil}s. May be caused by {parasite}s, {allergy}.

CD epilepsy Group of diseases which produce "siezures" during which a person may lose control of many body functions. Is usually {chronic}. Caused by abnormality in {brain} function.

CD Epstein-Barr Virus (EBV) A {Herpes}- like virus that causes one of the two kinds of mononucleosis (the other is caused by {CMV}). Lodges in nose and throat, is {contagious} and can be transmitted by kissing. Lies dormant in {lymph glands}, has been associated w/ {Burkitt's lymphoma}, a {cancer} of lymph glands. Is also suspected as a cause of {oral} {hairy leukoplakia} and as a {cofactor} in progression of AIDS. Is thought of as one of the few possible links between {virus}es and cancer. In presence of HIV, an {OI}.

CD erythema multiforme A blood {toxicity} disease. Stevens- Johnson syndrome is a severe, sometimes fatal form of "E.M." accompanied by {conjunctivitis}, "trench mouth" ({inflammation} of gums where teeth emerge) sometimes progressing to Vincent's angina, {ulcer}ations of {genital}s and {anus}. Often results in blindness.

CD esophageal candidiasis {Fungal} {infection} of {esophagus} or stomach (Gastric candidiasis if stomach is primary site). {Present}s as pain/ difficulty in swallowing, weight loss. See {candidiasis}. In presence of HIV, an {OI}.

CD essential tremor (benign/ familial tremor) Muscular {dysfunction} similar to {parkinsonism} but usually not present (or of less severity) at rest. Symptoms pronounced when a person uses hands, as in writing. (Handwriting of a person w/ parkinsonism is usually small and cramped; essential tremor produces large handwriting with a wavering quality.) "E.T." may produce head- shaking movements, problems w/ walking (titubation). (Parkinsonism causes persons to walk with feet close together, perhaps shuffling; in E.T. a person will walk with feet farther apart ({ataxia}). Hereditary E.T. is called "familial tremor."

CD exemia Condition in which most of blood leaves major vessel(s). Common in {shock} victim. See less serious counterpart {exsanguination}.

CD exsanguination Depletion of blood, possibly resulting in marked pallor. See more serious counterpart, {exemia}.

CD familia insomnia (fatal f.i.) Very rare disease found in familial clusters, caused by single- {codon} subst'ns. in PrP gene. See {prion diseases}.

CD fatigue Feelings of weakness, tiredness common in HIV disease, may be partially controlled by better diet, the right kind of moderate exercise, massage, nutritional supplements, perhaps acupuncture. Sometimes psychological counseling can help if fatigue is associated w/ stress, {depression}, which sometimes is the case.

CD febrile Feverish. See {fever}.

CD festination Walking gait marked by short, fast steps. One sign of {parkinsonism}.

CD fever Average human adult temp. is 98.6 degrees F, 37 degrees C when taken orally, higher rectally. Elevated temp. may indicate presence of {infection}. Mild malaise may be treated w/ an {NSAID}, otherwise consult physician. Note: Fever above 38.5 deg. C lasting for more than one month is considered (CDC-B) marker.

CD fibromyalgia {Etiology} is unknown, symptoms include {chronic} muscle pain, stiffness, tender areas on body, hypersensitivity to light, noise, perhaps even mood swings, sleep disorders. A diagnostic problem, as it imitates {CFS} or chronic Lyme disease. Lab tests will be normal. We're advised the only known diagnostic method here is by locating at least 11 of 18 possible "tender pressure points" on body. More info: Fibromyalgia Netwk., (805) 631-1950.

CD FIV Feline immunodeficiency virus. Counterpart to HIV peculiar to cats. See slso {SIV}, {BIV}.

CD flame retinal hemorrhage Bleeding, originates beneath inner surface of {retina}. Is literally flame- shaped, with indistinct "feathered" edges. See {hemorrhage}.

CD folliculitis Infection resembles "heat rash," affects hair follicles. Usual symptoms: itchy red bumps around roots of hair, may however occur at a variety of sites. {Etiology} may be {fungal}; else due to {staphlococcus}, requiring {antibiotics}; or "allergic" (see {eosinophilia}), which may respond to ultraviolet light exposure.

CD functional disease Disorder due to faulty working of one or more structurally sound parts of body. Opposite of {organic disease}.

CD G6PD deficiency Glucose-6-phosphate dehydrogenase deficiency, an inherited {enzyme} deficiency that can lead to {hemolysis} of {red blood cells} (RBCs) when an affected individual is exposed to drugs with oxidant properties.

CD gastroenteritis {Inflammation} of stomach, {intestine}s.

CD giardiasis {Protozoa}l {infection} caused by Giardia lambia, marked by intermittent though tenacious {diarrhea}; pain in {abdomen}, "gassy" sensations and {distended} abdomen, weight loss, fatigue. Undigested fat may be found in {stool} samples. Will {remit} to drug therapy such as {metronidazole}. In presence of HIV, an {OI}.

CD gonorrhea (gonococcus, neisseria gonorrhoeae) Venereal disease ({STD}), causes pain of, and emission of {exudate} from, {genital}s. May be visible {lesion}s. Will usually {remit} after treatment with 1 {IM} dose of {ceftriaxone} (Rocephin).

CD gout Disease of {metabolism} of {uric acid}. Affects {joints}, cartilege with symptoms resembling those of {osteoarthritis}. May produce {kidney} damage if not treated in timely manner. This disorder has features that are characteristic of {autoimmune} disease.

CD granulocytopenia Abnormally low number of {granulocyte}s in circulating blood, can lead to greater risk of severe {bacterial infection}.

CD granuloma {Lesion} composed of spirals of tissue exhibiting {inflammation}. These appear in such diseases as {sarcoidosis}, {tuberculosis}, and some {fungal} {infections}.

CD Guillain-Barr (Guillain-Barr Syndrome) Acute disease that results in bilateral (symmetrical) weakness, {inflammation}, {neuropathy} or paralysis, usually in legs, feet. Cause is unknown, but common in presense of {autoimmune} conditions

CD habituation State of reliance on a drug not necessarily as serious as {addiction} but analogous to {dependence}. Might signal {tolerence} as it indicates that a person is accustomed to regalar doses of agent. Considered undesirable.

CD Hansen's Disease Leprosy.

CD headache Persons with HIV should be aware that headaches are sometimes early warnings of other illness. If they are persistent or unusually severe, one's doctor should be consulted. The following sometimes are presaged by attacks of headaches: Ear or dental problems, medication interactions, and far more serious conditions affecting {CNS} or {brain}.

CD heart attack Symptoms: Chest pain or great discomfort; breathing difficulty; change in pulse rate; moist, pale skin or skin with blue cast. Get medical assistance or take person to emergency room.

CD hemagglutination A mass of red blood cells clustered together. May be caused by disease or by the immune reaction of antibody} against {antigen}.

CD hematologic neoplasms {Tumor}s of organs that form blood components. See {neoplasm}.

CD hemolysis The destruction of red blood cells (RBCs) by the action of drugs, serum proteins (complement), {infectious} agents, or turbulent blood flow.

CD hemolytic anemia {Anemia} due to greater than normal destruction or shortened life of {red blood cells}. In this condition, body isn't capable of supplying new red cells rapidly enough.

CD hemophilia Hemophiliacs are lacking or deficient in supply of a blood product called "{factor VIII}" to assist in normal blood clotting; this is an inherited condition. Those affected use reconstituted factor VIII concentrates made of the pooled blood of many donors or from baby hamster kidney cells altered by {recombinant} DNA means. For awhile, due to early lack of awareness of HIV hazards, the disease made inroads into the hemophiliac population, an alarming proportion of whom acquired the disease. Due to the high previous rate of infection and general vulnerability, hemophiliacs remain a {high-risk group} for AIDS.

CD hemophilius ducreyi {Bacterial infection}, sometimes {chancroid}. Mild form may yield to treatment with {erythromycin} 500 mg qid {PO}, else {ceftriaxone} (Rocephin) 250 mg intramuscular injection 1 dose.

CD hemoptysis The coughing up of blood from the lungs; may be a symptom of {tuberculosis}.

CD hemorrhage Bleeding, usually but not necessarily profuse, from a damaged blood vessel. Burst veins will emit very dark red blood. An arterial hemorrhage produces spurts of strawberry- red blood. If bleeding is not controlled and/ or treated, {shock} and even death may result.

CD heptatomegaly Enlargement of {liver}.

CD herpes See {Herpes Simplex Virus I}, {Herpes Simplex Virus II}, {Herpes zoster}, {Human Herpes Virus 6}, {Human Herpes Virus 7}.

CD Herpes Simplex Virus See {Herpes Simplex Virus I}, {Herpes Simplex Virus II}. See also {herpes}.

CD herpes zoster ophthalmicus An eye disorder caused by herpes varicella-zoster virus. It is relatively common in the presence of recurrent "VZV." In persons with normal immune systems the infection may be {benign}, but the frequency of eye system complications is still appreciable. This disorder is receiving more attention now because immune and autoimmune diseases make it far more dangerous. It may lead to dissemination of the virus, loss of vision, or death.

CD HIV (Human Immunodeficiency Virus, HIV, HIV-1) Generally regarded as the {virus} that causes AIDS. HIV is classified as a {lentivirus} in a subgroup of the {retroviruse}s. It {infects} and destroys a class of {lymphocytes}, the CD4 T-cells, thereby causing progressive damage to the {immune system}. Like other retroviruses, HIV has {RNA} as its genetic material and makes an enzyme, reverse transcriptase, that converts viral RNA into viral DNA. The viral {DNA} then is incorporated into the host cell's DNA and is replicated along with it. Meanwhile outside of the host body, HIV is transmitted by exposure to {virus}- bearing blood, mothers' milk, or sexual fluids. Once it enters a new host's body and causes infection, HIV replicates rapidly, but there'll be no {symptom}s of illness. Three to six weeks after exposure to the virus, many HIV-infected persons suffer flu-like symptoms related to the acute infection, such as fever, malaise, headaches, and swollen lymph nodes. Thereafter, the person involved generally goes into a symptomless stage of infection lasting for from perhaps four to (sometimes) as long as 10 or 12 years (see {dormant}). He or she will then become {symptomatic} with {AIDS}. See {HTLV-3}, {HIV -- the Basics}, {HIV antigens}, {HIV testing}, {HIV treatments}. (Text: AHCPR.)

CD HIV-1 Human Immunodeficiency Virus. See {HIV}.

CD HIV-2 Most closely related to {HIV-1} of all human retroviruses, and, like HIV-1, does cause AIDS and is tranmitted by similar methods. But HIV-2 is even more closely related to {SIV}, simian immunodeficiency virus. On at least one occasion a theory has been advanced that HIV-2 and HIV-1 derive from a common ancestor, but this cannot be proved. As of 12-91, there were 32 known cases of HIV-2 in U.S. 9-93 Sufficient concern over new cases of HIV-2 in U.S. results in mandatory screening of blood supplies for virus. See {HIV2 -- More}.

CD hives Skin {allergy} reaction to drugs, chemicals, stress, other factors. Affected areas are patches of itchy and raised flesh, perhaps having appearance of {inflammation}. Also called urticaria, "nettle rash."

CD Hodgkin's disease Form of {cancer} affects {lymphatic} system. Symptoms will include {lymphadenopathy}, {wasting}, {fever}, itching, weakness, {anemia}, {diaphoresis}. {Spleen}, {liver} may become involved. Has been treated with {radiation therapy}, {chemotherapy}; newer anticancer agents and combinations of same are being tried with increasingly rewarding results. Cure or {remission} possible in most cases. See {lymphoma}.

CD Human Herpes Virus 6 (HHV 6) 11-93 A new {herpes} recently discovered at {NCI}. It's been suggested HHV 6 may play a role as {cofactor} in AIDS development. HHV 6 {infection} is typically acquired early in life (in one study, 70% of those ever infected had acquired the virus by the age of 14 months). Most of this disease's FX are mild and self- limiting, but HHV-6 would probably cause additional illness in {immunocompromised} persons. HHV-6 may be treated by {ganciclovir}, {foscarnet}. Note: Speculation that HHV-6 "actually causes AIDS by activating a normally quiescent HIV infection" has been heard. Seems unreasonable but will be investigated.

CD Human Herpes Virus 7 (HHV 7) 11-93 A {Herpes} discovered recently, said to be an innocuous {strain}. Is of interest in that it may bind to the {CD4} {molecule} like HIV. One researcher has shown interest in trying to block CD4 receptors with HHV-7 to pre-empt HIV {bind}ing.

CD human papillomavirus (HPV) There are over 50 types of HPV; three subgroups lead to disease of {genital} areas. Two subgroups (types 16 and 18) are to some extent involved in invasive {cervical cancer}. The third is causative agent of venereal (or {ano- genital}) warts. HPV may multiply faster presence of HIV. See also {Human Papillomavirus -- More}.

CD human parvovirus B19 Small, non-{envelope}d {virus} with unique {DNA} {genome} structure. Single stranded DNA "self- anneals" at its end, leading to a hooked structure and a novel replication mechanism. Diagnosis by {antibody} testing. Frequently treated as {dermal} problem, although it can affect internal components of body.

CD Huntington's disease Disorder of {basal ganglia}, {degenerative} in nature, in which {striatum} becomes shrunken. Symptoms include {chronic}, degenerative {motor} dysfunction ({chorea} and/ or rigidity) plus mental deterioration terminating in {dementia}. Usually inherited, but there are rare "{mutation}al" exceptions.

CD hybridoma {Cell} {culture} made up of a {clone} of fused cells of different kinds, i.e., mouse {myeloma} cells and {lymphocytes}. A cell that produces {antibody} can, per one source, be "rendered immortal" by fusing it with a {tumor} cell. Investigation of theory underway.

CD hyperemia Describes an area w/ {inflammation}, blood- swollen in appear.

CD hyperpigmentation Darkening of skin. Sometimes observed in the nails, skin, or {oral} {mucosal tissues} of dark-skinned persons taking {AZT} & under other circumstances.

CD hyperplasia Enlargement of a body part, said to sometimes be due to overabundance of healthy {cell}s.

CD hypersensitivity 1. Excessive sensitivity to stimuli. 2. Excessive body {immune} response to drugs or other substances.

CD hyperuricemia Excess of {uric acid} or urates in the blood. {Precursor} to development of {gout}; may lead to {renal} disease

CD hypochondria Tendency of a person to be preoccupied or obsessed with state of health and to make exaggerated statements of bein in poor health. Affected person will expend much time and energy searching for explanations of usually inexplicable symptoms. The hypochondriac is sometimes said to be victim of a type of "neurosis." There seems to often be a clinical link between hypochondria and depression, which latter may be cleared by appropriate therapy. One study says hypochondriacs may be distinguishable by their heightened sensitivity to physical stimulation such as temperature changes, noise. See also {psychosomatic}, similar but not same. See {hysterical}, {fibromyalgia}, {rare diseases}.

CD hypogammglobulinemia Abnormally low levels of {immunoglobulin}.

CD hypoglycemia Inadequate levels of {glucose} in bloodstream.

CD hypogonadism Symptoms: Loss of muscle mass, decrease in sex drive and amount of {semen} made by body. Due to decrease in the male hormone called testosterone. Associated w/ HIV in males having {CD4 T-cell count}s under 200, can be treated under careful medical supervision w/ testosterone esters, a type of {anabolic steroid}.

CD hypokelemia Abnormally low level of the mineral potassium in blood; may result in {arrhythmia}, muscle weakness, or paralysis.

CD hypomagnesemia Abnormally low level of the mineral magnesium in blood, can cause fatigue and muscle weakness.

CD hypotension (Orthostatic hypotension) Low blood pressure. This can be caused by adrenal insufficiency, which is treatable. (See {adrenal gland}.) May be due to injury, or to heart disorder.

CD hypovolemia Decreased amount of blood in system.

CD hypoxia Effect produced by inadequate supply of oxygen to {tissues}. Causes numerous.

CD IBD Inflammatory bowel disease. {Colon} disorder. Symptoms are stomach pain, {diarrhea} or {constipation}. See {ulcerative colitis}, {Crohn's disease}.

CD ICL Idiopathic CD4 T-lymphocytopenia. Uncommon {present}ation of severe {CD4} depletion and {clinical} evidence of {immune} deficiency while the person tests "negative" for {HIV-1}/ {HIV-2} infection. Was subject of a stir at Amsterdam AIDS Conference in Ô92, but cases are few and isolated. In fact, as early as 1984, some cases of AIDS without presence of HIV antibodies in the bloodstream were being reported in England's LANCET.

CD immune chaos 10-93 Theory that HIV doesn't directly cause HIV disease/ AIDS, but "tricks" immune system into self- destructive state, with at least partly {autoimmune} character.

CD immunoblastic lymphoma A {lymphoma} of formative cells. (CDC-C).

CD immunocompromised Having reduced functioning of {immune system}.

CD immunodefiency Not having normal {immune} responses.

CD immunosuppression Restricted performance of body's {immune system} due to defect, illness, or other atypical phenomenon.

CD impetigo Skin disease Symptoms: Reddish patches, small {pustule}s.

CD incontinent Unable, to some extent, to control elimination of {urine} and/ or {feces}.

CD induration Hardening of tissue.

CD infarct Situation in which an area of {tissue} is deprived of supply of blood, due to clotting before blood reaches it or other reasons.

CD infected Being subject of an {infection}.

CD infection Invasion of body by a harmful {microorganism} or disease resulting therefrom. May be transmitted, depending on type, by insects, some degree of physical contact with a {carrier} or infected surface, ingestion of water or foodstuff that's been contaminated, etc. Microorganisms readily enter body through an unprotected sore or wound, will attempt entry via {mucous membranes}, and some may even be inhaled. The infective {agent} might be {bacteria}, a {virus}, {parasite}s or {fungus} and will probably tend to multiply/ spread. {Fever}, swelling, coughing and other complaints may be signs of infection. Of all infections, {viral} ones -- including the common "cold" -- are the most likely to be hard to treat. {HIV}, human immunodeficiency virus, is a blood- borne {pathogen}, a way of saying that its only known means of infecting a person is by actual exchange of blood or blood products. Also it's not an ordinary virus but a {retrovirus}, and it differs from other infections in many other ways. See also {opportunistic disease}, relevant because many of those diseases are a serious threat only to a person whose {immune} abilities are damaged by primary HIV infection.

CD inflammation Manifests itself as pain, swelling, reddening, sensation of heat as body's response to {infection}, {insult}. May be produced by {interleukin}s.

CD influenza Any of a number of {viral infection}s which may be extant at a given time. All variants of "flu" are highly contagious, spread in an air- borne manner by a {carrier} or infected person. They affect mainly the {respiratory} system but cause {severe} symptoms of other kinds, especially deep fatigue, aches. Protection, in the form of "flu shots" obtainable in Sept. or Oct., offer fairly substantial protection. In presence of HIV, "flu" FX will be far more serious. It is usually safe for a person with HIV to receive the inoculation; consult physician.

CD insult Injury, excessive stress, or result of maltreatment of body or organ.

CD intractable disease A disease unresponsive to treatment. In some usage implies disease is uncontrollable.

CD invasive cancer {Cancer} growth from its original site into surrounding {tissue}, associated w/ malignancy.

CD isoporiasis (coccidiosis) {Intestinal} disease caused by {infection}. May bring about {diarrhea}, and if this occurs and lasts about 30 days or more, the condition becomes (CDC-C).

CD jaundice {Present}s as yellow coloration of skin and whites of eyes, indocating excess {bile} pigmentation in blood. Is caused by {liver} disease (including {hepatitis}) or destruction of {red blood cells}.

CD keratitis {Inflammation}, affects {cornea} of eye.

CD klebsiella {bacterial infection}s including the enterobacter subfamily and others, may yield to antipseudomonal {penicillin}, imipenem cilastatin, else {ciprofloxacin}.

CD KS Kaposi's Sarcoma, a {tumor} of the walls of blood vessels just below skin or rapidly- growing masses of blood vessels. Pron. KAH' push eez. See {Kaposi's Sarcoma}.

CD kuru Nervous system disorder caused by slow- acting virus. Found among certain native peoples of New Guinea. Is {chronic}, {degenerative}, fatal. See also {prion diseases}.

CD LAV (lymphadenopathy-associated virus) Early name for HIV.

CD lesion A broad term describing irregularities observable on a bodily surface. May be used to describe abcesses, ulcers, or tumors, blisters, sores. Secondary lesions include scars and crusts, and are derived from primary ones.

CD leukemia {Cancer} of the blood- forming organs and {tissue}s -- {bone marrow}, {lymph glands}, {spleen}. Marked by overproduction of {white blood cells}.

CD leukocytosis Condition marked by increase in {white blood cells}.

CD leukopenia Abnormally low numbers of {white blood cells} in circulating blood.

CD leukoplakia {Present}s as rather thick pale or white patches on {mucous membranes} of the mouth. Could be mistaken for other disease (oral {thrush}), use caution in diagnosis. Sometimes becomes {malignant}.

CD listeriosis {Bacterial infection} affecting upper {respiratory} system or producing chest pain, {conjunctivitis}, {inflammation} of {lymph glands}, {septicemia}. Caused by Listeria monocytogenes. Usual therapy is {ampicillin}. {TMP/SMX} is an alternate therapy. (CDC-B)

CD lupus One of several conditions affecting skin, most common of which is a localized tuberculosis (lupus vulgaris). There are other forms such as lupus verrucosus and systemic lupus erythematosus. Systemic lupus erythematosus (SLE) is regarded as a {Connective tissue} disease, affects mainly mid- aged women. Symptoms include skin {lesion} eruptions, mainly on hands, face. Possible low {WBC} count, {concurrent} {rheumatoid arthritis}, {kidney} dysfunctions, internal lesions, {neurological} symptoms, fever, {lymphadenopathy}. Heart, brain, lungs may be involved, w/ {inflammation} followed by formation of scar tissue masses. As there are many abnormal {immunological} phenomena associated w/ SLE, the disease is often viewed as an {immune system} or {autoimmune} disorder.

CD lymphadenopathy Enlargement of {lymph glands} or other components of lymph system. Swollen areas generally firm, possibly tender. Cause may range from a temporary {infection} (including influenza) to {cancer} of {lymph glands} or {lymphoma}. Sometimes called "lymphadenopathy associated syndrome," (LAS); "chronic lymphadenopathy syndrome," (CLS); "generalized lymphadenopathy syndrome," (GLS); "persistent generalized lymphadenopathy," {PGL}. PGL is relatively common in presence of AIDS. It may also be marked by enlarged {spleen}, usually by definition consists of swelling of lymph nodes in at least two areas of body for 3 months or longer. May be an early sign of HIV infection, or a later- stage complication.

CD lymphangioma Cluster of enlarged {lymphatic vessels}. May form a {cyst}. Often seen on neck or underarm. Can be {excise}d.

CD lymphedema Condition marked by swelling, caused by buildup of {lymph} in {tissue}s. May be due to dysfunction of {lymphatic vessels}, but more likely an {infection}, injury, {inflammation}, etc. that has caused obstruction of those vessels. Most often affects legs. {Diuretic} drugs, or use of elastic support stockings, may provide some relief, but no surgical remedy has been developed to correct this condition.

CD lymphoma {Cancer}s of {lymph glands}. (See {Non- Hodgkin's Lymphoma}, which is one of two major lymphomas, {Hodgkin's disease}, the other.)

CD lymphoma of the brain Presence of brain {tumor} in a person under age 60, per CDC definition. A possible effect of HIV disease. (CDC-C)

CD MAI bacillemia Mycobacterium avium intercellulare bacillemia, a condition in which {MAI} organisms float freely in bloodstream.

CD malabsorption Inability of {intestine}s to {absorb} nutrients properly. May result in {anorexia}, {myalgia}, and weight loss, in which case it's called "malabsorption syndrome."

CD malaise Generalized and {moderate} discomfort. May in some contexts imply "queasy" feeling.

CD malignant Term applied to a {tumor} made up of {cancer} cells. Tumors will tend to grow, invade surrounding {tissue}; calls may break away and grow elsewhere also. See {metastases}.

CD MDR-TB (Multidrug-resistant tuberculosis) Tuberculosis caused by a strain of the organism M. tuberculosis that is resistant to more than one of the major antituberculous drugs.

CD Meige's Syndrome. {Etiology} unknown. Appears in mid- to- late adulthood, {present}s as forceful {blepharospasm}s, {dystonia} or {spasm}odic movements of lower face.

CD melalgia Pain in limbs.

CD melanoma {Cancer}ous concentration of pigmented skin {cell}s. Applied to a mole or other body component which has become {malignant}.

CD meningitis {Inflammation} of {membrane}s (the {meninges}) covering the {brain} and {spinal cord}. In presence of HIV, may be caused by cryptococcus (see {cryptococcosis} or one of several other {infection}s.

CD meningoencephalitis {Inflammation} of {brain}, {spinal cord}, their {membranes}.

CD metastases Secondary {cancer} growths located some distance from main site. They usually have travelled via bloodstream.

CD metastatic Indicates movement of disease (usually cancer) from one part of body to a relatively distant one via some predictable inner route.

CD microcytosis Condition sometimes caused by a form of {anemia}. {Red blood cells} will be smaller than normal. May also be due to {chronic} {infection}s.

CD microsporidiosis {Parasitic infection} caused usually by Enterocytozoon bieneusi, often found in small {intestine}. Disease site will be sinuses or eyes however due to dissemination. Diagnosis by {stool} sample exam. May cause cholangitis, a condition involving bile duct {inflammation}.

CD microsporosis Ringworm infection, caused by Microsporum fungi.

CD mitosis Natural process in which a {cell} divides, producing two identical "offspring." There are four parts to the early stage of this activity, which may technically be called karyokinesis. Then, {cytoplasm} divides ({cytokine}sis), forming two "daughter" cells. See also {Meiosis}.

CD mononucleosis An {infection}, mostly prevalent among teenagers and young adults, that affects {gland}s. Other than a convalescence due to symptoms of fever, sore throat and weakness, this disease is usually not thought of as a major medical concern. Diagnosis is by examination, blood test.

CD morbidity General term indicates any condition where there is a physical disorder, dysfunction, or disease.

CD motor nerve disease (motor neuron disease) Spontaneous atrophy of {motor} components of {nervous system}, usually beginning in middle age, causing {degenerative} muscle weakness and (typically) {wasting}. Corticospinal (see {cortex}, {spine}) nerve fibers involved, as are {motor} nuclei in {brain stem}, {spinal cord} cells. Takes three main forms -- {ALS}, progressive bulbar palsy, progressive muscular {atrophy}.

CD multiple sclerosis (MS) {Nervous system} disease marked by {demyelinization} of nerve fiber throughout {white matter} and sometimes extending into grey matter. Causes weakness, changes in speech, visual/ tactile aberrations, inability to walk, partial paralysis. Disease is {chronic}, long in duration. It's suggested that a virus may cause MS.

CD muscular dystrophy Disease in which muscles malfunction or fail and are subject to {wasting}. Onset is usually in childhood. Those affected lack a functional gene for dystrophin, a muscle {protein}. The most severe form of this disease is Duchenne's muscular dystrophy, also called Aran- Duchenne disease.

CD myalgia Pain in muscle(s).

CD Mycobacterium tuberculosis The micro-organism that causes {tuberculosis}.

CD Mycoplasma fermentans This infection, like others of its group, had once been thought of as more common in the presence of HIV, but that is apparently not so. Researchers in England with access to 117 HIV- positive subjects found the organism in similar proportions among the subjects and 73 HIV- negative people.

CD Mycoplasma incognitus Currently being investigated as possible major cause of illness in PWA's. May invade {thymus}, {liver}, {spleen}, {brain}, {lymph glands} or cause {systemic} {infection}s. Appears to result in organ failures. May yield to therapy w/ {doxycycline}, {tetracycline}, {clindamycin}, {lincomycin}, {ciprofloxacin}.

CD Mycoplasma penetrans A {virulent} disease that appears in those with HIV disease about 100 times more frequently than in others. M. penetrans, says one authority, is "not a simple opportunist." In one study, 35.4 percent of 444 HIV- positive subjects had serum antibody to M. penetrans, measured by enzyme-linked immunosorbent assay ({ELISA}) compared with only 0.4 percent of 893 HIV- negative persons. About 40 percent of those with AIDS were mycoplasma- antibody positive.

CD mycosis Any disease caused by a {fungus}.

CD myelemia Form of {leukemia} marked by overabundance of {myelocyte}s (immature {white blood cells}).

CD myelogenous leukemia One type of {malignant} {tumor} or {cancer} that may strike blood- forming structures of the {bone marrow}, which will then produce dysfunctional blood cells.

CD myeloma A {malignant} {bone marrow} disease. {Present}s as fatigue, possibly pain centered near bones, {anemia}. Exam and tests will reveal abnormal {IgG} level in {serum} or malignant plasma cells or flecks resembling holes on bone {x- ray}s. Usual therapy is limited to agents such as {cyclophosphamide}, etc. or {radiation therapy}.

CD myelopathy (or chronic myelopathy) {Degenerative} weakness and {spasticity} in lower extremities. {Sensory} symptoms variable. In advanced stages, urinary {incontinence} occurs. Myelopathy occurs fairly often in the presence of HIV disease, and could be mistaken for {neuropathy}. Also the appearance of this disorder calls for testing to determine cause -- it may signal presence of {CMV}, {herpes zoster}, {toxoplasmosis} or other agents that affect the {nervous system}. Otherwise, symptomatic therapy similar to that for neuropathy.

CD myelosuppression Impaired production of blood cells by {bone marrow}.

CD myoclonus Fast "startled" involuntary muscle movements of moderate or greater strength, seen normally in process of a person falling asleep but also an indicator of various illnesses. Control of abnormal myoclonus involves influencing the serotonergic (blood {platelet}/ {intestinal}/ {CNS}) systems.

CD myopathy Broad term for any muscle disease, In those with HIV, {wasting} of muscle {tissue}, weakness, may be caused by myopathy, or several other factors include {neuropathy}, drug side FX, simple malnutrition. Wasting of {gluteal} muscles may be seen. Serious muscle inflammation, pain, and/ or weakness calls for diagnosis among these several causes. CPK enzyme level should be checked; elevated level often signals myopathy.

CD necrolysis Separation (peeling or flaking) of skin due to {necrosis}, in which skin cells die due to lack of blood supply or disease. Necrosis has been called "mortification" by laypersons. Necrolysis is sometimes medically termed "exfoliation."

CD nematode infections {Parasitic infection} caused by a type of worm. Mainly manifested as {strongyloidiasis}. May be treated w/ thiabendazole (Mintezol). Retreatment often required.

CD neoplasm {Cancer}ous growth.

CD neoplastic Refers to {tumor}s, {camcer}ous growths.

CD neopterin A molecule produced by macrophages in response to gamma {interferon} and found in {serum}, urine, and {cerebrospinal fluid}. Elevated neopterin levels have been reported in the presence of all phases of HIV disease. According to some studies, high neopterin levels have been associated with a poor {prognosis}; low levels have correlated with a better prognosis.

CD neuralgia Sharp pain following course of nerve fiber's path.

CD neuritis 1. Loosely and improperly used to describe {neuropathy}. 2. Disease of peripheral nerves marked mainly by {inflammation}. See {paresthesia}.

CD neurodevelopmental delays Changes in the level of functioning of the central nervous system ({CNS}) that lead to the loss of skills that a child has developed or would have developed.

CD neuropathy A syndrome or disease of the {nervous system}, usually causing pain, "pins and needles" sensations, weakness, numbness. It is common in the presence of AIDS, and is often seen as a drug side effect in that context but may also appear in an apparently spontaneous way. In MONONEUROPATHY, a single nerve is affected; extent of symptoms depends upon distribution of that nerve. In POLYNEUROPATHY, many nerves are involved and symptoms are usually most pronounced at the extremities of the limbs. Polyneuropathy usually symmetrical. May spread inward toward trunk. This complex cannot at present be "cured," and in fact even the relief of its symptoms is not a simple matter for the physician. Neuropathy may result in partial or complete paralysis as worst- case possibility, but doesn't in most cases advance to that stage. Pron. new RAWP uh thee. Not to be confused with {neuritis}. See {CIDP}, for details see {peripheral neuropathy}.

CD neurosyphilis A form of advanced {syphilis} in which the {infection} has spread to the central nervous system ({CNS}).

CD neutropenia Shortage of {neutrophil}s (most common of white cells). Leaves a person vulnerable to {bacterial infection}, {fungal} {infection}. May be caused by primary infections, drugs, or {bone marrow} disease. (Note that neutrophils are produced in marrow. Their task is to kill invasive {bacteria}l {organism}s, thus shortage of neutrophils is potentially life- threatening. Usual range of neutrophils in a {CBC} will be from 3000-7000.) Very little practical difference between neutropenia and {bone marrow} suppression.

CD occlusion Obstruction of flow (other than in references to dental subjects).

CD occupational disease Loosely refers to illness caused by one's work.

CD OI Opportunistic {infection}. See {opportunistic diseases}.

CD OPC degeneration Olivo-ponto-cerebellar degeneration. {Degenerative} dis. with some of same characteristics as {parkinsonism}. However, OPC produces "intention" tremors, also certain forms of {ataxia}.

CD opportunistic diseases {Infection}s or other illnesses caused by agents commonly present in body or environment but which cause serious disease when a person is not normally healthy -- including instances where the {immune system} is {depress}ed. These are the diseases which actually cause fatalities to people with AIDS. Science is rapidly finding new tests that give advance warning if a person is becoming vulnerable to "opportunistic infections," and physicians can now supply better protective therapy via progressively milder drugs. (See {HIV progression testing}.) Result of this is that the life expectancy of a person with AIDS continues to rise, as does the quality of that life. Serious opportunistic diseases discussed in this document are tagged "(CDC-B)" or "(CDC-C)." See also {prophylaxis}.

CD organic disease Disease due to anatomic changes in a body organ that inhibit its functioning. Opposite of {functional disease}.

CD osteoarthritis {Degenerative} arthritis affecting bone, {joint}, {cartilege}. Common in older people. Differs from {rheumatoid arthritis}. Extremely painful, productive of stiffness, especially after resting. There's no effective therapy for this disorder.

CD otitis media {Inflammation} of inner ear.

CD palsy Form of paralysis, sometimes linked to {nerve} {degeneration}. Is also used sometimes to describe trembling or shaking moments marking illness, but this is no longer accurate. (progressive supranuclear palsy) {Degenerative} disease of {brain}, shares some features w/ {parkinsonsism}, may be mistaken for that disease Marked by rigidity/ {akinesia}, frequent balance problems. Unlike those with parkinsonism, those w/ PSP have progressive difficulty in moving eyes and also have a {dystonia} in which neck arches backward. PSP does not respond to available medications.

CD pancreatitis {Infection} or {inflammation} of {pancreas}. Produces intense stomach pain, nausea, vomiting, constipation, slow pulse, {debilitation}, perhaps {jaundice}. In what's called {acute} pancreatitis, the organ appears to "digest itself" due to liberation of digestive {enzyme}s into {tissues}. Latter condition may be irreversible.

CD papilledema Swelling of {optic nerves}, due to increased pressure within {brain}. Initially {present}s as minor, temporary visual loss.

CD papilloma Virus which causes {condyloma} (venereal warts). May however produce other {benign} growths -- some on "stalks," many times on areas of skin often or usually damp or wet, i.e., {mucous membranes}. Complete info under {human papillomavirus}.

CD papule Condition marked by lesions resembling small pimples or similar skin eruption. Also commonly has the appearance of a skin rash.

CD paraplegia Paralysis of lower part of body including legs.

CD parasitic infection Any kind of {infection} caused by {parasite}s.

CD paresis Partial paralysis.

CD paresthesia "Creeping," burning or tingling ("pins and needles") sensations. May indicate peripheral {nervous system} damage. Common to {neuritis}.

CD parkinsonism Disease affecting {basal ganglia} of {brain}, common in older people. Presents at first as as "resting" tremor, stiffness, {akinesia} ({bradykinesia}, inability to move), loss of postural reflexes (results in falling). Thought to possibly be related to decreased activity of striatal (see {striatum})/ {dopaminergic} syst. {Symptomatic} relief possible, cure has not been found. "Idiopathic" parkinsonism is of unknown cause, the post- encephalitic variety is associated with {encephalitis}. (drug-induced parkinsonism) Underactivity of {dopaminergic} system in those receiving {neuroleptic} drugs, due to drug- induced receptor site blockage. Ex: In those taking reserpine for hypertension (high blood pressure), this effect is fairly common, producing symptoms very much like {parkinsonism} but cause, therapy are different. Drug- induced FX will usually {remit} when offending medication is stopped.

CD parosmia Distorted sense of smell, sometimes indicating presence of {brain} {tumor}(s) or serious mental disturbance.

CD petechia Small round {hemorrhage} tending to spread slightly into skin and/or {mucous membranes}. Pl. is petechiae.

CD phlebitis {Inflammation} of vein.

CD plaque 1. An area that is noticeably raised. 2. Common dental problem.

CD pneumonia {Inflammation} of {lungs}, may be caused by pneumo{coccus} (specialized organism that causes pneumonia), sometimes by exposure to {streptococcus}, {influenza}, etc.) Can be treated successfully with antibiotics except when the person is highly symptomatic with AIDS or has lung disease. ({Recurrent} pneumonia is (CDC-C)). See also {PCP}. (lymphoid interstitial pneumonia) (lymphocytic interstitial pneumonia, LIP) Severe pneumonia w/ swelling of related tissue. "Interstital" implies involvement of spaces within organs or tissues. {Hyperplasia} may occur. Imitates ordinary pneumonia but requires different types of treatment. Occurs frequently in children who are HIV positive (incidence perhaps 35-40%). Diagnosis usually via lung {biopsy}, sometimes presumed when someone does not respond to standard pneumonia therapy and no other infectious organisms are present. May be a CDC- defined marker condition.

CD pneumothorax Air in chest cavity position usually occupied by {lungs}. May imply puncture, collapse of lung, in which case tube is inserted into a short incision (cut) in lung, positive air pressure applied via tube. People who are severely underweight sometimes suffer pneumothorax on a spontaneous basis, possibly due to abrasion or pressure of rib vs. lung wall.

CD pneumotitis {Inflammation} of {lungs} affecting the walls of air sacs. May be either temporary or {chronic}. May become a serious medical problem.

CD polycythemia A disorder in which the proportion of {red blood cells} to plasma is abnormal, with either a diminished level of the latter or too great a volume of the former. The net result will be an excessive {hemoglobin} level. Excessive production of RBC's may be linked to respiratory disease, which if serious causes shortage of oxygen in tissues; more often the imbalance will be due problems in the circulatory system. A type of polycythemia can result in concurrent high white cell counts. It is known as polycythemia vera, and its cause is not certain, but it can be treated successfully.-

CD polyneuritis (Disseminated {neuritis}) Inflammation of a relatively great number of {nerve}s.

CD polyneuropathy {Neuropathy} affecting a number of sites.

CD postherpetic neuralgia (PHN) {Neuralgia} with {chronic pain} that often occurs after {remission} of {herpes zoster}. Fairly common. Treatment mainly {symptomatic}.

CD prion diseases Prions are {pathogenic} agents of a group of diseases involving signs of {dementia}. These dysfunctions are associated with production of a unique {amyloid} {protein} called prion protein (PrP). (Specifically, there will be found a single-{codon} substitution in PrP gene.) Prion diseases are both {infectious} and {hereditary}. They're known at various times as human spongiform {encephalopathy}, "slow" or "unconventional" viral infections, and transmissible dementias. They are progressive and fatal, and no clinical tests or therapies exist. They are however relatively rare. Example: Gerstmann-Straussler-Scheinker syndrome, a very rare disease found in familial clusters. Add'l info: search on "prion" elsewhere.

CD proctitis Inflammation of {rectum}.

CD prostatitis {Inflammation} of {prostate gland}, with {bacterial infection} a likely cause.

CD pruritic papules (See {pruritus}, {papule}. Often no cause found. Unruptured papule should be {culture}d for S. aureus. {Topical} {steroid}s may help. Doxepin, starting at 10 mg/day, increased to as much as 150 mg/day, may be effective as antipruritic.

CD pruritus A {dermal} syndrome marked by profuse itching sensations. May be due to any of a wide range of causes, from poor hygiene to {leukoplakia}, {candidiasis}. May imply presence of {parasite}s, or may occur as a spontaneous, "paroxysmal" event.

CD pseudo-bulbar palsy A syndrome that sometimes follows a series of {stroke}s (transient ischemic attacks, apoplexy) or {ALS}. The person will have extreme ndifficulty in swallowing, talking. May smile, laugh/ cry uncontrollably or at inappropriate times.

CD psoriasis Symptoms: Itchy, red skin, with scaling. HIV exacerbates this condition. {Antiviral} therapy sometimes causes remission, else may use {topical} {steroid} preparations.

CD pustule Hollow lesion containing {exudate} or pus. May be tender, inflamed, may become site of {infection}.

CD rare diseases There are many diseases or disorders that are little known outside of medical circles -- and some that even baffle medical personnel, that's the challenge and excitement of medicine as a science. The person who is affected by one of the so- called "orphan diseases" has a specialized need for resources, and there's one good source of information on whom to call -- NORD, the National Organization for Rare Disorders, PO Box 8923, New Fairfield CT 06812, (203) 746-6518. NORD states that is has a computerized database with information on hundreds of "orphan diseases." (Note: With due respect to NORD, there are probably still many fairly serious "unknown quantities" out there. With passing of time, more and more complaints once dismissed as manifestations of ordinary fatigue, hypochondria or nervousness, etc. are being recognized as legitimate disorders. A few onetime "unknowns" are cited in this document.)

CD Reiter's An {autoimmune} syndrome.

CD retinal detachment Consequence of disease, {retina} thins and loses structural integrity. {Vitreous humor} elevates retina, with consequent loss of vision.

CD retinitis {Inflammation} of {retina}, occurs sometimes in {CMV}, may be due to other factors. If untreated, can lead to blindness.

CD retinopathy Refers to non- {infectious} disorders of {retina}.

CD rheumatic Sore, w/ {inflammation}.

CD rheumatoid arthritis 8-93 {Chronic} and incurable disease primarily affecting {joint}s with {inflammation}, much pain, {atrophy}, deformity, immobilization. {Etiology} may include {viral} factors, is now regarded as an {autoimmune} disease. See also {osteoarthritis}, an entirely different disorder.

CD salmonellosis (salmonella {septicemia}) {Bacterial infection} caused by intake of contaminated food or water. Caused by salmonella bacteria, and once acquired, may be spread through such means as {oral}- {anal} contact. Is 20 times more common in HIV- positive people than in others. Presents as nausea, cramps, loss of appetite, diarrhea, fever. Diagnosis by blood, {stool culture}. Most HIV- negative people recover even without treatment, HIV- positive people should receive {antibiotic} therapy. (CDC-C) when it occurs w/ another infection within a two- year period, or is {recurrent}.

CD sarcoidosis Disorder in which {granuloma}s develop in various parts of body, most commonly {lungs}, but also {liver}, {lymph glands}, {spleen}. Cause unknown. Severe cases may be treated w/ {corticosteroid}s.

CD sarcoma Form of {malignant} {cancer}, arises in {connective tissue}, muscles, or bones. The form of this of special concern to those affected by AIDS is {KS}.

CD SCID (severe combined immunodeficiency disorder) Rare immune disease syndrome. In this group, both specific and non-specific arms of the body's {immune system} are both disabled, so an antigen entering the system will encounter literally NO resistance. SCID also prevents production of {immunoglobulins}. See {SCID-HU Mouse}.

CD scleroderma {Autoimmune} disease characterized by hardening, shrinkage of {connective tissue}s of parts of body, especially skin, heart, {lungs}, {esophagus}, {kidney}s. Areas of skin may be discolored.

CD sclerosis Hardening of {tissue}s, w/ fibrous tissues replacing original structure (in a process called "fibrosis"). Affects walls of {arteries} in some cases (producing arteriosclerosis); lateral columns of {spinal cord}; medulla of brain (producing progressive muscular paralysis); scattered areas of {brain} or spinal cord (producing {MS}). Is commonly due to scarring after severe {inflammation}.

CD scotoma (scintillating scotomata) Condition, apparently peculiar to early HIV infection, in which {peripheral} visual field affected by "colored, jagged, flashing lights" while central area of vision is blurred. Not well documented.

CD scrofula Form of {TB} that generally appears in {lymph glands} of the neck.

CD seborrheic dermatitis Often a problem with HIV+ persons. Symptoms: itchy, flushed- looking skin in area of groin, armpits, face, chest, brows. May begin in scalp, cause dandruff (very small greasy, light- colored scales). The person may develop mildly pruritic (see {pruritis}) {lesion}s on central face, scalp. Areas other than scalp should be treated w/ {topical} {antifungal}s or {steroid}s or at worst case, {oral} {ketoconazole}, imidazole, etc. Scalp is best treated by anti- dandruff shampoos.

CD secondary infection Infection that appears in a part of body made vulnerable by a "primary" or prior {infection}. Example: {Bacteria} may secondarily infect a fever blister originally brought on by a {virus}.

CD seizure Uncontrollable body movements, called "convulsions" if entire body affected. Cause is often abnormal {brain} function due to disease or permanent injury. See {stroke}.

CD sepsis Body's reaction to {bacteria} circulating in blood. May result in some level of {tissue} destruction.

CD septic shock Possible result of {septicemia}.

CD septicemia (blood poisoning) Caused by {bacteria} in bloodstream. A serious condition marked by increased {cardiac}, {respiratory} rates, fluctuations in body temperature. Can progress to {septic shock}, at which time blood pressure will drop abruptly. This condition may be irreversible, fatal. Per one source, standard therapy vs. {present}ing septicemia is {penicillin} + {gentamicin} or other cephalosporins. Septicemia may qualify as CDC- defined AIDS marker condition.

CD shigellosis A {bacterial infection}, caused by Shigella, produces {GI} disturbance -- mild {diarrhea} to severe or even fatal {dysentery} if unchecked. Often treated w/ {ciprofloxacin}.

CD shock Condition arising due to loss of blood pressure in {arteries}. Circulatory system will be in a state of "collapse." Person will have irregular breathing, possibly {dilated} pupils, weak but fast pulse, dry mouth, pale skin, with "cold sweat." May be due to internal/ external {hemorrhage}, vomiting/ {diarrhea}, serious {dehydration}. Possibly due to drug overdose. Alternatively, heart failure -- pulmonary embolism, myocardial infarction, coronary thrombosis. Could be due to emotional "shock" or trauma. If certain a person is in state of shock, elevate feet/ lower legs, take measures to control bleeding if any. Splint broken bones if you know how to do so. Further therapy depends upon cause. Call paramedics, nurse or physician, whichever is closest. See {anaphylactic shock}.

CD Shy-Drager {Syndrome} features abnormal {motor} function, failure of autonomic {nervous system}. Produces extremely low blood pressure when standing, some {parkinsonism}- like symptoms. Therapy will be via antiparkinsonism agents and other methods.

CD SIL Squamous intraepithelial lesion. Findings in cells revealed by {Pap smear} that indicate changes requiring further evaluation.

CD silent infection Those which, like {Herpes}, may be resident, sometimes active and sometimes subsiding, for prolonged periods. In some respects, HIV may be thus classified. See {subclinical infection}, {asymptomatic}.

CD SIV Simian Immunodeficiency Virus. An equivalent to HIV, found in apes, etc. Its main interest is that although it's not identical to HIV, tests on SIV- infected monkeys yield valuable information to help devise strategies against HIV. See also {FIV}, which is not so closely related to HIV as SIV; also {BIV}.

CD Sjogren's {Syndrome} characterized by dry mouth. May be caused by salivary gland {degeneration}. Is sometimes linked to {rheumatoid arthritis}.

CD spasm Involuntary clenching, tensing, tightening of muscles.

CD spondylitis (ankylosing spondylitis) Rheumatic disorder that causes symptoms very much like arthritis. These will involve the spine, shoulders, neck, etc. {Inflammation} will be treated with {NSAID}s.

CD staphylococcus Extremely common {gram-positive bacteria} having a spherical or round shape as viewed under microscope. May cause boils, pimples, bullous impetigo, ecthyma, {folliculitis} or more serious symptoms/ {infection}s in various organs. Said to be {virulent}, {endemic} in hospitals & similar environs, possibly drug resistant. Therapy is usually {oral} {antibiotic}(s) with {adjuvant} {topical} therapy; drainage of {abcess}es; anti{pruritus} therapy.

CD staphylococcus aureus {Bacterial infection}, often in nasal area. Bullous {impetigo}, {ecthyma}, and folliculitis all common symptoms.

CD STD (Sexually transmitted disease) any of a wide range of diseases that may be communicated by sexual means. {HIV}/{AIDS} regarded as an STD when appropriate but not otherwise. STD's include {syphilis}, {chancre}, {gonorrhea}, etc.

CD stomatitis {Inflammation} of mouth; caused by mechanical trauma, irritants, vitamin deficiency, {allergy}, {infection}.

CD streptococcus Genus of cocci ({bacteria}) that cause {infection}s in skin, throat, {respiratory} syst. If not treated promptly, can lead to disease of heart, {joint}s, {kidney}s, etc. In some cases capable of killing {red blood cells}. See {coccus}. 6-94 Featured recently in the news are cases of necrotizing fasciitis associated with Group A Beta Streptococcus. Fascia are membranes making up connective tissue found here and there throughout the body. Necrosis is death of the tissue or its cellular components. The necrosis, at some point, can become a self- perpetuating condition, with swollen, dying tissue creating a gangrenous appearance, crowding aside healthy flesh. The incidence of Streptococcus shows a rising trend of late -- BUT there is no reason for alarm, only for investigation. This gram- positive bacterial infection doesn't seem to have clearly- distinguished transmission routes; it has always been abroad at some relatively low level (compared to some other diseases), and it's doubtful that it can be stopped in its tracks at this time. The usual therapy is Penicillin G. If the infection is fairly recent, it'll remit promptly. If it's had a day or two to become established, there may be trouble. Signs of swelling and redness, or a feeling of "heat" at the site of a possible infection, call for medical attention right away. Those with HIV have NO reason to panic over the recent flurry of Streptococcus cases. This is very important. Caution is called for, of course. Lack of immune competence is a "predisposing factor" toward most infections, however the causative agent of Streptococcus Group A is not known to present a special hazard to those with HIV.

CD streptococcus pneumoniae {Bacterial infection}, usually treated w/ {penicillin}. Persons at risk should be vaccinated against S.P.

CD stroke (transient ischemic attacks, {TIA}'s, apoplexy) Spontaneous loss of body control and/ or consciousness, caused by constricted or burst blood vessel in brain.

CD strongyloidiasis (strongyloidosis) {Parasitic infection} caused by Strongyloides stercoralis (roundworms). {Present}s as {diarrhea}, {ulcer}ation of small {intestine}, possible {hemorrhage} in {lungs}, {pneumonia}, {CNS} involvment or {disseminate}d {infection}. In presence of HIV, an {OI}.

CD stupor Semiconscious state, daze.

CD subclinical infection Any {infection} or phase of same having no signs or symptoms of disease. See {silent infection}, {asymptomatic}.

CD subluxation Partial dislocation of {joint}.

CD symptom Outward signs of disease or a patient's description of feelings indicating a disease. Are a diagnostic tool while not necessarily related in a direct way to the underlying problem. Not the same concept as {sign}.

CD syndrome A group of symptoms which, taken together, may identify a specific disorder. Also, a symptom or illness whose exact cause is unknown is sometimes loosely called a "syndrome."

CD syphilis Sexually transmitted bacterial (Treponema pallidum) infection, serious in that if not treated it will result in {lesion}s throughout body and other ill effects. Generally shows up as sores or rash at first. If unchecked, will lead to appearance of {tumor}- like masses, then more severe manifestations, culminating in death. This process is subject to periods of {remission} followed by reactivation. Readily treated by {antibiotic}s in early stages.

CD tardive dyskinesia A movement disorder associated w/ long term use of {neuroleptic} drugs. Movements of this condition similar to those of {levodopa}- induced {dyskinesia}, but cause is different.

CD Teratogenicity The ability to cause malformations in a fetus.

CD thrombocytopenia Abnormally low number of blood platelets (the cells that cause blood clotting, aka thrombocytes). This may result in the appearance of bruises without apparent cause, internal or more profuse external bleeding. In our context see {ITP}.

CD thrombosed Obstructed to some extent with clotted blood. This will likely occur in a {vein} or {artery}; when the thrombus, or clot, breaks loose it is called an "embolus" and is capable of causing an "embolism."

CD thrush {Oral} ({oropharyngeal}) form of {candidiasis}.

CD thymic aplasia Inability of {thymus} to develop normally.

CD TIA Transient ischemic (pron. is-Kee'-mick) attack. See {stroke}.

CD tinnitus "Ringing" or other noises in the ear. Causes are diverse, and diagnosis and relief may be difficult. Sometimes the cause is merely an accumulation of earwax, sometimes ear disease, but may also be due to drug side FX, possible {nervous system} damage per one source, a host of other possible culprits. Note: If earwax is hardened or thick, consult pharmacist for an inexpensive product that will enable safe removal, and if result is not successful, see your physician.

CD Tourette {Syndrome}. Begins in childhood, marked by rapid abnormal movements (tics), sometimes vocal sounds, curse words, words or statements without relevance, all involuntary. Sometimes condition is outgrown. Similar syndrome in adults may be due to {psychotropic} drugs, {encephalitis}.

CD toxic shock A form of {shock} marked by sudden onset, with vomiting and/or high fever and/or diarrhea. Often caused by {staphylococcus} in combination w/ foreign matter in body (sometimes a tampon proves to be the latter). Is very dangerous, calls for immediate skilled medical attention.

CD trauma 1: Physical injury. 2. Emotional damage or its effects.

CD treponema pallidum The microorganism that causes {syphilis}. Sometimes referred to as a spirochete because of its shape.

CD tuberculosis {Infection} caused by Mycobacterium tuberculosis, a {virulent} airborne {pathogen}. Commonly {present}s as {inflammation} and {congestion} of {lungs}. Extremely serious disease, especially to those w/ HIV. 1-93 "TB" and a multidrug- resistant counterpart, MDR-TB, are on the rise and are topics of great concern. This is partly due to the chilling memory of the way those with TB were segregated when medical therapy for TB had not been found, and the thought that those with HIV might be thus treated if fear and ignorance were allowed to prevail. See {Tuberculosis -- more}.

CD tumor Swelling or enlargement; abnormal mass, either {benign} (harmless) or {malignant} (cancerous).

CD ulcer Generally, a split or break in skin, or in {alimentary} area's {mucous membranes} or elsewhere, that fails to heal of own accord.

CD ulcerative colitis Inflamed or {ulcer}ated {colon} and/or {rectum}.

CD urticaria Rash, {hives}, etc. indicating serious {allergy} reaction.

CD viral infection {Infection} caused by a {virus}, arguably the toughest form of infection to cure. A virus needs a living cell host in order to replicate. It carries no {toxin}, but multiplies within the host. A viral infection is typically {contagious}. The common cold and HIV are two examples of the "V.I." Suggest random search on "viral infection."

CD viremia Presence of {virus} in bloodstream.

CD vitritis {Inflammation} of {vitreous humor}.

CD wasting Weight loss not brought on by deliberate actions of the person. Those who are {symptomatic} with AIDS are routinely troubled by this. A safe first- line treatment is to select a solid diet having bulk and rich in {protein}. See also {atrophy}, {Megace}, {IGF-1}, {Marinol}, {diarrhea}, {cachexia}, {Nutritive Supplements 2}, {Nutrition 1}, {Nutrition 2}. CDC- defined AIDS marker condition if: Involuntary weight loss of 10% of person's average body weight, coupled with chronic diarrhea for more than 30 days, chronic weakness, and fever lasting more than 30 days. (CDC-C)

CD xerostomia Dry mouth, generally due to insufficient secretion of saliva.

CD yeast infection An {infection} caused by yeast, such as {candidiasis}, etc. This group includes the vaginal yeast infection, produced by unicellular {fungus}, treated w/ {topical} imidazoles. Available are clotrimazole (Lotrimin, Canestin, Mycelex); tioconazole (Vagistat); terconazole (Terazole); econazole (Spectrazole); miconazole (Micatin, Monistat); butoconazole (Femstat). Not usually serious provided treatment is prompt, "V.Y.I." implications in conjunction with HIV disease vary but may be considered an {OI}. Convenience is served by the availability of "VYI" medication over- the- counter, but it's feared this will encourage women to avoid regular "gyn" examinations or otherwise be inadvertantly careless about a serious source of concern in the age of AIDS. Always, if in doubt, see your physician.

CD zoonosis A disease observed in a human that is usually confined to animals.

ES AIDS dementia One of the most common AIDS- related central nervous system, or {CNS}, problems. This {syndrome} may, in fact, be due to the direct attack of {HIV} on the brain. The possibility is currently under discussion. It is probable that from 10% to 45% of those with AIDS experience this disorder, usually in later stages of the disease. Early symptoms include mild forgetfulness, loss of concentration, and confusion, perhaps other mental/ behavioral changes. {Motor} symptoms may include loss of balance and leg weakness. Mental symptom development: Apathy and social withdrawal are often seen, as is {depression}. Also anxiety, with or without concurrent {hypochondria}, seen in many affected persons. Sooner or later, this syndrome causes some memory loss, slowness of thinking, and/or inability to perform complex tasks, as well as difficulty in walking, along with other or greater loss of coordination. In highly- developed AIDS dementia, the patient will be bedridden, and possibly {incontinent}. Many AIDS dementia symptoms will bear some resemblance to those of {Alzheimer's Disease}. It has been strongly recommended that when dementia is suspected, the person be given proper neuropsychiatric testing. Physical examination of patient's {nervous system} may be performed. There's no specific test for this illness -- thus other causes, and the symptoms of the person's other illnesses that might imitate dementia, and {OI} manifestations must be ruled out. AIDS dementia sometimes called "HIV dementia" or "ADC," for "AIDS Dementia Complex." (CDC-C).

ES AIDS -- the Basics Its full name is "Acquired Immunodeficiency Syndrome." It's a system of physical malfunctions that taken together are said to be a "disease" while in fact being a complex of illnesses caused by LACK of something -- natural immunity against disease. A previously undamaged, well-working immune system has begun to fail. As a built- in part of the human body, the immune system is taken for granted, while it fights off a lot of minor diseases without our even knowing it. But when the system breaks down, the affected person won't have "resistance" to infections or cancer. In AIDS, the immune system's ability to function has been disabled by the human immunodeficiency virus, {HIV}, about which we should not be fearful -- but educated and cautious, just as if we knew there was a loaded gun nearby. Even though AIDS itself is not the simple "disease" it seems to be, it can cause damage on its own. In addition to infecting the immune system, AIDS is capable of infecting brain tissue, causing serious illness in that way. It may cause HIV "encephalopathy," which often leads to a slow but progressive dementia -- and a loss of mental and physical funtions so serious that death may result. What can be done about AIDS medically? It can't be "cured," although we hold onto hope a cure will soon be found. There are just two basic things medicine can do for people with AIDS, those being {antiviral} treatment and {immune system} boosting strategies. Antiviral drugs focus on inactivating or holding back the AIDS {virus} itself. The usual ones are called {AZT}, {ddI}, {ddC} and {d4T}. In general, they slow progression of HIV for periods of time, after which they should be switched or withdrawn for awhile. Current medical opinion (11-93) is that there's no real reason for a person with HIV to use these drugs until some symptoms of disease appear or there's other evidence of trouble. Also, at that point, other strategies can be brought into the picture to fight the "{opportunistic}" diseases connected to AIDS. Immune boosters attempt to rebuild or stimulate the immune system. It is true that they're still in early experimental stages and they are not performing as effectively as we'd like. But they sidestep one problem caused by antiviral treatment -- serious or severe side effects from those drugs. Antivirals are strong stuff, and so are their side effects! As this is written, (1-94), the best "inside information" we have says to watch and hope for progress in beefing up the body's natural immunity. (By the way, there are lots of con artists making fortunes by claiming they've found a cure for AIDS. As fraud goes, that's about as low as one can get.) People often ask us just how long someone can live with an illness like AIDS progressively making him or her more and more ill, and the simple answer is -- it depends. It depends on the person's initial strength and will to live. A question of attitude, and being able to understand there will be rough spots to ride out. Also the efficiency of even a damaged immune system can be improved by proper nutrition, rest, social activity, avoiding potentially- {toxic} substances, and other common sense steps. So, some of those with AIDS do poorly, but we know one person who's "survived" with AIDS thirteen years! For practical purposes, there is no likelihood of AIDS not resulting in death, although we emphasize that AIDS is NOT a "death sentence." Those who have AIDS can and do live on, productive and happy, far longer than generalized medical statistics indicate. And advances in medicine are increasing lifespan and quality of life for those involved with increasing success. Those diagnosed with AIDS now have twice the survival time of those diagnosed in 1984. It's helpful to people with AIDS when they experience understanding and a positive attitude on the part of those around them. Even a choice of words, such as "AIDS patient" versus the more accurate term "person with AIDS", can make a difference. See, words like "patient" and "victim" put an unfair and untrue label on almost all of those with AIDS. People with AIDS are people, and they do have AIDS. They may and should be treated with simple courtesy and goodwill -- the way you'd want to be treated if you were having some health problems but didn't want or need a lot of flowery "sympathy." No, plain courtesy and goodwill suit the situation just perfectly. (Sidelight: There are and always will be those who find it hard to think of people with AIDS in those terms. As everyone knows, it's easier to fall back on old ideas and ways than confront a situation that's unfamiliar and uncertain. But that's what the future always is. And in the 1990's, either you're a realist or you're out of the game.) Since the subject of the future has come up, let's try to predict what effects AIDS is likely to bring. It is going to place a serious strain on the health- care system, because it is a {pandemic} -- a world wide "epidemic." The World Health Organization tells us that there are hundreds of thousands of people infected with HIV in Thailand, some two million in India. AIDS is rampant in Africa, from whence it seems to have come originally. Even the former Soviet Union, so anxious to "Westernize," is now suddenly coping with HIV infections along with all the good things of Western life. Very few of the world's countries really have a decent health care system in the first place. Even here in the U.S., people are for some reason forced to go without medical care, and so there is talk of health care reform. Any changes, though, will have to work with, not against, growing HIV caseloads. From the time he or she is first diagnosed with HIV, a person will need about $120,000 worth of medical care. Not all of this will be paid for by insurance companies, we can be sure of that. And so we may wonder where this money is to come from, with so many economic uncertainties today. There's another kind of cost we'll all bear in some way. The social cost. The cost of having wrongly assumed that drugs and careless sex are neatly limited to the "wrong side of the tracks." From Big Apple to Middle America, HIV spreads into various social groups whose members thought AIDS couldn't possibly affect them. Sadly, they were wrong. The price they will pay is too high. And AIDS will cause many arguments over educating young people about AIDS, because that will mean talking about a disease that's often spread sexually or by drug use. Many parents, thinking about these points, will suddenly decide they want this "education" to end before any discussion of sex or drugs is begun, which will cause a lack of education, which will cause more transmission of AIDS. All of us want to help each other be and stay safe from AIDS, and from here on out, that'll mean calling a spade a spade. There should be open discussion and clear understanding of the points found here under "{high-risk behavior}" and {HIV transmission}. If you want more details or verification of our statements, fine, please do go to someone with medical training and discuss the subject. Don't be embarrassed to do that, it's the SMART people who are asking the questions these days, with the others assuming they have all the answers. This briefing on the basic facts about AIDS was prepared as a public service by the Friends Projects, PO Box 635, Chowchilla CA 93610. (Technical note: To qualify as AIDS, malfunction of the immune system must not be associated with genetic disorder, malnutrition, or medical action such as chemotherapy or organ transplants.) (Sidelight: There is an ongoing discussion about the likelihood of AIDS not in fact being caused by HIV infection, but by other factors, such as "recreational drug use," etc. Despite the great amount of publicity raised over all this, science and statistics both say that no significant numbers of non-HIV-caused AIDS have been recorded. Until further notice, in PRACTICAL terms there's no AIDS without HIV.)

ES analgesic A drug, ranging in power from that of aspirin to that of {morphine}, that decreases effects of pain. In lay usage, the milder pain relief agents are called "analgesics", the more potent ones "pain- killers." This document will refer to pain relief medication usually as analgesic in nature, but also indicate relative strength for your convenience. The mildest analgesics -- acetominophen, ibuprofen, aspirin -- can give surprisingly good results against minor pain, especially if their use is coupled with other palliative measures (massage, a brief rest in a darkened room, etc.) Somewhat stronger are the non- steroidal anti- inflammatory drugs ({NSAID}s) called Motrin, Voltaren, Feldene, Lodine, Toradol, etc. These agents may fail to relieve stubborn or serious pain, but they are almost the last line of defense before use of some type of {opium} derivative. Of which, codeine is most common. It works in a "dry, precise" sort of way that is usually effective, sometimes even against relatively {severe} pain. It's usually dispensed in tablet form combined with one of the three very mild analgesics mentioned in previous paragraph. As an alternate to codeine, there are Darvon or Darvocet-N, which may be preferred for {moderate} pain that has a "burning, spreading" quality. They are regarded as being safer than codeine. Percodan and Demerol are somewhat stronger than codeine, with of course higher potential for side FX and {dependence} or {addiction}. Percodan or Percocet is indicated for moderate to moderately severe pain, while Demerol is rated for pain which is of moderate to severe. Morphine is the most potent of the usual pain medications. It is usually reserved for persons who are dying and are in acute pain, though a combination of pain relief/ other drugs called "Brompton's Mix" is now being used with success instead of morphine. This latter is found mostly in a hospital or {hospice}. Some of the more potent pain drugs are now available in transdermal patch form, to eliminate dosage problems. An {antidepressant} may be given as {empirical treatment} against some types of pain at a doctor's discretion. For related info on pain that isn't just temporary, see {chronic pain}.

ES antioxidant 10-93 There is much discussion of "antioxidants" currently, and it's not very easy to separate medical fact, of which there's some, from plain speculation -- of which there's plenty. It is true that some studies have found that an unwanted kind of oxidation, associated with appearance of "singlet oxygen" and "{free radical}s" can occur. (Singlet oxygen is not a "radical" but is said to be highly "reactive.") We find references to "highly charged" oxygen molecules being produced by {white blood cells} during the {immune system} response process. This kind of oxidation is said to actually damage structure of {DNA}, cause potentially carcinogenic mutations (see {carcinogen}, {mutation}). Singlet oxygen and free radicals are also said to cause an oxidative "chain reaction" among {lipid} substances that might cause destruction of the {cell} {membrane}, help cause {atherosclerosis} development. Also, "oxidative damage has been associated with arthritis and the aging process in general." (Cross CE et al., Oxygen radicals and human disease, Ann Intern Med, 1987;107:526-545). Antioxidants of whatever composition may aim to inhibit "peroxyl" and "hydroxyl" radicals -- postulated to be involved in cell damage leading to cancer or heart disease. Some natural substances, such as beta carotene, have high levels of antioxidant activity, and are not harmful in any case (more about them in a minute). Also, lots of sources like {buyers' clubs} offer more exotic substances with that property. There are claims that {BHT} "inactivates ... viruses with lipids in their envelopes, including {CMV} and the Semiliki Forest Virus ... and inactivates {HSV}." However the writer of that last was referring to some experiments that rely in part upon tests with sheep subjects -- not humans or HIV. Our researcher also finds accounts of attempts to use corticosteroids (see {steroid}) against {rheumatoid arthritis}, in which free radical agents were seen to cause injurious effects to the {metabolism}. The mechanism of antioxidant action is such that, by being easily oxidized themselves, such effects may be minimized. And in a recent edition of the Berkeley Health Letter, there was material advocating more research directed to this area. Conclusion: Oxidation is a proven phenomenon, resulting in certain unfavorable physical changes. At the same time, the necessity of using agents to limit or control oxidation ex vivo is not established. If someone tries to tell you antioxidants are medically necessary or that they have curative effects, check his or her motives. If someone recommends antioxidants of some kind that cost more than, say, ordinary vitamin supplements, there's something wrong. Seek someone else as an advisor, preferably your own physician. Note: Some foods said to be high in beta carotene do make for a good healthy diet anyway, notably carrots, spinach, and lettuce. See also {Nutritive Supplements}.

ES Apthous Ulcers (AUL, cancer sores) Common {oral} disease common in AIDS population. In the mouth, {ulcer}- type {lesion}s may be found anywhere. They usually are seen as an oval depression surrounded by a yellowish, slightly higher border with an inflamed outer ridge. The oval valley area will gradually take on the appearance of uniform yellowish {tissue}. Apthous ulcers may be persistent and recurrent, and are very painful. This is especially true when the person eats acidic foods, e.g., catsup or tomato paste. Lesions may be accompanied by {fever}; will not be cancerous (see {cancer}). Diagnosis is by visual examination. It's been suggested that these ulcers may be due to the {herpes} virus, but this has not been confirmed. Some physicians are giving {acyclovir} in severe and persistent cases, however this treatment has not been proven effective to date, 10-93. {Topical} {steroid} has been used vs. discomfort. Please note: Pigmented plaques or {nodule} in oral cavity could be {KS}.

ES Candidiasis ("Candida," Moniliasis) A {fungal} (yeast) {infection} usually caused by an organism called Candida albicans but in rare cases by C. tropicalis. Candida is a normal growth in certain parts of the body, e.g., the vagina or {intestine}. During times of lowered {immunity}, Candida sometimes spreads to other parts of body. It can cause recurrent vaginitis (vulvovaginal candidiasis, vaginal {yeast infection}) (CDC-B) -- which is a possible sign of HIV infection. Candidiasis may cause "jock itch," or sinus infection. (Also, sometimes Candida infections occur soon while taking an {antibiotic} that kills organisms that normally control Candida growth.) Oral Candida infections are extremely common, and normal, in children. They are loosely called called "thrush," ({oral}/ oropharyngeal candidiasis) but in the presence of HIV, "thrush" is a serious medical problem, (CDC-B) with symptoms seen as creamy white patches of gray or white exudate (pus or inflammatory fluid), with the {mucosa} becoming inflamed and sometimes painful at affected sites. The exudate can readily be wiped or scraped off, unlike oral "{hairy Leukoplakia}" manifestations. It is unsightly, and worrisome to the affected person. Sometimes lesions -- fiery red ({erythematous}) areas -- will be exposed beneath the removed coating. Infection might only cover one part of the tongue, or the entire inside of mouth. Although thrush is generally found on buccal mucosa, palate or the dorsum of tongue, {lesions} may be at several sites. Persons affected with thrush may experience change in taste, sore throat. Candidiasis that spreads to the {esophagus} causes difficulty swallowing (candida esophagitis). The {respiratory} tract may become involved (bronchocandidiasis). This infection, if it does progress from the mouth to the bronchi, trachea or {lungs}, qualifies the person for a diagnosis of full- blown AIDS. (CDC-C) Candidiasis may occur systemically (see {systemic}) and affect the heart and the linings around {brain} or {spinal cord}. Other possible sites for infection include the nailbeds, umbilicus, around the {anus}. In candidiasis, diagnosis is by {culture} or visual exam of symptoms. A wet- mount preparation using potassium hydroxide (KOH) shows characteristic microscopic budding yeast; but again the precaution that {hairy leukoplakia} may be present also or instead. Treatments to control Candidiasis vary according to site in the body. Some of them would likely be {amphotericin B}, {ketoconazole}, and {flucytosine}. {Fluconazole}'s efficacy hasn'yet been confirmed for this infection.

ES CDC case definitions On 12-18-92, the {CDC} issued the "1993 Revised Classification System for HIV Inf'n. and Expanded Surveillance Case Definition for AIDS Among Adolescents and Adults." Under the new system, the case definition includes all {HIV}- infected individuals who have a {CD4 T-cell count} of less than 200 CD4+ T-lymphocytes/ microliter, or a CD4+ T-lymphocyte percentage of total lymphocytes of less than 14. (See {HIV progression testing}. The expansion includes the addition of 3 clinical conditions -- pulmonary {TB}, recurrent {pneumonia}, and {invasive} {cervical cancer} -- and retains the 23 clinical conditions in the AIDS surveillance case definition published in 1987; it is to be used by all states for AIDS case reporting after January 1, 1993. Three CD4+ T-lymphocyte count categories are defined as follows: Category 1: Greater than or equal to 500 cells/mL, Category 2: 200-499 cells/uL, Category 3: less than 200 cells/uL. The clinical categories of HIV infection are as follows: Category A consists of one or more of the conditions listed below in an adolescent or adult (13 years of age or older) with documented HIV infection in the form of: {Asymptomatic} HIV {infection}, Persistent generalized lymphadenopathy ({PGL}), or {acute} primary HIV infection with accompanying illness or history of acute HIV infection. These illnesses are shown in this document, followed by the legend "(CDC-A)." (Note: Conditions listed in Categories B and C must not have occurred.) Category B consists of {symptomatic} conditions in an HIV-infected adolescent or adult that are not included among conditions listed in clinical Category C and that meet at least one of the following criteria: a) the conditions are attributed to HIV infection or are indicative of a defect in {cell-mediated immunity}; or b) the conditions are considered by physicians to have a clinical course or to require management that is complicated by HIV infection. Examples of conditions in clinical Category B include, but are not limited to those marked in this document, "(CDC-B)." Category C includes the clinical conditions marked herein as "(CDC-C)." For classification purposes, once a Category C condition has occurred, the person will remain in Category C.

ES CFS (chronic fatigue syndrome, "myalgic encephalomyelitis" in U.K., chronic fatigue immune dysfunction syndrome) Recently recognized though not yet well understood system of symptoms -- fatigue; {neurological}, {joint}, muscle problems; general impairment in functioning. There's some question as to cause; a {viral} source has suggested but not substantiated. Illness may {remit} spontaneously. It's been suggested that CFS is accompanied by an impairment in activity of {NK cells.} It does in fact have some {autoimmune} disease hallmarks. It almost certainly has as one of its centers the central nervous system {CNS}. Very similar to fibromyalgia (fibrositis). Some have attempted to connect CFS with neurasthenia (syndrome w/ CNS and {nervous system} dysfunction), and some insist that CFS is a psychiatric problem -- these are the same sources who have painted neurasthenia as a mental and not physical problem. Recent evidence shows no link between CFS and depression, although depression {secondary} to CFS has been documented. From those affected, we would hear these descriptions of "how CFS feels" -- "It saps all your energy, makes lifting the covers to get out of bed a real effort. You avoid ... the basement because you cannot make it back up the stairs without having to sit and rest half way. You can read the words and sentences of a newspaper article, but you can't put it all together ... "Feeling like you were receiving handreds of intramuscular injections simultaneously in all your muscles ... painful to sit, impossible to move, making a hug no longer pleasurable. Frequent chills, cold sweats, with a low- grade fever."

ES coccidioidomycosis (California disease, valley fever, desert rheumatism, San Joaquin Valley fever.) {Fungal} {infection}, caused by inhaling the spores of Coccidioides immitis, found in southwestern U.S., Mexico, and Latin America. Travelers may become infected and not exhibit symptoms for a long time thereafter. There are two forms of the disease. The first type is a self- limiting {respiratory} infection. Symptoms of this pulmonary involvement may resemble {bronchitis} -- fever, shortness of breath, unproductive cough, weight loss, and fatigue. The symptoms vary in severity, and may resolve and then reappear. The second form of this disease is progressive coccodioidomycosis, which is {virulent} and severe if unchecked, or in the presence of HIV. It includes symptoms of {anemia}, {allergy} stimulation, skin problems, and/ or {inflammation} of veins. There may be {CNS} involvement. It is usually treated with {amphotericin B}, otherwise {ketaconazole}, {fluconazole}. (CDC-C)

ES Cryptococcosis An {infection} caused by the {fungus} known as Cryptococcus neoformans, commonly found in dust or soil that's been exposed to bird droppings. Readily transmissible, fairly common in {PWA}'s. It enters the body through the {respiratory} tract, and causes {inflammation} of {meninges}. {CNS} commonly involved, and CNS {lesions} include {diffuse} {mengitis} ("cryptococcal" meningitis or CM), as well as meningeal {granulomas}, soft areas, {infarcts}, {tissue} destruction, neuro{glia}. The most common symptoms are headaches, blurred vision, confusion, inappropriate speech/ behavior, agitation, stiff or aching neck, fever. In time, the {lungs}, skin or {kidneys} may be affected. Disease may cause {coma}. Diagnosis by {sputum test}, which may reveal budding yeast with clear capsular matter around buds; pus or other {exudate}. In those w/ AIDS, a fungus {culture} from blood sample may be easily had. Diagnosis of cryptococcal meningitis through {lumbar puncture} reveals a high {lymphocyte} count and an abnormally high {protein} level, while a {CAT scan} may be needed to check for brain lesions. Treatment options include {amphotericin B} 20 mg/day IV + {flucytosine} 150 mg/kg/day {qid}, duration about 45 days, or {fluconazole} if person is intolerant to amphotericin B. There is less than optimal response in presence of HIV disease, and a lifelong maintenance may be required, in which case fluconazole 200 mg/day {PO} is probably best. Sometimes fluconazole {prophylaxis} is routinely started when an HIV positive person's {CD4 T-cell count} falls below 100/ ul. Note that this is a very dangerous disease if not treated in a timely, aggressive manner. (CDC-C)

ES Cryptosporidiosis An {infection} caused by Cryptosporidium, a {protozoal} {parasite} found in the {intestine}s of animals. It is transmitted by direct contact with {feces} of infected animals or persons, or ingestion of contaminated food or water. This disorder attacks the intestines, and after 5-15 days causes severe (explosive) {diarrhea} and {abdominal} cramps which may last for 10-12 days then abate temporarily. Other possible symptoms are nausea, vomiting, weight loss, fever. However in HIV- positive persons, onset may be more gradual, and symptoms more severe; person may lose more than 15 {liter}s of fluid daily in some cases. Disease may abate for periods of time, then reappear. Diagnosis is made by recovery of acid- fast {oocyst}s in multiple {stool culture}s. (Stools of infected persons/ animals are highly infectious.) There is no effective cure for symptomatic cryptosporidium, however treatment of mild symptoms may include anti- diarrheals, and treatment w/ {azithromycin} (experimental) may give short term benefits. Other experimental therapies include {paromomycin}, {spiramycin}, {octreotide acetate} or {eflornithine}. Symptomatic persons must drink plenty of fluids, maintain a high caloric intake, latter including use of {nutritive supplements}. In AIDS, cryptosporidiosis may become {chronic}, subject perhaps to some periods of partial relief, followed by return of severe symptoms. (CDC-C) after 30 days.

ES Cytomegalovirus (CMV) A common {viral infection} not associated solely with {AIDS}, this is a member of the {herpes} family of viruses but distinct from {herpes simplex virus}. Half of the population have had CMV infection at some time in their lives -- some estimates are that 90% of homosexual men have been infected at one time or another. Usually asymptomatic and self- limiting in those with healthy {immune system}; when mildly symptomatic is productive of {influenza}- like symptoms -- fever, aches, mild sore throat, weakness, enlarged {lymph glands}. Full- blown, CMV symptoms include {encephalitis}, or {ulcers} in {colon} or {esophagus}. In the {liver}, can cause {hepatitis}, in {lungs} can cause {pneumonia}. In eyes can lead to loss of sight, the condition called Cytomegalovirus Retinitis, {CMVR}. By itself CMV causes at least mild {immunosuppression}, and it can last in body for up to 15 months before the infection is resolved. Of all described CMV developments, the one requiring most attention is CMVR. CMV is transmitted via sweat, saliva, {urine} or {feces}. Also communicable via cervical/ vaginal secretions, and semen -- thus is considered an {STD} when appropriate. Severe CMV infection may be seen in terminal stages of AIDS. Infection can be controlled but not cured. It may be a {cofactor} in development of full blown AIDS. Diagnosis is readily made by {culture} of body fluids. Standard treatment is {ganciclovir} 5 mg/ kg {IV} at constant rate for 1 hr. ea. 12 hrs. for 14-21 days, then maintenance via same 6 mg/ kg IV daily, 5X/ wk., indefinite. Another agent available is {foscarnet}. (CDC-C) other than liver, {spleen}, lymph glands.

ES Cytomegalovirus Retinitis (CMVR) {Cytomegalovirus} {infection} of eyes. Symptoms include sudden vision changes, increases in {floaters}, distortion or absence of visual fields or areas. There may be swelling of the {retina}, possibly {necrosis}. CMVR is said to occur in about 10% of all PWA's in time, and is the most common {CMV} symptom in those with AIDS. {Ganciclovir} and {foscarnet} are standard treatments for CMVR. Acyclovir has not been shown to be effective against CMV. Continued, perhaps lifelong, maintenance necessary. Loss of sight possible if proper therapy not applied in timely manner. Sudden or progressive worsening of CMV retinitis may be result of some other infection. The retinitis may be much easier to treat if the other infection is treated. The infection may be bacterial, fungal, or another virus. CMVR is a (CDC-C) condition w/ loss of vision.

ES d4t (2',3'-didehydro 3'-dideoxythymidine, stavudine, 2-94 Zerit) This {Antiviral} is a dideoxynucleoside (thymidine) analog. (See the entry for {thymidine nucleoside analog}s). d4T, like other drugs of its type, inhibits HIV replication by inducing a premature {viral DNA} chain termination. The {plasma} {half-life} of d4T in humans is over five hours. (6-92) In six early (phase I/II) studies of d4T {PO}, 264 patients received d4T in 2, 3, or 4 daily doses totaling 0.1 to 12.0 mg/kg/day. {Paresthesia} and some {neuropathy} were observed at doses greater than 2/mg/kg/day. Transient increases in subjects' {CD4 T-cell count}s and decreases in {p24 antigen} occurred. A {double-blind trial} of d4T (30 or 40 mg PO {bid}) versus {AZT} (600mg/d) for HIV+ persons receiving at least 6 months prior AZT was undertaken, and results were not extremely favorable. Side effects include: Relatively frequent dose- related {peripheral neuropathy}, elevated {liver} function tests, headaches, and nausea. These are generally reversible when drug is discontinued. 12-92 {FDA} has announced that d4t, made available for expanded investigational use 10-92, will be the first drug accessible under the agency's {parallel track} policy. It will be provided for those who have not responded to or are intolerant of AZT or {ddI} and who are ineligible for the {controlled study} designed to demonstrate if d4t can extend life or delay the onset of AIDS. Those enrolled in the parallel track study will include those who have experienced serious side effects from other antiviral drugs or whose conditions have worsened while taking those drugs. Evidence from early clinical trials involving 259 subjects indicates that the potential benefits of d4t outweigh the risks linked to early expansion of use because d4t meets a serious unfulfilled health need. Many of the volunteers receiving d4T experienced at least a temporary increase in the {CD4 T-cell count}, which tends to indicate a beneficial effect on the {immune system}. Though the drug was well tolerated by many patients, these trials identified side FX as noted above, generally reversible when the dose was decreased or the drug was discontinued. Warning: Use of this agent did apparently cause some instances of peripheral neuropathy that were non- reversible. Our sources aren't generally recommending use of d4T at present unless all other therapies have failed to help the person being treated.

ES ddC (HIVID, dideoxycytidine) ddC aims to stop HIV replication by halting {reverse transcriptase} and {viral DNA} {synthesis}. Seems to reduce {p24 antigen} levels, increase {CD4} levels. 10-92 renamed: zalcitabine. (7-93) Despite hopes, this {antiviral} hasn't proven to be superior to AZT. Hopes rested on the outcome of ACTG 155, just released. The first full {clinical study} of ddC, ACTG 155 involved some 990 subjects. They all had a {CD4 T-cell count} of 300 or less, and all had received {AZT} in past. Those with advanced HIV disease had "similar {clinical} outcomes" whether they took AZT alone, switched to ddC, or took a combination of the two. ddC produced a significant decrease in the beneficial peripheral blood components called {neutrophil}s in those with very advanced HIV disease. There was some indication that those with a relatively strong {immune system} might benefit from a combination of AZT + ddC. Preliminary trials of ddC had indicated general failure compared to AZT when ddC was used alone, especially in participants who hadn't taken antivirals before. Also it was seen that high doses of ddC may cause severe {peripheral neuropathy} and other side FX. Other early tests involved "alternating" treatment -- ddc for awhile, AZT for awhile, then back again. Better responses were obtained from this method of use, and our own researcher believes that until and unless there's a better way, antiviral therapy is more likely to be effective and free of side FX if dosages are minimal and agents are switched after just a few months, or when tests hint at resistance. ddC is mfd. by Hoffman-La Roche. It is FDA approved in combination w/ AZT for those with advamced HIV who've demonstrated significant deterioration.

ES ddI (didanosine, Videx) A {purine nucleoside analogue} type {antiviral}, said to have relatively few "overlapping" side FX, i.e., for those with impaired {kidney} function. Like {ddC}, is intended to interrupt {HIV} replication by inhibiting {reverse transcriptase} activity and {viral} {DNA} {synthesis}. ddI is a {NARTI}- type therapy. 12-92 Wider access to and lower doses of (ddI) have been approved by {FDA} for persons who've previously been treated with {AZT} and who are intolerant of AZT or whose health has significantly deteriorated during AZT treatment. Based on {CD4 T-cell count} data obtained in early trials, as well as an interim evaluation of CD4 cell count data from a {controlled trial}, this early approval was given in order to make the drug available for treatment of HIV-infected individuals for whom there are no alternative therapies. At that time, data were not available to demonstrate actual {clinical} benefit -- a slowing in the progression of HIV disease or a reduced number of AIDS- related complications. A two-year controlled clinical trial, sponsored by the manufacturer and the {NIH}, has compared patients who had received prior AZT treatment and were switched to one of two doses of ddI, with patients who continued AZT treatment. The median duration of prior AZT therapy was 13.7 months. Results of this trial were that the ddI- treated patients took longer to develop AIDS- related illnesses than those on continued AZT therapy. The study provided no information on the optimal time at which patients should be switched from AZT to ddI. The new FDA-approved physician package insert for ddI describes the studies participants and results. These data also show that a lower dose of ddI than is currently used is associated with less {toxic}ity -- most significantly, a lower rate of the drug's major side effect, {pancreatitis}. The lower dose was shown to be no less effective than the higher dose studied. Use of ddI also appears to produce a specialized {neuropathy} in some persons, with reduced {sympathetic} flow to {salivary glands}, producing {chronic} dryness of mouth. Other studies comparing doses of ddI, as well as a study of ddI versus AZT in patients who have not received prior antiretroviral therapy, are ongoing. Mfr.: Bristol Myers Squibb, NY.

ES Enteropathy (Non-Infectious Enteropathy) A {syndrome}: Presenting symptoms will almost inevitably feature a disorder of the ability of {GI} tract to {absorb} nutrients, and impairment of {gastric} secretions (see {secrete}). Susceptibility to {enteric} {pathogenic} agents (e.g., {Salmonella}, Helicobacter); also leads to {chronic} {inflammation} of lamina propria of {intestine}s. Diagnosis is made by blood test for elevated mean corpuscular volume (also occurs w/ AZT treatment or folate/ vitamin B12 deficiencies); finally, hypersegmented {neutrophil}s will be seen on peripheral blood smear w/ {megaloblast}ic {anemia}. Treatment: Rule out and treat other causes of anemia; may require lowered {AZT} dosage.

ES Esophagitis Fairly common in HIV, an {inflammation} of {esophagus}. Typical early symptom: upper chest pain provoked by swallowing or pain in mid-chest. A regurgitation reflex may be seen. {Candida} is the most common causative {organism}; differential diagnosis includes {Herpes} Simplex virus and {Cytomegalovirus}, although the fungal Candida and viruses may coexist, i.e., {esophageal candidiasis}. Diagnosis is by barium swallow with endoscopic {biopsy} ({endoscopy}) to distinguish {viral} from {fungal} {etiology}; good response to the therapeutic trial of a {systemic} {antifungal} may establish fungal diagnosis. Therapy (10-92): {toxicity} and {efficacy} of {absorption} of antifungals must be considered -- {ketoconazole} must be taken with acidic drink, potentially hepatoxic (regularly follow {liver} function tests); meanwhile {fluconazole} is less hepatoxic, does not require an acidic environment.

ES Hairy Leukoplakia (Leukoplakia, Oral Leukoplakia) This is a fairly common {viral) {infection} that's sometimes mistaken for the form of {Candidiasis} called "thrush." Oral Leukoplakia is thought to be caused at least in part by {Epstein-Barr virus} (EBV), perhaps combined with {human papillomavirus} or HIV. Presentation: A white patch usually appears on the sides of the tongue. It is usually thicker than thrush and can only be scraped off with great difficulty (if at all), normally cannot be "wiped" away. It is generally not painful. It's called "hairy" because of its appearance which is like wet cotton or velvet, sometimes with very fine- textured "hairlike" projections. The {lesion} itself may have smooth, corrugated or folded surface appearance. In some people it may resolve on its own, but in the presence of HIV, this outcome shouldn't be expected. Symptoms of "H.L." are a strong indication of {immune} suppression (including HIV). It is not known if H.L. is contagious. 10-92 There is no approved treatment but resolution of symptoms has been seen in persons receiving high- dose acyclovir for herpes zoster. HL was not identified prior to AIDS epidemic, and it's thought by some to be seen only in those w/ HIV. (CDC-B)

ES hepatitis Generally, an {inflammation} or {infection} of the {liver}. Depending on type, the disorder may be caused by a {virus} and/or {toxic} agents in the bloodstream, perhaps by {immunological} abnormalities. Hepatitis A ("HAV") is transmitted by food or drink that has been contaminated by a {carrier}, and is common where sanitation is poor. Causative agent is a small {RNA} virus. After 15-40 day incubation period, the affected person develops fever and feels ill. {Jaundice} develops about a week later, persists for perhaps 3 wks. The person may be {infectious} throughout this period. Serious complications seldom occur, and a childhood attack of hepatitis A is fairly common and often confers immunity. Injection of {IgG} may offer temporary protection. IgG and {Igm} {antibody} are the body's natural defensive team against this disease. There is no vaccine against it at this time. Hepatitis B ("HBV" or serum hepatitis) is transmitted by {infected} blood or contaminated "needles" in IV drug use (see {bleach}). Has on occasion been transmitted by tattooing with a contaminated needle. This disorder is also regarded as a sexually transmitted disease or {STD} in persons engaging in anal sex. Long before the advent of AIDS, "Hep B" was known as a dangerous, sometimes deadly phenomenon within the groups first struck by HIV in the early 80s. Caused by a double- stranded {DNA} virus, this disease can take any of several courses, including a {chronic} state or {acute}, "fulminant" conditions with or without obvious symptoms. The typical symptoms develop suddenly after an incubation period of about 1-6 months: Headache, fever, chills, weakness, jaundice. {GI} distress is also likely, perhaps accompanied by dark or discolored urine. Most persons make a gradual recovery, some of these after treatment via {alpha interferon}, although a fatality rate of between 5-20% is associated with hepatitis B. "INT-A" therapy, by the way, is an expensive and drawn- out process. There are some faint {autoimmune} markers attached to this disorder. "Hepatocyte- bound" antibodies have been noted; so have antiactin autoantibodies and changes in in vitro lymphocyte function. However, these factors are not accompanied by more substantial ones. In presence of HIV, hepatitis B is much more likely to be serious or fatal and is a recognized {OI}. A vaccine against hepatitis B is available. There is a "type C" or "non-A, non-B" hepatitis, caused usually by blood transfusions, etc. It is fairly common; as many as 5 to 10% of those receiving transfusions may become infected. It's caused by an {RNA} virus related to the flavivirus. This hepatitis has typical hepatic disorder symptoms, but progression to chronic disease occurs in as many as 50% of those who contract it. Of these, perhaps 20% will suffer from cirrhosis. (Some sources say that figure is lower than what they see clinically.) Exact diagnosis of this disorder is very difficult, although {PCR} testing, if available, can be of use. Like the "B" variant, this hepatitis may yield to alpha interferon therapy, but hepatitis C thus treated may recur after a short time. Although corticosteroids and acyclovir have been tested against this disease they have not proven effective. Type D or so- called "delta" hepatitis seemingly occurs only with or after hepatitis B infection. {Etiology}: A small, defective {RNA} virus that has caused some incidents of {epidemic} proportions in varied locations. Hepatitis E is confined to third world countries as best as is known at this time. It has {enteric} properties and some characteristics found in hepatitis A. There is a known {autoimmune} hepatitis, having several variations; these are often lumped together under the name "lupoid," as in {lupus}. It presents with elevated IgG and antibody of what are called smooth- muscle types (antinuclear/ antiactin). These disorders seem to affect women far more often than they do men.

ES Herpes Simplex Virus I (HSV, HSV-1) This {virus} is just one member of the Herpes family of diseases. It causes "cold sores" or "fever blisters" that appear at corners and edges of eyes or (more commonly) lips, also at times on genitals. (Its counterpart {Herpes Simplex Virus II} appears more often as sores on genital areas. Both are very common. Of the two, HSV-2 is more specifically spread by direct contact with other {lesion}s, however HSV can be transmitted without lesions present.) Like other Herpes viruses, HSV-1 may lie dormant for random periods of time in {lymphatic tissue} or {nerve} tissue before appearing or reappearing. In both HSV-1 and -2, lesions present an appearance of {inflammation}, at first tingling or itching, then pain if pressure is applied to the mature and deeper lesion. Herpes and its typical {symptomatic} sores may {remit} spontaneously. They recur during illness and its {immunosuppression}; with excessive exposure to sunlight; and stress (either mental or physical). HSV-1 may in some rare cases appear about the ears or fingers, and may be very painful. HSV may be treated but no cure is available. Diagnosis is made by viral {culture}. Treatment of choice is usually acyclovir. {Topical} idoxuridine or trifluridine have been used. Other agents available are brovavir, desciclovir (a prodrug of acyclovir), bishydroxymethyl cyclo- butylguanine (BHCG) and 1-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine (HPMPC). While receiving therapy the person affected must exercise disciplined hygiene for remission to occur. {Immunocompromised} individuals previously infected with the Herpes virus can experience outbreaks of HSV that do not heal in the expected 7-14 days, or that appear on other parts of body, such as hands. Frequent genital herpes may call for {prophylaxis} with acyclovir, 400 mg twice daily. (CDC-C) if with chronic {ulcer}s, greater than 30 days, or if with {bronchitis}, {pneumonitis}, or {esophagitis}.

ES Herpes Simplex Virus II (HSV II, HSV-2) A {virus} that causes painful sores on {anus} or genitals. Sexually transmitted. It's the second most common venereal disease or {STD}, and in AIDS the infection tends to persist and cover large areas. An infected mother may transfer this virus to a {neonate}. HSV may be treated but no cure is available. HSV conditions lasting longer than 30 days may be considered a CDC- defined AIDS marker condition. Therapy options include {acyclovir}.

ES Herpes Zoster (HZ, Herpes Varicella-Zoster, HZV, Acute Posterior Ganglionitis, Shingles) Caused by the {virus} responsible for chicken pox, varicella- zoster, affects the {CNS}. After a few days of chills/ fever, {GI} problems, small bulbous {lesion}s with inflamed bases may be evident, roughly following the course taken below skin by nerves. Lesions are tender and painful. After about five or 6 days the person involved may experience remission. One attack of this disease usually leads to limited immunity against future outbreaks. ("Shingles," especially as seen in elderly persons, are temporary reactivations of herpes zoster.) In {immunocompromised} persons like PWA's, the involvement may become more widespread and persist. If lesions are still present after 10-14 days, the person will require antiviral treatment. {Acyclovir} is safest effective therapy (10 mg/kg ea. 8 hrs for 7 days). May administer {amytriptyline} vs. pain that aspirin, alone or w/ codeine, doesn't resolve. (CDC-B)

ES Herpes Zoster Ophthalmicus (HZO) A common recurrent form of herpes zoster infection, caused by Varicella-Zoster Virus, which affects the eyes. Although HZO is often benign in persons with normal immune systems, it is not so often harmless to those with HIV or other complicating conditions, and the incidence of ocular complications is high for these persons. Those affected will also have more severe complications and courses, which our sources say "may lead to loss of vision, dissemination of the virus, or death. An increased incidence of acquired and [other] immunodeficiency states has given rise to a greater occurrence of recurrent VZV infection. Thus, there is a greater need for earlier diagnosis and appropriate management of the protean manifestations of this potentially disastrous disease." As with other Herpes infections, first- line therapy options include acyclovir and similar agents.

ES Histoplasmosis A {fungal} {infection} that may begin with flu- or pneumonia- like symptoms. It is caused by the spores of Histoplasma capsulatum, often found in the midwestern U.S., including the Mississippi and Ohio river valleys. Symptoms include cough, shortness of breath, fever, malaise or weakness, {anemia}, weight loss, and/ or swollen glands. Histoplasmosis is rarely fatal but may become severe if {diffuse}. It may cause {inflammation} of {meninges}, {adrenal glands}, heart, peritoneum, and other parts of body; may also cause acute {pneumonia}. Diagnosis involves {differential WBC count}: Check polymorphonuclear or mononuclear leukocytes for fungal forms resembling H. capsulatum in {peripheral} blood. {Amphotericin B} would be the primary treatment, but {fluconazole} or {itraconazole} may be considered. In presence of HIV, an {OI}. (CDC-C) if diffuse or external to {pulmonary} system.

ES HIV preventive testing A person with HIV should ask his or her doctor to conduct certain tests to provide advance warning of the possible approach of a dangerous {opportunistic disease}. {Toxoplasmosis} is usually presaged by latent Toxoplasma {infection}, although the {latent} form only becomes fully active in 30% or so of PWA's. Presence of Toxoplasma may readily be determined by a positive {antibody} {titer} to Toxoplasma gondii. {Baseline} {IgG} Toxoplasma titers can help locate those who may meed {prophylaxis}, and one source suggests this testing be done at least annually. Skin tests can identify persons with past exposure to {histoplasmosis} or {coccidioidomycosis}, two diseases that sometimes have long, low-level {dormant} stages. Reactivation of these diseases is uncertain, however; their appearance is just as likely to result from fresh exposure. As of 3-93, it's believed that {TB} is 500 times more prevalent among the PWA than the general population. Screening HIV+ persons via {PPD} will be useful subject to availability. ({CDC} recommends yearly testing w/ 5 TU of PPD for HIV+ persons with no history of prior PPD reaction.) Though practical application of this point may lie in the future, it's been learned (8-93) that presence of {Epstein-Barr virus} {DNA} in {CSF} seems a viable {tumor} "marker." Recent tests with 85 subjects took aside the 17 who were found to have {lymphoma} of {CNS}, and all 17 had EBV DNA traces in cerebro- spinal fluid. Rising triglyceride levels may sometimes be associated with {CMV} infection. Careful eye exam is warranted at the very least when rising triglyceride values are encountered, particularly if the T-4 cell count is less than 100. (CMV retinitis does not occur often at T-4 levels above 100.) Special considerations may be needed due to {anergy} in some PWA's. Chest {x-ray} may detect {occult} TB. {Hepatitis} B {serologic} tests will help a physician decide whether a person should receive hepatitis B {vaccine}. Vaccination vs. influenza should be considered (H influenzae type B conjugated), as should vaccination vs. pneumococcal {pneumonia}. Of these, hepatitis B and influenza vaccines are most likely to cause {immunological} overload in asymptomatic individuals. (Note: Many other forms of protection and observation are recommended for those with HIV. See also the various types of {prophylaxis} mentioned elsewhere here that give protection against other concurrent/ {opportunistic} diseases. And be sure to discuss these matters with your doctor!)

ES HIV progression testing The three most- studied quantitative markers of HIV within the body are 1) absolute {CD4}, or T4, {lymphocyte} count (the commonest, herein called {CD4 T-cell count}); 2) percentage of lymphocytes w/ CD4 marker, called {CD4%}; and 3) the {T4:T8 ratio}. The CD4% method is a better predictive method than the simple CD4 count, being less subject to laboratory variation than the CD4 count technique, and also less subject to cyclical variations. In the CD4% method, a technician determines what percentage of ALL white blood cells bear CD4 protein. This figure, in a healthy person, is typically around 40%. At 30% it's certain that some {immunosuppression} is taking place, and at 20%, moderate suppression. At 10%, suppression will probably be obvious by any marker. It is worth noting, however that the FUNCTIONALITY of CD4 T-lymphocytes is the only practical and absolute indicator of a HIV- positive person's ability to fight off disease and thus survive. A subset of T-helper cells -- memory T cells -- act on first exposure to HIV, and if the virus enters the body again, these cells stir the immune system into action. They may be measured by the "T lymphocyte proliferation assay," which indicates the strength of their responses. Other tests are sometimes called "surrogate markers," and include beta-2 microglobin studies and the like. And there's a method of checking level of serum neopterin, a substance {secrete}d by cells of the {immune system} (generally by {macrophages}) in {urine}, blood {serum}, {CSF}. Level of this agent reflects the severity of HIV or efficacy of therapies. See also the reference to {PCR}.

ES HIV replication HIV uses the blood cell called the CD4 or T-helper as a "staging area" for its own purposes. In technical terms, here's the process: First, the gp120 HIV envelope protein binds to the {CD4} receptor on the host {T-helper cell} surface. (Though HIV is most attracted to these cells it's also found on {macrophage}s, {monocyte}s, and similar "tissue- dendritic" cells.) The virus is then adsorbed and integrated into the cell. (As of 10-93, we have reason to believe HIV enters the cell via the "{CD26}" co- receptor.) HIV sheds its coat of proteins, releasing its {genetic} information in single- stranded {RNA}. It also releases an {enzyme} unique to the retroviruses, called {reverse transcriptase}. The "R.T." inserts (integrates) HIV's RNA into host {DNA}, thus forming "viral" DNA, and a "{provirus}" has been created. The HIV provirus now integrates itself into the host cell's genes, directing production of new viral RNA, which splices to "messenger" RNA. The result of the splicing process is new HIV protein, ready to be combined with proviral- stage RNA into HIV core (p24) and envelope (gp120) proteins. The assembled viral particles "bud" from the host cell's membrane and travel into bloodstream to infect other cells in the same way. When the lymphocyte has been destroyed for practical purposes the virus seeks out a new host.

ES HIV -- the Basics (Human Immunodeficiency Virus) (HIV, HIV-1) Generally regarded as the virus that causes AIDS. * How do people "get" HIV? There's a lot of misinformation out there on this topic. You'll be relieved to know that the TRUTH is simple. It's possible for a woman with HIV to pass the disease along to her infant through the nursing process; apart from that, HIV can be passed from one person to another by only by exchange of blood or penetration into the body of items bearing blood. The three ways this usually happens are (1) by anal, or "back-door" sex; (2) by sharing of a hypodermic needle or use of a "contaminated" one in the course of drug abuse, or (3) possibly, but very unlikely, receiving infected blood during a transfusion if one has been injured or is very ill. (For all the details on what's true about AIDS being communicated, and some examples of the bogus chatter that gets circulated around on this subject, see {HIV transmission} and {high-risk behavior}. HIV is unique in that it doesn't yield to medical therapy that would work against other diseases. First off, it is a member of the toughest group of infections to cure -- the {viral infection}. Next, it's what's called a "{retrovirus}," which means that at one point in its life cycle it does the opposite of what a normal virus would do, technically called "reverse transcription." This makes it at least doubly difficult for all involved, including the infected person, physician and others. Worse yet, it shows an underhanded character in that, of all possible targets, HIV selectively attacks the {immune system}, the organs and {organism}s that make up the body's DEFENSE against disease. If it sounds like a vicious circle has been set in motion, that's exactly right. Once it enters the body, HIV replicates -- reproduces -- rapidly and spreads. In this stage, called the acute or primary stage of infection, large numbers of viral particles spread throughout the body, "seeding" themselves in various organs, particularly the {lymphoid} tissues, but there'll be no symptoms of illness. Three to six weeks after exposure to the virus, up to 50-70 percent of HIV- infected persons suffer flu- like symptoms related to the acute infection they've acquired. They may experience headaches or fever or both, feel generally "strung out," and notice some swelling of the organs in the neck called {lymph glands}. A week to a month later, the immune system fights back. (Paradox: HIV replication actually increases when this happens. But the symptoms fade and soon the person who's infected feels all right again.) Until about this time, the usual test for HIV presence in the body, called the {ELISA test}, lacks the sensitivity to detect the virus. This is why you should allow at least 4-6 weeks to pass before "getting tested" for HIV -- but if you think you may have been exposed, please DO GET THE TEST DONE. Yes, it's a scary kind of deal, we know that. But you need to know the truth. If you've been exposed, and gotten the virus but don't know it, you are a walking time bomb. Please don't let that happen -- do the right thing! Meanwhile, in the infected person's body, HIV is very quietly attaching itself to some of the immune system's most valuable components, the {white blood cells} called {T-helper cell}s. (Briefly, these are {lymphocyte} type cells that have a vital -- even crucial -- role in defending us against illnesses.) There will be no symptoms on the outside at this point, but on the inside, the T-helper cell has been taken over by HIV, and is being forced to help the HIV replicate and {mutate} into slightly different forms. Only when the virus has destroyed the host cell will it consider moving on. Progression of first- stage HIV infection to obvious {symptomatic} disease takes a period of time, perhaps four to at most 8 to 12 years. The infected person's inner state of health may be measured during this time in a variety of ways (see {HIV progression testing}). Eventually, the person will show symptoms of disease that are too stubborn to be anything except "markers" of AIDS. This is where the struggle for survival begins, and only at this point do we start describing the condition called "AIDS." This is the term that applies when someone undergoes the so- called "opportunistic" illnesses -- discussed here under the general heading of "{CDC case definitions}" and elsewhere. Still, the fact is that HIV is the agent of disease and destruction -- and we recognize it as our common enemy. The good news is that if you're reading this and you haven't acquired HIV, you have exactly one last chance to get a guarantee that you won't ever get it! Read the section on {high-risk behavior} and begin to make plans for a lifestyle without risk. Please, do it for yourself, nobody benefits from this but YOU. As you'll see, steering clear of HIV does take a little thought, and maybe a degree of effort or change. Well, think of it as a lifesaving strategy -- which it is ... it's worth it. Got questions? Okay, the answers -- honest ones -- are easy to get, and you can start by calling the CDC National AIDS Hotline ... a free call, (800) 342-AIDS. Nobody will ask who you are or why you're calling, and you'll talk to a courteous, professional operator whose only interest is in making sure a caller's concerns are all answered. This briefing on the basics of HIV was prepared as a public service by the Friends Projects, PO Box 635, Chowchilla CA 93610. * There are sources who claim that AIDS is caused partly or entirely by other factors. Although nothing in science is held as absolutely unarguable, these claims have failed to hold water time and time again. NOTE: {Asymptomatic} HIV infection or {acute} (primary) HIV infection with accompanying illness or history of acute HIV infection is classed as (CDC-A).

ES HIV transmission Rule Number One: HIV is transmitted only in blood, sexual fluids, or to infants by an infected mother's milk. Rule Number Two: There are no other rules. See Rule Number One. There are a lot of valid questions about how HIV is transmitted, and they deserve answers. And at the same time, calm factual answers will help deflate some of the excitement we hear out there sometimes -- when people speculate about risks that are mostly imaginary. A good example is the groundless claim that the mosquito or any other insect is capable of infecting people with HIV. Mosquitoes do transmit some types of parasites (see {parasite}), none of which have anything to do with HIV, and mosquitoes have no record of transmitting HIV itself. The reason is this: there's no mechanical transmission, because the shape of the mosquito's equivalent to a mouth doesn't retain fluids; and contrary to belief, the insect doesn't pump a previous victim's blood into you when it stings. (It did take in blood from some other human, but its digestive juices destroyed the blood.) Other sources worry about HIV in sewage or waste water, but of all the cases of HIV reported since 1981, not one has involved waste water. This is because HIV is transmitted only in blood, sexual fluids, or to infants by an infected mother's milk. Maybe you see a pattern starting to emerge here. If, since 1981, some event involving HIV hasn't been verified as having happened at least a few times -- it isn't likely to ever happen. This concept is not only good common sense, it's scientifically valid as well. There's some concern over "viability" of HIV in dried blood (hardly any viability at all. HIV dies within 30-60 minutes after "host" blood dries.) HIV can survive if frozen. This is how many hemophiliacs were infected with the virus in the 80's. And in most countries, that tragic mistake was never made again. Blood and blood products are now so stringently tested that giving blood or getting a transfusion are now among the very safest of medical procedures. Exchange of HIV during sports is virtually impossible (with the wildly improbable exception of unconstrained fighting with mutual bloodshed and physical contact -- and you could get killed that way anyhow). There's one baseless claim that use of "recreational drugs" is the main method of AIDS transmission, and that sexual fluids, blood, etc. aren't factors. The source of this theory -- and he knows who he is -- is going to have to find some proof of some kind if he wants to ever be believed. HIV isn't communicated by any kind of {casual contact}. In late 1993 there was an instance where HIV was communicated by one person who shared his razor with another. Plainly, there was cut skin and fresh blood during that episode, so in fact this was not "casual contact." This was actually a predictable situation -- people shouldn't share toothbrushes either. Now, let's get down to brass tacks. Rumors and excitement are one thing, but medicine is a science, and the scientific method and its findings can never be inconsistent with good logic and statistics. Using those points as rules, then, the only transmission of AIDS over which anyone's justified in feeling any concern are the ones mentioned here under the heading of {high-risk behavior}. About those, yes, we should feel plenty of concern -- and we should eliminate high- risk factors from our lives, to save our lives. (See also case report statistics available from the {CDC} National AIDS Clearinghouse. To reach an information specialist call them at (800) 458-5321, or the National AIDS Hotline (800) 342-2437.

ES HIV-2 Most closely related to {HIV-1} of all human {retrovirus}es, and, like HIV-1, does cause {AIDS}. But HIV-2 is even more closely related to the simian immunodeficiency virus, {SIV}. Was at one time called HTLV-4, LAV-2. On at least one occasion a theory has been advanced that HIV-2 and HIV-1 derive from a common ancestor, but this cannot be proved. Theories that one is a {mutation} of the other are probably past substantiation. First suspected in examination of {serologic} {assay}s of West African prostitutes, then isolated in Ô86 from West Africans who had AIDS. HIV-2 has probably been circulating in West Africa since the Ô60's. Currently, highest prevalance is in West African nations which were once Portuguese colonies, and in Portugal. So far, the few reports of incidence in U.S. have been attributed to infections aquired via heterosexual contact with West Africans. A negative anti-HIV-1 enzyme immunoassay ({EIA}) does not exclude a diagnosis of HIV-2 infection. A positive anti-HIV-1 enzyme immunoassay, with a negative or indeterminate anti-HIV-1 {Western Blot Test}, suggests possible HIV-2 seropositivity, should be confirmed by use of specific assays for HIV-2. Relative to HIV-1, HIV-2 may be less {pathogenic} or {virulent}, or have a longer "latency period," or both. It's suggested that survival of those with HIV-2 is better than that of HIV-1 infectees. As of 12-91, there were 32 known cases of HIV-2 in U.S., but as of 9-93 there's sufficient concern to begin monitoring blood supplies for presence of this virus.

ES HTLV-1 {Virus} found largely in southern Japan, Caribbean islands, S. America, and Africa, with high incidence among southern Japanese living in Hawaii. Highly cell- associated. Infected {lymphocyte}s mediate HTLV transmission by methods similar to those of HIV. Also, like HIV, infects CD4 marked cells. Diagnosis by {Western Blot test}, which detects antibody to HTLV-1 {gag} gene products p19, p24, p28; "RIPA" test is most sensitive for detecting antibodies to HTLV-1 envelope glycoprotein gp46 and {env} precursors gp 61/68. HTLV-1 seems to cause no manifestations in most infected persons, or may cause some {malignant} growths, chronic {myelopathy}, adult t-cell {leukemia}- {lymphoma} ("ATL"). (No truly satisfactory treatment regimen for ATL is known.) Some reports of this virus producing tropical spastic para{paresis}. Typical infected subject will go for long times, up to 18 years, asymptomatic. Main risk group in U.S.: IV drug users. Simultaneous infection ("coinfection") with HTLV and HIV is possible and some cases have been reported. However HTLV does not cause AIDS.

ES HTLV-2 {Viral infection} found in U.S. among intravenous drug users; and in New Mexico, in a small group of Native Americans and Hispanic persons donating blood; in Panama, among Guyami Indians. One report claims that this infection actually is more prevalent among U.S. IVDU's than is {HTLV-1}. Natural history and clinical manifestations of HTLV-2 infection probably different from HTLV-1. Non- {parenteral} transmission is probably the rule in the second and third groups mentioned. This virus is not endemic in the same Japanese and West Indies locales known for high HTLV-1 incidence. Like HTLV-1, HTLV-2 causes disease in few of those infected. However HTLV does not cause AIDS.

ES HTLV-3 Also called {LAV}, ARV. These three names were previously used for HIV-1, the virus which causes AIDS. Respectively, the 3 names stand for Human T-cell Lymphotropic Virus Type 3, Lymphadenopathy Associated Virus, and AIDS- Related Virus. (Sidelight: HIV disease was at an early time called "Gay- Related Immunodeficiency Disorder," or GRID. This usage was dropped when it was seen that sexual orientation had nothing to do with HIV, and that the disease was simply a blood- borne pathogen seeking the most vulnerable targets first.) See {HIV}.

ES human papillomavirus -- more (HPV) There are over 50 types of HPV; three subgroups lead to disease of {genital} areas. HPV 16, HPV 18 are involved in invasive {cervical cancer} although to a lesser extent HPV 31, 33, & 35 are thought to be associated with this disease. HPV 6, HPV 11 produce venereal warts (which are usually transmitted via sexual means). Venereal (or ano-genital) warts may be inside an aperture where they can't be seen, also may be of "subclinical" nature and not visible unless painted with acetic acid for diagnostic purposes. Otherwise, they'll {present} with appearances which may be regular or irregular, but are not usually discolored or subject to {pruritus}. Anal warts may be mistaken by the layperson for hemorrhoids. It's believed by some that {anal} HPV is "attracted" to and/ or encouraged by moist conditions at site. Since HPV is sexually transmitted, a person who has had relations with someone w/ HPV can be a {carrier} of the disease, and so should request medical testing for presence of it before continuing sexual activities. HPV May be extensive, resist usual treatment ({cryotherapy}, {topical} {salicylic acid} or {alpha interferon}, etc.), subject to {relapse}. HPV may multiply faster in {HIV-positive} persons.

ES immune system -- more You asked what's so important about the immune system? Well, plenty. Consider the existence of a vast network, within the body, that helps recognize and resist {infection} by such disease- causing organisms as the {virus}, {bacteria}, and the {parasite}. The system, once you get to know it, really is an amazing phenomenon. Its many components are skilled and pre-trained in the task of protecting us against invaders while NOT mistakenly attacking its own elements. (This is the "self/ not self" phenomenon that gives the system much of its unique power. "Self" is an immune foot soldier, "not self" is an alien thing called an {antigen}.) This ability is achieved by "marking" the immune elements in some way. The most "antigen-specific" parts of the immune system are cells, called the {lymphocyte} -- see below also -- and they are indeed marked clearly, by means of different types of protein "receptors" scattered on their surface. The cells wear their markings proudly, like combat stripes. Also, the system is able to recognize "foreign agents," and to "remember" the agent later when confronted with an identical one. You would almost think these simple substances and organisms had the gifts of intelligence and thought, to be able to recall first impressions in this way. Such a memory is part of the immune response. And overall, it's said that "specifity," -- awareness of its own identity -- along with the "memory" and response just mentioned, define the immune system as what it is. Now, most immune system components are pretty much free to move about through the body's systems, and cellular immune components can replicate, sometimes in order to amplify and enhance immune response. Lest this latter get out of hand the system has built-in "suppressive" mechanisms as well. The immune system, like the Chinese Yin and Yang, has two parts. Not to push the simile too far, each branch needs the other to form a viable system. The T-lymphocytes we just mentioned (along with "B-lymphocytes") are thought of as the SPECIFIC or CELLULAR or CELL-MEDIATED immune system. They're distinguished by the fact that they do not manufacture defensive {antibody}. They have their own function, which basically involves killing antigen directly. Yes, they have that much power. Their counterparts belong to the HUMORAL or ANTIBODY-MEDIATED immune system, which is generally "NON-SPECIFIC." These antibody- oriented components confer protection via cells and molecules that modify or amplify the immune response, and by other means. They DO produce antibody, which circulates in blood and lymph. Antibody is harmful or even deadly to unwelcome strangers. Let's glance through the non- specific side of the system, so the names will ring a bell if we hear them later. The T-lymphocyte cell gets help from "antigen- presenting" cells (APCs), which as their name implies hand off unwanted bacterial matter for disposition. The {phagocyte}, glial (see {glia}) and {endothelial} cells, and some B-cells also have this ability. To counter {inflammation}, the system circulates the {mast cell} and {basophil}, with the cells called the {neutrophil} and {eosinophil} standing by in case of complications. Also in the background is the "complement system" of non- specific immunity. It can work against the {microbe} and is sometimes involved when {autoimmune} illnes strikes. Finally we come to nonspecific "soluble" agents -- substances, not cells, that round out the body's immune capabilities. As a class, we call them {cytokines} (whereas, on the other side of the street, those made by lymphocytes are called lymphokines). There are two of these substances, sometimes called immune "mediators," of special interest. {INTERLEUKIN}S have many functions, so there are at least 10 different kinds of them. They originate in various ways, and act in differing ways, though some "overlap" in that regard. {IL-2}, like IL-9, helps with lymphocyte growth; other IL's produce inflammation or help produce {immunoglobulin}. Then there are the {INTERFERON}S -- three major types, some of which decrease replication of a virus, and one, produced by activated T- cells, known as an activator of the {macrophage} and a stabilizer of the agent called immunoglobulin. (Interferons are sometimes synthesized in the lab and used to treat disease, but they're basically a natural substance.) Other soluble cytokines include colony-stimulating factors (for info see {G-CSF}), transforming growth factor (see {growth factors}, and the {tumor necrosis factor} to be mentioned in a moment. To complete the picture, there are the {IMMUNOGLOBULIN}S, B-cell products made of polypeptides (a {peptide} complex). They take the form of "chains." There are 5 immunoglobulins, but the "gamma" type {IgG} is the most important, being an {antiviral}/ {antibacterial} agent, capable of neutralizing {toxin}. So you see, the hard- fighting lymphocytes of the specific immune system don't get all the fame and glory, not at all. In fact, the real "keystone" of the immune process is seldom heard of in casual conversation. It is called the MAJOR HISTOCOMPATABILITY COMPLEX. The MHC is the function that causes such concern when organs are transplanted. Particularly true in the past, a suitable organ would be installed surgically, then there'd be a brief but agonizing period, waiting to see if the organ would be "rejected." This is how demanding and exact the "MHC" is! And now, what do you suppose is in charge of overall supervision of our immune systems? That's right, the MHC. To the most critical component goes the most important task. In humans, the MHC is specifically called the "HLA" or Human Leukocyte Antigen complex. Found on what's known to researchers as "chromosome 6," this is a series of four gene "families" of antigens and you inherit from each parent one gene or "set" of genes for each sub- division of the system. (The "tumor necrosis factor" you may hear of is part of the HLA chain separate from the A, B, C, and D- complex components. The four molecules of those components are related so closely to the immunoglobulins that they even look like "Ig's.") Anyway, the HLA complex is the immune flag waver, the keystone. Now what are the cells doing, meanwhile? Regarding T-cells and B-cells, you'll hear both types spoken of as lymphocytes, and in fact they do mingle in the lymphatic system. The B-cell is said to "derive" from {bone marrow} mostly, though it's also supported by the {spleen}, {lymph glands}, and blood, to successively lesser degrees. The T-cell derives largely from the {thymus} and lymph glands, though they're also supported in the blood and spleen. The B-cell protects us by producing antibody and it can be stimulated to enlarge, develop its defensive skills, mature, and finally be ready for battle -- but it requires "signals," which may come from the non- specific immune components or in many cases from the counterpart T-cells, which assist the B-cell in formulating the right antibodies for the challenge. There are three basic types of T-lymphocytes ... (T-helper cell) Sometimes called a T4 cell, it is formed in the {thymus} and is an extremely important part of immune system, helping body fight off certain {infections} directly. It is known to help the body {express} the {cytotoxic} or {T-killer cell} by production of the interleukin {IL-2}. On its surface, the T-helper cell has the {CD4} receptor, to which {HIV} is attracted and may attach itself. Using CD4's "co-receptor," called "CD26" as an entry point, HIV invades T-helper cells, weakens or destroys them by using them as hosts, else destroys them when it has replicated and then bursts out into bloodstream. See {T-helper cell -- more}. (T-killer cell) Here's a {cytotoxic} cell, one which kills foreign organisms. Recognizes {antigen}, "expresses" the {CD8} {protein} marker. "Killer cells" can destroy a {viral infection} under any normal circum- stances. See {T-killer cell -- more}. (T-suppressor cell) This cell is seen as having a "modulating" effect in the immune system. Its action is almost certainly {antigen}- specific, and it's thought that they're critical in terms of peripheral tolerance, {autoimmune} phenomena and what's called immunoregulation. See {T-suppressor cell -- more}. Why so many different types of cells and substances simply to guard the body against disease? The easy answer is that there are lots of types of disease. But the real reason is that, being designed so elaborately, with so many specialized components, the immune system is virtually self- regulating, self- sustaining, and failure proof -- like the best Swiss watch. As implied in the sketch above, the many players function as a team, with wonderful cohesion, and to win. Under normal circumstances, the team functions without error or failure for the life of the owner -- it takes generations of time, or some tremendous injury, to "break the system down." That, or AIDS. Finally, we hit the bottom line. This whole monolith we're given to help us fight off disease can be brought crashing down -- by something any of us can acquire if we don't know how to avoid it -- and suddenly life is not so safe.

ES Infectious Enteropathy Primary {present}ation in those with AIDS is {diarrhea}. {Etiology}: Multiple infectious agents including ... Isopora belli -- only found in bowel; clinically indistinguishable from Cryptosporidium. Enteropathy traced to I. belli should respond to {TMP/SMX} (Septra, Bactrim). May administer 1 double- strength tablet {PO} {QID} for 10 days then {BID} 2-3 weeks. Other causes are {Salmonella} and Shigella, both of which have a higher incidence and severity in PWA's, who are at greater risk for {bacteremia} and disseminated {salmonellosis}. These can usually be treated with ciprofloxacin given {PO} at 500-750 mg {BID}. Diagnostic workup of diarrhea: {Stool} specimen for {bacterial} {culture} and ova and {parasite} evidence; acid-fast stain for signs of {Cryptosporidium} and {Mycobacteria}; C. difficile cytotoxin (history of antibiotic use); {endoscopy} and bowel {biopsy} may be needed because stool cultures often negative; antibodies to Cryptosporidium may not be present in the person who has HIV. Note: Diarrhea is a prominent complaint in AIDS, can be persistent and cause severe {dehydration}. Helicobacter pylori is strongly associated with {gastric} {inflammation} and ulcers of the gastric antrum and pylorus. It was not well known prior to the AIDS pandemic. Helicobacter is thought to be associated with gastric {carcinoma} and has been linked to chronic atrophic gastritis, an inflammatory {precursor} of gastric adenocarcinoma. This organism responds to {erythromycin}.

ES ITP (Idiopathic Thrombocytopenic Purpura). ITP is an {autoimmune} {hematologic} condition wherein the body produces {antibody} against its own platelets (blood cells that cause clotting, aka thrombocytes.) This decreases the number of available platelets. Primary symptoms include easy bruising, although blood in {feces}, bleeding {mucous membranes}, or slow healing of wounds may also be seen. Small lesions ({hemorrhage}) may appear under the skin. {Etiology} of ITP is not known and it is not necessarily associated with AIDS. It is however uncommon in adult men, but seen more and more in adult men at increased risk for AIDS. It sometimes resolves spontaneously. Diagnostic clues: ITP does not produce fever, and may result in enlargement of {spleen}. The peripheral blood cell count will disclose no {RBC} fragmentation and no {WBC} abnormalities; however enlarged platelets may be seen. Therapy, if needed, is highly specialized; if profuse bleeding occurs, high IV dosage of immune globulin may be required as an emergency measure, followed by platelet transfusions. In some cases removal of the spleen has been used to help relieve ITP symptoms. (CDC-B)

ES Kaposi's Sarcoma (Multiple Idiopathic Hemorrhagic Sarcoma) (KS) {Cancer} or {Neoplasm} of {connective tissue} that supports blood vessels, though often referred to loosely as a "skin cancer" because it produces visible lesions (see {lesion}) just under the skin. "KS" can be found on the hard palate of the mouth -- this is very common. But the disease also may appear elsewhere in mouth or in throat, and in many other body organs, and not just under skin. It results in spotted areas ({node}s, {plaque}s), pink to purple to brown, from 3-4 mm to 40 mm across, usually irregular in shape. Spots may grow and darken, and may grow together at edges. They usually don't hurt or itch. "Lymphoadenopathic" KS spreads quickly through the inner organs such as the {lymph glands} and the {GI} tract. (KS may also occur in the nose, rectum, or on eyelids. It is by nature proliferative.) In the GI tract, KS appears as pigmented plaques or nodules. Lesions may look red, purple, or blue ... can be flat or raised, solitary or multiple. Early stage or tentative KS lesions may be removed by laser surgery, treated by radiotherapy or lightly administered chemotherapy agent. KS {neoplastic} growth may be aggressive, and is sometimes resistant to therapy. Early lesions may yield to {recombinant} {alpha interferon} or intralesional {vincristine}. {Radiation therapy} may be required for aggressive lesions, but treatment can be complicated by the rapid onset of severe mucositis (inflammation of mucous membranes) and often may have to be interrupted. Common {chemotherapy} against Kaposi's sarcoma includes such regimens as {etoposide} (50-80 mg/sq. m. IV daily for three-day intervals), {vincristine} (1.5-2.0 mg/wk. diluted {IV}), {vinblastine} (.05-0.1 mg/kg/wk. by experienced practitioner monitoring {WBC}), {bleomycin}, possibly {doxorubicin}. Doxorubicin given at effective doses may cause unacceptable {toxic} reaction in {bone marrow} or {myelosuppression}. Toxicities from bleomycin and vincristine include pulmonary fibrosis and {neurological} abnormalities such as {paresthesia}s, muscle weakness, hyporeflexia, respectively. Both types of side effects seem dose- related, call for careful monitoring. Aggressive combination therapy would consist of doxorubicin 10-20 mg/ sq. m. + bleomycin 10 units/ sq. m. + vincristine 1.5-2.0 mg IV ea. 14 days. About 1/3 of those with AIDS show some symptoms of KS at one time or another. 11-92 Incidence of KS cases decreasing for unknown reasons. (CDC-C)

ES MAC Mycobacterium avium Complex. (Mycobacterium avium intracellulare, MAC/MAI) Related indirectly to M. tuberculosis. (Other Mycobacterium include M. scrofulaceum, M. kansasaii, M. xenopii, M. marinum, M. ulcerans, and M. fortuitum/ M. chelonae. All of these are common in soil and water, and none of them threatens the general population, though they are threats to those with a weakened {immune system}. MAC/MAI is known to cause potentially- dangerous infections in {immunocompromised} hosts, especially the PWA. It usually occurs when the {CD4 T-cell count} is below 100/ ul. It is detected in about 50% of AIDS postmortems. In the PWA, MAC tends to "disseminate" through body. May spread to {lymph gland}, {bone marrow}, joints, and skin. Some reports of MAC/MAI involving muscles, {brain}, {liver}, {spleen}, {CSF}, {intestines}. It may also be found in sputum, {stool}. Symptoms include fever, {anemia}, diarrhea, and {abdominal} pain. Other possible symptoms: weakness and {wasting}, and possibly an enlarged {spleen}. Diagnosis may require {culture} of bone marrow or blood, and sometimes biopsy of small bowel specimens. MAC cannot be eliminated, but physician may provide {prophylaxis} against MAI with {clarithromycin} plus {clofazamine}, {azithromycin} or {rifabutin}. Therapy with azithromycin or clarithromycin (500-1000 mg PO bid) may be tried in established cases, also azithromycin (600-1200 mg PO qid) + clofazamine or rifampin. There are other strategies available. Most doctors seem to favor combination therapy for existing MAC in hope of preventing development of resistance to a single agent. (CDC-C) if widespread. Does not qualify as CDC AIDS disease unless present in areas other than lungs & lymph nodes.

ES molluscum (molluscum contagiosum) A {viral infection}, spread by sexual/ other means, that causes very small umbilicated {papule}s on skin. These {lesion}s are {tumor}s, and are persistent, but often produce no further symptoms. May be flesh- colored, pale yellow or "pearl" white, w/ sac of {viral} material. May be confined to face, pubic area, buttocks; may be widespread in advanced HIV disease. In healthy persons, the lesions cause only temporary discomfort and cosmetic concern; usually go away in awhile. If persistent, they're subject to various forms of treatment: {Cryotherapy}, phenol, silver nitrate, trichloroacetic acid, iodine; may {cauterize} isolated lesions. Anti{purulent}s may be of limited benefit if the disease is widespread; however, in the presence of HIV, there are times when molluscum cannot be made to {remit}. {Systemic} therapy w/ {oral} {isoprinosine}, despite good preliminary reports, does not seem to be effective.

ES nervous system -- more The body's nervous system is the means by which the {brain} coordinates messages received from the sensory areas or organs of body and actions to be taken in response, if any. Components of system scattered throughout entire body, and range in size and complexity from single cells on up. (The basic building- block of the nervous system is the cell called the {neuron}. Brain and spinal cord make up the central N.S., and the rest is simply called the peripheral N.S.) Most of the peripheral N.S. consists of what's called the autonomic N.S. -- which sends/ receives signals involving relatively involuntary functions of body. Included are {intestinal}, {respiratory} activities, blood pressure, heartbeat, and to some extent, perspiration, etc. The bladder and bowels are also controlled by ANS. The ANS has two sub- branches: The parasympathetic nervous system, whose endings release {acetylcholine}; and sympathetic nervous system, releasing {norepinephrine}. These two substances named are known as {neurotransmitter}s. Sympathetic and parasympathetic branches may work against each other to produce a given function. This is a normal condition. The parasympathetic NS is connected to many internal organs and glands, and also controls blood vessels. The sympathetic NS is connected to {genital}s, sweat glands, intestines, lungs, heart, and abdominal organs. It also influences blood vessels. See also {CNS}, {spinal cord}, {dendrite}, {axon}, {synapse}, {myelin}. The branch of medicine dealing with the NS is called neurology, and most words that begin with "neuro-" relate to NS phenomena.

ES Non-Hodgkin's Lymphoma (Diffuse Undifferentiated Non-Hodgkin's Lymphoma, DUNHL, NHL) The {Epstein-Barr virus} has been implicated as a possible cause or {cofactor} in this {lymphoma} of {B-cells}, which may be difficult to distinguish from {Burkitt's lymphoma}. Symptoms are similar to typical peptic {ulcer} disease, {intestinal} obstruction. Other symptoms include {lymphadenopathy}, {diaphoresis}, weight loss, and fever; intra- or extrahepatic obstruction, enlarged {spleen}, etc. Anorectal lymphoma may also be present. "DUNHL" causes rapid, abnormal growth among {lymphocytes}. This is not a common condition, but is somewhat more likely to appear in advanced AIDS. It often affects the {bone marrow}, {CNS}, {lymph glands}, {meninges}, {liver}, {lungs}, gut. If the CNS is affected, the person may have headaches, memory loss, problems with speech, difficulty in walking. Diagnosis is by {histological} study of excised tissue (biopsy). It's said that evidence may be seen in lactic dehydrogenase levels elevated alone or out or proportion to other liver tests. {Hodgkin's lymphoma} and {Burkitt's lymphoma} must be ruled out. {KS} must be ruled out if there are {GI} symptoms associated with bleeding. {Toxoplasmosis} must be ruled out if the CNS is involved, using blood tests and x-rays -- a brain biopsy may be needed in some cases. Treatment is by {chemotherapy}. Both NHL and Burkitt's lymphoma are currently AIDS indicator diseases.

ES nutritive supplements 1 Vitamins and other nutrients are factors in better health for us all. Some sources feel that nutritional supplements may play some role in control of HIV and other disease. Unfortunately, there doesn't seem to be direct curative value to foods, minerals or vitamins, but we are certain that good, balanced nutrition is important. As we gathered information about the various components needed by the body, we were warned a number of times that supplements are no substitute for good nutrition "at the dinner table." An example of this is the protein your body needs. HIV makes it really hard to keep enough protein coming in, and that problem is hard to solve with a handful of pills or herbal agents. You have to eat foods rich in protein to make up for any shortfalls. Liquid intake is important. One source advises us that six to 8 quarts per day is barely enough, and another source says to put down that coffee while we're at it. Are you taking in toxins? If you are, you want to set yourself free as the first step forward. The most common supplement is vit. C, and while the idea that it fights off colds is an exaggeration, there's evidence that it makes symptoms more bearable. Citrus fruits are just one source of this good stuff -- greens like broccoli, kale, turnips, and brussels sprouts supply natural vit. C as well. Even sweet items like cantaloupe and strawberries are high in Vit. C. Recommended Daily Allowance (RDA) for men is 5,000 IU; for women, 4,000 IU. It is true that this vitamin has {antioxidant} qualities, however it is also capable of producing very unpleasant side effects like diarrhea and nausea if taken in excess. You can find incidental information about vit. C in the "AA" database under {ascorbate}. Vitamin B12 deficiency is common in those with HIV, and may be caused by gastro- intestinal mal{absorption}. Though the use of Vit. B12 supplements as a preventive measure is not an established need, moderate supplementation does appear to improve {hemoglobin} levels, might even improve immunity or mental functioning, according to some reports. It's true that B12 is used by the body for maintaining the "cellular complement." RDA is 2 micrograms (.002 mg) per day. Animal- based foods are the primary natural source of B12 -- beef and liver especially. Fermented items are often high in B12. Some sources counsel the use of nasal gels or "shots" for administering vitamin B12, saying that otherwise the body doesn't absorb the agent well enough. These same sources state that massive doses on the order of 2000 micrograms are in order for resolving B12 deficiencies. But before going that far one should have a urine test for methylmalonic acid and a plasma homocysteine level test. These are the best way to check for a shortfall of B12. The most vocal advocates for this vitamin see it as a means of helping those who experience or risk neurological problems, and they state that shortfalls result in fatigue syndromes common to HIV. Vitamin B6, selenium, and zinc deficiencies are often seen in PWA's, and they are of some significance here because they may be involved in {cell-mediated immunity}. One study indicates that moderate vit. B6 supplementation gives {immunological} benefits and in some cases appears to help resolve feelings of depression. Caution, though -- too much B6 can actually cause damage to the nervous system. Natural sources of vit. B6 include nuts, meat or poultry, dark leafy vegetables, avocados and whole grains. Bananas have B6 if you have a sweet tooth. The RDA of this vitamin is 1.6 mg for women; 2 mg for men. At levels above 200 mg/ day, appearance of sensory {neuropathy} has been noted, and mega- doses are proven to be toxic over a period of time. Selenium: RDA for men is 70 micrograms. For women, it's 55 micrograms. Excessive levels of selenium in the system can cause tissue damage. Deficiencies of this element are rare, and seafood abounds in it. About zinc ... there's been one small study finding that reversal of deficiencies of this mineral may improve some immune functions and the CD4 {T-cell count}. RDA is 12 mg for women, 15 mg for men. Doses of zinc higher than 15 milligrams per day are proven to HASTEN, not delay, progression of HIV to AIDS, according to a well documented 1993-4 medical report. Vitamin D may strengthen the skeletal system and help you retain immune function. A couple of cups of vit. D- fortified milk will supply the RDA of 200 IU. Megadoses (above 750 mg/ day) can cause heart trouble. Vitamin A is mostly found in liver, kidney, raw carrots and spinach. Carrots pack as much as 11,000 IU of vit. A apiece; the RDA is 4,000 IU for women and 5,000 IU for men. Benefits of this dietary building block are mainly immunological, though some say one's vision also gets a boost (thank you, Bugs). Overdosages of vit. A may cause joint pain or cramps. At levels of 25,000 IU's, over a period of time, vit. A can cause liver disease. How about beta carotene? It's known as the {precursor} to Vitamin A, and right now there's a lot of talk about its antioxidant abilities and so forth. Well, though some of that discussion is overblown, it's true that in some small studies, beta carotene has been linked to slight and transient rises in immune "ability." Get your beta carotene and vitamin A at the same time -- a carrot a day will do it, or go for some peaches or cantaloupe. Broccoli is also a rich source. Vitamin E enhancement is recommended as well as proper intake of iron and riboflavin. Studies with animals have hinted that Vit. E may give a little immunity boost, and it is said that it can block {prostaglandin}, which is a potential down-regulator of immunity. There is some discussion of vit. E as a nutrient of tissues and cell membranes, particularly in the vital areas of the lungs and brain. One source states that vit. E is needed for proper neurological function. It's established that "E" is an antioxidant. We're not sure about its supposed ability to fend off cancer, or heart disease; it shows some possible promise against arthritis. Vit. E is found in peaches and prunes, safflower oil, and wheat germ. The RDA for women is 12 IU, and men need 15 IU. There's not much concern about overdoses of this vitamin. One authority advises us to use d-alpha or mixed natural tocopherols only -- and to take some in a water-soluble form and some in the natural oil form, both with meals. This is because each of the two forms has different attributes, both needed. We mention iron because a shortfall of it seems to make people more susceptible to infection. In children, lack of iron may be linked to learning difficulties. This mineral is found in eggs, raisins, beef, blackstrap molasses, dried apricots and green leafy vegetables. Just like certain other items on our shopping list, too much iron is not wanted. RDA is 15 mg daily for women; 10 mg for men. Niacin is part of a well- balanced diet, and chicken, peanut butter, peas, beef and some seafoods provide plenty. Your RDA is 20 mg/ day. At levels above 500 mg, severe {GI} effects (burning pain, nausea, vomiting, bloat, cramps and diarrhea) have been noted. One last mineral to consider: Calcium. It builds stronger bones and teeth, so we need it. Too much of it may cause kidney stones, so we have to stick to the RDA, which is 800 mg for adults. Milk and cheese provide calcium of course, but yogurt, whole wheat bread and some types of seafood are also good choices. Folic acid is found in leafy greens. This substance helps up- regulate cell division when necessary. While the RDA for men is 200 micrograms, women require only about 180 micrograms. If there's a shortfall of folic acid in the system, a lab test called a "hypersegmentation index" will spot the problem. Also in leafy greens is Vitamin K. If you're sick of leafy greens by now, have a couple of peaches. Vit. K's function is to assist the circulatory system on its rounds. It is best not to consider using supplements in this instance, as there is high danger potential in synthesized vit. K. Finally, we repeat the precaution: "Megadoses" of vitamins, minerals, or any supplement are almost guaranteed to provoke ill effects, so please just keep yourself up to what they call the "minimum daily requirements" or the "RDA." If in doubt about that subject, a professional dietician can help you set up a game plan. And as unexciting as it sounds, your best move is to take a pass on the "fad" stuff -- the harder somebody tries to sell you something, the less value it really has -- and go with a regular multivitamin, bought at a regular drug store or supermarket. But there's this one very exciting thing about good nutrition, in the form of a good basic dietary plan supplemented as required: This is the natural, economical way to work in harmony with your body for a better tomorrow. There is probably no drug anywhere that gives the benefits we reap from just following this one simple plan. Here's to your health!

ES pelvic inflammatory disease (PID) This disorder seems to be derived from the {bacterial} sexually transmitted disease {chlamydia}. It is by no means limited to women with HIV infection, but its symptoms are far more severe in the presence of AIDS or HIV, and treatment will be more difficult. The upper genital tract is affected by early signs of infection -- there will be inflammation, swelling and some degree of pain. {Exudate} will appear, and presently the woman's menstrual process will become extremely uncomfortable and difficult. There may be abnormal bleeding. If a woman has HIV, she may not present the usual symptoms, or the signs may be masked by manifestations of HIV/ AIDS. In healthy women, this disorder can produce {ectopic pregnancy} or sterility if not halted. Diagnosis may be difficult, although a viewing device, called a laparoscope, offers some help. Infected {lesion}s including tubo- ovarian {abscess}es may be found. (The latter are sores affecting fallopian tubes and ovaries.) "PID" that is not highly- developed or complicated by HIV is readily treated. (CDC-B), especially if complicated by tubo-ovarian abscess.

ES Peripheral Neuropathy Neuropathy is a {syndrome} affecting the {nervous system}, rather than a disease. In HIV- positive persons it may be caused by many common drugs including all of the {NARTI}s. Drug- induced neuropathic symptoms should clear substantially or entirely after discontinuing use of the agent, although up to 60 days may elapse before this is achieved. Neuropathy may also be a result of direct HIV infection of some portion of the {nervous system}. The syndrome has two basic designations, the first of which is termed MONONEUROPATHY. One general site will be involved, but this form may be seen as "single," with one main nerve affected, or "multiple." Both of these subtypes produce pain and weakness, later possibly but not often paralysis as worst case. Multiple mononeuopathy may appear at several sites more or less at same time, or "spread," and has an asymmetrical character. If enough nerves are involved, multiple mononeuropathy will be difficult to distinguish from the second designation, POLYNEUROPATHY, which is commonly seen with AIDS. With polyneuropathy, development of symptoms is more or less symmetrical. Symptoms are likely to begin at the outer extremities, and consist of tingling sensations, "hot" radiating pain, or loss of sensation (numbness). Severity of pain may vary with temperature or according to the time of day or night. In time, damage done to the nervous system may cause discoloration of skin, impotence, incontinence. In the presence of HIV, "subacute" (fairly serious) polyneuropathy often occurs at a relatively early stage, perhaps before appearance of opportunistic disease. It will likely, in these cases, have a chronic and demyelinating character, meaning that the protective outer coating of the long fibers of body nerves is being lost in some places. Some of our sources see this neuropathy as an {autoimmune} dysfunction. It may be amenable to treatment with glucocorticoids, or (preferably) by plasma exchange. In later HIV, predominantly sensory axonal polyneuropathy may develop as a late complication. It almost exclusively affects the "input" or sensory nerves -- as opposed to the "output" or motor nerves that control limbs and extremeties. This neuropathy's major symptom is pain. Diagnosis of any type of neuropathy is complex, but if blood or urine tests show abnormal signs, nerve conduction velocity testing can be done, electromyography can help confirm the diagnosis. Usual therapy is Elavil (amitriptylene) 100 mg in evening. The mechanism of action of the drug in this application is unknown. Analgesics may be considered for short- term use, though there are many drawbacks to that approch. One source suggests that phenytoin, carbamazepine, topical capsaicin, or mexiletine (10 mg/kg/d PO) can be tried against peripheral neuropathy. The latter, it's said, may relieve symptoms if not signs of the syndrome. It is a congener of lidocaine. A report from {AMFar} says that "Peptide T, given on a compassionate use basis at the University of Toronto, was studied as a palliative treatment for HIV-related peripheral neuropathy. 9 out of 27 patients given Peptide T (10 mg SC qd) had symptoms of peripheral neuropathy. All these patients experienced ... [some] resolution of pain as early as two days after treatment initiation. Numbness and sensory loss were unchanged but improvements in two patients with ataxia were noted. Recurrence of pain occurred in two patients whose doses were reduced and alleviated when the dose was increased to 5 mg/qd. There were no reported side effects." Acupuncture is being studied as a therapy for the effects of this syndrome.

ES PGL (persistent lymphadenopathy, Lymphadenitis) Persistent Generalized Lymphadenopathy. Any time an {infection} occurs -- including various {bacterial} or {viral} types -- some {lymph glands} become subject to {inflammation} and swelling, usually the ones nearest the site (lymph glands or "nodes" are located throughout the body). Discomfort may be relieved by placing hot, wet towels on swollen areas. After serious infection, these nodes may stay swollen for several weeks, or may cause {abscess} areas which may reqire surgical attention. And although lymphadenopathy usually clears when the infection is cured, in the presence of HIV, it may persist. If lymph glands are chronically swollen for more than six months in at least 2 locations, "PGL" is a safe diagnosis. The lymph nodes might be tender to the touch, and may be visible externally. (CDC-A)

ES PML (Multifocal Progressive Leukoencephalopathy) Progressive Multifocal Leukoencephalopathy. This is a {viral infection} caused by the "JC" virus, a human {papovavirus} that may cause disease in those with {immunosuppression} due to AIDS (or {lymphoma} or {leukemia}). Its symptoms include visual or speech difficulties, weakness of arms or legs, and sometimes difficulty in walking. Often these problems will affect only one side of body. There may also be memory loss in some of those affected. There may be seizures or mood swings. PML is sometimes a component of {AIDS dementia}. The JC virus attacks the {myelin} (outer coating around {nerves}) in the white matter of the {brain} -- rarely if ever in {brain stem} or cerebellum). Diagnosis is via {MRI} or {CAT scan}, which will disclose brain {lesion}s possibly in the form of abscesses. Progression over a matter of months can result in death, but in about 10% of the cases seen there is spontaneous remission. Treatment may be partly or temporarily helpful -- some reports suggest that {cytosine} & {adenine arabinoside} can give limited relief, and therapy via AZT + cytarabine is in experimental phase (4-93) per AMFAR. (CDC-C)

ES Pneumocystis carinii Pneumonia (PCP, Interstitial Plasma Cell Pneumonia) PCP is the most common {opportunistic} {infection} seen in AIDS. It's caused by an {organism} that has characteristics of both the single- celled {protozoa} and a {fungus}. Though it's not a problem to those with normal {immune system}s, "PCP" multiplies rapidly in {lungs} of those with AIDS or others with weakened {immunity}. It's easily transmitted between PWA's. It is found in nearly 80% of all PWA's at least once, and is a major cause of death. Symptoms include fever, shortness of breath, and (usually non- productive) coughing. Other symptoms: fatigue, chills, {diaphoresis}. Symptoms may appear slowly or rapidly. Exam will reveal fluid buildup in the lungs; if an {x-ray} is normal, gallium scanning may reveal the infection. After first appearance, "PCP" tends to become recurrent in presence of HIV. Should begin {prophylaxis} when the patient's {CD4 T-cell count} = 200/cu ml or T4:T8 ratio is less than 1.0. Earlier prophylaxis at physician's and the patient's discretion. As of 2-93, {TMP/SMX} (Bactrim/ Septra)or {dapsone} is used by many physicians for prophylaxis although aerosolized {pentamidine} (non sulfa- based agent) is a time- proven alternative for those who cannot tolerate TMP/SMX. Treatment options include TMP/SMX 20-100 mg/kg/day, 4 doses {PO} or {IV} for 3 weeks. May induce allergic reactions or other side FX (see {allergy}). If the person has severe PCP and cannot tolerate TMP/SMX, physician may administer IV pentamidine (Pentam) 4 mg/kg/day X 20 days. Relatively common side effects are {Leukopenia}, {renal} insufficiency, dysglycemia, hypotension. Other treatment options include {atovaquone} or dapsone. If the person has PCP while on aero pentamidine and is allergic to TMP-SMX and Dapsone, one may consider using {primaquine+ + {clindamycin}. Otherwise use IV pentamidine, desensitizing the patient to sulfa drugs or increased use of aerosolized Pentamidine. One authority cautions that desensitization should be done by an experienced physician. From that same source comes a reminder that after therapy vs. PCP is completed, prophylaxis should be started. (CDC-C)

ES psychosomatic Applied to physical disorders that are believed by the examiner to be caused by psychological factors. Usually, unlike the manifestations of {hypochondria}, these are not imaginary illnesses in a bid for attention -- but until the person's underlying mental state is given therapy, the condition may persist despite any medical measures taken. Mitigating information: In that there are obscure or "orphan" diseases being discovered with some frequency as medical technology improves, it's said by some sources that 25% or more of the complaints dismissed as psychosomatic or hypochondriacal by physicians could be in fact genuine physical disorders. (See {rare diseases}.) Also, just to complicate matters for the physician, some diseases are legitimate physical dysfunctions AFFECTED significantly by psychological factors such as stress or worry about practical problems. Examples of this would be eczema, asthma, peptic ulcers, and the like. As this is written (1992), physicians are being encouraged to see the more puzzling and {diffuse} complaints as possible indicators of the mental state called depression. In fact, there's some basis for doing so, if this is done in good faith. (See {empirical treatment}.)

ES Quackery Because of the nature of the HIV pandemic, practitioncers with phony credentials and methods, and substances that are claimed falsely to be curative or healing, these have descended upon all of us like a phalanx of aluminum siding salesmen. In assembling this document, we've been given rare opportunities to see the good, the bad, and the ugly. Come with us, see what we have seen. There's no need for a lot of "deep background" here. Every form of fraud feeds off of a given need ... to be loved, to be successful -- or to be made whole again. The last of these makes people the most desperate, the most willing to BELIEVE. If you've been there, you know how true it is. You would literally give anything to be freed from the tyranny of pain, the weakness, the sleepless nights. "PI Perspectives" -- a publication directed to people with AIDS -- printed an article called "Hope, Folly, or Fraud?" in their 4-92 issue, and we appreciate their letting us quote from it a couple times as we go along here. First, let's talk about buyers' clubs, and what they sell. What we say about the "clubs" is, "Great, go ahead! But be your own best friend, be the educated consumer. Disconnect your heart from your wallet, and use your head -- please." Are we "down" on these clubs? No, just cool and collected. The authors of the PI Perspectives article, Larry Tate and Martin Delaney, say buyers' clubs are "community- based groups which strive to improve access to legitimately promising treatments." Wait, hold on. Is there a problem here, two obviously different opinions side by side? No, there's nothing wrong. This is dialog; the truth about buyers' clubs will, depending on the club, be closer to one statement than the other. In fact, Tate and Delaney then go on to back US up, saying that a second "underground" exists ... with "mysterious treatments that don't have or invite FDA evaluation or scientific credentials ..." being peddled about. "Our generic name for these treatments," the authors continue, "is Ôcures of the week.'" And there you have a very fair summary of this topic. We suspect that the authors may privately, like us, be MAD AS HELL that smooth- talking quacks are bilking our brothers and sisters with AIDS out of a collective amount that some sources say may run into 7 figures each year! This is not just fraud, this is a whole new dimension in deceit. Tate and Delaney included in their article a very useful checklist that was based on recommendations from the Calif. AIDS Fraud Task Force. We hope you'll read it, think about it, and keep it in mind ... for the next time a trusted friend says, "I've heard there's a clinic down in Mexico where they ..." WARNING SIGNS OF FRAUD ( ) Products claimed to be a "cure." ( ) Products said to render persons HIV negative. ( ) Promotion as "miraculous," "secret," "suppressed." ( ) Non-specific claims to "boost the immune system." ( ) Involves doctor in foreign country. ( ) Products sold only in foreign country. ( ) Support by journals your doctor hasn't heard of. ( ) " " universities " " ( ) Claims that a therapy also cures cancer. ( ) High cost ($500- 1000 or more) payable in cash/ advance. ( ) Promotion based on personal testimonials. ( ) "Everybody's talking about ..." fads known only to PWAs. If any of those points sound familiar to you, you are not alone. We all want to believe, we've all been approached. It takes strength to hold back or demand proof. But the alternative? That's it. There is no "conspiracy of silence" in medical science, and if somebody discovers (for example) that aloe vera is a good therapy against AIDS- related disease, it'll be written up in the New England Journal of Medicine within 30 days. And we'll write one dickens of a revision to this document!

ES Strain Variation HIV continually evolves as a result of genetic mutation and recombination. Thus, researchers must estimate the significance of strain variation within individuals and among populations when developing AIDS vaccines. Usually, it's believed, a person is not infected with more than one HIV strain. But once HIV infection becomes established, the virus undergoes changes. When a drug or {immune} reaction destroys one variant, a new and distinct (but related) variant can emerge. Certain variants might thrive in specific tissues or become dominant in an individual because they replicate faster than others. The envelope regions of many HIV isolates ({isolate}, the viruses taken from those with AIDS) have been genetically analyzed and compared. Based on this information, scientists have grouped HIV isolates into at least five subtypes or clades, each about 30 percent different from any of the others. Attempts have been made to place a figure on the {gross} number of HIV variants that can be identified as somehow unique. As of 1-94, it's said that more than 170 strains are extant. The first AIDS vaccines made were based on the LAI strain (also known as IIIB and LAV). Subsequently, LAI has been shown to be unlike most strains found in infected people. Newer vaccines have been based on the SF-2 and MN isolates, which are the same subtype as LAI but seem to more closely represent those HIV strains isolated from Europeans and North Americans. The most volatile strain of HIV is the "SI," or Syncytia Inducing type. See {SI Strain}. See also {vaccine therapy}, etc.

ES T-helper cell -- more A type of {lymphocyte} (see {white blood cells}), also called a T4 cell, which like other {T-cells} is formed in the {thymus} and is an important part of the {immune system}, helping the body fight off certain {infection}s. They are said to carry "T4 marker," and are known to help expression (see {express}) of the {cytotoxic} or {T-killer cell} by production of {IL-2}. This cell makes up about 60% of all the T-cells in the body. Bearing in mind that there are both T- and B-lymphocytes, the T-helper comprises about 45% of the system's total number of lymphocytes. They also control development of {B-cells} , and are capable of recognizing {antigen} and major histocompatibility complex ({MHC}) of the "class II" variety. On their surface, the T- helper cells express {CD4 receptor protein}, to which {HIV} is attracted and may attach itself. In Nov. Ô93, researchers in France presented evidence that the T-helper cell also expresses the CD26 "co-receptor," which is now thought to be HIV's actual "doorway" into the healthy cell. After HIV invades T-helper cells, it weakens or destroys them by using them as hosts, otherwise destroys them when it has replicated and then bursts out into bloodstream. Regular testing of the {CD4 T-helper cell count} in HIV- infected persons provides a rough idea of the progression of HIV in the body. The usual count for people who are HIV negative varies from 430 to 1800, depending upon test method, diurnal variations, other factors. The lower the T-helper cell count, as you'd surmise, the greater the risk of {opportunistic disease}. There is a "threshold" for HIV positive persons at a count level of about 500, where conventional practice has indicated antiviral treatment should be initiated if not already begun. Current recommendations aren't so unequivocal, though such therapy usually has to start if the person shows symptoms of HIV indicator diseases (see {CDC case definitions}. Another threshold exists, somewhere below 200 T-cells/ ul, where onset of profound symptomatic disease usually becomes unavoidable. See also {HIV progression testing}, {HIV preventive testing}. A subset of T-helper cells, memory T cells, are evoked upon first exposure to an invading organism such as HIV. The name "memory" reflects their specialized function, which is to create a "criminal record" file on that virus or microorganism. If the virus enters the body again, memory T cells will quickly stir the immune system into action. The most common way to measure memory T cells is by a test called the "T lymphocyte proliferation assay," which indicates the strength of such cell responses to HIV. (These cells bear both CD4 and CD8 marker.)

ES T-killer cell -- more {Cytotoxic} T-{lymphocyte} cell that kills foreign organisms. Directly destroys HIV- infected cells. T-killer cells identify {antigen}, including those of the {MHC} class I, and are a major factor in graft rejection also. They can destroy targets of the MHC class I type bearing {viral infection} if {immune} function is not impaired. They are marked with the CD8 protein. Since the CD8+ T- cells are one of the body's most critical defenses against HIV, there's one study underway that seeks to infuse HIV- positive persons with cytotoxic T-cells, drawn from their own blood then tested, with the most active being cultured for reinjection. The concept is one form of what's called {cell therapy}.

ES T-suppressor cell -- more This T-cell is seen as having a "modulating" effect in and upon the {immune system}. Its action is almost certainly {antigen}- specific, and it's thought that it's critical in terms of peripheral tolerance, {autoimmune} phenomena and what's called immunoregulation. Many of these cells bear CD8 marker, and it's thought they work via "secretion of free T-cell receptors." One source phrases their function as that of "turning off" the immune response after an antigen has been destroyed. They seem to control development of the {T-killer cell} and {B-cells}.

ES Toxoplasmosis (Toxoplasmic encephalitis, cerebral toxoplasmosis, "toxo") Caused by a small {protozoal} {parasite}, Toxoplasma gondii. This {infection} causes mild or no symptoms in those with normal {immunity}, but will strike the {immunocompromised} person with great force. It can be transmitted via cat {feces}, soil, or improperly- cooked meat. In presence of HIV, it most often infects {brain}, but sometimes heart/ {lungs}. Possible symptoms include headache, fever, weakness, confusion, dizziness, seizures. After time, there may be paralysis or other severe {neurological} indicators, {brain} {abscesses}. The disease may cause hemiparesis, in which one side of body is paralyzed, indicating a {pathological} infection on the opposite half of brain. Diagnosis is by blood test: Detection of {IgM} {antibody} w/ indirect fluorescent antibody method. {Prophylaxis} to control symptoms is possible, but a complete cure is not. Treatment: {pyrimethamine} 25-45 mg/ day for 3-4 wks. + {sulfadiazine} 2-6 gm/ day, known to be possibly {toxic}, sometimes not effective. If patient is intolerant of first therapy, see 566c80 ({atovaquone}). Finally, {clindamycin} may be used, caution against side effects. Reccurrence of this infection may be fatal. (CDC-C)

ES tuberculosis -- more {Infection} caused by Mycobacterium tuberculosis. Its symptoms appear in the {lungs}, and although at one time "TB" was thought incurable and those who had it were confined to "sanatoria," medicine is now in a position to promise a cure of TB unless there are unusual factors that make treatment ineffective. TB may cause weakness; general malaise; weight loss; fever; night sweats. Symptoms for pulmonary TB generally include: long-term cough; chest pain; and blood in sputum. If not treated, TB will in time render the affected person listless, gaunt. A person with tuberculosis may spread the disease readily. (For example, when a tubercular person coughs, extremely small particles of infected matter linger in the air around him or her for awhile, and a person who inhales this matter may become infected. Thus, "TB" is seen as highly {virulent}, and is referred to as an "airborne {pathogen}.") Diagnosis of TB is done by a simple and entirely safe skin test, called a "PPD," in which traces of TB {antigen} are introduced into the testee's system. If any sores or {papule}s appear, with skin raised more than 5 millimeters, a more exhaustive series of tests must be made. Use of {rifampin} + {pyraminazide} usually effective in achieving cure. {Isoniazid} sometimes used. 10-92 Reports of new TB cases have risen by 28,000 in past 5 years, and it's estimated that 52% of known TB cases are resistant to one drug, 32% of them resistant to combination drug therapy. The latter are termed "multidrug resistant TB" or "MDR-TB," and are subject of great concern, as HIV- positive persons are easy prey to infection, statistically more likely to die afterward -- and the "PPD" skin tests most often used to detect TB are unreliable when performed upon those with HIV/AIDS. 3-93 A study in New York City found MDR-TB case incidence had more than doubled in the years between 1984 and 1991. Health care workers, hospital patients, PWA's, immigrants, homeless among highest risk groups. TB in prison facilities is a hazard due to population density and other factors. 8-93 Current recommended therapy for TB is {isoniazid} + {rifampin} + {pyrazinamide} + (preferably) {streptomycin} or (alternatively) {ethambutol}. (Pulmonary TB is (CDC-C)).

ES virus Of all {infectious} {organism}s, this group of agents is set apart in many ways. It is certainly the smallest, and the infections it causes are the most difficult to cure. Unlike {bacteria} (another common cause of infection), the virus does not produce what are termed {toxin}s. It does much of its damage by multiplying in {tissue}. As it can't {synthesize} {protein} on its own, it needs a host cell in which it can reproduce. When a virus does take over a cell, it can cause the cell to act on its behalf in many ways, usually producing disease in the process. The virus has a core of {nucleic acid}, which is its {genetic} matter, and the core is surrounded by a coat, or {envelope} made up of {protein}. The envelope contains {antigen}, and each virus has its own unique antigenic property or "marker(s)." Most viruses are "DNA viruses." Their {DNA} will be transcribed (or copied) into {RNA} as part of a reproductive process. There are also "RNA viruses" that contain a complete RNA chain. The "retrovirus" will begin as RNA, transcribing in reverse into DNA that has characteristics of the virus. HIV is a retrovirus. The host body's {immune system} will note the presence of a virus and its attendant antigen, and begin delivery of {antibody} to the infection site. Flow of {interferon} will be started. Interferon is named appropriately, as its job is to "interfere with" the virus' activities. Antibody, on the other hand, is generally a type of {immunoglobulin}. Until or unless a disease caused by a virus has been dealt with, the person affected will be a {carrier} of it, capable of transmitting the virus to others if medical advice is not heeded. See {viral infection}, {immune system}. HIV is a nearly classic example of a virus aside from the qualifying information that it is a {retrovirus}, and is one of the {lentiviruses}.

ES zidovudine -- more (AZT) A {thymidine} {NARTI}, inhibits replication of some retroviruses, including HIV, by interfering with their usual {reverse transcription} ability (see {HIV replication}) and possibly by other mechanisms. In early (double-blind, placebo-controlled) trials, zidovudine was seen as a potential therapy to increase the length, and relative day- to- day quality, of life of persons with advanced HIV infection and AIDS. Largely on the basis of the results of these trials, zidovudine was approved for marketing by the FDA, indicated for treatment of adults with {symptomatic} HIV infection. Treatment with zidovudine was especially indicated for those with a history of cytologically confirmed {PCP} or a {CD4 T-cell count} of less than 200/ul. The dosage of zidovudine originally approved for oral use by persons who have AIDS and advanced symptomatic HIV infection was 200 mg every 4 hours. In January 1990, FDA approved a change in labeling that recommended administering the drug at 600 mg/day (100 mg every 4 hours) after a person had received 1 month of zidovudine therapy at a dose of 1,200 mg/day (200 mg every 4 hours). Later studies ({NIAID} {ACTG} numbers 016, 019) indicated that this agent could also delay disease progression in those with less advanced HIV infection (having a CD4 T-cell count of less than 500/ul, whether symptomatic or asymptomatic). In Oct. Ô92 studies indicated that "early" treatment with zidovudine (i.e., for those w/ CD4 levels above 500) would increase life expectancy somewhat. This advantage however was to be weighed against known side FX. Specifically, among persons with AIDS or symptomatic HIV infection and who are treated with zidovudine, the most frequently reported adverse events are {granulocytopenia}, {anemia}. Other adverse events that affect greater than or equal to 5% of zidovudine recipients include one or more of the following: headache, nausea, fever, insomnia, {myalgia}, {diaphoresis}, {malaise}, {anorexia}, {diarrhea}, indigestion, vomiting, {dyspnea}, rash, and taste abnormalities. Occurrences less commonly reported include polymyositis, {peripheral neuropathy}, and seizures. Among 3,200 volunteers with asymptomatic HIV infection treated in protocol #019 with placebo or with zidovudine doses of either 1,500 mg or 500 mg daily (either 300 mg or 100 mg given every 4 hours, five times daily), investigators reported the following {toxicity} after a median of 44 weeks of therapy: in the 1,500-mg/day group, approximately 12% of the subjects developed moderate to severe hematologic toxicity, defined as {hemoglobin} less than 8 g/l, {granulocyte} count less than 750/mm3, or {platelet} count below 50,000/mm3. In the 500-mg/day group, this toxicity occurred at a rate of about 3%, compared with approximately 2% in the placebo group. Nausea was rarely reported in the placebo group; however, 3%-5% of zidovudine recipients, irrespective of dose group, experienced moderate to severe nausea. No statistically significant difference was observed between zidovudine dose and placebo for any other moderate to severe clinical adverse experiences. Over time, "AZT" has become the primary antiretroviral agent in the treatment of HIV disease, although experience and more sophisticated testing techniques have sometimes produced reports that undermined the confidence of all concerned. Many times the actual survival of those using zidovudine has seemingly been little better than that of control groups, but each time there's been other, equally compelling evidence in the drug's favor. Our sources sustain the mainstream philosophy current in early 1994: Use of zidovudine is recommended in symptomatic HIV or if the person's CD4 T-cell count shows a distinct falling trend below 500 per ul; dosage may be established at 250 mg. ea. 4hrs. with limit of 1500 mg. per day, or initiate combination therapy with AZT + {ddI} per judgement. They also believe that because of the resistance any single AIDS therapy meets in time, strong consideration should be given to initiating on AZT and later alternating or comibining with ddI. For general and additional info see {AZT}.

HT adaptogens "Adaptogen" is a coined term referring to substances that are thought to enhance immune function, "restore bodily systems to balance while aggravating none," and cause minimal or no side FX. In practice these substances are of herbal derivation, and they include the form of {ginseng} called {eleutherococcus} (Siberian ginseng, Eleutherococcus senticosus). Also highly regarded are schizandra (Schizandra chinensis) and reishi (Ganoderma lucidum). Other herbs mentioned as adaptogenic sources are: astragalus (huang chi, Astragalus membranaceous), burdock (Arctium lappa), fo-ti (ho shou wu (Polygonum multiflorum), suma, (Pfaffia paniculata), ashwaganda (Withanica somnifera), gotu kola (Centella asiatica), and wild oats (Avena sativa).

HT aloe vera (Acemannan, carrisyn extracts) Aloe vera is derived from the aloe barbadenisis plant. It's been used with some success as burn therapy and in cosmetic products. Aloe vera products are being heavily promoted as nutritive and quasi- medicinal substances. Those responsible for this cite a group of studies, mostly done in Texas by vetrinary personnel, although the Journal of Gastroenterology and J. Advancement of Med. are also referenced for what that is worth. Aloe vera is said to "contain all 8 essential amino acids, 7 vitamins, 12 minerals and 13 different enzymes." However, promoters also state it functions as {immunomodulator}, and that it has {polysaccharide} anti- HIV properties. They can advance no proof of the latter -- in fact the reference they provide on that point only says that "good nutrition" is important in the control of HIV progression. Another claim of "in vitro decreases in HIV replication" is followed by a reference omitting the name of the publication which is supposed to have printed it; a mention of anti- {HSV} activity presents the same problem to the researcher, only saying the information comes from Texas A&M Medical School. Aloe vera is said to "stimulate {cytokines} such as {interferon} as well as {interleukin}s and other chemicals which regulate {immune system} function." Acemannan is not specified as a form of aloe vera but as some kind of "compliment" (sic) to it. There doesn't seem to be any body of scientific proof of the claims made on behalf of aloe vera, Acemannan or carrisyn against illness.

HT alopecia pill A Chinese herbal remedy for treatment of {alopecia}, whose ingredients have also been used for {anemia}, menopausal syndromes, and to counter {immune} suppression as seen during {chemotherapy}. Components may include Polygonum multiflorum, Rehmannia glutinosa, Angelica sinesis, Ligustrum lucidum, Morus alba, Alpinia chinesis. (See {adaptogens}.) There have been complaints of {GI} disturbances from persons using these agents. The problems have sometimes been resolved if the person stopped using them before meals (latter is the usual practice). Loose {stool}s, due to the oily nature of some ingredients, sometimes reported.

HT ashwaganda This is a "safe" member of the often- narcotic or poisonous nightshade family, and it is found mostly in India. It's said to be important in both "traditional ayurvedic and folk medicine." Proponents say the root of this small shrub can be administered successfully against growth of {tumor}s and other disease. They list arthritis and generalized back pain, as ashwaganda is said to have {anti-inflammatory} properties; heart disease; fevers; indigestion. Found at health food stores, etc.

HT astragalus Found at {buyers' clubs}. It's claimed that this herbal substance (a derivative of Astragalus membranaceous, of the pea family) can improve {metabolism} and energy level, and also that an American Cancer Society study found it caused improved {immune} function. Actual efficacy if any unknown. See {adaptogens}.

HT burdock The roots, seeds and sprouts of this plant, Arctium lappa, were used as medicinal substances in ancient Greece, and modern herbalists claim that burdock inhibits carcinogens and has other benefits. The roots are very popular and may be sauteed, deep fried, etc. The burdock plant is related to dandelion and the very popular herbal remedy {echinacea}.

HT carnivora This item, sometimes promoted as an {alternative therapy}, is liquid extract of the Venus' flytrap plant, Dionaea muscipula. It's most often ingested in amounts ranging up to two teaspoonsful at a time, although one source says it can be used by inhalation or {IV} injection. It's not approved by the U.S. Food and Drug Administration, though the FDA's German counterpart is said to be considering its record. It has not been subjected to any formal clinical trials. Carnivora's main proponents include Dr. Helmut Keller of Bad Steben, Germany. He's devised a system whereby he furnishes the extract to interested parties in the U.S., apparently relying on "compassionate use" policies which make importation acceptable to U.S. authorities. This agent is supposedly effective against both cancer and HIV, along with various chronic illnesses of some seriousness. Regarding its use against HIV, a source claims that "I have observed laboratory test readings on HIV positive patients, recorded by Dr. Keller and some American Holistic physicians. The patients' T-helper cell counts rose from as low as 11 per cu. mm. ... to well beyond 700, while the T- suppressor cells decreased sharply. This makes the individual's important [T4:T8] ratio almost normal." That last appears in "Natural Health" magazine, Sept/Oct 1992 issue. Most of the material cited as evidence of carnivora's usefulness is only anecdotal, the most interesting of it being the statement that former U.S. President Ronald Reagan at one time used a 4X daily dose of 30 drops of carnivora to check the spread of cancer. When we checked in late 1993, various entities were selling carnivora extract at around $315 per 50-ml bottle.

HT chamomile Herb typically used as a tea, said by some to have sedative effects and to be useful vs. "children's complaints" (sic).

HT Composition A Health food store item, contains several herbs common to Chinese / alternative paratherapies.

HT dandelion One source claims that dandelion greens contain vitamin A, and that they are rich in {beta carotene}, a vit. A {precursor}. Said to have mild laxative and diuretic properties and be useful as "tonics" for {kidney}s and {liver}. Actual benefits unknown. Available at some health food outlets.

HT dong quai Herbal item (extracted most often from Angelica polymorpha) said by its adherents to "do for women what ginseng supposedly does for men." A variant, taken from Angelica sinensis, said to be useful vs. breast cancer. Claims not substantiated to the best of our knowledge.

HT echinacea (elhincea, eahincea, etc.) Extract of the North American plants E. augustifolia and E. Purpurea, said at one time to be a primary Native American "medicine." Claimed to be to varying degrees effective vs. {cancer}, {viral} and {fungal} diseases, {bacterial infection}s. The same sources state that echinacean {polysaccharide} molecules seem to boost production of T-cells, thus immunity, by some 20-30%. Pathogens entering the body use an {enzyme} called hyaluronidase, the sources say, which helps infection spread by lowering the viscosity of the protective cell membrane chemical, hyaluronic acid. Echinacea, it's said, reinfoces the latter and helps fight infections in that way. Further, it's thought that hyaluronidase is inhibited by echinacea's constituent chemicals, especially by echinacein. Echinacea "tonics" go back to 1870, under the name Meyer's Blood Purifier ... in the gay 90's, anti- infectives based on echinacea were developed and sold by John Uri Lloyd, professor at the Eclectic Medical Institute. This herb is sometimes called by enthusiasts an {adaptogen} or an "immune tonic." Is popularly brewed into tea. Efficacy unknown. One informant states that echinacea tends to increase tumor necrosis factor levels {in vitro} and so should not be used.

HT eleutherococcus (Maxim-L) A form of {ginseng}. See also {adaptogens}. We are told that this herb may be used to "counteract general debility and weakness. In the Soviet Union, millions of people take eleuthero daily, among them mountain climbers (and) sailors ..." The same source cites studies done some years ago in what was then the USSR, conceding they were "not double- blind experiments" but suggesting they showed this herb "protects against environmental pollutants and radiation, normalizes body temperature, regulates blood sugar levels, protects the liver and enhances its ability to eliminate drugs from the body, improve the body's ability to resist infection, optimize adrenal function." Presently the source concludes, "... eleuthero (increases) semen output and reproductive capacity in men," having "natural plant steroids called eleutherosides" concentrated in the root bark from which the best quality eleuthero is derived. We are informed that many busy, active people take "one dropperful of eleuthero tincture before breakfast." This tincture is about 35% alcohol if made in the traditional way. During times of "heavy stress," more of the agent may be taken.

HT fo-ti (Ho Shou Wu) An herbal item of Chinese ancestry, said to be capable of lowering serum cholesterol and promoting proper blood flow to the heart. Its botanical name: Polygonum multiflorum. Derivatives of fo-ti, according to the very colorful legends we've heard, function according to the age of the root -- a member of the buckwheat family. The ancient herbalist Li Shih-Chen says 50 year old fo-ti will "preserve the black hair of the hair and moustache." 100- year old fo-ti may "preserve a cheerful countenance," and ingesting tea made from 200 year old roots will give one a "gait equal (to) that of a running horse." Available where health food and supplements are sold, and at most of the {buyers' clubs}.

HT garlic Claims made in favor of garlic as a medicinal substance: It has selenium, "which stimulates the immune response and acts in a similar fashion as other antioxidants, such as vitamin E. The anti- oxidating qualities of garlic make it an excellent anti-aging factor, by interfering with the formation of free radicals." From another source: Beneficial because of "its ... ability to lower cholesterol and its usefulness as an anticancer, antiaging, antibacterial, antiviral and immunostimulant agent and protector of the liver." Another source: Garlic is "a stomachic, vermifuge, antispasmodic, and carminative, an intestinal antiseptic; it provides protection against amoeboid dysentery, typhoid and other infectious diseases. It is choleretic and cholagogic, diuretic and an expectorant. Garlic is also a febrifuge, lowers the blood pressure and works against {atherosclerosis}." Sold at health food stores, {buyers' clubs} and other outlets.

HT ginkgo (ginkgo biloba) One source states that this herb increases blood flow to the brain and stimulates mental alertness. "Because of its contents of bioflavinoids, ginkgo ... aids the body's vascular [blood vessel] system, inhibits {platelet} aggregation, serves as a {free radical} scavenger, and acts as a {neurotransmitter}, among other things," states the source.

HT ginseng A root sometimes used in Oriental medicine. There are several distinct and different kinds, some of them grouped geographically -- American, Korean, Siberian, etc. Some types are claimed to be efficacious vs. HIV or its {OI}'s. It is known that ginseng has a long tradition of medical, or at least "ex officio" medical use in China and elsewhere. It's been used against stomach disorders, hypertension, and the like. Also, as a sort of general tonic, it's thought effective against nervous system/ stress related complaints and as a sexual stimulant. From a purely scientific viewpoint, ginseng has not been proven as a therapeutic, and contentions that it works against HIV are at present not accompanied by viable evidence. See {Panax}, {adaptogens}, {eleutherococcus}.

HT gotu kola Ayurveda, the ancient East Indian pre-medical system, seems responsible for legends that this herbal item provides benefits like improved healing of wounds, brain and nervous system "restoration," and longer lifespan. Its botanical name is Centella asiatica, and it is found in Asia, also the Hawaiian Islands. A member of the parsley family, it has a weedy appearance, and is often found growing in drainage ditches. Says one enthusiast, "If you wish to try gotu kola, make sure to purchase the fresh liquid extract or grow the plant yourself and take it fresh. I have found that gotu kola loses its properties rapidly when dried." Like {aloe vera}, this herb has a good track record for helping to heal burns. Available at health food outlets, etc.

HT herbal treatments Usually small amounts of plants ground or made into a paste. Roots, bark, leaves sometimes used, juices or teas. Some herbal treatments cannot be expected to bring good results, no matter what claims are made for them by enthusiasts. However, many of our most necessary modern medications are derived from plant substances, some of which are subjected to very little or no "processing." (4-94) A statement by one of our sources, Gary Hite of positively hiv, inc., deals with new proposals by the U.S. Food and Drug Administration to exercise tight regulation of nutritional supplements, including herbal items, vitamins, and anything else that might fit the broad description: "... the FDA has asserted that the labeling of some 27 pure herbs is Ôtoo suggestive'. These include Goldenseal, Echinacea Root, Pau D' Arco and St. John's Wort ... I can relate a specific experience that happened ... when I attempted to reorder St. Johnswort capsules. "During the telephone order I was informed that the FDA had banned the sale of St. Johnswort in capsule form as being unsafe for human consumption. I immediately ordered one pound of the ground herb and empty gelatin capsules so that I could make the capsules for my own use. Questioning why the FDA could or would ban an herb, I discovered a quotation that might shed some light on these recent events. "Ô... AIDS TREATMENT NEWS ... reported that a chemical compound called hypericin ... found in the herb St. Johnswort, may inhibit retroviral infections, which may be useful in the treatment of AIDS patients.' "When one considers the per pound price of St. Johnswort (approximately $9.00), as well as the price of empty gelatin capsules ($3.00/ hundred), is it any wonder that the FDA is suddenly determining such alternative treatment to be Ôunsafe for human consumption'? After all, the pharma- ceutical drug AZT, which is also promoted as Ômay inhibit retroviral infections in persons with AIDS', costs $287 for 100 capsules. One pound of any herb could likely provide a minimum of 1000 capsules which, in the case of a comparative with AZT, would equate to a $2870 loss to the manu- facturing pharmaceutical company per thousand capsules. "... when patients diagnosed with any catastrophic illness choose to adopt a treatment plan that can be beneficial to their longevity and health, who loses? Not the patient. The loss is directly incurred against the medical profession, the pharmaceutical industry, the trial lawyers and the insurance companies." "Freedom of choice," Mr. Hite concludes, "falls within the rights assured by the constitution." That summarizes his remarks, which we've had to condense drastically. For an unedited copy of the essay send a self addressed stamped envelope and a note asking for document #GH1 to Friends, POB 635 Chowchilla CA 93610.

HT Iscador Extract of Viscum album, common European mistletoe. Used as {cancer} treatment in Western Europe. Is supposed to directly destroy cancer cells and enhance {immune system}. One informant however says this herb can increase tumor necrosis factor levels {in vitro} and should NOT be used.

HT licorice The roots of the licorice shrub are regarded as a venerable remedy for sore throat or stomach distress in China, although the plant itself is mostly native to the eastern Mediterranean area. Real licorice -- not the usual imitation stuff flavored with anise -- is sticky- sweet and not safe to consume in quantity. It may cause high blood pressure or heart failure, or just headaches and general malaise. Licorice is a member of the legume family, a' la soybeans and the like. It contains chemicals called triterpenoids, which are potential anti- cancer agents. They have been seen, in test tube experiments, to block production of {prostaglandin} -- one type of which (E2) seems to appear in excessive amounts when HIV is present in the body. This alone doesn't mean that anything extracted from licorice will be of medical benefit to us, but it's worth noting. Trials of licorice derivatives against ulcers have failed, however the National Cancer Institute slates additional tests. See {glycyrrhizin}.

HT maitake A mushroom containing a {polysaccharide}, {glucan}.

HT Momordica charantia (bitter melon, Ku Gua) Made from a gourd which is a staple of Asian cooking and medicine, sometimes promoted as therapy for HIV disease. Effectiveness not proven. As compounded and sold, is said to "contain 3 anti-HIV proteins: alpha- and beta- momorcharin, MAP-30, and charantin, beta-D-Sitosterl- beta-D-glucoside, 5,25- Stigmastadien- 3-beta-D- glucoside, serotonin, and amino acids ... tested {in vitro} and found to possess inhibitory effects on HIV-infected {macrophage}s and {syncitia}l formation ..." and so forth. "In vitro" studies, of course, do not prove that the agent has any value in real life conditions; many drugs that do not work against disease are successful in vitro. There is one account of a PWA who decided to try introducing a crude extract of bitter melon into his system after hearing that the Philippine health department was investigating use of it to treat {leukemia}. This person had at that time a {CD4 T-cell count} of about 480. Finding the substance very distasteful, he began taking the extract via retention {enema}. Thereafter he stated that his CD4 count had risen due to his efforts to above 1,300. Through history the gourd, stems or roots of this plant have been ground or made into juice or tea as a curative for flu, colds, dysentery and inflammatory diseases. The dried root, in suppository form, has been used vs. gynecological inflammations and {carcinoma}s. "Bitter melon" is sold by importers and {buyers' clubs} today in the U.S. in foil bags of 5 grams of powdered product per bag. Instructions say to prepare this with 4-5 ounces hot water, and when water cools to use the result by "rectal infusion." One promoter states that this product "can be used for AIDS, cancer, and some other ailments." Studies by Qing Cai Zhang, written up in the Journal of Naturopathic Medicine, are quoted. The citation discloses a small study in which 60% of participants experienced some increase in CD4+ {T-cell count}, though the average increase was "not very large." Caution ... enema therapies of any kind may cause damage to the rectal {mucous membranes} and imbalance of vitamins/ minerals in body. Wild plants may be contaminated.

HT Panax A form of {ginseng}, supposedly conferring benefits of longevity.

HT pau d' arco (trumpet bush, taheebo, ipes) A native of South America's rain forests, this member of the Bignoniacea family is credited by Brazilian and Peruvian native healers with curative power against bronchitis and asthma; infections; diabetes, etc. The Brazilians, along with Bolivian and Paraguayan counterparts, sometimes call the bush "ipe roxo," and its scientific names are Lapacho colorado and Lapacho morado. In animal studies, a suspension containing lapachol (one of several substances that can be extracted from pau d' arco) was reportedly cause of a 44% inhibition of tumor growth, although the paper in the Lawrence Review of Natural Products has not been seen or verified here. Similar findings, our source says, were written under {NCI} auspices. We're attempting to locate that report also. With the erosion of rain forest land ongoing, Pau d' arco cannot be taken for granted, if it has significant promise as a pharmaceutical. Finally, some real arcana, from Frank Murray. He writes in "Better Nutrition for Today's Living" that "One of [pau d' arco's] constituents, lapachic acid, was included in an informational volume on Argentina that was made available in 1876 during the Philadelphia World's Fair. In Dr. Atkins' Health Revolution, Robert C. Atkins, M.D. reported that a colleague in Texas, John Parks Trowbridge M.D., includes pau d' arco, acidophilus, some homeopathic remedies and other procedures in treatment of {candida} infections."

HT phyto- Prefix indicates relationship to plants, herbs, etc.

HT reishi (ganoderma, ling-chih-tsao, wu-ling-chih) A relative rare mushroom whose use derives from ancient Japanese medical or quasi- medical beliefs. "There are stories," we're told, "of people traveling on foot for hundreds of miles to pick them in hopes of curing some chronic condition or incurable disease." Reishi's scientific name is Ganoderma lucidum. It's found in remote places and is a tough, fibrous plant. The list of properties claimed on reishi's behalf includes "blood-sugar regulation, immune support, anti-cancer properties, ability to oxygenate the blood efficiently." At the same time, though, it is said to be a good antioxidant, so it would have to "oxygenate" in a rather sophisticated or unusual way. Reishi's other claims: faster than normal regeneration of the liver, radiation protective effects, reduction in sensitivity to {allergen}s, sedative and anti-hypertensive ability, lowered cholesterol levels. It's said that a high content of ganodermic acids is the key to the mushroom's value in treatment of heart conditions. "Korean scientists," one source says, "report that [reishi] hardens the muscles of the immune system by supercharging the two types of fighting cells: macrophages and polymorphonuclear leukocytes." It is true that augmenting the strength of these two cell types would be most desirable from an immune standpoint. The red reishi is the most popular. Chinese doctors prescribe it, dried and powdered, at a dosage around 3-5 grams per day for most ailments. The plant may also be chopped up and made into a syrup or tea.

HT Resist A "resistance tonic" sold at health food outlets, etc. Said by promoter to be "immune enhancing," indicated for "lack of energy, reduced ability to concentrate, depression, reduced sexual energy, reduced appetite, shortness of breath ..." Main ingredient is {astragalus}. Also contains {reishi} (ganoderma) mushroom; atractylodis; {schizandra}; ginger root; jujube fruit extract; Chinese yam root, etc. Promoter promises increased {leukocyte} levels and phagocytosis, transformation of {B-cells}.

HT rosemary Herbal substance often used as a spice. Said to contain Vitamins A and C, calcium, iron, magnesium, phosphorus, potassium, and zinc. Recommended by "herbalists" for "bad breath, high blood pressure, baldness, female problems, digestive complaints, circulation, etc."

HT Schizandra (Schizandra chinensis) Small red berry-like fruits from a relative of the magnolia tree; in fact schizandra is loosely called "magnolia vine" sometimes. Proponents say its extracts work against stress, obesity, and liver malaises, that they're good for helping digest fatty foods or the control of skin problems. Schizandra's use in Chinese medicine is said to go back to the earliest times, because it contains all of the "flavors" herbalists there use for classification purposes: sour, salty, bitter, sweet, and acrid. Products containing these extracts are found at {buyers' clubs}, health food stores, etc.

HT suma (Pfaffia paniculata) Herbal enthusiasts say that suma is "prescribed in Brazilian hospitals for cancer and diabetes, given as a tea, two or three cups daily ..." It's also supposed to be useful for women who are experiencing fatigue or hormonal imbalance. One source recommends using around a teaspoonful of powdered suma as often as once every waking hour, but concedes that this may cause nausea, in which case he says it's okay to cut back the dosage.

HT una de gato 3-94 A jungle shrub found in the Andes, this plant is being studied vs. early- stage HIV disease at the Institute of Tropical Medicine, Cayetano Heredia University, Lima, Peru. It is not giving good results so far, according to admissions by trial's administrators. A more romantic picture of the plant Uncaria tomentosa is painted in material received from a source who asks not to be identified. "Una de Gato has been used for hundreds of years by the Ashaninka Indians. Its medicinal applications are various: Arthritis, rheumatism, gastritis and ulcers are some of the diseases that are treated by folk medicine." An Austrian scientist named Klaus Keplinger is said to have brought the plant to light, and his earliest experiments were with cats infected with Crown virus and lambs with Visna virus. Encouraged by good results, he tried Una de Gato extract against Herpes, then HIV, in humans. Our source's material says this agent enhances phagocytosis, which would be desirable in some instances -- and that it boosts the immune system. Active ingredients responsible are said to be "oxindole alka- loids, specifically Alloisopteropodine or Isomer A." In addition, we hear that "[the plant's] quinovic acid glycosides, from the bark, have antiviral activity. Studies done at the University of Napoli also ... showed presence of beta- Sitosterol," accounting for effects against inflammatory disorders. Dr. Keplinger is said to be continuing his research with Una de Gato, and derivatives of the plant are for sale at various outlets in the U.S. It is probably not wise to experiment with them until more substantial information is available.

HT wild oats (Avena sativa) This common form of wild grass is said by herbalists to have restorative properties that act upon the human nervous system when an extract or tincture is made from it and given orally. We're told the agent may be used against "nerve weakness or trauma," and also that it may reduce cravings for nicotine or other addictive substances. This is interesting, in view of the plant's botanical name.

ID 2-5A-antisense Drug in tests by Cleveland Clinic/ {NIH} against {viral infection}s including HIV. See {Antisense}. The technique being studied used modified antisense (to which an {enzyme} activator called 2-5A was attached) which it's stated sought only viral RNA, and not human RNA.

ID 256U87 1-93 (IND) {Antiviral} in trials vs. {Herpes Simplex Virus II}, {cytomegalovirus} infection, {Herpes zoster}.

ID 5-ASA An oral reformulation of mesalamine, a rectal suspension enema approved for therapy vs. colitis (colon inflammation), proctosigmoiditis, and proctitis. Now being considered for symptomatic relief of inflammatory bowel syndrome.

ID 882C87 (882) 8-93 {Antiviral} in Phase III trials vs. {herpes zoster}.

ID 935U83 (2',3'-dideoxy-3'-fluoro-5-chlorouridine) 10-93 Experimental {NARTI}. Trial underway at U. of Pittsburgh.

ID A-77003 Abbot's {protease inhibitor}. 8-93 Tests so far show no {efficacy}. Side FX: {phlebitis}, some elevated {lft}'s.

ID ABCD {Liposome}-encapsulated {amphoteracin B}. Has been tested as {PCP} {prophylaxis}.

ID accrual Process of signing up participants in drug trials.

ID ACDCC AIDS Clinical Drug Development Committee, made up of mostly academic and government physicians who review drugs submitted by researchers, drug companies. From available data, they assign a research priority: Low, Medium, or High.

ID ACTG AIDS Clinical Trials Group. Formal, sanctioned tests of a substance, assigned a serial number for efficiency. Sponsored by {NIAID}. Numerous medical centers throughout U.S. participate in evaluations. See {ACTIS}, {Clinical Trials}.

ID ACTIS AIDS Clinical Trials Information Service, a central resource providing current data on both federally-, privately- sponsored {clinical trial}s for drugs vs. AIDS diseases. This service is a {PHS} project, produced collaboratively by {CDC}, {FDA}, {NIAID}, and National Library of Medicine. Phone # (800) TRIALS-A, (800) 874-2572, Fax (301) 738-6616, Internatinal (301) 217-0023. See also {ACTG}.

ID ACTU AIDS Clinical Testing Units, where {NIAID}'s {clinical trials} of AIDS drugs are performed.

ID adeno-associated virus (AAV) 1-93 A {virus} produced by {biosynthesis}, in tests vs. HIV. It's said that in early experiments, "AAV" showed promise in inhibiting HIV reproduction after modifying {genetic} pattern of {T-helper cell}.

ID adverse reaction In context of {drug trials}, subjects are told via a "{protocol}" about anticipated adverse reactions, but unanticipated ill effects caused by the agent are to be reported within 24 hours by telephone to the sponsor of the trial. If reaction indicated {toxicity}, sponsor must notify {FDA}. Result may be that trial will be halted.

ID AL-721 Was studied as {antiviral}, but no evidence of benefit was seen. May be given another chance to perform.

ID Alferon N Injection 1-93 (IND) {Immunomodulator} in trial stage only.

ID all-trans retinoic acid (retinol) This natural acid, a component of vitamin A, is believed to be a regulator of {epithelial} {differentiation} within many {neoplastic} cell systems. Some tests indicate it can inhibit laboratory viral carcinogenesis or cancer formation {in vivo} and suppress {papilloma}virus- transformed cell growth and the number of viral DNA copies {in vitro}. (2-93) Currently under investigation for the treatment of Kaposi's sarcoma.

ID alpha-APA Alpha-anilino phenylacetamides (R 18893, R 89439) 10-93 (IND) {NNRTI}. Johnson + Johnson subsidiary Janssen Pharaceuticals concedes that HIV develops resistance to this agent when used alone. Combination testing (with {antiviral}s added) to be announced.

ID ALX40-4C 4-94 Phase I {clinical trial}s of this {antiviral} completed in Canada and Phase I/II tests to begin soon. Agent works to inhibit {tat} protein from taking its critical role in HIV's replication, according to one brief item.

ID AMFAR American Foundation for AIDS Research, a private nonprofit agency which raises funds for, tracks, and disseminates results of, AIDS research. In New York: 733-3rd Ave., 12th Fl., NY 10017-3204, (607) 798-1706.

ID aminosalicylic acid Aspirin. An aspirin derivative (Asacol) has been tested against non- specific {colon} {inflammation} in PWA's. Preceding not a misprint. 9-93 {CRI} in NYC recruiting for study of aspirin as therapy vs. AIDS.

ID amphotericin B lipid complex (ABLC) (IND) {Anti-infective} / {antifungal} in Phase II/III trials vs. systemic {candidiasis}. Has also been tested vs. {cryptococcosis} (cryptococcal meningitis), {coccidioidomycosis} and {aspergillosis}. Comprised of two {lipid}s, DMPC and DMPG, plus the familiar amphotericin B. This compound may cause such side FX as transient {renal} comlaints, elevated {transaminase} levels, fever, chills.

ID ampligen An {antiviral} / {immunomodulor}, comprised of mismatched double- stranded {RNA}. May slow progression of HIV. 4-93 Results of Phase II/III clinical trials not known to our sources.

ID anti-B4-blocked ricin (Oncolysin B) 6-93 (IND) In Phase I/II trials vs. {relapse}d or {refractory} HIV- related {lymphoma}. {Monoclonal antibody} connected to a "blocked" plant {toxin} that won't {bind} to most {cell}s. Meanwhile the anti-B4 antibody "targets the molecule to malignant {B-cells}. This agent may be useful for {IV} therapy vs. {Non-Hodgkin's lymphoma} in presence of AIDS. See also {anti-idiotype vaccine}.

ID anti-idiotype vaccine ({anti-idiotype} {monoclonal antibody} vaccine) (Theravir, murine) (IND) In phase I trials vs. {asymptomatic} HIV. See also {MSL-109}.

ID antineoplaston AS2-1 (3-93) (IND) Developers say antineoplastons are naturally- occurring {peptide}s. Derived from {amino acid}s, they are believed to be components of a biochemical defense system that protects us by "normalizing" defective {cells} (whereas the {immune system} acts to eradicate invading, or defective, cells).

ID antisense compound Antisense is a piece of {DNA} that seeks and {bind}s with "sense" {RNA} -- RNA being determinant of which {protein} will be made in the person's {white blood cells}. HIV requires this RNA for replication purposes. Practical considerations involved in using antisense as therapeutic include making it {resistant} to other body chemicals, which might hamper its activity, then making it small, so that it can enter a target cell. See {GEM 91}, {2-5A antisense}.

ID AR-121 ({Nystatin} LFTM): {Antiviral} in Phase I&II trials vs. HIV.

ID artemisinin 8-93 {Antiparasitic}s derived from this agent are in Phase II trials.

ID AS-101 (IND) An {immunomodulator}. {Synthetic} ammonium of salt of tellurium, apparently able in some instances to enhance production of {white blood cells} and {interleukin-II}.

ID ateviridine (ateviridine mesylate, U-87201E) (12-93) {NNRTI} {antiviral} similar to {pyridinone} and {nevirapine}, but is said to work differently from other {RT} inhibitors. Early trials indicated little if any development of HIV {resistance} to agent combined w/ AZT, with which agent is said to have {synergy}. New trials soon w/ and w/o AZT. See also {BHAP compounds}.

ID atovaquone (Mepron, 566c80) ... (IND) 9-92 This {oral} hydroxy- naptho- quinone agent said to be effective and well tolerated as alternate therapy for those with {toxoplasmosis} who are intolerant of standard drugs (i.e., {pyrimethamine} + {sulfadiazine}). Usual dosage is 750 mg {qid}. Sometimes given in combination w/ pyrimethamine. {Clinical trial}s also underway to determine FX vs. {microsporidiosis}, {cryptosporidiosis}. Because of wide variations in {bioavailability}, (atovaquone is highly lipophilic and {absorption} is erratic), an improved formulation is under development. (3-93) Agent has, per {AMFAR}, been OK'd for treatmemt of mild- to- moderate {PCP} in PWA's. In a study, participants were randomly assigned to 21 days of ther. with either 750 mg. of atovaquone {tid} or 320 mg. of TMP and 1600 mg. of SMX tid (latter being equivalent to {TMP/SMX}. Although atovaquone had less therapeutic {efficacy} than TMP/SMX, it still had fewer side FX that required discontinuation of treatment. Success rates for the two courses were similar. Therapy involving only the initial drug was successful and free of adverse events in 62 % of patients assigned to atovaquone and 64 percent of those assigned to TMP/ SMX. Also there's some thought of trying atovaquone for persons intolerant of pentamidine. 1-93 Side FX incl. maculopapular rash, nausea, fever.

ID Averol Substance developed from sea sponges. Has been suggested as possible AIDS therapy by German-Japanese research team at U. of Mainz. Patent held by Marz Co., Frankfurt.

ID Azidouridine 1-93 (IND) {Antiviral} in trial stage only. A {nucleoside} {analog}, the compound has shown HIV- suppressive activity, and tendency to interfere with HIV's ability to replicate. Might delay progression of HIV to AIDS. Seems to produce few side FX. See also {NARTI}.

ID azithromycin (Zithromax) 12-92 (IND) {Antibiotic} in trials vs. {toxoplasmosis}, {MAC}. A {macrolide}, also being tested vs. {cryptosporidiosis}. May be available under {compassionate use} for those who've failed standard therapies for {toxoplasmosis}, physicians contact Dr. DeBruin (203) 441-5701. See also {amikacin}. This agent is known for achieving high intracellular (within a {cell}) chemical concentration, and is being used vs. {chlamydia}.

ID AZT-P-ddI (IVX-E-59> Per AMFAR, a heterodimer {NARTI} made up of one molecule of AZT coupled to a molecule of ddI by a phosphate linkage. Early results encouraged current Phase I/II trials.

ID BACI (Bovine anti-Cryptosporidium Immunoglobulin) (IND) (1-92) This {anti-infective} is in Phase I trials vs. {cryptosporidial} diarrhea. It is an {immunoglobulin} derivative of pasteurized, concentrated hyper-immune bovine colustrum. It may be adminstered {PO}.

ID BCG This anti- {TB> drug was dismissed as unreliable by U.S. public health agencies in 1988. They dropped recommendations of its use, but there are indicators the agent can in fact reduce full scale TB infection of the lung by as much as 50%, and can reduce TB mortality by 70% if used to its full capabilities. There is apparently evidence that this drug cannot be used for people with advanced HIV or AIDS, but its use would confer indirect benefits on those with AIDS, as they're especially vulnerable to TB and the newer MDR- TB.

ID BHAP compounds (U-87201E) (U-90, U-90152, Delavirdine) Bisheteroarylpiperazines. These {NNRTI}'s cause development of {resistance} even {in vitro}. It's been reported, though, that development of high-level resistance to BHAP compounds in lab conditions appears to "sensitize" HIV {RT} to inhibition by other NNRTI's. 4-94 Despite some problems, at least 3 trials are ongoing.

ID BI-RG-587 (Nevirapine) Non-{nucleoside} dipyridodiazepinone derivative having {in vitro} {antiviral} activities comparable to {BHAP compounds}, the {TIBO derivatives}, {L-697,661}, other members of the family called the {NNRTI}s. However all these compounds have unique structures. BI-RG-587 is a selective, and "non- competitive," inhibitor of HIV-1 {reverse transcriptase}, an {enzyme} which HIV needs in order to reproduce. This drug {bind}s to HIV-1 RT at same site as other NNRTI's.

ID BIBB 11-93 A variant of {pentamidine}, developed by Dr. Richard Tidwell, U. of NC at Chapel Hill. Developer expects it to be superior to pentamidine.

ID blind trial a {controlled study} of a drug in which patients don't know whether they are being given the trial substance or a {placebo}.

ID BRL 61063 A product of {purine} breakdown, this agent blocks production of {TNF} in lab studies. Desirable insofar as TNF may be implicated in HIV progression. Trials {in vitro} show some promise.

ID bropirimine (6-92) An {immunomodulator}, last seen in Phase II tests for {KS} therapy.

ID Bucast Anti-HIV compound, has been studied in laboratory tests and in animals. Phase I trial forming w/ subject having {T-helper cell count}s over 500. Bucast is 6-0-butanoylcastanospermine, which is a chemical derivative of castanospermine, an antiviral found in an Australian tree, Castanospermum australe. Bucast is a glycosylation inhibitor -- interfering with an enzyme required by HIV for processing glycoproteins (chemicals composed of both proteins and sugars). Laboratory studies suggest that glycosylation inhibitors will make the virus more susceptible to attack by the immune system, and also prevent the formation of syncytia -- giant cells formed when T-helper cells join together abnormally and die. (A different glycosylation inhibitor, {butyl-DNJ}, is already in human trials.)

ID butyldeoxynojirimycin (N-Butyl-DNJ, NbuDNJ, Sc48334, DNJ) (IND) An {antiviral}, N-Butyl derivative of deoxynojirimycin, an alpha glucosidase I inhibitor. Orphan drug application submitted. In lab, is said to inhibit formation of HIV- induced syncytia (see {syncytium}), reduce the production of {p24} core {antigen}. Said to block addition of glucose (sugar) molecules to HIV's outer envelope, tending to disable its infective abilities. Test data based on Rhesus primates indicated {GI} irritation, nausea, unfavorable hepatic (liver) changes, decreased {platelet} counts, other side FX. 10-93 See {SC-49483}. Probably for sale at {buyers' clubs}.

ID BV-ara-U 9-92 (Brovavir, SQ32,756) {Antiviral} {nucleoside} {analog} currently in trials vs. {herpes simplex virus I}, {herpes zoster}. {Toxicity} similar to that of acyclovir, but has been used at levels up to 600 mg/day for 5 day periods without side FX. May be given {PO}, but {IV} use is being studied. See {acyclovir}.

ID BW256U87 {Antiviral} that is metabolized to {acyclovir} in the human body yet has better and more consistent {bioavailability}. A pharmacokinetic and safety trial for HIV+ subjects with CD4+ cell count below 150 is underway, and a study comparing BW256U87 to oral acyclovir for treatment of recurrent anogenital HSV infection in the presence of HIV is being held.

ID BW348U87 A ribonucleotide reductase inhibitor that potentiates or amplifies the activity of {acyclovir} vs. {HSV} and is active {in vitro} vs. acyclovir- resistant HSV. Phase II studies are being held.

ID BW882C87 {Antiviral} of {nucleoside} {analog} type shows {in vitro} activity vs. {herpes zoster}. A Phase I study involving healthy participants is being done in England.

ID calanolide A Substance found in Calophyllum Lanigerum (gutti-ferae family) gum producing trees in Malaysia. Seems to block spread of {HIV-1}, but environments in which the tree is found are being destroyed. (Some confusion possible between this compound and "costatolide." Latter is said to be less powerful, but more readily available.)

ID canarypox Used as {vector} for {rgp160} {vaccine therapy}.

ID case-control study Scientific test in which healthy population w/ certain characteristics is compared with counterparts who have a given disease.

ID CBCT (community-based clinical trial) Trials of therapies which, unlike traditional research methods, are conducted by primary- care physicians in cooperation with their patients and AIDS advocates.

ID CD4 immunoadhesin A hybrid substance that may be able to block AIDS {infection} of blood cells {in vitro}. It's said that the hybrid was able to bind to special sites on {white blood cells}, suggesting that it might be able to trigger an {immune} response vs. the HIV virus and infected blood cells. See also {CD4-PE40}.

ID CD4-IgG 1-93 (IND) {Immunomodulator} in trial stage only.

ID CD4-PE40 9-93 (IND) (pseudomonas CD4 exotoxin A) (IND) 2-93 {Recombinant} {CD4} protein w/ Pseudomonas aeruginosa exotoxin A attached to {bind}ing region. Phase I trials done, some {liver} {toxicity}. Is hoped this agent will selectively kill HIV- infected cells, though size of agent's {molecule} may be too large for it to pass through {blood-brain barrier}. See also {CD4 immunoadhesin}.

ID CDR3 11-93 Molecule created by French researchers that may be able to block HIV entry into various cell types, including {macrophage}, {lymphocyte}. Used {in vitro} only so far.

ID ceftriaxone (Rocephin) 2-93 Rel. new {antibiotic}, in experiments vs. {penicillin} G for {syphilis} affecting {CNS}, {gonorrhea}.

ID cell ID (cell growth therapy) An experimental technique, involves removal of {T-killer cell}s from subject, then isolating and treating them with {interleukin-II}, thought to have {cancer}- fighting properties, plus phytohemaglutina (PHA), a soybean extract. Cells are then incubated 2-3 weeks, during which time it's said they multiply X10. They're then reinfused into patient, and it's said the person's {immune system} will be strengthened thereby. Is said {HIV-1} replication arrested in some instances. Unlike other drugs, interleukin-II targets receptors present on replicating cells, not cell itself or virus. 1-93 Synthetic interleuken-II mfd. by Seragen Inc. as DAB389IL-2. 8-93 A similar experimental technique proposed at {NIH}, would remove CD8 from 15 HIV+ subjects, {culture} them, then infuse massive numbers of them back into subjects' bloodstreams. 12-93 {NIH} ok's human tests of latter technique.

ID CHIRI Consumer Health Information Research Institute. (800) 821-6671.

ID chlorhexidine gluconate (Peridex) 1-93 (IND) An {Anti-infective}, now in trials vs. {oral} {candidiasis}. Has been used during {bone marrow} transplants to minimize chance of oral Candida in the past. In solution w/ alcohol, given {PO} like mouthwash.

ID cilofungin No longer available, per sources. Was at one time in trials vs. {oral} {candidiasis}.

ID cimetidine (Tagamet) Drug for treatment of peptic (stomach) ulcers, inhibits production of {acid} in stomach. One source says this agent is being used as an {alternative therapy}, and one non- {controlled study} has been run, based on possible {immunomodulator}- type effect via the {histamine} pathway. The results of that very small trial were very good, but sources doubt the results will ever be replicated.

ID cisapride Agent being considered vs. {GI} upset, food {intolerance}.

ID clindamycin (Cleocin) 1-93 (IND) {Antiparasitic} / {antibiotic}, given {PO}, is in trials vs. {PCP} or AIDS- related {toxoplasmosis}. Info: Mark Jacobson, M.D., San Francisco. Studies have shown this agent causes intolerable side FX such as {diarrhea}, severe rashes in some persons. Has been used in combination w/ pyrimethamine vs. toxoplasmosis. {AMFAR} states that the agent is typically used in combination with primaquine for PCP, and in some cases may cause include pseudo-membranous colitis.

ID clinical comparison (clinical comparison study) A type of {clinical trial} where the test drug is compared to existing therapy rather than a {placebo} (as in {blind trial}).

ID clinical trial Drug test w/ human subjects. For definitive word on current trials, do not rely upon this database or written sources, which may be out of date. Call {ACTIS} (800) TRIALS-A.

ID CMV immune globulin {IgG} from pooled, purified plasma with high {CMV} {antibody} {titer}s. Limited usefulness.

ID CMV MAb (Tl-23) {Antiviral} in Phase I trials vs. {CMVR}.

ID Coca-Cola There's been some evidence that Coca-Cola helps with {absorption} of {ketoconazole}, a drug that often has problems in this regard. If stomach acidity is lowered due to other drugs' effects or presence of HIV, a few ounces of Coca-Cola may restore acidity by some 65%.

ID cohort Usually a group of subjects involved in a "longitudinal," or "cohort," medical study. The study is carried out over a period of time or until specific events have occurred or failed to do so.

ID combination sequential This therapy mode uses standard anti{retroviral} drugs in combination, with components "switched" at certain intervals. One of our sources has advocated broad trials of this approach, and also of non- combination sequential administration, for quite some time. In part, this is due to the constant difficulty posed by {resistance} to antivirals and the serious nature of the drugs' side effects. In a recent small study, 21 volunteers were given {AZT} + {acyclovir} for three weeks, then {AZT} + ddI for 3 weeks, then AZT + {ddC} for 3 weeks. After two years, 10 of the original 21 persons were still in the study. Their average {CD4 T-cell count} had been 184 at the start; the counts did not return to baseline until an average of 48 weeks, which is about 4 to 6 months usually found with AZT alone. It's emphasized that this study was not only flawed by small size but also in that it was not a true {controlled study}.

ID comparison study A test comparing two different therapies, or two different applications of the same therapy.

ID comparison trial Tests in which experimental drugs are compared to each other or to an approved drug.

ID compassionate use Program under which seriously ill people may have their doctors request access to experimental drugs. Requires {FDA} approval, drug maker may not charge for the drug. (Program now called the Open Study Protocol by FDA.) See also {Expanded access}, {parallel track}.

ID Conocurvone 9-93 Agent derived from Australian "smoke bush," shows {in vitro} action vs. HIV ability to attack T-cells. {NIH} seeking drug company to test and develop this agent, which is said to have low {toxicity}.

ID control In medical tests, a known standard against which experimental observations may be compared.

ID controlled study Usually, trial of an experimental drug in which a group receiving the drug is compared to a similar (control) group which is given an inert {placebo} or an approved drug. Subjects are not advised which substance they are receiving.

ID convergent combination ID 8-93 Therapy using {AZT}, {ddI} and an {NNRTI} or {foscarnet} together. Early reports held that this therapy could suppress HIV replication, but the study's results could not be duplicated afterward. Then, later, the original researchers admitted erroneous {in vitro} findings. Similar therapies are however still in various planning or test stages.

ID cosalone 9-93 Said to be effective at halting HIV infection at the {bind}ing stage, when HIV seeks to attach to new cell. Seems effective vs. a number of HIV {strain}s including some that are {AZT}- resistant. Little or no {toxicity} vs. uninfected cells. {NCI} interested in preclinical tests.

ID CP-38 12-93 Experimental agent, called a "psoralen molecule," said to reduce "model viruses" in tests from blood products. Promoters say CP-38 eliminates platelets, which they state are critical components of viral contaminants including HIV.

ID CPCRA Community Program for Clinical Research on AIDS. Auspices {NIH}.

ID CRI (Community Research Initiative) Nonprofit organization in NYC, studies AIDS treatments.

ID crossover Point during a {controlled trial} where the "control" group is switched over to experimental drug, other group switched over to {placebo}.

ID cryptosporidium immune colostrum 1-93 (IND) An {immunomudulator}, in trials vs. {cryptosporidial} diarrhea.

ID curdlan sulfate 9-93 (CRDS) {polysaccharide} {Antiviral} in Phase III trials vs. {herpes zoster}, Phase I/II tests vs. HIV. Comparable to {dextran sulfate} except CRDS is said to block target cell surfaces' tendency to {adsorb} {virion}s.

ID Cyclobut-G (SQ 34,514) 1-94 A {nucleoside} {analog} {antiviral}. Shows activity, {in vitro}, vs. human {herpes}viruses and HIV. Early studies now being carried out.

ID cysteine precursors (OTC, NAC, {n-acetylcysteine}) These are said to be in use as an {alternative therapy}. Not proven effective at this time. One example of these agents is OTC (2- oxothiazolidine- 4- carboxylate, Procysteine), which is a {precursor} of cysteine, an amino acid used in the biosynthesis of the peptide substance {glutathione}. Not enough about this latter is known to establish its relevance in the presence of HIV or AIDS, although it's an {antioxidant}. It's been seen that glutathione seems to suppress HIV {in vitro}, but that by itself is not enough to justify assumptions of protective or therapeutic qualities. When it was demonstrated that OTC also had some in vitro anti-HIV capability, a small trial was conducted. Its sponsors state that the substance was "safe and well tolerated," but "no significant differences in CD4 percentages, viral load, or weight were observed between treatment groups."

ID cytarabine An FDA- approved intravenous {antineoplastic} drug, mostly used with other agents for the {IV} treatment of acute nonlymphoblastic {leukemia}. May be useful vs. {PML}, though trials so far have not been promising. May cause such side FX as {myelosuppression}, nausea, stomatitis, vomiting, {anorexia}, and oral {lesion}s.

ID Cytochalasin D 7-93 Experimental drug made from a natural {fungal} {metabolite}. Instead of attempting to prevent HIV {infection}, it simply prevents release of {virus} by affected {cells}. Blended with {AZT}, the result is said to perform in test tube as well as AZT vs. HIV generally, with reduced {toxic} FX.

ID cytomegalovirus I.G. (cytomegalovirus immune globulin, CYTOGam) In Phase I trials vs. {CMVR}. Agent is a derivative of human {plasma} having high levels of CMV {antibody}, has been used as {prophylaxis} during transplants. Given {IV}, may cause fever/ chills; body pains/ cramps, {GI} upsets, shortness of breath.

ID d-ala-peptide T {Antiviral} in Phase I/II trials vs. AIDS {neurological}/ cognitive impairment. See {Peptide T}.

ID DAB389IL-2 {interleukin-II} (IL-2) receptor- targeted {fusion toxin}, OK'd by {FDA} for {clinical trials} w/ HIV positive subjects. Maker states previous studies showed it stopped HIV-1 replication in {infected} human {lymphocytes}, the "holding place" of the {virus} (presumably {in vitro}). Distinguishing characteristic of agent is that it targets receptors on replicating cells instead of the virus itself. Maker is also trying this drug vs. {rheumatoid arthritis}, Type-1 {diabetes} and {chemotherapy}-resistant {lymphoma}s.

ID DATRI Division of AIDS Treatment Research Initiative, a program conducted under auspices of {NIAID}. Was begun in Ô91 as a means for rapidly conducting {clinical trials}, prior to consideration for {ACTG} tests.

ID daunorubicin (DaunoXome) Vestar Inc.'s {cytotoxic} agent, a proprietary {lipsomal} formulation. Findings from trials (1-93) said to show {efficacy} vs. {KS}. In 150-pt. group, 60% had "partial response," disease was "inhibited" in several others. Liposome coating is intended to assist in "cellular uptake" of active daunorubicin and reduce {toxic} FX in system. 7-93 An {FDA} advisory committee has voted not to recommend approval of drug based on available data.

ID dehydroepiandrosterone 1-93 (DHEA, EL-10) A {steroid} {hormone}, levels of which may be a predictor of HIV disease progression. Is now being tested as an HIV therapeutic ({antiviral}/ {immunomodulator}) as some research shows it modestly inhibits HIV-1 infection {in vitro}.

ID delaviradine 1-94 This new {NNRTI} is similar to {ateviradine} but apparently effective at lower concentrations. {NIH} sponsors early trial.

ID deoxyoligonucleotide (3-93) Some research indicates that both thioate and dithioate deoxyoligocytidine inhibit {reverse transcription} of HIV by specifically {bind}ing to the active site for "primertemplate," thus blocking the binding of natural substarate and subsequent {polymer}ization. These agents both fall into the class of phosphorodithioate {DNA} oligomers.

ID dextran sulfate (Uendex) Experimental {antiviral} vs. HIV. {In vitro}, blocks HIV from {bind}ing to and entering {T-helper cell}s. May also block {reverse transcription} activity in cell {culture}s, may block infection between {macrophage}s. Also said to block syncytia formation (cell-cell infection of multi-celled {protoplasm}), which AZT cannot do. Noted for low {toxicity}. Available in a compound w/ {AZT}.

ID DHEA (dehydroepiandrosterone) A {steroid} secreted by {adrenal gland}s, its natural function is not well defined. It is thought that DHEA works as an immunomodulator; HIV certainly causes declines in serum levels of the substance, which in turn seem to cause downward shifts in the {immune} function. It's suggested that DHEA assists the activated {T-cell} in its production of {interleukin 2}, and for this and other reasons DHEA has been eyed as a possible therapy. {In vitro}, DHEA and its synthetic analogs 8354 or OH8356 produce a modest down-regulation of HIV replication in peripheral blood lymphocytes as measured by syncytia formation, release of p24 antigen, and reverse transcriptase activity. In real-life conditions, though, the agent has not shown much promise. In one very small trial, three dosage levels of DHEA were given to separate groups of volunteers: 750, 1500, 2250 mg/day. At the lowest dosage, there was no perceptible effect on downward trends in subjects' CD4+ T-lymphocyte counts. At the two higher levels, CD4+ decline was slowed (averages 8 cells/ul versus 53) at the end of 16 weeks. Adverse effects were not very pronounced. There was episodic nasal congestion, fatigue, headache, and the like, along with cough and elevated levels of alinine aminotransferase.

ID DIMP This {pentamidine} {analog}, in developmental tests involving rats, showed {efficacy} as therapy vs. {PCP}. {Toxicity} profile was good. There's talk of trying this agent vs. {cryptosporidiosis}.

ID dose comparison Trial that uses different amounts of same drug. Sometimes the drug is also tested vs. {placebo}.

ID dose escalation Refers to drug trial in which succeeding groups of subjects are given higher dosages.

ID dose ranging A drug trial in which two or more doses of a given drug are being tested vs. each other in order to determine which dose works best and is least harmful.

ID double-blind trial A {controlled trial} in which neither recipients nor experimenters know which participants are receiving the substance being tested, and which the {placebo}. Believed to produce the best results, since the well-known psychological {placebo effect} is minimalized.

ID doxorubicin (Doxil, Adriamycin, Rubex) 1-93 (IND) An FDA approved {antineoplastic} agent. According to {AMFAR} reports, doxorubicin is believed to {bind} {DNA} and to inhibit {synthesis} of nucleic acid, DNA's basic component. It is administered {IV}. Side FX may include {leukopenia}. Currently in trials vs. {KS}, {leukemia}s, {carcinoma}s, {lymphoma}s. Sponsored by {NIAID}. 5-93 After considerable {toxicity} problems, most notably {cardiac}, the agent has been packaged in a layer of {liposome}, then polyethylene glycol for use in further KS trials. This form of doxorubicin, by Liposome Technology Inc., is called Doxil. See {PRO-MACE/MOPP}. (liposomal stealth doxorubicin HCl) (IND) In Phase I trials vs. {KS}. See comments above.

ID EF13 11-93 Developed in UK as anti- {cancer} agent, {in vitro} tends to kill some HIV- infected {WBC}s. Also appears to help the WBC develop resistance to HIV infection. No formal tests yet.

ID eflornithine (DFMO, Ornidyl) (IND) {Antiparasitic} in trials vs. {PCP}, symptoms of {cryptosporidiosis}. Said to have a {synergism} with {ganciclovir}, implying that lower doses of latter might be required if in combination w/ DFMO. Has been used vs. leishmaniasis, studied as therapy vs. {PCP}. Reportedly inhibits polyamine synthesis. Side FX: mainly {leukopenia} or {bone marrow} suppression, {diarrhea}, {thrombocytopenia}, {phlebitis} at injection site.

ID end point Specific condition whose appearance indicates {clinical trial} should be stopped -- usually involves disease progression, high {toxicity}, or death of subject.

ID epoetin alfa (Epogen, Procrit, EPO) FDA approved vs. {anemia} in persons taking {AZT} or those with {chronic} {renal} failure. This is a {biosynthetic} copy of a natural {protein} whose task is stimulation of {red blood cells}. It's being studied with AZT and {G-CSF} in children with HIV, auspices {NCI}. See {erythropoietin}.

ID expanded access System for providing experimental drugs to persons who are unable to participate in {clinical trial}s and having no other options for therapy. See also {Compassionate use}, {parallel track}.

ID experimental drug A drug not approved by {FDA} as treatment for a given condition or population. Differs from what would be termed "alternative therapy" in that it will be the subject of regular trials or attention that would lead to same.

ID F105 (gp120 monoclonal antibody) Antibody derived from an HIV+ donor, able under some circumstances to bind to HIV's {gp120} envelope protein, "reacting with a conformationally defined {epitope} ... important for binding to the cell surface by the virion." F105 may neutralize HIV strains MN, RF, IIIB and SF2 at concentrations achievable clinically (0.150 -10 mcg/mL). A phase I pharmacokinetic and safety study of intravenous F105 is underway; no toxicities have been reported.

ID famciclovir (BRL39123A) 10-93 Experimental broad- spectrum drug for use vs. {herpes zoster} and {herpes simplex virus}, similar to {acyclovir}, a {prodrug} of penciclovir. Shows both {in vitro}, {in vivo} activity vs. HSV Types I and II. 7-94 FDA- approved for therapeutic use vs. {Herpes Zoster}.

ID FIAC 1-93 See {fiacitabine}.

ID fiacitabine (FIAC) {Antiviral} in Phase I/II trials vs. HIV, {CMV}, {CMVR}, AIDS. Said to be active vs. all {herpes} {virus}es and vs. {hepatitis} B. A {NARTI} like {AZT}, {ddI}, {ddC}. Its {efficacy} vs. HIV debatable or nil. Has been in trials vs. severe {CMV}, but caused {bone marrow} {toxicity}, {GI} upsets; vs. {cryptosporidiosis} but {compliance} was poor.

ID fialuridine (FIAU) {Antiviral} Originally indicated vs. {herpes}, in Phase I trials vs. HIV, {AIDS}, {herpes} group infections. {In vitro}, {ganciclovir}- resistant {CMV} strains are susceptible to FIAU.

ID filgrastim (Neupogen) A {cytokine}, in Phase III trials vs. AIDS.

ID FK-565 (IND) {Immunomodulator} in Phase I trials vs. HIV.

ID Fluorouracil (DRG-0161, Ro 2-9757, Adrucil, Efudex, Fluoroplex, 5-Fluorouracil, 5-FU, FU) (3-93) {Topical} drug used in {Bowen's disease}, in trials vs. high- grade {dysplasia} of {cervix}. Originally developed for the treatment of actinic or solar keratosis, {basal cell carcinoma}. Said to inhibit {DNA} and some {RNA} {synthesis}, "preferentially in rapidly-dividing cancer cells." Reported side FX include localized pain or {pruritis}, {hyperpigmentation}, {allergy} activation, scaling, swelling, many others, though it's unknown how frequently these occurred.

ID fluorthymidine (PLT) {Antiviral} in Phase II trials vs. HIV {infection}, AIDS. A {reverse transcriptase} inhibitor.

ID fluoxymesterone (Halotestin) {Hormone} approved by FDA vs. delayed puberty, deficiency of testosterone in males. Being investigating vs. {wasting} syndrome in AIDS. Side effects in men can include enlargement of the breast, excessive erections and low sperm counts; in women, menstrual cessation and acquisition of male secondary sex characteristics.

ID fusion toxin (IND) Single {molecule}, {recombinant}, w/ one end designed to attach to certain kinds of {cell}s, while other end, bearing {toxin}, kills the cell. Intended to work vs. activated {immune system} cells {express}ing high- affinity {IL-2} receptors (gen. a sign that AIDS has taken over the cell). There's risk that the drug might destroy other immune system cells also, and so tests are proceeding with caution. See also {DAB389IL-2}.

ID G-CSF (Granulocyte colony stimulating factor, Filgrastim, Neupogen). Purpose is to stimulate {white blood cells}, said to be superior to the similar {GM-CSF} in Phase I/II trials. However like the latter, this is a {recombinant} version of the human {cytokine} that helps growth of blood cell {precursor}s, also involved in their {differentiation}. In {cancer} {chemotherapy} G-CSF is used {SC} vs. decreases in {neutrophil} counts. Might be useful as {adjunct} to {ganciclovir} therapy vs. {CMVR}. Side FX include pain associated with bone structures.

ID gamimune-N (IND) ({intravenous immunoglobulin}). Human {serum} {globulin}. {Immunomodulator} in Phase I/II tests vs. AIDS, pedriatic HIV infection.

ID GEM 91 (GEM= gene expression modulation) Antisense oligo{nucleotide}, said to inhibit messenger {RNA} -- RNA being determinant of which {protein} will be made in {white blood cells}, thus necessary for HIV replication. Clinical studies will probably be done in France.

ID gene transfer ID Process by which a person's blood is enriched in {immune} abilities by addition of {retrovirus} {vector} taken from lab mouse. The vector has a "gimmicked" {gene} sequence, and added cells are subjected to radiation in order to halt division processes.

ID genetic knife theory 8-93 Involves alteration of {T-helper cell}s by insertion of a "hairpin" ribozyme -- a chemical thought capable of "cleaving" {RNA}, which HIV uses for its replication and dissemination processes. Theory's weak point is that a person would have to be given massive numbers of cells with altered RNA in order to slow HIV spread in body.

ID gentamicin, liposomal (TLC G-65) 12-92 {Orphan drug} in trials against {MAC}. Gentimicin sulfate already has long been an {FDA} approved agent for use against some {bacterial infection}s, regarded as a powerful {aminoglycoside}, but it doesn't adequately reach the interior of human cells where MAC is rooted. (Most other {antibiotics} have this problem.) {Liposome}s are capable of penetrating cell walls; they are sometimes used to encapsulate and deliver a given drug to intracellular targets. One subject given high-dose TLC G-65 in a phase I trial developed reversible kidney failure but no other toxicity was observed. See also {amikacin} etc.

ID GLQ223 1-93 (IND) (Compound Q) {Antiviral} in trial stage only. {Synthesize}d trichosanthin, a {protein} isolated from root tubers, used in China to induce abortion. Promoters say active ingredient is in a class of drugs called "ribosome inhibitory protein." As of June 1992, early tests claiming change in {CD4} levels are being disputed, with several serious side FX noted. (8-93) Trials closed. (10-93) Mfr. of this drug states it has evidence of "treatment associated benefits" for GLQ223 in "clinical, immunologic and virologic parameters." No specifics given though. Since this agent does have {in vitro} activity vs. HIV, we have not heard the last of it.

ID GM-CSF (sargramostim, Leukine, Prokine) Virtually identical to {G-CSF}. See {rhGM-CSF}, {molgramostim}.

ID gp120 1. An HIV {envelope} {protein}, binds to {CD4} receptor on the host {T-helper cell} surface. 2. 1-93 (IND) {Synthetic} agent in trials as {vaccine}, {vaccine therapy} for AIDS prevention, infection. 10-93 "MN," "IIIB" types are being tested by one maker, with some favorable early reports. A similar product is in development elsewhere, ("SF2" type with either "MF-59" or "MTP-PE" {adjuvant}). Early tests show some promise. gp120 and its parent protein, gp160, form the basis of many "recombinant subunit vaccines," so- called because they are genetically engineered and contain only pieces of the virus. See {F105}.

ID gp160 1. See {envelope}. 2. See {rgp160}.

ID guanfacine An oral drug for use vs. hypertension, 8-93 (IND) vs. AIDS dementia. Side FX include weakness/ dizziness, dry mouth.

ID HA-1A (9-91) {Biosynthetic} human {antibody} reportedly showed promise vs. {microbe}- associated {toxin}s in persons w/ {gram-negative bacteria} {infection}s. Such bacteria are common in {immunocompromised} persons, those undergoing {chemotherapy}. HA-1A binds to {endotoxin}s, blocking them from producing such effects as {septic shock}, organ failure.

ID HEPT Hydroxyethoxy methyl phenylthiothymine. Potential {antiviral}, shown to work in both {T-cell}s and {macrophage}s {infected} w/ {HIV-1}. Did not affect {HIV-2} or other viruses. This shortfall sometimes indicates that HIV-1 will show {resistance} to an agent.

ID HGP-30 In development as an HIV {vaccine}, this is a {biosynthetic} copy of "p17" HIV core protein per one source, probably a typo indicating the p18 variety (see {HIV antigens}). Patented in Europe by Viral Technologies Inc, Wash. DC.

ID hivac-ie Experimental anti-HIV {vaccine} made from {envelope} {protein} of HIV. Produced by {genetic} modification of {vaccinia virus}. Not practical as a therapy for those w/ HIV.

ID HIVIG Therapy in which {plasma} from {HIV-positive} {asymptomatic} persons is processed to kill off HIV, then infused into {HIV-positive} subjects. Plasma donors selected on criteria of HIV {antibody} levels. See reference to {Passive Immunotherapy},

ID HPMPC (12-92) Experimental {antiviral} {nucleoside} {analog} with some broad spectrum activity vs. {herpes} and, in lab tests, said active against human {CMV} in very small concentrations. 8-93 {In vivo} studies also have been completed, and drug is ready for {IND} application. Along the line, HPMPC has shown some species- related toxicity in rabbits, guinea pigs. Less {toxic} in monkeys, rats. Phase I/II trials being held -- auspices NIAID, Mt. Zion Med Center SF CA.

ID human growth hormone (GH, somatrem, BioTropin, rHGH, Protropin) (IND) In Phase I trials vs. HIV {tissue} {wasting}. A {synthetic} version of a {hormone} normally {secrete}d by {pituitary gland}. Increases production of {protein} and thus muscle growth. Also promotes use of fats as energy source. Is used as therapy in children w/ endrogenous "GH" defiency, who are typically smaller and shorter than peers. Some believe GH stimulates {immune system} via increased {T-cell} and {NK cell} activity, increased {differentiation} of {white blood cells}.

ID humates Substances from decaying organic matter. 9-93 Research in Germany hints that {synthesized} humates might act as anti-{bind}ing compounds vs. {virus}- {cell} attachment.

ID hydroxyurea Possibly in "underground" use vs. AIDS, this agent has shown itself to be productive of many serious side FX and little or no effect vs. HIV if used by itself. It has been tried or used vs. certain {leukemia}s or {cancer}s, with mechanism of action unknown. It has been established that the agent inhibits {DNA} {synthesis} but not that of {RNA} or {protein}. At {NCI}, earlier work indicated that hydroxyurea inhibits an {enzyme} needed for "activating" DNA building blocks enroute to stimulation of {T-helper cell} (the step at which HIV was believed to complete its "life cycle"). Apparently, the agent did this by "quenching a {free radical}" produced by said enzyme. In test tube conditions, hydroxamates such as hydroxamate (DAH) or hydroxyurea (HU) have an inhibitory effect on ribonucleotide reductase in replicating cells. In one study a hydroxamate "yielded a synergistic effect resulting in complete suppression of viral production, total protection against the cytopathic effect induced by viral replication, and non effect on the cells' ability to replicate normally after treatment."

ID imipenem-cilastatin (Primaxin) (6-93) (IND) An {antimycobacterial}, investigational status only at this time.

ID imitrex Agent being considered vs. migraine headache.

ID immune globulin IG-IV 1-93 (IND) in trials alone and in comb. w/ {AZT} to treat or prevent misc. {OI}'s.

ID immunoID Treatment of disease by stimulating the body's own defense mechanisms. 1-93 Tests will treat HIV+ persons w/ {culture}s of own HIV-specific {cytotoxic} cells. Subjects w/ {CD4 T-cell count}s of 100-400 to be involved. Auspices {NIAID}/ {DATRI}. Trial results may not be available until early 1995. See also {PATH}, similar but not same.

ID immunotoxin A {toxic} protein or radioactive substance linked to a {Monoclonal} {antibody} or to an {antigen}, e.g., {CD4-PE40}.

ID Immupath 8-93 Substance used in {PATH}.

ID imreg-1 1-92 {Leukocyte}-derived {immunomodulator} that is said to enhance production of some {immune system} {protein}s in {CD4} cells from {HIV-negative} subjects. Said to enhance production of {interleukin-II}, {gamma interferon} in {lymphocyte}s of PWA's. No reported {toxicity}, trials underway. 3-94 Orphan drug application filed. Maker also wants to make agent available for investigational use vs. TB, {MDR-TB} in those with weakened immune function.

ID imuthiol (diethyldithiocarbamate) (DTC) {Immunomodulator}, said to cause production of {T-cell}s by {liver}. Results of one major trial mixed. Those receiving drug had fewer {OI}'s, but only if they were not using AZT or receiving {PCP} {prophylaxis}.

ID inclusion criteria Given reasons why a person from a particular social group may be accepted into a drug trial. The reasons are scientific, not discriminatory. Reverse of "{exclusion criteria}."

ID IND investigational new drug. Certain relatively unproven new drugs are available on a "case- by- case" basis, or for testing purposes, through this method. Such drugs, if mentioned here, are marked "(IND)." Obtain further information from {ACTIS}.

ID informed consent As related to drug trials, a legal statement of 1) why research is being done, 2) what researchers want to accomplish, 3) duration of trial and procedures performed, 4) risks, 5) possible benefits, 6) alternatives to treatments used in trial, and 7) right of subject to quit trial at any time.

ID interleukin 1r {Recombinant} version of IL-1,a {molecule} that is stumulated during early {immune system} response. It can cause {fever} and thus is sometimes called {progen}. It is thought to be implicated in AIDS- related {septicemia} and {wasting} syndrome. A {synthetic} IL-1 receptor {antagonist} is in early trials; it is hoped it will stabilize blood pressure during episodes of {septic shock} after septicemia.

ID interleukin 2r {Recombinant} version of IL-2, a naturally- occurring {glycoprotein} {hormone} that is produced when a {T-lymphocyte} is stimulated by {antigen}, {mitogen}. IL-2 controls {express}ion and "re-activity" of T-cells. 1-93 (IND) The {synthetic} {immunomodulator} in trial stage only. Also called Interleukin sII. Has been produced in combination w/ {AZT} as "PEG." Some promise seen vs. {KS}, other HIV diseases. Unlike other agents, interleukin-II targets receptors present on replicating cells, not cell itself or virus. See also {Cell therapy}. See also {DAB389IL-2}. 11-93 (Aldesleukin, Proleukin) in Phase I trials, alone & w/ ganciclovir + antivirals in HIV+ subjects w/ {CMV} retinitis.

ID interleukin 3r (human, {recombinant} IL-3) 6-93 (IND) This {cytokine} functions to control the growth and {differentiation} of lymphoid and hematopoietic blood cells, is one of several colony-stimulating factors or "CSF's." Has {synergism} {in vitro} with other growth factors such as {GM-CSF}, {G-CSF}, {erithropoietin}. Now in Phase I trials vs. {cytopenia} in HIV- infected persons, given {SC}. Side FX reported include fever, headache, {erythematous} {dermal} areas, especially near injection site.

ID interleukin 4r (IND) A {recombinant} version of the natural {cytokine}; an {immunomodulator} that downregulates production of {TNF}, IL-6. Being investigated for possible use {SC} as therapy against {KS}. Interleukin 4r has been tried in Phase I trials vs. non-HIV cancer, per {AMFAR}, results unknown. However side FX were seen: headache, fever, and edema or fluid buildup in tissues.

ID Intron-A Schering's {alpha interferon} 2-B, {recombinant}.

ID IRB Institutional Review Board, a body that initially approves and periodically reviews research. Federal regulations mandate that, for protection of subjects' rights, any biomedical or behavioral research must have this oversight.

ID IVIG (Gammagard, Venoglobulin, Sandoglobin, Gamimune N) Intravenous (or IM) immunoglobulin. Sterile solution of {protein} {gamma globulin}s containing {antibody} normally present in blood. Has been used vs. non-AIDS {ITP}, non-AIDS {immune} deficiency syndrome. In experiments w/ HIV- infected children, adults w/ AIDS whose {platelet} counts are deficient. 10-93 early results: May slow decline of CD8 cells in children w/ AIDS, adults given high doses (4g/kg 2X/ wk for 6 wks.) seem to require less hospitalization. Otherwise little efficacy in AIDS. Side FX incl. feelings of "tightness" around chest, headache.

ID Kemron {Oral alpha interferon}, heavily promoted as AIDS therapy. Is not effective, has been removed from contention as therapeutic. 10-93 Despite preceding info, {NIH} plans to study Kemron in future and it's been learned that Kemron is selling as a black market item, priced as high as US$1,000 for a month's supply.

ID L-693,989 6-93 Per {AMFAR}, a "water soluble echinocandin {analog}" still in pre- clinical studies. In tests with rats, fast clearance of {PCP} {cysts} seen. May be useful vs. {candidiasis}.

ID L-696,229 {Antiviral} in Phase II trials vs. HIV. See {NNRTI}.

ID L-697,661 See {NNRTI}. {Antiviral} in Phase II trials vs. HIV. A pyridinone derivative having {in vitro} FX much like those of {BHAP compounds}, {TIBO derivatives}, {Nevirapine}. Probably most useful as part of combination therapy w/ AZT, etc. 9-93 Maker has withdrawn this agent from trials. There were unfavorable indications even early on, as HIV variants resistant to agent emerged rapidly, probable result of a single {amino acid} substitution in {reverse transcriptase}. One report calls variants by a stronger term, {mutation}s.

ID L-735,524 (11-93) See {protease inhibitors}. This agent is involved in small studies, with early results indicating possible 50% reduction in levels of {p24 antigen} {in vivo} (about same as AZT). Duration of these reductions may be brief, however, so a Phase II trial is planned. Side FX: {liver} dysfunction at high doses. 3-94 Most recent tests reported this agent effective in reducing viral load by an average of 70% within about 12 days. However {resistance} was seen to develop in 12-14 weeks. Maker plans continued trials, but has shelved very large tests that had been anticipated.

ID l-carnatine To be tested as possible standard therapy vs. AIDS muscular weakness, fatigue. Specifically looked to as possible therapy vs. {myopathy}. 11-93 In trials at U.S. Nat'l Inst. of Neurological Disorders & Stroke. It's claimed that this substance is an "essential nutrient," that heart problems may be caused by deficiency. NIH said to be interested in future tests. (See {carnatine}.)

ID l-leucoverin 1-93 (IND) in trials (w/ {TMP/SMX}) vs. {PCP}.

ID lamivudine (3TC, GR109714X) (IND) {NARTI} type {antiviral} said to have a longer half- life than {AZT}, with no apparent {bone marrow} or {cell} {toxicity} or resistance. Side FX: headache, fatigue, nausea, diarrhea. 3-93 Two phase I/II trials completed at {NCI}, others starting or ongoing, one of them pediatric, others in combination w/ common {antiretroviral}s, with which this agent has {synergistic} FX. Summary of test results so far mixed, side FX incl. {paresthesia}, blood vessel {inflammation} leading to rash. 12-93 In trials combined w/ AZT.

ID lentinan (Lentinan-Ajinomoto) (IND) {Immunomodulator} in Phase II trials, in combination w/ {AZT} or {ddI}, vs. various stages of AIDS. In Phase I trials without other ingredients, failed to slow HIV infection. Basically a {polysaccharide}, or sugar, obtained from edible mushrooms (shiitake/ Lentinus edodes, a derivative of which is used vs. {cancer} in Japan.) Does appear to cause transient increases in immune cell levels. See {sulfated polysaccharide}, {glucan}.

ID letrazuril 1-93 (IND) In some ways comparable to diclazuril, this {antiprotozoal} agent is now in trials vs. {cryptospridiosis}, cryptosporidial {diarrhea}. Has shown good activity vs. coccidial infections in some animals. See also {Paromomycin}.

ID levamisole Experimental {immune system} stimulant studied vs. {colon}/ rectal {cancer}, not shown to be viable vs. AIDS. Some PWA's are nonetheless using this agent and claiming reduction in minor {infections}. One small and inconclusive trial of this agent has been conducted, with 100 Third World children as subjects. It is claimed that progression to permanent {lymphadenopathy} was inhibited in the levamisole- treated participants; that mortality was reduced; progression to AIDS slowed significantly. Side effects were generally confined to mild anorexia, nausea, metabolic irregularities. Levamisole has been used as an adjunct during treatment of cytomegalo- virus in infants, where the main agent was {interferon}. It's been used in experiments as a reference against which an antiviral and immune potentiating agent called "MM-1" was compared. The latter demonstrated superiority to levamisole. A Dutch study enrolled 34 HIV- infected persons for infusion with 150 mg levamisole once a week for three months. In that period, 6 subjects (18%) developed an opportunistic infection, 4 patients (12%) reported other medical complications and in 13 cases (38%) side effects were seen. The conclusion: "no beneficial effects what so ever of 150 mg Levamisole once a week on HIV-infected patients." (See also {MM-1}.)

ID liposomal amikacin (MiKasome) To be tried vs. "drug- resistant" {TB}. Fatty {liposomal} coating may mitigate {toxicity}. See {amikacin}.

ID lithium carbonate (Lithane, Eskalith, Lithotabs, etc.) Lithium salts, frequently used vs. manic-depressive illness (a severe involuntary form of "mood swings," for simplicity) and other serious mental disturbance. In non- PWA's, may increase {granulocyte} production. This agent being studied vs. AZT- related {neutropenia}. Has serious {toxicity} drawbacks.

ID luciferase (5-93) An {enzyme}, responsible for firefly's glow, which may be useful in future tests for drug- resistant {TB}.

ID LY73497 10-93 {NNRTI} in experimental stages.

ID lymphoblastoid interferon 1-93 (IND) {Immunomodulator} in trials vs. {KS}. For general features, see {interferon}.

ID M-CSF Macrophage colony stimulating factor. A {cytokine}, in Phase I trials vs. {MAC}. See {rhGM-CSF}.

ID Marinol (Dronabinol) {Synthetic} delta-9-tetrahydrocannabinol (THC), the active ingredient in marijuana. First approved by {FDA} in 1985 for experiments vs. nausea, vomiting associated with {chemotherapy}. In 1-91, received "orphan drug" status after it showed promise vs. {anorexia}, {wasting}, as it tended to stimulate appetite. Tests of other beneficial properties (pain suppression, anxiety relief, etc.) ongoing, as THC has demonstrated ability to mitigate pain and produce feelings of well- being or even euphoria. Excessive amounts of it have been shown to cause dizziness, feelings of paranoia (fear), hallucinations. Many PWA's are not waiting for FDA and medical science to complete studies and deliberations, and stating that marijuana helps ease their symptoms and causes them no harmful side FX, are purchasing it on street. Note: The search for a {biosynthetic} form of THC that doesn't make people "high" goes on and on, and as of 3-94 U.S. courts have confirmed illegality of natural marijuana use, even for medical purposes.

ID MBACOD 1-93 (IND) A complex {antineoplastic} / {chemotherapy} agent in trials w/ AZT vs. primary {lymphoma}. Spons. by {NIAID}. MBACOD is made up of {methotrexate}, {doxorubicin}, {bleomycin}, {cyclophosphamide}, {vincristine}, {dexamethasone}. Sometimes {GM-CSF} is given w/ MBACOD to counter {toxicity} affecting {white blood cells}.

ID mechlorethamine Agent derived from mustard gas, inhibits rapid cell proliferation. Used as {antineoplastic} drug and as part of "MOPP" therapy against {Hodgkin's disease}. Side FX include {hematologic} problems, nausea, {alopecia}. See {PRO-MACE/MOPP}.

ID menogaril 1-93 (IND) {Antineoplastic}, previously tested in Europe, said to be less {cardiotoxic} than {doxorubicin} although similar in {bone marrow} toxicity. In trials vs. {KS}. Spons. by {NCI}.

ID Merck "L" drugs 11-91 Antivirals in Phase I trials, site NIH. Early tests not encouraging. See {L-693,989} {L-696,229} {L-697,661} {L-735,524}.

ID metenkephalin (MEK) {Endorphin} produced by {virus}- {infected} {lymphocyte}s, by adrenal medulla or in {brain}. (IND) {Biosynthetic} MEK in phase I/II trials vs. {immune system} {degeneration}.

ID methionine enkephalin (MEK, MET-ENK) {Immunomodulator}. Status unknown.

ID mexiletine An antiarrhythmic, FDA- approved for the treatment of ventricular rhythmic disorders. Being considered as a treatment for HIV- related {neuropathy}. Side FX include {GI} distress, dizziness.

ID Michellamine B (6-93) Said to have activity, {in vitro}, vs. HIV. Derived from a vine native to Cameroon in W. Africa, Ancistrocladus korupensis, first collected in 1987. Is to be tested for {toxic}ity.

ID milk antibodies Said to hold some promise for therapy against {cryptosporidiosis}.

ID mitoxantrone A drug approved for {chemotherapy} in treatment of {leukemia}. Side FX can include {granulocytopenia}, nausea, and {alopecia}. May be useful vs. {KS} and {lymphoma}s.

ID MM-1 An {antiviral} and immune stimulant drug, tried at one time at Cairo University, Egypt. It is believed to be capable of in-vivo potentiation of {NK cell}s, macrophage-mediated cytotoxicity and B-cell response. It was studied in groups of rats whose immune systems were rendered incompetent by doses of cyclophosphamide. MM-1 corrected the consequent changes to total leucocytic count, lymphocytes and IgG. The effect of MM-1 was significantly superior to that of {levamisole}.

ID molgramostim (Leucomax) 11-93 A {cytokine}, {GM-CSF} mixed with {ganciclovir}, in Phase II trials vs. {CMVR}. Also in Phase II/III trials (GM-CSF + {AZT}) vs. AIDS.

ID monoclonal antibody An {antibody} produced artificially from a {cell} "clone," specific to a given {antigen} and having one type of {immunoglobulin}. 7-93 In recent experiments, {Lymphocyte}s from mouse {spleen} are combined with mouse {myeloma} cells. Resultant combination- component cells produce same antibodies as their "parents," multiply quickly. 8-93 Recent tests encouraging. Combination- component cells said to be "defective" in respect to {antigen} properties, as desired. See {TI-23}, {anti-idiotype vaccine} {MSL-109}.

ID MSL-109 {Antiviral} ({monoclonal antibody}) in Phase I studies vs. {CMV} infection, AIDS. Seems to {bind} to surfaces of CMV- infected cells. In trials w/ {ganciclovir}, {foscarnet} as secondary {prophylaxis}. See also {anti-idiotype vaccine}. {AMFAR} says this agent "has high neutralizing activity against CMV strains and no cross-reactivity with other herpesviruses. No adverse effects related to MSL-109 have been noted in animals or {bone marrow} transplant patients."

ID naltrexone (Trexan R) An {opiate antagonist}. Some researchers say that small amtounts of this agent may help re- establish normal regulation of some {immune} functions by increasing {endorphin} levels and sensitivity of endorphin receptor sites on {white blood cells}. This drug also appears to reduce excessive levels of {alpha interferon} in some persons. Naltrexone was developed to help in treatment of heroin {addiction}. Blocks {opiate} receptors, the microscopic sites in {cell} walls necessary for cells' response to opiates. Blocks endorphins, i.e., {metenkephalin}, {beta endorphin}, leuenkephalin. Has been used by some PWA's in very small doses as {immunomodulator}, based on its ability to trigger increased endorphin production.

ID NDA New Drug Application, filed w/ {FDA} after Phase III trials, before drug can be released for sale. An NDA typically runs into thousands of pages of documentation. 6-93 Until recently FDA review/ approval of NDA could take 2-3 years, but many FDA processes, especially those related to drugs used vs. HIV, are being streamlined, we are told. "NIH red tape" has been a constant source of complaint from AIDS activists.

ID Nevirapine (BI-RG-587) {Antiviral} in Phase II studies vs. HIV infection. A non- {nucleoside} dipyridodiazepinone derivative with {in vitro} activities comparable to other {NNRTI}'s, but all these compounds have unique structures. BI-RG-587 is a selective noncompetitive inhibitor of HIV-1 {reverse transcriptase}; it {bind}s to HIV-1 RT at the same site as the other NNRTI's. 8-93 In trials w/ {AZT} + {ddI} as antiviral combination therapy. Also has undergone trials alone, in one of which most subjects had reductions in HIV {RNA} and p24 {antigen}, but {resistance} had developed, and there had been declines in CD4 {T-cell count}s. Side FX: {liver} {toxicity}, rash. Slightly better results in trials w/ {AZT}. 7-94 Trials temporarily halted due to development of hepatitis in three normal, uninfected females within the first three weeks of exposure to the agent. Trials were put on hold on June 24, 1994. Data were reviewed and the hold was lifted on July 8, 1994. According to the drug's maker, when looking at the database for all patients there is no preponderance of LFT changes in females. The LFT increases that are observed with nevirapine exposure are not significantly different from those seen in other patients receiving antiretroviral therapy. They are currently in the process of investigating any and all possible explanations for this phenomenon.

ID nimodipine (Nimotop) A calcium- channel blocker, associated with therapy for {hemorrhage}s of {meninges}. 2-93 in experiments combined w/ {AZT} vs. {AIDS dementia}.

ID nitric oxide (NO) A gaseous molecule that dilates blood vessels, and is said to transmit messages between {neuron}s, kill some {parasite}s, etc. 9-93 a paper suggests nitric oxide may be used by {immune system} vs. {viral infection}s. It states that NO shows activity vs both poxviruses (ectromelia and vaccinia) and {HSV} type I, suggests that NO can be induced by {cytokine}s. A very important cytokine, gamma interferon, tends to stimulate cells to produce NO by directing {synthesis} of the enzyme NO synthase. NO, nitROUS oxide not same.

ID NNRTI Non-{nucleoside} {reverse transcriptase} inhibitor. Category includes such drugs as BI-RG-587, pyridinone, nevirapine, TIBO derivatives, BHAP compounds. These have been shown to inhibit HIV replication {in vitro} by attacking the reverse transcriptase {enzyme}, which is needed by HIV if it is to reproduce. However, as of 12-93, trials of these drugs have not been rewarding. Our sources say high level {resistance} has usually developed in non test- tube trials within 6-12 weeks. Drugs such as {AZT}, {ddI} and {ddC} are {nucleoside}-{analog} reverse transcriptase inhibitors, abbreviated here as "NARTIs."

ID NOBA/NOBP Compounds said to have some activity vs. cancer, AIDS or both. We found the following two items available on the topic. (3-nitrosobenzamide) 2-93 said to "inhibit HIV-1 {infection} in the human {lymphocyte} and to eject zinc from isolated HIV-1 nucleocapsid zinc fingers and intact HIV-1 virions (see {virion}). Another compound having this property is 6-nitroso-1,2 benzopyrone." New research in {chemotherapy} AIDS treatment claims that "{retroviral} nucleocapsid and {gag}-{precursor} {protein} from all of the known strains of {retrovirus} contain one or 2 copies of an invariant sequence ... populated with zinc in mature particles. Modification of cysteine or histidine ({amino acid}) residues results in defective packaging of genomic (see {genome}) viral {RNA} and formation of non- infectious particles, making these structures attractive targets for {antiviral} therapy ... aromatic c-nitroso ligands of poly (ADP-ribose) {polymerase} ... destabilize one of the 2 zinc fingers with concommitant loss of enzymatic (see {enzyme}) activity, coincidental with ... {cytocidal} action of C-nitroso substituted ligands on {cancer} cells." Based on occurrence of (3Cys, 1HIs) zinc- binding (see {bind}) sites in both retroviral nucleocapsid and gag proteins and in poly (ADP-ribose) polymerase, it's thought the C-nitroso compounds may also have some antiretroviral effects. (3-NOBA-Cysteine Sulfinic Acid adduct) 5-93 Agent said to release free NOBA and organic C-nitroso compound in water soluble form, binding and inactivating HIV {virion}. All C-nitroso compounds target and alter certain chemical structures on HIV called zinc fingers, according to developers of this compound, and render virus non{infectious}. NOBA and NOBP are said to have similar characteristics.

ID NUC-ZM A combination of deoxythymidine, zinc, and magnesium. NUC-ZM is thought to inhibit virus replication similar to zidovudine (AZT) but is claimed to be safer and more effective. Status unknown.

ID nystatin (Mycostatin, AR-121) 1-93 (IND) Polyene {antifungal}/ {antibiotic} in Phase II trials to prevent {oral} {candidiasis}, other {systemic} {infections}. This agent is adequate for its task in general, but in presence of HIV it is subject to failure. Thus the emphasis on its use as a form of {prophylaxis} and not treatment.

ID octreotide acetate 1-93 (SOM, Sandostatin, Octreotide, Somatostatin) (IND) also called SMS 201-995 -- Experimental neuro{peptide} similar to a natural regulatory peptide {hormone} (somatostatin), now in trials vs. {cryptosporidiosis}, severe HIV- related {diarrhea}. Given {SC}, has been shown to inhibit secretion (see {secrete}) of water, {electrolyte}s into {intestines} and has been used to treat rare forms of intestinal cancer. Though this agent may relieve HIV diarrhea, underlying cause must still be isolated, treated.

ID off-label A drug prescribed for conditions other than those in maker's list of {indication}s.

ID OK B7 w/ iodine-131 A {monoclonal antibody} specific to the OK B7 {antigen}, seen as possible therapy vs. some {lymphoma}s.

ID open-label trial Drug test in which all participants are aware of what's being administered and to whom. Opposite of {double-blind trial}.

ID oral alpha interferon Proposed AIDS therapy in which tiny amounts of alpha interferon are taken orally instead of (usual therapy) large doses injected. {SC}. Since mouth lacks interferon receptors and drug would likely be destroyed by digestive enzymes, this proposal seems to lack merit, one source says. 4-93 {FDA} and {NIH} have both stated that current test results whow this therapy isn't effective. See {alpha interferon}.

ID oral combination chemoID A 3-drug treatment administered {PO}, in trials vs. progression of {lymphoma}. Contains: lomustin (CeeNU, CCNU); {etoposide} (VePesid); {procarbazine} (Matulane).

ID ornidyl eflorinthine Drug for use vs. {PCP} that was withdrawn from study by maker.

ID orphan drug A drug that while not {FDA}-approved, may be avail. to patients due to rarity of a disease, failure of other therapies. See {compassionate use}.

ID oxandrolone (Oxandrin) (IND) Once available as therapy for weight loss after surgery, agent is an {anabolic steroid} in Phase II trials as possible therapy vs. muscle weakness, {wasting}, {myopathy}.

ID oxidoreductase (oxidase, dehydrogenase, etc.) Type of enzyme able to precipitate oxidation reduction (reductase) process.

ID paclitaxel (Taxol) 11-93 (IND) In Phase II trials vs. HIV infection and {KS}.

ID para-aminosalicylic acid (PAS) Per AMFAR, is an anti{mycobacteria}l drug sometimes used vs. {MDR-TB}. (8-93) Can be obtained from CDC for stated use; call (404) 639-2530.

ID parallel track System which expands access to a promising drug to people who can't participate in a formal {clinical trial} of the therspy and have no other options left. See {compassionate use}, {Expanded access}.

ID paromomycin (Humatin) 9-92 A broad spectrum {antiparasitic}/ {antibiotic}, FDA- approved and sometimes administered vs. {amebiasis}, {giardiasis}, now in trials vs. {cryptosporidiosis}, see also {Letrazuril}.

ID PATH Passive hyperimmune therapy. Experimental process of transferring relatively healthy {plasma} from 1 HIV+ person to less healthy HIV+ person. Plasma is enriched with {p24 antibody}, other ingredients (including "{Immupath}" in some instances) in centrifuge before transfer. The process is sometimes called passive immunotherapy. See also {hivig}. See also {immunotherapy}, similar but not same.

ID pefloxacin A fluoroquinolone- class drug (as are {levofloxacin}, {ofloxacin}, and {ciprofloxacin}. OK'd in France vs. {GI} tract {infection}. In experiments w/ rats the agent showed some activity vs. {PCP}.

ID penciclovir See {famciclovir}.

ID pentosan polysulfate {Sulfated polysaccharide} studied at {NCI} as possible therapy vs. {KS}.

ID pentoxifylline (Trental, PTX) {Immunomodulator} in Phase I trials vs. {KS}, {cachexia}/ {wasting}/ {acute} {OI}s, {neurological} impairment. Seems to reduce undesirably high levels of {tumor necrosis factor}, {triglycerides}, said to indirectly inhibit HIV. Probably for sale as {alternative therapy}. 2-94 In a phase I/II study whose subjects had T-helper cell counts between 150-300, combination of PTX 400mg {TID} + AZT 100 mg 4-5X/ day slowed increase in viral load above baseline.

ID Peptide T 1-93 (IND) (d-ala-1-peptide T amide) Listed variously as an {antiviral} or an {Immunomudulator}, consists of a chain of 8 {amino acid}s. Appears to block entry of HIV into cells bearing {CD4} receptor, notably HIV's "target" the {T-helper cell}. It's reported that this agent, like vasoactive intestinal peptide, can prevent gp120-induced {neuron} cell death in test tube conditions. It's said the agent enters the brain easily, and to enhance this quality it's often administered as nasal aerosol. At other times it is given {SC}. Peptide T has reportedly been associated with improvements in {neurological} symptoms, thought disorders. Several small studies claim increases in energy, arithmetic concentration, logical memory, and visuospatial processing by those receiving the agent. Phase I trials have revealed no {toxicity} and improved {CD4 T-cell count}s. When given {SC} at 10 mg {qd} has produced "significant resolution" of pain caused by {peripheral neuropathy}. In general, increases in health- related quality of life due to fatigue suppression has been seen in studies of peptide T. Now in trials sponsored by Nat'l Inst. of Mental Health. 7-93 Probably for sale at {buyers' clubs} as {alternative therapy} again soon as in past, though at this time European supplier has "decided not to sell to U.S. buyers' clubs." Has been one of the hottest items in alternative therapy newsletters, many true believers. The "T," by the way, is for threonine, an essential amino acid.

ID peptide vaccine 3-93 {NIAID} is to test this agent, based on a {synthetic} {protein} fragment or {peptide}, as a {vaccine}. Only 36 volunteers involved, reliable results not likely. Peptide vaccines would have one particular asset, in that they may be easily modified to work against various {strain}s of HIV. See also {antineoplaston AS2-1}.

ID peptidoglican (polysaccharide-peptidoglycan, sulfated) Experimental compound from Arthrobacter {bacteria}, said to starve {KS} {tumor}s.

ID peroxidase {Enzyme} that facilitates oxidation, or dehydrogenation, of various substances. Found in plant/ human life. In humans, peroxidase is seen in {leukocyte}s, milk.

ID Phase I clinical trial Typically involves 20 to 100 patients and lasts several months. The major purpose is to determine safety and dose. Approximately 70 percent of drugs successfully complete phase I.

ID Phase II clinical trial Typically involves up to several hundred patients and usually lasts from several months to 2 years. The major purposes are to continue to determine short-term safety and, primarily, effectiveness. Approximately 33 percent of drugs successfully complete phase II.

ID Phase III clinical trial Typically involves from several hundred to several thousand patients and may last from 1 to 4 years. The major purposes are to study safety, effectiveness, and dosage. Sponsors may compare the drug to other agents, either alone or in combination. If this trial has good results, an application to market drug may be submitted to {FDA}. Approximately 25 to 30 percent of drugs successfully complete phase III.

ID photophoresis An early experimental therapy vs. AIDS. Subject's blood was enriched with a chemical called 8-MOP, diverted from body, subjected to ultraviolet light, reintroduced to body. There were claims that it helped in treating {T-cell} {lymphoma} of skin and mycoses fungoides. Probably not in fact effective, no reports of current use. Note: Many references to this therapy are spelled "photopheresis."

ID piritrexim 1-93 (IND) Anti{protozoal}/ anti{neoplastic}. Dihydrofolate reductase inhibitor in trials to treat {PCP}. Some consideration as therapy vs. {KS}, apparently. Side FX include {bone marrow} suppression, {GI} problems, rash, taste abnormalities.

ID Platelet Factor 4 {Biosynthetic} version of a natural occurring protein that controls angiogenesis, or formation of blood vessels. Being considered for treatment of {KS}.

ID PMEA (IND) (8-93) {Antiretroviral} in Stage I-II trials. Is an {adenine} {nucleoside} {analog}.

ID polyanionic Refers to drugs said to interfere with {virus} {absorption} into or attachment to host {cell}. Ex: {suramin}, {dextran sulfate}.

ID pre-clinical Very first stage in drug testing, carried out in laboratory.

ID principal investigator Head of researchers at site of an {ACTG}.

ID PRO-189 Along with simular compound PIC 024-4, said to block "interaction" of {T-helper cell} {CD4} receptor and HIV's {gp120} envelope proteins. Both agents are called "anti-{bind}ing" compounds. See also {CD26}.

ID protease inhibitors Class of agents that may interfere with replication of HIV. HIV- infected cells produce large "polyproteins," the {precursor}s of HIV's components. {Protease} functions to "slice" these large proteins to separate them into building blocks for assembly of {virus}. If the precursors aren't processed by protease enzyme, only nonfunctional, non- infectious {virion}s are formed; the replication process halts. "PI"s include {A-77003}, {Ro 31-8859}, {L-735,524}, {DMP-23}.

ID protocol Standardized procedures followed by physicians so that results of treatment of different persons in trials can be compared w/ accuracy.

ID pyrimethamine 1-93 (IND) (Daraprim, aka Malocide, knopyrimethamine) An {antifolate} sometimes used with {sulfadiazine} -- else w/ {clindamycin} -- vs. {toxoplasmosis}. Also to be tested in combination w/ {dapsone} as {prophylaxis} vs. {PCP}. A "substitute {pyrimidine}." Main side FX: sulfa allergies, {bone marrow} suppression. 4-93 Mfr. warns against use of this drug as prophylaxis. 10-93 Pyrimethamine + sulfadiazine now considered a first- line therapy vs. toxoplasmosis.

ID pyritrexim Possible drug therapy vs. {PCP}. Info scarce.

ID quinoxaline derivative 10-93 German {NNRTI} in experimental stages.

ID r-beta-ser interferon 1-93 (IND) {Antiviral} in trial stage only.

ID r-gCSF R-Granulocyte Colony Stimulating Factor. 1-93 (IND) {Immunomodulator} in trial stage only.

ID R24 monoclonal Ab {Antibody} under investigation vs. Hodgkin's disease.

ID randomized dosage Term used in drug trial where sub- groups of subjects receive dosage levels differing from those given other sub- groups.

ID randomized trial Drug trial in which a number of sub- groups are assigned to take one of a variety of drugs under test.

ID RBC-CD4 complex 9-93 Experimental technique inserts CD4 protein into {RBC}s. Theory: HIV will seek the CD4, but as RBC's have no nucleus, they will simply absorb HIV like a "sponge."

ID RBP9-27 (3-93) a {protein} that, {in vitro}, {bind}s to {RNA} and inhibits HIV {express}ion after transinfection into human cells. It's therefore said to be a "cellular factor that antagonizes rev function." RBP9-27 is "product of a {gene} inducible by {interferon}-alpha and interferon-gamma that has been isolated by screening of a human complementary {DNA} library for {protein}s binding to the rev- responsive element (RRE) of HIV-1." Researchers believe that determining the workings of RBP-27 could result in a better understanding of the {mechanism} of interferon action during HIV infection.

ID recombinant soluble CD4 (rsCD4, rCD4) Soluble replica of {CD4} {protein} like that found on surface of {T-helper cell}s, in this case produced by {recombinant DNA} technology using mammalian and insect {cell} lines. It's known that HIV must bind to CD4 before gaining entry into t-cell, and there's been hope that recombinant CD4 could draw HIV and neutralize it before human host CD4 could be attacked. Although this approach has not yet shown itself effective in trials, it holds out intriguing possibilities.

ID RG-83894 (HIV immunotherapeutic vaccine) 1-93 (IND) In trials as therapeutic {vaccine} for treatment of {asymptomatic} HIV- {infected} persons.

ID rgp160 1-93 (IND) in trials as AIDS {vaccine therapy}. 10-93 Studies quietly optimistic ("well tolerated, induced some new lymphoproliferative responses.") Mfd by Immuno AG. Similar produced by MicroGeneSys gives similar results.

ID rhGM-CSF {Recombinant} human granulocyte macrophage colony stimulating factor. 1-93 (IND) {Hormone}- based {immunomodulator}/ {intralesional} sclerosing (see {sclerosis}) agent in trial stage only. Said to stimulate growth of {granulocyte}s, {macrophage}s. Has been tried vs. {neutropenia} caused by {AZT} and {ganciclovir}, has been given to those suffering from {bone marrow} supporession. Under investigation as an adjunct to ganciclovir therapy in those with CMV retinitis in presence of AIDS. Side FX can include fever, {asthenia}, headache, bone or muscle pain, chills. 5-93 One anecdotal report of this agent's success tells of a 46 year old male w/ several sites profoundly affected by {KS}. {Vinblastine} and {vincristine} cleared all but two sites. These areas' peripheries were injected w/ rhGM-CSF. Reddening and signs of {inflammation} occurred (not unexpectedly). After 10 days the {lesion}s had cleared and a fibrotic cicatricial reaction was noted. No side FX noted, no recurrence after six months. See also {G-CSF}. Agents of this type are not as scarce as they are expensive.

ID ribavirin 1-93 (IND) {Antiviral} in trial stage only. Made by Viratek/ ICN Pharmaceuticals. For some time many persons w/ HIV purchased this drug in Mexico, hearing anecdotal reports that it slowed or stopped HIV disease. No clinical evidence of {efficacy} however, and currently less in demand as "underground" therapy.

ID Rifater 9-93 {NDA} filed for this 3-drug anti-TB combination: {rifampin}, {isoniazid}, {pyrazinamide}.

ID RMP-7 (IND) {Synthetic} {peptide} that helps small molecules penetrate {blood-brain barrier}. In Phase I trials w/ {amphotericin B} vs. {cryptococcosis} (cryptococcal meningitis) etc. (Note: The penetration mentioned is highly important, and not easy to achieve.)

ID Ro 24-7429 12-92 A derivative of the common tranquilizing drug, {benzodiazepine}, thought to have anti-HIV activity. Considered to be an inhibitor of HIV's {long terminal repeat} sequence. One "alternative" medical newsletter believes this drug should not have been dropped from serious development by its maker (Hoffman-LaRoche) as it was. There were trials that didn't find the agent effective but, says this source, later laboratory tests have shown that the drug works many times better when combined with {pentoxifylline}. It's claimed that HIV developed no {resistance} at all to Ô7429 in two years of studies. "Unfortunately," says AIDS TREATMENT NEWS, "the company had been trying to kill the project for several years, for business reasons, and had only kept it alive because of pressure from scientists," who understood this agent's real value. See also {tat antagonist}, {TIBO derivatives}.

ID Ro 31-8959 (6-93) See {protease inhibitors}. {NIAID} has opened a Phase II trial for HIV-infected people to compare combinations of {AZT}, {ddC}, and this agent. 10-93 Early trials show slight elevation of subjects' {CD4 T-cell count}s in many cases, side FX of {GI} type or weight loss. In combination w/ AZT, {synergistic} FX have been seen.

ID roxithromycin (Rulid) {Macrolide} {antibiotic} once thought possibly effective vs. {cryptosporidiosis}, {toxoplasmosis}. After poor trial results, maker discontinued drug.

ID rp-24 1-93 (IND) in trials as AIDS {vaccine}. Mfd. by MicroGeneSys as VaxSyn HIV-1.

ID S. boulardii 10-93 (Saccharomyces boulardii), a yeast that may help resolve {diarrhea} in those w/ HIV. Is non- {pathogenic}, may be given {PO}. A subspecies of S. cerevasiae. The human digestive tract normally contains various {intestinal flora}, which assist the host body in making chemical conversions. S. boulardii is believed to help ferment carbohydrates such as glucose, fructose, etc. into lactic acid and other components. Chronic diarrhea has been treated by administration of this agent with some success. There are indications that S. boulardii is protective of intestinal mucous membranes; mechanism of action is acidification of the tissues' environment. There have been some experiments in which this yeast was used against secondary emergence of Clostridum difficile. For treating diarrhea, it has been given at 1 to 3 grams/ day. (Information re: C. difficile see {Infectious Enteropathy}).

ID SACF Single-agent continuous infusion. Apparently misnamed experimental technique using {etoposide}, {dacarbazine}, {doxorubicin}, {vinblastine}, {cisplatin}, {bleomycin} vs. {KS}.

ID Salk HIV Immunogen 1-93 (IND) {Immunomodulator} in Phase III tests. Properly known as Salk HIV-1 Vaccine Immunotherapy. Contains inactivated HIV-1, minus gp120 envelope, plus "IFA," Incomplete Freund's {Adjuvant}. The latter is emulsified minerals/ oil intended to increase vaccine's {antigen}ic properties. 10-93 Trial results thus far not encouraging.

ID sargramostim (Leukine 2t) is yeast- derived {GM-CSF}, a {cytokine}. 6-92 in Phase II/III trials vs. {non-Hodgkin's lymphoma}, HIV, {MAC}.

ID SC-48334 1-93 (IND) {Antiviral} in trial stage only.

ID SC-49483 The {prodrug} of {N-butyl DNJ}. Its purpose is to sidestep that drug's tendency to provoke {diarrhea} side FX.

ID sCD4-PE40 {Antiviral} in Phase II trials vs. AIDS.

ID Sch 39304 (IND) Wide-spectrum {antifungal} of triazole class in Phase II trials vs. {cryptococcosis} (cryptococcal meningitis), {diffuse} {candidiasis}, {histoplasmosis}, {coccidioidomycosis}.

ID SDZ ILE-964 1-93 (IND) {Immunomodulator} in trial stage only.

ID SO221 11-92 {Antiviral} in experiments, compared favorably to {AZT} by some British researchers.

ID sodium tetradecyl (sodium tetradecyl sulfate) 2-93 May be considered useful as an alternative regimen for treatment of intra{oral} {KS} {node}s/ {lesion}s. "Sclerotherapy" with this agent may be appropriate for reducing lesions before radiation therapy. Most significant side effect: {necrosis}.

ID soluble CD4-PE 40 1-93 (IND) {Immunomodulator} in trial stage only, also called Pseudomonas Exotoxin A.

ID SP-303T {Topical} {antiviral} is said to be active vs. many {viral infection}s including {Hepatitis} A, {influenza}, respiratory {syncytia}l viruses. 6-93 In trials vs. {acyclovir}- resistant {HSV} symptoms.

ID SP-PG 8-93 (IND) {Sulfated polysaccharide} {peptidoglycan} works in lab mice to inhibit {KS} "spindle cells."

ID sparfloxacin 12-92 This quinolone (see {quinolone antibiotics}) shows {in vitro} activity vs., and is under investigation for use in treatment of, {MAC} (see also {amikacin} in this regard). It is said to be most active of fluoroquinolones against M. {tuberculosis}. Mfd in comb. w/ {azithromycin} by Warner-Lambert. NJ. Current {clinical trial}s combine {ethambutol} with sparfloxacin; lab studies combined the two with {rifampin}. Agent may produce {GI} disturbances, sunlight hypersensitivity.

ID spiramycin (IND) {Macrolide} {antibiotic}, may be useful vs. {cryptosporidiosis} although early results w/ drug taken {PO} were not good. Now being tried {IV}. Used in Europe/ Canada vs. {toxoplasmosis}. Side FX: Colitis routinely seen, and at dosages above 90 mg/kg/{qd}, {cytotoxicity} in {bowel} reported. Available on a {compassionate use} basis only. Call {ACTIS}.

ID squalamine 6-93 {Steroid} {antibiotic} substance found in stomach of dogfish shark. Resembles plant compounds now used to kill {intestinal} {parasite}s. In vitro, shows activity vs. some {fungus} types, {protozoa}, and both {gram-negative bacteria} and {gram-positive bacteria}. Steroid contents chemically augmented by {bile} salt. Experimental status only, no serious clinical implications yet seen.

ID sulfated polysaccharide "S.P."s are a family of substances, contain diverse forms of {glucose}, include {lentinan}, {carrisyn}, {heparin}, {dextran sulfate}. {In vitro} they have demonstrated varying degrees of anti-HIV activity. See also {peptidoglycan}, experimental agent vs. {KS}.

ID superoxide dismutase 3-93 according to one report, this {enzyme} is vital to {immunity}. The report states that HIV "quells" S.I.'s functioning, and authors are testing human cell {culture}s hoping to determine if the enzyme can be chemically protected against HIV. Another report says superoxide dismutase helps destroy "highly reactive" oxygen molecules called {free radical}s. If the enzyme is missing or not working properly, the report continues, free radicals typically generated during "nerve cell" {neuron} activity may build up and slowly destroy the neurons. The finding suggests that getting rid of free radicals may slow the progression of some physical dysfunctions or illnesses. See also {Dismutase}, {antioxidant}. 8-93 More about this substance's workings has been learned during research into {ALS}, or Lou Gehrig's Disease. Researchers say an error in {genetic} sequencing leads to alterations in the body's superoxide dismutase. They find that the enzyme is activated by unison of two subunits to form a "dimer," which is able to convert free radicals to hydrogen peroxide or molecular oxygen, among other tasks. The researchers, it is true, did not find as dramatic a situation as might be anticipated. They found functioning of the enzyme impaired by a factor of 50-65%, not halted. Also, their methods were just slightly flawed -- even the number of persons studied (total= 15) was inadequate.

ID suramin {Antiparasitic} vs. African sleeping sickness. Might be useful vs. {lymphoma}s, has anti-HIV activity {in vitro} but no promise of more {efficacy} than as stated.

ID surrogate markers Lab tests which may predict patient's clinical outcome or indicate drug effectiveness w/o having to rely on "endpoints" of death or development of major {OI}.

ID tacrine (Cognex, tacrine hcl) 9-93 Anti{dementia} agent OK'd by {FDA}. Superior to {placebo} in influencing measurements of memory, reasoning ability, and general mental function. Dosage range: 80-160 mg. at unstated intervals. Side FX incl. mild {liver} {toxicity} occasional nausea, vomiting, diarrhea, rashes.

ID tat Antagonist (Ro 24-7429, tat gene inhibitor) 12-92 Blocks replication of HIV by inhibiting {tat}, which is thought to regulate rate of HIV reproduction. Appears to halt replication in {cell}s already {infected}, not just prevent initial infection. Preliminary studies also show HIV may be less likely to develop {resistance} to Ro 24-7429 than to conventional {antiviral}s. 9-93 Development suspended, lack of {efficacy}.

ID TBC-3B Experimental preventive AIDS vaccine in pre-clinical stages. More info being sought.

ID thalidomide (Synovir) Originally released as tranquilizer in 60's, withdrawn when it caused birth defects in users' offspring. Now in trials vs. {MAC}/ HIV infections. Said to work {in vitro} vs. HIV growth at 60% success rate, and it's believed that it targets and reduces {TNF} production. Suggestions it be tried vs. {apthous ulcers} of oral type, various other inducations. 2-94 NIAID to sponsor {clinical trial} after small study shows this agent inhibited activation of HIV in peripheral blood mononuclear cells of 16 or 17 subjects.

ID Theravir (5-93) Experimental {vaccine therapy} vs. HIV consisting of purified Ab2 {anti-idiotype} {antibodies} derived from mice. See {anti-idiotype vaccine}.

ID THF Thymic humoral factor. Injectable {thymus} {hormone} derivative. See {thymopentin}, {humoral immunity}.

ID thioacetazone (Conteben, Thioparamizone, TBI) Anti{mycobacteria}l, not available in U.S., some indications it is not entirely safe.

ID ThyMA Thymidine nucleoside {analog}. Thymidine is a {nucleoside} component of {DNA}, one of the primary {genetic} materials. Its modified variant or {analog} seems to halt {viral} production if incorporated into DNA during HIV's reproductive process. {d4T} uses this principle.

ID thymic humoral factor (IND) {Immunomodulator} in Phase I trials vs. HIV. Is a natural {peptide} {hormone} derived from calf {thymus}, and, it's thought, might enhance {cell-mediated immunity} and improve {CD4 T-cell count}. 10-93 Early tests note some {mitogen} response, activity of {NK cell}s, {DTH} responses. No mention of {toxicity}; higher- dose studies being planned. See also {thymopentin}.

ID thymopentin (Timunox2, TP-5) {Immunomodulator}. When used in combination w/ {AZT}, may slow onset of AIDS. Currently in Phase III trials. The agent is a {synthetic} {hormone} that imitates active portion of the natural hormone thymopoientin, which is believed to incite body's {immune system}. 1-93 In preliminary studies w/ 340 persons for 48 wks., 3 people receiving AZT + TP-5 had worsened, while 16 in AZT+ placebo group had worsened. Said to have low {toxicity}. Two other injectable {thymus} hormone derivatives now in trials -- THF ({thymic humoral factor}) and {thymosin}. See also {thymostimulin}.

ID thymosin 9-93 Injectable {thymus} {hormone} derivative. Has been used in Italy as {adjuvant} for {influenza} {vaccine} under limited conditions, in Singapore as therapy vs. {chronic} {hepatitis} B. Now in clinical trials as possible therapy vs. AIDS. See {thymopentin}, {Immunoplex 402}.

ID thymostimulin (TP-1) 10-93 Called a "thymic {hormone} product," claimed to work well in combination w/ {AZT}. May be parallel to {TP-5} in one or more ways.

ID TI-23 10-93 (IND) {Monoclonal antibody} currently in Phase I trials vs. {CMV} infection.

ID TIBO derivatives 6-92 New class of {antiviral}s, in early trials show some activity vs. HIV, little {toxicity}. Like {Ro 24-7429}, are modified forms of {benzodiazepine}, the family of tranquilizing drugs. 8-93 In trials as {NNRTI}s without conclusive results. TIBO derivatives have little activity vs. {HIV-2}, which implies that HIV might develop into TIBO- {resistant} {strain}s readily, a supposition confirmed by one researcher. Activists have urged high priority TIBO tests, but {NIAID} says TIBO not ready for {clinical trial}s.

ID Tn-antigen Experimental vaccine being developed in Sweden, amid optimistic statements that it "should be active against all types of HIV." This refers to good results {in vitro} that can not likely be replicated clinically, though we can certainly hope. Good luck to Prof. Sigvard Olofsson.

ID TNP-470 Mentioned as experimental drug vs. {KS}. Per {AMFAR}, is an {analog} of fumagillin, "a naturally secreted antibiotic of Aspergillus fumigatus fresenius which inhibits {angiogenesis}" of undesirable type.

ID topotecan Experimental drug may be tried vs. AIDS. Showed ability {in vitro} to inhibit HIV in {chronic}ally as well as {acute}ly {infected} cells, which {NARTI}'s can't generally do. {Analog} of a {cancer} drug, camptothecin, derived from Camptotheca acumitica. Info on {toxicity} of original drug and topotecan is contradictory. Agent's anti- HIV properties were seen in tests that looked for inhibitors of the "{long terminal repeat}" of HIV, thought important in virus' replication. Is said agent inhibited p24 antigen production and mRNA in transfected (see {transfection}) human {epethelial} cells. Some sources however not satisfied as to early studies' reliability.

ID trifluridine (TFT, Viroptic) 2-93 in experiments vs. {herpes simplex virus} when there is {resistance} to {acyclovir}, {foscarnet}. A {pyrimidine} {nucleoside} {antiviral} used {topical}ly vs. {epethelial} {keratitis}. May produce mild burning sensations at site, no other side FX seen. ACTG 172 is investigating topical TFT for acyclovir-resistant chronic {mucocutaneous} HSV. Info per {AMFAR}.

ID triterpine derivative 10-93 (RPR 103611) Substance isolated from plants, especially root of Tripterygium wilfordii. Mfr. sees some promise as early- stage anti-HIV therapy.

ID trospectomycin sulfate 12-92 {Antibiotic} in development vs. {gonorrhea}, {chlamidia}, etc., under investigation as possible {IV} therapy vs. {MAC}. See also {amikacin} etc.

ID uncontrolled trials Research studies in which no participants are taking a {placebo}. Contrast {controlled trial}.

ID vaccine ID (specifically against HIV, AIDS) Both preventive and therapeutic types of vaccines are being developed and tested, with variable results. 1-93 Announced: Trials of two expimental vaccines. Both genetically engineered to resemble gp120 protein of HIV. One copies "MN" strain of virus, other copies "SF-2" strain. Initial tests found vaccine safe, with "promising evidence" that they can produce antibodies to neutralize several different HIV strains. See {gp120}, also {HGP-30}, {rgp160}.

ID valaciclovir 2-94 Status unknown, but this Burroughs Wellcome acyclovir {prodrug} is said to work vs. {herpes zoster} somewhat like its parent, without that agent's quirky absorptive curve. Valaciclovir is said to be as effective as acyclovir, and to work faster with fewer doses.

ID vasoactive intestinal peptide A natural hormone, interacts with CD4 receptors. See {Peptide T}.

ID vesnarinone Drug vs. heart dysfunction, now seen to work vs. harmful {cytokine}s such as {TNF}, Interleukin 6. Minimal side FX. Being developed in Japan.

ID vidarabine (VIRA-A, ARA-A, adenine arabinoside) A {PurNA} {antibiotic}. Has been used vs. {HSV} {encephalitis}, HSV eye {infection}s. Seems active vs. skin infections of {Herpes simplex virus} and also {Herpes zoster} in {immunocompromised} persons. In trials (vs. {foscarnet}) against HSV skin infections. Has been used, w/ limited success, vs. {PML}.

ID VIMRxyn 9-93 {Antiviral} to be tried as AIDS therapeutic, auspices of {NIAID}. Maker of this agent is VIMrx, producer of {hypericin}.

ID WF-10 6-93 Experimental {immunomodulator} said to have both direct, indirect {antiviral} activity. Designed for {IV} administration, contains an oxidizing agent said to incite {immune system} to high level of activity in presence of {hemoglobin}. Major cellular defense mechanisms of "killer systems" and {phagocytic activity} were reportedly improved in studies, exerting an indirect {viricidal} effect. Drug is said to eliminate infectivity of extracellular (external to cell) HIV particles by modifying outer {envelope} {glycoprotein} {gp120}.

ID WR 6026 One of several 8-aminoquinolone {analog}s. In mice, it is effective against {PCP}; it is in phase II studies for leishmaniasis. A phase I dose-ranging study is underway. Side FX reported from leishmaniasis studies include {methemoglobinemia} and low-grade {leukocytosis}.

MG a- Prefix means "without," "lacking in."

MG AABB (American Association of Blood Banks) Entity that coordinates intake, storage, distribution of whole blood and associated products. Provides technical and other education, specifies standard procedures. It works with some 5000 regional blood banks nationwide.

MG Ab {Antibody}.

MG ABDCC (ADCC) Antibody-dependent cell-{mediate}d {cytotoxic}ity. An {immune} response in which {antibody} coats or marks target {cells}, making them vulnerable to attack by killing cells. See {AGDCC}.

MG abdominal Refers to the area between thorax and pelvis, the abdomen ("belly").

MG absorption Process by which drugs and foods are received by {tissue} and then pass through them, very often as part of digestive process, where the small {intestine} absorbs food.

MG acetylcholine Chemical found in body, {brain} that is believed to be important as a {neurotransmitter}. Appears to counteract many actions of {dopamine}. See {choline}, {anticholinergic}, {nervous system}.

MG acid Broad category of chemical substances, having generally a sour taste and a capability of reaction with {alkaline} substances (bases) to form salts. Most body functions depend upon a balance between acids and bases in systems.

MG Acid-fast bacilli (AFB) Any rod-shaped {bacteria} that can be stained as part of lab test and still show the stain after treatment with {acid}. Used as the basis of a test for identifying Mycobacterium tuberculosis and other mycobacteria.

MG acquired Neither inherited {genetic}ally nor {congenital}.

MG ACTH Adrenocorticotrophic hormone, the {pituitary gland}'s {hormone} that regulates {cortisol} production.

MG ACTH stimulation test Assesses functioning of adrenal cortex, which makes {cortisol}. See {ACTH}.

MG active immunity {Immunity} produced by body in response to stimulation by disease- causing {organism} or {antibody}.

MG ACUS Atypical cells of undetermined significance. Abnormal cells with certain characteristics that are revealed by {Pap smear}.

MG acute Relatively sudden in onset; life-threatening. Medical conditions are described progressively in seriousness as {mild}, {moderate}, {severe}, acute.

MG adenine One of components (other being guanine) which comprise {nucleotide}s of {DNA}, {RNA}. They are {purine}s.

MG adjunct Any substance taken in conjunction with, and used as a secondary therapy to, main treatment.

MG adjuvant Any agent that enhances the capabilities of an {antigen} or drug to assist the {immune system}. May be a substance added to a {vaccine} that is expected to increase {antibody} production or immune response. Only one adjuvant -- alum -- is used for vaccines licensed for use in humans, because it doesn't set off {cytotoxic} effects against {T-lymphocyte}s. Alum's formal name is aluminum hydroxide. Other, experimental adjuvants are currently being used in vaccines in the developmental stage only. Used in combination with an "immunogen," they bear names like Monophosphoryl lipid A (MPL); MF-59 + MTP-PE; SAF/2 + MDP. The immunogen is {recombinant} {gp120}.

MG administration Means of introducing a drug or nutritive substance, etc. into a person's body.

MG adrenal gland Located just above kidneys. Consist of "cortex," outer portion, which produces {cortisone}, and "medulla" at center which produces {adrenaline}. The latter is commonly known as the "fight or flight" substance, a natural means of achieving bursts of otherwise impossibly fast reflexes and great strength. Also important in contolling balance of potassium, sodium and chlorides in body. A source of {steroid}s.

MG adrenaline (epinephrine) {Secrete}d by the adrenal gland, this {hormone} affects muscles, sugar {metabolism}, circulation, heartbeat and breathing -- all in response to surprise, fright, or many other stimuli.

MG adrenergic Nerve strands that emit the {neurotransmitter} {norepinephrine}.

MG aerosolized Administered as fine spray to be inhaled. A nebulizer or inhaler is used to convert liquid to aerosol.

MG AFB isolation A specific type of hospital isolation for persons with tuberculosis. Its purpose is to prevent the spread of infection during the infectious phase of the disease.

MG Ag {antigen}.

MG AGDCC (antigen-dependent cell-{mediate}d cytotoxicity) Means by which a {T-cell} destroys a cell marked as an {antigen}. This is one of the two major means available to the {immune system} for destroying cells bearing {cancer} or {infection}.

MG agent In our context, any substance or force which may bring about a physical, biological or chemical change. We've used it here often due to the unnecessarily pejorative connotation carried by the word "drug," and the length of words like "compound," "chemical," "medication," etc.

MG agglutinization Process in which {serum} {antibody} facilitates "clumping" together of {bacteria}, blood {cell}s. Not to be confused with coagulation. Can be used in lab for identification of substances.

MG agonist Chemical that enhances {neurotransmitter} activity. Indirect agonists increase release of neurotransmitter or delay its breakdown. {Amantadine} (Symmetrel) is an example of this type. Direct- acting agonists (DAA's) directly stimulate {dopamine} receptors and have been used mainly vs. {parkinsonism}. Example DAA's are bromocriptine, pergolide, lisuride. (4-93) Pergolide and lisuride were still at last report still (IND)'s. vs. FX of AIDS.

MG airborne transmission Process by which an {infectious} agent passes through the air to infect susceptible individuals by droplet infection (e.g., sneezing, coughing). This is common in such diseases as tuberculosis; it is not considered a factor where HIV is concerned.

MG alcohol 1. {Antiseptic}, used to cleanse skin, environmental surfaces, etc. 2. Alcohol in the form of liquor depresses the body's {immune system} for a period of time after ingestion. During this time, CD8 cells are apparently in a state of dysfunction. For that and other reasons, the use of alcohol is an unhealthful practice if one has HIV.

MG algesimeter This is said to be a device that measures skin sensitivity to various kinds of stimuli, and thus helps quantify the presence of pain. The references to this instrument are obscure, and it may be only an historical curiosity.

MG algologist Practitioner specialized in study of pain, a relatively new phenomenon.

MG alimentary Generally, referring to upper digestive tract. The alimentary canal is below the opening of the throat.

MG alkaline Opposite of {acid}. Having more hydroxyl than hydrogen ions. Synonym: base.

MG alkaline phosphatase An {enzyme} measurement, indicates health of {liver}.

MG alkaloids A large group of organic medications derived from plants, i.e., {morphine}, digitalis, etc.

MG allogenic Having {cell} types that are identifiable and cause reactions of the {immune system}. Usually refers to reaction of body to grafted tissue from donor of same species as recipient but different {histocompatibility}. See {haplotype}, {HLA}.

MG allopathic (Allopathy) Medical philosophy, opposite of {homeopathy}, calling for use of drugs which counteract symptoms and diseases against said conditions.

MG alpha interferon This {cytokine} is one of 3 major classes of {interferon} produced by body's {leukocyte}s in response to {infection}, others being beta, gamma types. In HIV+ people, elevated "A.I." levels are an indicator of disease progression. {Recombinant} alpha interferon is a single human gene subtype, has anti-{RT}/ {immunomodulator} activity; inhibits growth of {tumor} cells {in vitro}. Used {IV} vs. {KS}, its main side FX are fatigue, fever, {myalgia}, {neutropenia}. (alpha interferon, low-dose oral) (Kemron, Immunex, Immulin) is being sold by {buyers' clubs} in U.S. despite proven lack of {efficacy}. (alpha interferon 2-A, recombinant) (Roferon) A {synthetic} interferon for inhibition of growth of {tumor}s. Most common side FX include flu-like symptoms such as fever, chills, muscle aches; {neutropenia} is sometimes seen. This {cytokine}, usually given {IM}, has been shown effective vs. AIDS {KS}, {genital} warts and other disease in some studies, but please consult authoritative source for current information on effectiveness and safety of interferon as a therapeutic agent, as there have been unfavorable reports ca. early 1993. 2-94 In the face of those reports, availability of "A.I." is now mostly confined to {buyers' clubs}. Note: Roferon, Intron A are sometimes confused with each other in casually- assembled literature. (alpha interferon 2-B, recombinant) (Intron A) For inhibition of growth of {tumor}s, e.g. {KS}, etc. 4-92 low dose {oral} therapy may not be effective for PWA's per {NIAID}. See {oral alpha interferon}, see also alpha interferon 2-A, recombinant, above. (alpha interferon w/AZT and ddC) (Wellferon) {Recombinant} agent in Phase II/III trials vs "HIV disease, non-AIDS." (acid-labile alpha interferon) {Alpha interferon} that is destroyed by {acid}. Has been shown to be prod. at high levels by {white blood cells} infected w/ HIV. May be a predictor of AIDS, and is associated with likelihood of developing {OI}'s. (acid-stable alpha interferon) Alpha interferon that remains stable in acid. Has been reproduced readily through {recombinant} DNA means, has been used vs. {KS}. Also being investigated as {antiviral} vs. HIV.

MG ALT Alanine aminotransferase, {SGPT}.

MG alum An {adjuvant}.

MG alveolar sac Smallest end unit of {lungs} where oxygenation of blood occurs and where carbon dioxide (CO2) is removed from blood to be exhaled. There are typically about 1.5 million alveolar sacs in each lung, and they are about .25 mm in size.

MG amino acid {Acid}s, often produced by body organs. Chemically, they have amino and carboxyl components. These are the basic structural units of which {protein}s are composed. Necessary for growth and {metabolism}, there are at least 20 types. Some are manufactured by the body, while others must be converted from food (the latter are the "essential" amino acids). Amino acids include the following: histidine, isoleucine, leucine, lysine, methionone, phenylanine, threonine, tryptophan, valine (those being the essential aminos); tyrosine, alinine, asparagine, arginine, cysteine, cystine, aspartic acid, glutamic acid, glutamine, glycine, proline, nylalanine, serine. Non-protein amino acids include gamma-aminobutyric, ornithine, taurine, citrulline. Amino acids are {precursor}s for, or may function as, biologically active molecules -- examples being {neurotransmitter}s and {hormone}s. For this reason, they are doubly important to the body's systems. The essential aminos are available in adequate dietary intakes as components of protein and are usually not needed as separate, or "free," items. Some of them, however -- L-tryptophan, L-arginine and others -- are popular as supplements. There are claims that supplementing amino input helps maintain strength and muscle mass, but such statements are theoretical. See also {free-form amino acids}.

MG aminoglycoside Class of {antibiotic} sometimes administered vs. {infection} by {gram-negative bacteria}. Includes {streptomycin}, {gentamicin}, neomycin, kanamycin. Considered effective but with some {toxicity}. 9-93 It's indicated that this class of drug could have anti- HIV activity, possibly by {bind}ing to viral {RNA}. Neomycin has drawn attention, but its high toxicity has to be resolved before taking lab tests further.

MG ampules Small, sealed glass containers used to hold a solution for {IV} or {SC} administration.

MG amylase A class of {protein} {enzymes}, {secrete}d by salivary {gland}s, {pancreas} to aid digestion of food. An increase in amylase levels may ind. {pancreatitis}.

MG amyloid A starch-like {glycoprotein}.

MG an- Prefix means "without," lacking in."

MG anabolic steroid Often consisting of {synthesize}d male sex {hormone}s, or androgens, these are the agents used by athletes for "bulking up" while often causing long-term damage to their bodies. The substances work by increasing the {metabolism}'s processes involved in {protein} {synthesis}. Common "AS" agents are ethylestrenol, methandrostenolone, nandrolone, norethandrolone, oxymesterone, and stanolone. (3-93) more recently, people with HIV have been treated experimentally by such AS's as Deca-Durabolin (nandrolone deconate) and oxandrolone, testosterone derivatives. The point of these tests is to determine if {wasting} can be controlled via AS's. (9-93) AS's show promise in treatment of the weakness and muscle wasting linked to AIDS {myopathy}. AS's should not be used by women, individuals with diabetes or other endocrine problems, or those with {liver} disease. AS's are known to have feminizing effects when used by men, along with the other possible side effects. They are not the same as {corticosteroid}s.

MG analog Chemical compound similar to another compound structurally, but not identical. May or may not have same effect on body processes but commonly has same. An analog of a drug may be more powerful or have fewer side FX.

MG anamnestic response Heightened {immunological} response elicited by 2nd or subsequent exposure to a particular {pathogenic} {microorganism} or {antigen} after {serum} {antibody} can no longer be detected in blood. This would usually be in reference to the {immune system} "memory" phenomenon.

MG anandamide Substance said to chemically resemble marijuana's "THC." See {Marinol}, {brain stem}.

MG anergy 1. Lack of response to a foreign substance, such as an {antigen}. May indicate inability of {immune system} to mount normal allergic response (see {allergy}.) CD4 {T-helper cell}s can be deactivated or "turned off" by a signal from HIV, and that state will be termed "anergy." 2. Sometimes used loosely to indicate lack of energy. See {asthenia}, far more precise.

MG anesthetic Drug used to deaden pain or cause loss of consciousness. "Local" or {topical} anesthetics dull sensation at a specified part of body while "general" anesthetic brings on a deep artificial sleep. There are of course other variations available.

MG angiogenesis Blood vessel formative process.

MG angiostasis Cessation of blood vessel formation.

MG antagonist A drug that prevents or reverses the action of a biological process or another drug.

MG anterior Front.

MG anti-idiotype An {antibody} that recognizes and {bind}s to another antibody (the {idiotype}).

MG anti-infective Agent used vs. an {infection}.

MG anti-inflammatory Substance that works against {inflammation}. Some are {steroid}al agents ({cortisone}, etc.) and others are non-steroidal (aspirin, Motrin, etc.). The latter are sometimes called {NSAID}'s (non-steroidal anti- inflammatory drugs.) See also {analgesic}, in that inflammation may cause pain. {Infection} commonly produces inflammation.

MG antibacterial A drug which slows or stops growth of {bacteria}.

MG antibiotic Medication used to destroy {bacteria} or treat {fungus} {infection}s. Made from living {organism}s such as bacteria or mold, or {synthesize}d in lab. Ex: {penicillin}, {sulfa drugs}, etc. Some antibiotics are fairly specific as to what dis. they're used against; some very general ("broad-spectrum").

MG antibody (Ab) A molecular (see {molecule}) substance formed by the body from {white blood cells} as reaction to foreign agent or {antigen}. The antibody formed works only against that particular antigen, identifying it then neutralizing or killing it. Most Ab's are members of a class of {protein}s known as {immunoglobulin}, {secrete}d by {B-lymphocytes}. Presence of antibody is the usual means of tentatively diagnosing the presence of HIV disease. (See {HIV testing}) (Fully covered in {Immune system}). Several different antibodies against HIV can be generated by parts of the immune system. "Binding antibodies simply attach to HIV and may or may not have {antiviral} effects. "Functional" antibodies are binding antibodies, but actually do something. For example, one subtype -- the "neutralizing" antibody -- may actually deactivate HIV or prevent it from infecting other cells. The word "antibody" may be used as a plural noun, with "antibodies" held in reserve for emphasizing differences within a group.

MG anticholinergic Describes a chemical, a drug, or a drug effect that relates to {acetylcholine} inactivity or blockade. Anticholinergic drugs (Artane, Benedryl, Cogentin, etc.) are used as ancillary drugs in treatment of symptoms of {parkinsonism}; their side FX include dry mouth, blurred vision, difficulty w/ urination and sometimes personality changes.

MG anticoagulant Substance that delays or counteracts blood clotting.

MG antidepressant Medication to control symptoms of moderate or mild {depression}. One antidipressant, {amytriptyline} (Elavil) is also used to help control {neuropathy}.

MG antiemetic A drug that stops or prevents nausea and vomiting.

MG antifolate Agent that inhibits intracellular production of folinic acid {leucovorin}.

MG antifungal Agent that kills or inhibits growth of a {fungus}.

MG antigen (Ag) Substance that normally stimulates an {immune} response by forcing body to produce {antibody} or specific activity on the part of {T-cells}. An antibody is usually "specific," and will react only with the antigen which provoked its production. An "antigenic determinant" portion of Ag molecule interacts with an antibody or a receptor on a T-cell. Disease- causing {virus}es and {bacteria} are common examples of antigen, but "foreign" proteins or sugars (such as {polysaccharides}) may act as antigen as well. The antigen/ antibody relationship is a most important part of the {immune system}. Note: "antigen" is sometimes used as plural form also, as illustrated here. See {HIV antigens}.

MG antigenemia Condition in which detectable amount of {antigen} is present in blood.

MG antigenic diversity (antigenic drift) The (usually) slight random variations in a virus' antigen makeup over time.

MG antimicrobial therapy Administration of therapies vs. {infection}s -- ({antibiotic}s, {antifungal}s, etc.)

MG antimycobacterial An agent able to control or cure disease caused by {mycobacteria}.

MG antineoplastic Tending to inhibit or prevent proliferation of {cancer} {cells}.

MG antiparasitic Agent vs. {infection}s, other diseases caused by {parasite}s.

MG antiproliferative Substance that stops {cell} growth, e.g., antiproliferative drugs used vs. {cancer}, whose proliferation is unwanted.

MG antiprotozoal Substance that kills or inhibits growth of {protozoa}. Ex: {Toxoplasmosis} and {cryptosporidiosis} are caused by protozoan {infection}, which can be treated by drugs of antiprotozoal group.

MG antipyretic Drug that lowers {fever}.

MG antiretroviral drug A drug that reduces the replication rate of HIV and is used to treat HIV-infected persons. The most commonly used are zidovudine, didanosine, and zalcitabine (AZT, ddI, and ddC, respectively).

MG antiseptic Chemical that destroys {infection}- causing {microorganism}s. Used externally or on objects which will touch someone who is ill; mild specialized antiseptics may be used to cleanse wounds, infected areas.

MG antitoxin {Antibody} that recognizes and inactivates {toxin}s produced by certain {bacteria}, plants, animals.

MG antiviral (or antiretroviral) A drug that may weaken or destroy a {virus}. Some antivirals inhibit reproduction of virus. The common AIDS drugs {AZT}, {ddI}, and {ddC} are antiretrovirals, seeking to slow reproduction of the {retrovirus} HIV by inhibiting availability of {reverse transcriptase}.

MG anus Sphincter- like opening to {rectum}, located between buttocks, used to {excrete} solid waste. Also can be used in some forms of sex, those most likely to transmit HIV disease (see {high-risk behavior}.

MG APC (Antigen-Presenting Cell) A {macrophage} that presents {antigen} to {T-lymphocyte} cells for disposition.

MG apoptosis 6-93 A structurally unique {cell} death phenomenon. Because of the orderly way in which it takes place and its {genetic} nature, it is sometimes referred to as "programmed." And it's also sometimes, not inappropriately, termed "cellular suicide." It is not necessarily connected to disease; it's been noted in most forms of healthy mammal life including humans. Beginning in embryonic stages, a poorly- understood {gene} or genetic code of some type apparently sends "death sentence" messages to certain cells. The signal is probably of a biochemical type. On receiving it, the cells manufacture {proteins} they'll use to dismantle themselves. It's believed that apoptosis is a mechanism of {lymphocyte} depletion in AIDS, and that when peripheral mononuclear (single-{nucleus}) blood cells are active with HIV, apoptosis is induced. Researchers hope to find a way to block one or more steps of {metabolism} in apoptosis to help fight AIDS, {cancer}, {autoimmune} disease, {degenerative} {CNS} disease. There's been one recent discovery that may help in this effort, which is the discovery of of a human gene called "bcl-2," nicknamed "savior gene." Bcl-2 has been removed from newborn mice in experiments, and although the subjects developed normally for some weeks, they then began to quit producing new lymphocytes, and their immune systems declined then failed. Bcl-2 has a counterpart, "bcl-x," which works in a similar way.

MG arteries Vessels carrying blood outward from heart.

MG arthralgia Pain in {joint}.

MG -ase Suffix used for {enzyme}s.

MG assay Refers to test for detection of presence and concentration of a drug or substance in blood, other {body fluids}, {tissue}s.

MG AST Aspartate aminotransferase. One of many {amino acid} catalysts enabling transfer between substrates.

MG asthenia Lack or loss of strength or energy.

MG astrocyte Cell associated w/ {CNS}, sometimes called "astroglia," part of the cell family called {glia}. They may help function of CNS information handling; certainly do help sustain {neurons}.

MG asymptomatic Having no symptoms, though underlying disease may be present -- in HIV, persons at this stage may be termed "asymptomatic seropositive." Such persons can transmit HIV as readily as {symptomatic} persons can, and could technically be termed "{carrier}s" except for the needlessly frightening sound that term conveys to the layperson. For simplicity, we'd denote the person as "asymptomatic" -- infected with HIV but without apparent illness. Refer to {HIV transmission}. See {silent infection}, {subclinical infection}.

MG atonic Lacking {tone}, as in loss of muscular tensile ability. Condition seen when a muscle, or nerves which are connected to it, have been injured.

MG atrophy Decrease in bulk, loss of firmness or strength. May be due to lack of use -- or from disruption of {nervous system} activity, blood flow, or {hormone} delivery. Also may be a result of inadequate nutrition, many other factors. See {anorexia}, {wasting}.

MG attenuated virus Weakened {virus} whose potential ability to cause {infection}, disease is greatly reduced. Would typically be used in a {vaccine}.

MG auscultation To listen, typically w/ stethoscope.

MG autoantibodies {Antibodies} that mistakenly attack host {cells}. See {autoimmune}.

MG autoimmune Adjective refers to autoimmunity or diseases involving same. In these cases, the {immune system} will sometimes mistake members of its own complement of components for {antigen}, attacking them and causing a variety of ill FX. A perusal of the sections on {immune system} will hint that this involves some kind of reversal of the "self/ not self" phenomenon that is unique and invaluable when it functions as it should. Some diseases -- such as systemic {lupus} erythematosus or "SLE," {rheumatoid arthritis}, etc. -- are thought or known to result from autoimmune responses. There's also an "autoimmune {hepatitis}," whose {etiology} is unknown even to our best sources. They take a "lupoid" form sometimes, otherwise the person will have anti- {liver}- {kidney}- microsomal antibodies or anti- soluble liver antigen antibodies without antinuclear antibodies. Autoimmune hepatitis responds to therapy via {corticosteroid}s. Scleroderma is thought to be of autoimmune derivation. It is seen as hardened and discolored patches of skin or connective tissue, or as contracting areas of tissue of lungs or other internal organs including the heart. It can be fatal. Incidentally, this disease is affiliated with what's called "CREST" syndrome, an insidious collection of dermal diseases. Then there's dermatomyositis. Its cause is uncertain, though there's some evidence this skin disease, involving {degeneration} and {inflammation} is caused by an autoimmune reaction. At the same time, electron microscopic views of diseased tissue show hints of {viral} and {neoplasm} involvement. In any case, there will be {atrophy} until and unless {corticosteroid}s are administered. Reiter's syndrome is a disease that sometimes appears in young men w/ AIDS or others. To generalize, "R.S." is an arthritic syndrome, possibly bringing with it {lesion}s of a {mucocutaneous} nature, {conjunctivitis} and other symptoms. There may be some connection between RS and the recently- identified disorder called ankylosing spondylitis. Antibiotics are used to clear most of the syndrome, though corticosteroid therapy may also be needed. The latter is {immunosuppressive} and may not be an attractive option. It's thought by a few sources that RS is caused by autoimmune factors though others may dissent. {Chronic fatigue syndrome} is now suspected of having an autoimmune character. And there is sometimes conjecture that AIDS is an autoimmune disease of some kind. See {immune chaos}, also {autoantibodies}.

MG autologous Pertains to same organism or one of its parts, i.e., autologous "blood draws" from same part of circulatory system for surgery, grafts.

MG axon This elongated structure (sometimes roughly 3 feet in length) in the {nervous system} acts as a pathway for nerve impulses. See "{neuron}," of which the axon is a component. An axon terminates by branching out into "telodendria." Along its line of travel it derives some protection from a sheath, made of {myelin}, called the "neurilemma," along which are found occasional junctions called "nodes of Ravier."

MG B-lymphocytes {White blood cells} of the {immune system} derived from {bone marrow} and involved in production of {antibodies}. When {infection}s appear, these cells -- assisted by {T-cells} and {macrophage}s -- multiply and are transformed into {plasma cell}s, and the antibodies produced thereby will be specific to the {pathogen}. Some B-cells become "memory" B-cells, which will produce antibody vs. an {antigen} if it reappears after initial exposure.

MG bacilli Rod-shaped {bacteria}. Plural of bacillus.

MG bacteria (Pl. form of "bacterium") Microscopic {organism}s composed of a single {cell}, having no {nucleus}. Many varied bacteria can cause disease. They range from relatively innocuous to {virulent}; the {immune system} and/ or medical therapy are required to fend off their FX. One may skim through this database to get a sketch of the wide variety of bacteria extant, and will be astonished at the spectrum and potential seriousness of their {infection}s. Some bacteria live in soil, water, etc., while some are {parasite}s living on animals or humans. There are useful bacteria, some of which aid digestion, but they are exceptions. See referencess to {Gram-negative bacteria}, {Gram-positive bacteria}, or do a random search on the keywords "bacteria" and "bacterial." Final point: adverse affects of disease- causing bacteria are far more destructive in presence of HIV disease -- even though the {viral infection} is even more {virulent}.

MG bacterial Refers to phenomena related to or caused by {bacteria} (plural of bacterium).

MG bacterialcidal Capable of killing {bacteria}.

MG bacteriostatic Capable of inhibiting reproduction of {bacteria}.

MG bacterium Singular form of {bacteria}.

MG barbiturate a {narcotic} drug used as a sedative or hypnotic, having also an incidental {analgesic} effect. Regarded as dangerous, w/ high potential to prod. {habituation} or even {addiction}. Infrequently prescribed due to the latter fact.

MG basal ganglia Group of {brain} areas that collectively are involved with control of normal voluntary movement. They are connected to the cerebral {cortex} and the {thalamus} by a neural "network." They include the caudate and lenticular nuclei (centers), which comprise the {striatum}, as well as the amygdaloid nucleus. (The lenticular nucleus is comprised of the globus pallidus and putamen.) See {brain}, {ganglion}, {brain stem}.

MG basal metabolism Refers to amount of energy used by body just to maintain vital processes.

MG baseline a known value with which later tests may be compared. Ex: baseline temperature, baseline {hemoglobin} level.

MG basophil Type of {white blood cells}, the granular {leukocyte}, filled with granules of {toxic} chemicals that can digest {microorganism}s. Basophils are partly responsible for the symptoms of {allergy}.

MG BCG Bacille Calmette-Guerin. A vaccine containing a bovine- derived, live, attenuated strain of {mycobacteria} that has been used in countries other than the United States as immunization against {tuberculosis}.

MG benign Harmless, as in {benign tumor}. Opposite of {malignant}, which implies presence of possibly life- threatening disease.

MG beta blockers Drugs which block excitation of beta- adrenergic receptors of the {sympathetic nervous system}. These are one of the 2 types of receptors for {neurotransmitter} {norepinephrine} (noradrenaline). Major use of beta blockers is in treatment of hypertension and heart dis. but they are also frequently used to treat {benign} tremors. The best known of these agents is propranolol (Inderal). Caution: these agents tend to constrict airway passages.

MG beta endorphin A {hormone} in body that works like {opiate} drugs to control pain; involved in coping with acute stress. Functions include control of fear reactions, increase in airflow to {lungs}, reduction of {GI} {intestinal} activity to shift blood to {brain} and muscles, mobilization of the {immune system}.

MG beta interferon One of three members of the {interferon} family, this agent exhibits various degrees of {antiviral}, {immunomodulator}y, and anti- {cancer} activity. (beta interferon, recomb't.) (Betaseron) (1-92) Prod'd. by {recombinant} means, exhibits same {antiviral}, {immunomodulator}y, and anti- {cancer} activity as the "B.I." naturally prod'd. by the body. Like {alpha interferon}, in test tube studies BI inhibits HIV replication, progression. Trials in progress (Phase II/III). 3-93 Some evidence that this agent slows progression of {MS}, w/ {MRI} documentation. 7-93 Ok'd for use vs. MS.

MG beta-2 microglobulin {Protein} found on surface of many cells that have a {nucleus}, i.e., most {lymphocytes} of the {immune system} excluding {red blood cells}. Production stimulated by {infection}, {inflammation}. Elevated levels of this protein are seen in a variety of diseases, including {cancer}, and there may be a correlation between this marker and reaction of body to anti- HIV drugs or progression of HIV.

MG BID Twice daily.

MG bilateral Symmetrical.

MG bile Fluid made by {liver}, having green/brown/yellow pigment and rather thick consistency, that helps with processes of {metabolism}. Stored in gall bladder.

MG bilirubin Reddish yellow pigment appearing in blood, {bile}, {urine} and gallstones. Elevated level may indicate dysfunction of {liver}, {pancreas}, or bile ducts. A person's eyes may become {jaundice}d or yellow in color, indicating {liver} dysfunction. ({CBC} should show level of 0.1-.25 mg/ 100 cc.)

MG bind to enter into a chemical bond, as when one substance unites or combines closely with another. Synonym: {adsorb}.

MG bioavailability The rate and extent to which a substance is {absorb}ed and circulated in the body.

MG biochemistry study of chemical structure, chemical function of living {organism}s.

MG biofeedback Process which gives a person information about his/her physical processes (heart rate, perspiration, etc.) to assist him/her in gaining control over body functioning or becoming "attuned" to it and relaxed. Uses a device like a simplified lie detector. (Sidelight: It's believed that the "E-Meter" involved in L. Ron Hubbard's "Scientology" cult is a crude biofeedback device.)

MG biologicals Medicines made by living {organism}s, including humans. These include {gamma globulins}, {insulin}, etc.

MG biopsy Surgical removal of {tissue} from living subject for microscopic exam. Results enable definitive diagnosis of conditions such as {cancer} and many others, help identify causes of {infection}.

MG biosynthesis Making of a chemical compound in the physiologic processes of a living {organism}.

MG biosynthetic Produced by {biosynthesis}.

MG biotechnology Production (or modification of characteristics) of substance using living {organism}s or their products. Ex: Use of fungus in manufacture of penicillin. This fascinating branch of science encompasses {recombinant DNA} technology ("genetic engineering") and {hybridoma} technology, a process of combining components to build am organism. Term is generally interchangeable with "{recombinant}."

MG BIW Twice per week.

MG blastogenic Process of maturation of {lymphocytes} in response to challenges by {infectious} agents ({bacteria}, {virus}es, etc.). Blastogenic ability is a measure of {cell-mediated immunity} or humoral {immune} response, is typically lowered in presence of HIV.

MG blood count Exam of blood to count number of white and red cells and platelets. Will usually also give information on size and shape of red cells, analysis of types of white cells, and amount of {hemoglobin} present. Also see {CBC}, {Differential WBC Count}.

MG Blood urea nitrogen (BUN) Measured as part of {CBC}. Usual result: 12-15 mg/ 100 cc. Indicates status of {kidney}, {GI} syst.

MG blood-CSF barrier Lining between {brain} blood vessels and {tissues}, {spinal column}. This barrier presents a potential problem in treating HIV because treatments must cross it to stop HIV infection in the {brain}. {AZT} and some other agents are capable of this. See {CSF}.

MG body fluids Fluids manufactured in and by body. Some of these fluids are known to contain and/ or transmit HIV. Blood, urine, sexual fluids, and a nursing mother's milk may contain the virus. 12-92 It's been established that HIV in body fluids "dies" when the fluid in question has dried completely. Tears and sweat are also {body fluids}, but are not suspected as a means of {HIV transmission}.

MG bone marrow Soft "pithy" tissue located in hollow centers of bones. It produces blood cells including {erythrocytes}, {leukocyte}s and {platelet}s. (These cells are formed from maturing {stem cells}.) Marrow cells that make such blood cells are called "bone marrow cell pool." It's probable that {red blood cells} are marrow's main contribution to the {immune system}. (bone marrow suppression) A condition that can be caused by certain drugs, leading to decrease in {white blood cells}, {red blood cells}, and {platelet}s. This can lead to bleeding, {infection}s. People taking medication known to cause this effect should have frequent blood tests. Bone marrow suppression may lead to, and resemble, and {neutropenia}. See {CSF} definition 2.

MG BPI Bacterial permeability increasing protein. Substance believed to be {express}ed by {white blood cells} (specifically neutrophils, the most common WBC's) in presence of certain {bacterial infection}s; {bind}s to lipopolysaccharides (LPS) (see {lipid}, {polysaccharide}). LPS is then thought to be restrained from interacting w/ {macrophages}, which in turn are unable to release {tumor necrosis factor} or {IL-1}. To be tried as ther. vs. gram-negative infections (see {gram-negative bacteria}).

MG brain The central sensory and directive organ of human body, upper terminus of the {CNS}, made up of {nerve} {tissue}, having many distinct areas responsible for various input, analysis, output. It's protected by skull, within which it's surrounded by {CSF}. Its {connective tissue}s are called the {meninges}, and you'll find references to these often when diseases of brain are discussed. Critical brain functioning is done with mild electrical impulses analogous to coded "signals" via telegraph, radio, etc. These move via {CNS} to {peripheral nervous system}. See {electroencephalograph}, also {brain stem}. Medicine has now reached the point where the areas of the brain performing specified functions can actually be "mapped," irregularities noted with newer "imaging" techniques (grandchildren of the {x-ray} machine).

MG brain stem A part of the {brain} that controls life support functions. A counterpart to {substantia nigra}, involved in {motor} control. Both areas are believed by some researchers to have cannabinoid receptors, which are settling- places for a naturally produced substance, called {anandamide}. This substance is said to chemically resemble marijuana's "THC." See {marinol}.

MG BRM Biological response modifiers. {Biosynthetic} or natural agents that tend to restore or improve normal {immune} defenses. Included in this group are {interferon}s, interleukins, {monoclonal antibody}, {thymus} {hormone}s. See {interleukin 1}, {interleukin 2}. Sometimes used as synonym for {immunomodulator}.

MG bronchi Subdivisions of the trachea, or windpipe, which further sub- divide into bronchioles (progressively narrower air tubes). The bronchioles descend deep into the {lungs}. Pl. of bronchus.

MG bronchodilate To expand or open the {bronchi}. Drugs called bronchodilators improve air movement, thus reduce coughing, wheezing, shortness of breath. Some of these drugs are taken by mouth, (e.g., theophyline); others are administered by inhalation of aerosols. Some of the latter medications contain forms of {steroid}s, and all bronchodilators are to be used only to the extent that is safe.

MG bronchoscopy Examination of trachea, {lungs} by use of a tubular instrument containing optic fibers. Also enables taking of {tissue} samples or smears if required. Often used to help diagnose cause of {pneumonia}, although it's sometimes possible to test for {PCP} by a non- invasive procedure called sputum induction.

MG buccal Referring to mouth.

MG buffered Coated or encased in a substance which allows easier {absorption} of drug by neutralizing {acid}ic environment of stomach.

MG campylobacter Genus of {gram-negative bacteria}, usually attracted to the {intestinal} tract; can cause {diarrhea}, {enteritis}. Usual therapy is via {tetracycline}, etc.

MG capsid The outer cover around a virus' {nucleic acid} core, a {protein} shell.

MG carbidopa A drug that helps insure safe passage of ingested {levodopa} to the {brain}, where it's converted to {dopamine}, which acts at appropriate (striata receptor) sites. Carbidopa prevents levodopa from being broken down by body {enzymes} before it reaches its target. See {striatum}.

MG carbohydrates Sugar/ starch compounds destined to be converted into {glucose} by body, used by {metabolism} for energy.

MG carcinogen Any substance that causes {cancer}.

MG carcinogenity Potential for a given agent to cause development or recurrance of {cancer}.

MG cardiac Refers to heart.

MG cardiotoxic Harmful to {cardiac} system.

MG carotid arteries Large {arteries} on either side of throat. Easier area for locating pulse than wrist in an emergency.

MG carrier (1) a person capable of transmitting a {contagious} disease, regardless of his/her state of health. (2) A relatively inert substance with which drugs are mixed for ease of {administration}.

MG cartilege Fibrous, gristle- like material found in {spine} between bony discs of vertebrae, protecting against bone-bone contact, also found elsewhere in body.

MG cascade Continuation of a process, perhaps cumulatively, through a series of processes or steps.

MG cat scan Computer- aided tomography or computer axial tomography. Process of taking a series of high- definition {x-ray}s which produce images of subject from all angles, including visualization of soft tissues as well as bones. Same as "CT scan."

MG catalyst Agent that provokes change or reaction.

MG catecholamine Class of chemicals including {dopamine} and {norepinephrine}, both of which are important to {brain}'s functioning.

MG catheter Flexible tube to be inserted into some part of the body for purpose of injecting or extracting fluids. Usually placed in canals, vessels, passageways such as {vein}s, others. Tube may be of {synthetic} materials or in some cases animal {tissue}. Commonly supplied with steel tip which may be retracted after successful insertion. Best known are the Hickman catheter and Groshong catheter, used for the chest area -- one end is placed in a vein while other end lies below neck and shoulder. Foley catheter is inserted into bladder to drain {urine}. Porta-Cath is placed entirely beneath skin, has reservoir at one end. Drugs may be injected into the reservoir using needle and {syringe}.

MG cauterize Cut or burn away unwanted living {tissue} (warts, etc.). Sometimes done chemically w/ caustic compounds, either {alkaline} or {acid} in content.

MG CBC {Complete blood count}. Is useful in routine medical testing of PWA as it can give early warning of certain HIV- associated diseases, especially {anemia}, {ITP}, {leukopenia}. Scan on "CBC".

MG cc Cubic centimeter (about 15 drops).

MG CD Cluster of {differentiation}. Used to indicate classes of {antigen} on {leukocyte} exterior. (12-93) One recently identified "CD" protein, is the {CD26}. A French research team states that this is the portal by which HIV, after settling upon the CD4 cluster, enters a lymphocyte. The roles of {CD4} and {CD8} are described at length in this document. There are other antigens of which we seldom hear. Mature T-cells commonly {express} CD2 (in common with the {NK cell} and CD3, said to be associated with certain T-cell receptors for antigen. "Memory cells" are found to bear CD29 and CD45RO markings. The latter has a counterpart in the CD45RA protein, which unfortunately doesn't have its sister's range of skills.

MG CD26 10-93 Pasteur Inst., Paris has announced discovery of a second "CD" receptor that populates the outer layer of the {T-helper cell}. It's called CD26, and its function is such that, after HIV adheres to the CD4 receptor (already a well known process), the CD26 receptor serves as the final gateway for invasion of the lymphocyte, or in another simile, a "lock" for HIV to operate for access. Existence of CD26 protein is not news, but until now its purpose, if any, was not certain. Australian researchers had been exploring its relationship to liver disease. 2-94 The second receptor is referred to as "DPP-IV," or depeptidyl IV, and is said to act at such areas as HIV's {V3 loop}, cleaving {genetic} sequences on HIV's behalf. At least one source believes CD26 also sends what are termed "transduction signals" through the victim cell.

MG CD4 {Protein} embedded in cell surface of defensive {T-helper cell}s and certain other cells, may be found on surface of {monocyte}/ {macrophage}, {Langerhans cell}s, {astrocyte}/ other {glia}l cells, keratinocytes. HIV invades T-helper cells by first attaching to the CD4 receptor protein. (See also {CD26}. (Caution: "CD4" also refers to experimental, {biosynthetic} drugs that are designed to work vs. HIV.)

MG CD4 cell (aka "T4 cell," "CD4+ cell") see {T-helper cell}.

MG CD4 T-cell count (absolute CD4 T-cell count) The actual number of {T-helper cell}s (or {lymphocytes}) in a microliter of blood. Though this "count" is an indicator of progression of HIV disease, the FUNCTIONING of the cells -- their ability to do their job -- is as important as the count. Functioning may be improved by {antiviral} or other therapy which still may not during a given time produce stability or increase of CD4 cell count. Also the count is subject to diurnal swings -- in an HIV positive person the number may rise and fall by more than 55 between 8 A.M. and 10 P.M. (For an HIV negative person, fluctuation is about 500.) The count is affected by stress, and in women by pregancy. Various studies are underway that may show links between the count and {alcohol}/ drug/ {tobacco} use; there is some evidence that the number rises and falls due to psychological factors, etc. See {HIV progression testing}.

MG CD8 (T8) {Protein} embedded in the cell surface of {T-suppressor cells}, {T-killer cell}s.

MG cell The unit of {protoplasm}, having a {nucleus} and {cytoplasm}, separated by a double {membrane}. All {tissue} is made up of individual cells -- of microscopic size, the smallest independent unit of an {organism}.

MG cell body Part of {neuron} that nurtures it. Surrounds cell {nucleus}.

MG cell lines Cell types utilized for experimental purposes.

MG cell membrane Generally, outer coating that separates a {cell} from its surroundings. Within cell, however, there's a double membrane which contains the {nucleus}.

MG cell proliferation Multiplication of a given type of {cells}.

MG cell-mediated immunity Defense mechanism involving the coordinated activity of {T-cells} ({T-killer cell}s said to be main participants) and {macrophage}s and other {white blood cells} to kill invading {organisms} directly (otherwise the role of {antibody}). Aka "cellular immunity." See also {humoral immunity}, {gamma interferon}, {immune system}.

MG central nervous system {CNS} Made up of {brain} and {spinal cord}, along with incidental {dendrite}s, {neuron}s, etc. Controls voluntary motions. HIV has been found in fluids surrounding CNS and is believed to affect same. Once in CNS, the virus can cause a variety of symptoms including hearing, speech, and vision problems. In time there may be headaches, loss of {motor} control, and even {dementia}. For CNS info, scan on "CNS". See also {nervous system}.

MG cerebral Pertaining to {brain}.

MG cerebrospinal fluid (CSF) Found circulating about {brain}, {spinal cord}, may be examined for evidence of {CNS} disease. For examination, must be withdrawn by needle from lower back; this procedure is called a {lumbar puncture}. An alternate method is the cisternal puncture, which draws CSF from the neck.

MG cerebrovascular Combined terms indicate brain, blood vessels. Cerebrovascular disease is any condition of the {brain} caused by insufficient blood supply or brain {hemorrhage}/ injury.

MG cervix Opening into, and lower portion of, womb. A portion of it descends into vagina.

MG chemosuppression Inhibition, via {chemotherapy} or other means, of {viral} or other {organisms}.

MG chemotherapy Treatment of disease by chemical compounds, typical in {cancer} therapy. "Chemo" vs. cancer causes several types of serious side FX, though medical science is making progress in this regard. The most obvious example of a chemo side effect is hair loss, demoralizing to the person taking the treatment; but {GI} instability is equally common. The positive side is that this therapy may be discontinued after results are achieved, and side effects will remit.

MG chiropractic Method of disease treatment by physical manipulation of parts of a person's body. The practitioner may pull, palpate, massage, etc. May concentrate on back's vertebrae. The manipulations are called "adjustments." Chiropractors theorize that many diseases can be traced to misalignment of bones, with consequent malfunction of muscles and nerves. Unfortunately, the benefits from this system are temporary and cannot be quantified, and it's noted that there's some question of chiropractic therapy's overall value.

MG cholinergic 1. Nerve strands that release {acetylcholine}. 2. Otherwise related to acetylcholine.

MG choroid Tissue w/ profuse blood vessels, nourishes parts of the eye, especially the {retina}. See {choroidretinitis}.

MG chromosome "Thread- like" structure in {nucleus} of a cell, contains {genetic} information encoded by {DNA}. These structures can be broken and partly lost or wrongly reunited by certain chemicals, {infectious} agents, radiation, and other factors. See {gene}, {genetic code}.

MG chronic Continuing, recurring, or persistent. May refer to a disease which is irreversible, an {intractable disease}.

MG clear To {remit} or be satisfactorily healed.

MG clinical Describing study and treatment of disease in human beings by direct observation as opposed to laboratory tests or research. In lay usage, term may be mistakenly used in reverse.

MG clone Group of identical, (usually) {recombinant}, {cells}/ {organism}s from single ancestor. Word also used as verb, to clone.

MG clotting factors Coagulants found in normal blood. See {hemophilia}.

MG cm centimeter, 1/100 of a meter. 2/5 (very roughly 3/8) of an inch. 1 inch = 2.5 cm.

MG CNS {Central nervous system}. Refer to {spinal cord}, {brain}, {striatum}, {basal ganglia} {brain stem} {nervous system}. Also {neurological}, or do random scan on "CNS".

MG coagulation 1. Discrete parts tending to form a mass. 2. Loosely, clotting, as of blood. Tested blood clotting time should be 4-6 minutes, bleeding time 1-2 min.

MG coalesce Assemblage of discrete parts. Coagulation.

MG coccobacillus Very small rod- shaped bacteria. Some care must be taken not to mis- identify as {coccus}.

MG coccus Refers to any bacteria of spherical shape. Ex: streptococcus, pneumococcus, staphylococcus, meningococcus.

MG codon A section of a {DNA} {molecule} consisting of 3 {base}s which will, with other codons, be sequenced in a way that determines the type of {amino acid}s in {protein} {express}ed by a {cell}. The codon is considered the basic unit of a {genetic code}.

MG coenzyme (Coenzyme A, FAD, NAD) A chemical compound that has {synergy} with {enzyme}s in actions and reactions of {metabolism}. Coenzymes and other elements may be spoken of as "cofactors."

MG cofactor 1. Activity or agent that may increase susceptibility to acquiring an illness or later disease progression. Possible cofactors for AIDS: other {infection}s, poor nutrition, {genetic} factors, {depression} or stress, {herpes}, etc. 4-93 Speculation that use of alcohol or tobacco could be a cofactor in HIV development has been presented. 7-93 Speculation that HHV-6 is a significant cofactor in HIV or AIDS. There is a tendency to confuse the causative factor(s) or {etiology} of a disorder with agents found to be cofactor(s), where the latter may mistakenly be assigned higher significance than is called for. The popular media are especially negligent in this way. 2. See {coenzyme}.

MG collagen See {connective tissue}, {collagen disease}. 1-94 Collagen derived from chicken cartilage has shown some {in vitro} action against symptoms of arthritis. See also {shark cartilage}.

MG colon Part of large {intestine} that extends from end of small intestine to {rectum}. {Inflammation} of this area is {colitis}.

MG colonoscopy Technique for visual examination of large bowel using lighted flexible tube.

MG colposcopy A procedure in which the surface of the uterine cervix, or womb, is examined through a flexible fiberoptic tube.

MG combination therapy Use of two or more therapies together to achieve best results. Often the best approach in presence of HIV, although there's also apparent advantage to alternating between therapies.

MG complement {Protein}s which help {antibody} inhibit {antigen}s. Found in normal blood {serum}, {plasma}. When combined w/ antibodies, mostly target {bacteria}, foreign blood {corpuscles}.

MG complement cascade Specific events brought about by {antigen}/ {antibody} interaction. Various parts of the {complement} system are activated in sequence.

MG complete blood count (CBC) "Battery" of tests including cell counts, {hematocrit}, {hemoglobin}, cell volume measurement. Useful in routine medical testing of PWA as it can give early warning of certain HIV- associated diseases, especially {anemia}, {ITP}, {leukopenia}. See {Blood urea nitrogen}, {platelet}, also {differential WBC count}, {HIV preventive testing}.

MG compliance Refers to patient's willingness to undertake and/ or stay with a regimen. May be due to his or her attitude, regimen drawbacks, or both. See also {intolerant}.

MG concommitant Sometimes used in reference to drugs taken together, w/ possibly adverse interactions.

MG congenital Refers to a condition present at birth but not inherited. Compare to {constitutional}.

MG conjugation The combining of two organisms. In this process, DNA genetic material may be intermixed. Term is also used very loosely to describe mixing of agents.

MG conjunctiva A {mucous membrane} that lines inside of the eyelid, touching the surface of eyeball. Its {secretion}s are vital to lubrication of eye surface, and its mucous character usually protects it from {infection} (conjunctivitis), but is not infallible.

MG connective tissue Soft gelatinous {tissue} in which most cells are embedded. Generally made of a material called {collagen}. Some diseases such as {rheumatoid arthritis}, {lupus} erythematosus, rhematic fever, etc. are disorders that affect collagen adversely. Note that these happen to be {autoimmune} disorders.

MG constitutional Technically refers to a condition that is inborn. Loosely used in reference to some {chronic} conditions. Compare w/ {congenital}.

MG contagious Originally referred to diseases that could be transmitted by proximity or contact, now used loosely to refer to any communicable disease. HIV and AIDS are communicable, but only in the ways discussed under the heading of {HIV transmission}, and so referring to AIDS as "contagious" is probably not justified for those reasons.

MG continuous infusion Continuous injection of blood, medication, nutrients, etc. into a {vein}. Ordinarily done by {catheter}.

MG contraction Pulling inward, seeming to "shrink."

MG contraindication Used in descriptions of drugs to warn that usage is dangerous under certain conditions. ("To indicate against.") Many otherwise safe drugs must not be used during pregnancy, in presence of heart disease, etc.

MG controlled substances Certain prescription drugs that are regarded as potentially dangerous. Physicians and druggusts are legally required to account for the prescription/ dispensation of these, and the former may be reluctant to prescribe them because of the "chilling effect" of regulations.

MG core protein An integral {protein} in HIV made up of three units -- p24, p15, and p18. See {p24 antigen}, the most prominent "C.P." See also {HIV antigens}.

MG cornea Outermost layer of the three {tissues} that make up the wall of the eyeball.

MG corpuscle Small {cell} or particle of {tissue}.

MG cortex Outermost part of organ such as {kidney}, {adrenal gland}, {brain}, etc.

MG corticosteroid (corticoid) {Steroid} substances obtained from the {cortex} of the {adrenal gland} or synthesized in lab. Have been used as {adjunct}ive therapy vs. moderate-severe {PCP} and vs. fatigue linked to AIDS. "C.S.'s" are immunosuppressive* (producing among other possible side FX {oral} form of {candidiasis}, {herpes simplex virus}. It's also thought they generate {free radical}s. Abrupt discontinuation of their use may increase risk of PCP relapse. People with AIDS should not use "CS's" without specific advice from physician and monitoring of therapy. The glucocorticoid group includes {cortisone}, {cortisol}, {prednisone} and {corticosterone}; they're used by body to metabolize** fat, {protein}, {carbohydrates}. They have {anti-inflammatory} properties. Mineralocorticoids, such as {aldosterone}, control the water/ salt balance in body. See also {anabolic steroid}; {prednisone}. *{immunosuppression} ** {metabolism}

MG corticosterone {Steroid}al {hormone} found naturally in small amounts in normal human body. Produced by adrenal cortex. See also {corticosteroid}.

MG cortisol (Hydrocortisone) {Steroid} {hormone} of glucorticosteroid class, {secrete}d by {adrenal} {cortex}. Can cause {immunosuppression}. See {corticosteroid}.

MG cortisone a {corticosteroid} that can be made in the body or {synthesize}d. Used in treatment of some diseases, but has dangerous side FX. Can cause {immunosuppression}.

MG corynebacteria Genus of {bacteria} include Listeria monocytogenes, can cause {infection}. In presence of HIV, an {OI}.

MG CPR Cardiopulmonary recuscitation. First aid technique to restore pulse, breathing.

MG cranial nerves Twelve pairs of nerves in brain.

MG creatine phosphokinase (CPK) An {enzyme}, vital to use of muscles, present in abnormally high amounts during some diseases.

MG creatinine A {protein}, {excrete}d by {kidney}s in the {urine}, whose level can be used as indicator of kidney function. Also found in muscles, blood. It's comprised of creatine and creatine phosphate.

MG cryotherapy Therapy via extreme cold temperature, usually performed {topical}ly w/ liquid nitrogen, vs. {condyloma}, {molluscum}, other protruberant {lesions}.

MG cryptosporidial Caused by {cryptosporidium} {parasite}. Example: Cryptosporidial diarrhea, which is of a profuse and watery type, along with possible {fever} and enlarged {lymph glands}, pronounced weight loss. In presence of HIV infection, an {OI}. See {cryptosporidiosis}.

MG CSF 1. See {Cerebrospinal fluid}. 2. Colony stimulating factors, {protein}s that control production of {white blood cells}. It's hoped a way cam be found to use CSF's to counteract loss of white cells after {chemotherapy}, produce additional {bone marrow}, cause some {cancer} cells to stop dividing, maybe control {neutropenia} due to drug side FX, {bone marrow} suppression. See also {rhGM-CSF}, {G-CSF}.

MG cu mm Cubic millimeter.

MG culture Method of growing living {tissue}, {cells} or {microorganism}s in lab, often dependent upon addition of a solution, chemical, etc for sustenance of growth. Used in developing drugs, also in tests to aid in diagnosis of disease.

MG cutaneous Refers to skin.

MG cyclic Refers to events taking place repeatedly and at times which can be predicted.

MG cyt- Prefix usually refers to {cell} or cells.

MG cytocide Process by which {cytoplasm} is destroyed. See {cell}.

MG cytokine These are small, soluble {protein}s produced and released by {lymphocyte}s or {macrophage}s. They're critical to {immune} response. Though they emphatically are not {hormones}, there are parallels to be drawn, as cytokines do act to change or hold back growth of certain {cells}, and they function as chemical "messengers" between cells. But unlike hormones, cytokines are produced by almost all cells, and they also differ in that their biological repertoire is more varied. When all is well within the body there is little need for cytokine activity. When something goes wrong, cytokines stimulate movement of {white blood cells} to areas affected by {infection}/ {inflammation}, help in stimulating {tissue} repair process. If the {immune system} over- reacts, too many cytokines will be produced, {septicemia} or {shock} may result, or in less serious cases there may be ill effects including loss of appetite and weight. That is why medical science sometimes seeks to limit cytokine presence in the body. {T-killer cell}s release a cytokine that seems to block HIV replication in infected cells during early stage only. Note that cytokines are not the same as {antibody} however. Prominent cytokines include {interleukin 2}, which helps to transform {NK cell}s; {alpha interferon}, inhibitor of {viral} growth and causative agent in enhanced {lymphocyte} activity; {tumor necrosis factor}, a stimulator of other cytokines and {toxic} to both the {virus} and {tumor} type cells; and Transforming growth factor Beta {TGFB}, which suppresses lymphocyte reproduction in some cases but assists in the healing of damaged {tissue}.

MG cytoplasm Jellylike substance, covers {nucleus} of a cell. Outer layer is called ectoplasm. Inner cytoplasm is called endoplasm; nucleus and cytoplasm together form protoplasm, the living {cell}.

MG cytosine Agent may be useful vs. {PML}.

MG cytotoxic Adjective implies damage to, or killing of, {cells}. Also describes action of {cytotoxic T-lymphocyte} or {T-killer cell}s.

MG cytotoxic T-lymphocyte (CTL) Cell that kills foreign cells that have been marked as targets by cells of {immune system}. See {T-killer cell}.

MG defervescence Remission (see {remit}) of fever.

MG degeneration Pertains to changes for worse in physical function and/ or appearance.

MG degenerative Often, medical personnel speak of generalized worsening of a person's condition as "degenerative changes," or simply "{degeneration}."

MG demi- Half. Used loosely, partial or incomplete.

MG demulcent Any substance that softens or protects surface of a {mucous membrane}.

MG dendrite 1. One of the shorter branching components of the cell body of a {neuron}. Makes contact with other neurons at {synapse}s, carries nerve impulses into cell body. See also "{neuron}, of which dendrites are a component, also {CNS}. 2. See also {Langerhans cell}, called a dendrite during one of its phases.

MG depress To lower, or to have been lowered.

MG depressant 1. A substance that acts on {CNS} to diminish mental and muscular function. Alcohol, {anesthetic}s, {opiate}s, {barbiturate}s fall into this category, as do other substances. They may also depress the functing of {respiratory} system. 2. {Cytotoxic} drugs are depressants of {white blood cells}' levels.

MG derma- Prefix refers to skin, epidermis.

MG dermal Refers to skin.

MG desoxycorticosterone {Hormone} used as therapy vs. {adrenal gland} dysfunction/ failure. Usually {secrete}d by {cortex} of the gland.

MG DHR (delayed hypersensitivity reaction) A test of immune system strength in which antigens are injected {SC}. Redness and swelling are guaged some hours later. An immediate "hypersensitivity" means antigens are being sent to site promptly; a delayed response will be ascribed to infection and/or pre- existing lymphocyte activity as part of the mechanism called {cell-mediated immunity}.

MG diagnosis Confirmation of suspected illness/ discovery of cause. Will be based on evaluation of patient's medical history, examinations, possibly {x-ray}s and laboratory tests (see {pathology}), etc.

MG differential WBC count (differential white cell count, differential {leukocyte} count) Test to compare levels of various {WBC}'s in system. Results will be given both in percentage and projected quantity of type per liter of blood. Typical results: polymorphonuclear leuko's, 68-70%; segmented p.m.n. l.c.'s, 58-66%; stab cells, 3-15%; juvenile cells, 0-1%; myelocytes, 0; small l.c.'s, 20-22%; monocytes (large l.c.'s), 3-6%; basophils, 0.5-1.0%; eosinophils, 1-2%. Elevated values may signal disease.

MG differentiation Process, sometimes during maturation, of components becoming distinguishable from one another.

MG diffuse Tending to spread outward or having done so. Related to {disseminate}.

MG digital Examination technique involving use of physician's gloved and lubricated finger, as in rectal/ {prostate gland} exam.

MG dilation Enlargement, or to cause outward enlargement.

MG dismutase {Enzyme} useful in organ transplantation, heart attack therapy. Prevents "repercussion injury" when oxygen- starved tissue is again allowed oxygen, or blood is for other reason relatively rich in oxygen.

MG disseminate Distribute through organ or body. Related to {diffuse}.

MG distal Farthest from center, or from central point of reference. See also {peripheral}.

MG distended Inflated, bloated or engorged.

MG distress Refers to a sudden onset of acute symptoms having a labored quality, along with probable emotional distress on a patient's part if he or she is conscious.

MG diuretic Agent that encourages passage of more urine.

MG DNA Deoxyribonucleic acid. Complex {protein} {molecule} in {nucleus}, or center, of a {cell}, contains cell's {gene}s/ {genetic code}. Typical DNA construction is that of a "right-handed" double helix (B-DNA). (B-DNA has a relatively rare "left hand" twisted counterpart, "Z-DNA," which is said to revert to a right-handed form readily. Certain {peptide}s and metal ions can convert B-DNA to Z-DNA.) HIV, using {RNA} as a vehicle, can insert itself into a cell's DNA ({reverse transcription}) and use cell mechanisms to replicate itself. Medical science is now able to {synthesize} DNA molecules, an achievement which holds great promise for future treatment of disease. See {HIV -- the Basics}, {Chromosome}, {nucleotide}, {PurNA}, {intron}, other references to DNA, and HIV's relationship to it.

MG Donovan bodies Calymmatobacterium granulomatis. {Bacterial infection}, may yield to treatment w/ doxycycline (Vibramycin, etc.) 100 mg bid {PO}.

MG dopamine Natural {amino acid} needed for passage of nerve impulses, therefore called a {neurotransmitter}. Its action in {brain} is thought to be important in facilitating normal body movements. It's been found to be an agent in producing spontaneity, elevated mood, and general energy level. Most highly concentrated in {basal ganglia}, specifically in {striatum}. See {parkinsonism}.

MG dopaminergic Describes an agent related to {dopamine} or its effect.

MG dormant Inactive, though physically present. (4-92) See {Latency} for info re: non-existence of HIV "dormant period."

MG DTH (skin test reactions) Delayed-type {hypersensitivity}, a "skin test" that measures immune response strength or events, including drug side FX, in {immune system}. Agents are injected {SC} and spot of skin is checked later for reddened or inflamed appearance.

MG duodenum First part of small {intestine}, beginning immediately after stomach. Takes in food from stomach, {bile} from {liver}, juices from {pancreas}.

MG dura mater Outer covering of {brain}.

MG dx Diagnosis.

MG dys- Prefix meaning improper, inadequate.

MG dysfunction Inadequate or abnormal functioning.

MG ECOGPS Eastern Coordinating Oncology Group performance status. System that measures a person's ability to function. 0=normal; 1=capable of caring for self, doing light work; 2=bedridden less than 50% of time; 3=bedridden more than 50% of time; 4=completely bedridden. See {Karnofsky score}.

MG effective drug Food and Drug Administration definition of a drug that benefits persons having specified disease.

MG efficacy Strength or efficiency; effectiveness.

MG electrocardiograph Machine that detects electrical impulses from heart, produces electrocardiogram ("EKG").

MG electroencephalograph Machine that detects abnormalities in electrical waves emanating from various areas of {brain}. Would be used to help diagnose {epilepsy}, brain {tumors}, etc. Produces electroencephalogram ("EEG"). (Note: The {nervous system} is basically electrical in nature. If one visualizes brain and nervous system as producers and carriers (respectively) of electrical signals or codes, one will have a not inaccurate picture of the workings of these remarkable components of the human body.)

MG electrolyte Electrically- charged salts (of potassium, chlorine, sodium, etc.). Normally found in {tissue}, {cells}, and {body fluids}. Electrolyte "balance" is important to biologic functions.

MG electron beam therapy A type of radiation therapy.

MG ELISA test (EIA, enzyme linked immunoabsorbent assay) Usual primary test for HIV infection. Does not report upon pres. of HIV, but instead detects {ANTIBODY} to virus, which the person's body will have generated if HIV is pres. Although generally reliable, this test is not 100 % accurate or definitive. If an ELISA test comes back "positive" for antibodies, or if any doubt exists about HIV presence, other tests (i.e., second "EIA," {Western Blot Test}) should be used. (Refer also to {seroconversion}, {false positive}, {false negative}, {HIV testing}, {PCR}.)

MG emetic Substance that provokes vomiting.

MG empirical 1. Describing data taken from practical observation. 2. See also {empiracal treatment}.

MG empirical treatment Therapy given when, for example, an exact diagnosis isn't possible. Will be based on past experience with similar cases.

MG endemic Refers to disease peculiar to a particular locale, population group. Opposite of {pandemic}, the adj. properly applied to HIV disease.

MG endo- Prefix refers to inner phenomena, i.e., {endogenous}.

MG endocrine glands Group of glands responsible for production of {hormones}. Includes {adrenal gland}, a portion of the {pancreas}, the placenta, ovary/ testis, thyroid, parathyroid, {adrenal gland}, {pituitary gland}. Common factor among these glands is that their products go directly to bloodstream.

MG endogenous Relating to, or produced by, the body. Opposite of {exogenous}.

MG endorphin One of a group of {hormone}s occurring naturally in {brain} which have pain- relieving properties similar to those of {opiate}s, though they are chemically more like {enkephalin}s. They're derived from a substance found in {pituitary gland}, called beta lipotropin. Are thought to affect activity of the {endocrine glands}. See {beta endorphin}, {metenkephalin}.

MG endorphinergic Related to or similar to {endorphin}s.

MG endoscopy Exam of body's interior, using a tube- shaped fiber optic device called an endoscope.

MG endothelial Refers to cells that line the heart, blood vessels, certain body cavities, each called an endothelium.

MG endotoxin A {toxin} found within a {bacterial} {cell}. Is released when the cell dies. This and {exotoxin} can produce {bacterial infection}s.

MG enema Injection of fluid into {rectum}, often to induce bowel expulsion of waste.

MG enkephalin Natural {peptide}s found in {brain} having chemical action similar to {opiates}. Also spelled encephalin. See also {endorphin}, {naloxone}, {naltrexone}.

MG enteric Referring to {intestine}.

MG enteric pathogens {Organism}s that infect {GI} tract and sometimes spread to other parts of body.

MG env {Envelope}. See {HIV antigens}.

MG envelope A natural {viral} coating that, in the case of HIV, is made up of {gp160}, {gp120} and {gp41} components. gp120 is the portion of HIV that binds to a {T-helper cell} surface {CD4 receptor protein}, and may be thought of as a descendant of gp160. The "gp" indicates {glycoprotein} composition. See also {HIV antigens}, {vaccine therapy}.

MG enzyme {Protein}s that can produce or accelerate chemical changes in other substances without being changed themselves. Thus, may be considered a "catalyst." They cause biochemical reactions, break down food and other substances into simpler compounds that can be used by the body. There are a broad variety of specialized enzymes; each has certain requirements as to environment in which it will function, some require "coenzyme" helpers. Names of enzymes commonly end with the suffix "ase" after the name of the chemical agent to which they {bind} and affect or a term indicating type or reaction produced. Enzymes are critical to {metabolism}.

MG eosinophil One type of {white blood cells}, also called {granulocyte}, capable of digesting {microorganism}s.

MG epidemic Outbreak of disease within a population. See {endemic}, also {pandemic}.

MG epidemiology The study of incidence, distribution, environmental causes, and control of a disease in a population. Differentiated from {immunology}.

MG epidermis Outermost layer of skin, having itself 4 component layers, all pierced by channels for flow of perspiration. Skin diseases commonly bear the prefixes "derm-" or "derma-". See {epithelial}.

MG epithelial Pertaining to skin surface.

MG epitope A unique characteristic on an {antigen}'s surface, triggers {antibody} resp.

MG ergograph Instument that measures amount of work being done by muscle.

MG erythematous Reddened. Perhaps inflamed. Opposite of {exsanguination}.

MG erythropoietin (EPO, Eprex, Procrit) Possible therapy for {AZT}-related {anemia}. Is a natural hormonal (see {hormone}) {cytokine} released by {kidney}, stimulates {red blood cell}s' formation by {bone marrow}, can be produced by {recombinant} means readily. Has been used vs. kidney disease.

MG Escherichia coli (E. coli) A gram-negative organism sometimes found secondary to animal waste as a water or other contaminant. Can produce {GI} distress, other problems of varying severity. Boiling contaminated water for 5-10 minutes kills this {bacteria}, though obtaining water from another area is preferable.

MG esophageal Refers to {esophagus}.

MG esophagus Tubular organ that leads from throat to stomach.

MG et al. (As seen in med. credits) "and others" as collaborators.

MG etiology Refers to causes and origins of a disease. Pron. ee-tee-AHL-uh-gee. British spelling "Aetiology." In our discussions of serious HIV- linked diseases, we follow a convention where etiology is given before other facts.

MG euphoria Exaggerated feeling of well- being or elation. May be natural or induced by drugs.

MG exacerbation Worsening, or provocation into worsening of a condition.

MG excise To surgically remove a diseased body part, include {cancer}ous growths, warts, etc. {Cryotherapy} or use of diluted acid is an alternative in some cases.

MG excrete To expel into environment.

MG exo- Prefix refers to phenomena outside of body, i.e., {exogenous}

MG exogenous Produced outside of the body. Opposite of {endogenous}.

MG exon A {DNA} component said to contain {genetic} instructions for building a {protein}. See {intron}.

MG exotoxin {Toxic} substance, or poison, made by {bacteria} and {excrete}d outside the {bacterial} {cell}. This and {endotoxin} can cause some types of {bacterial infection}.

MG experimental drug A drug not approved by {FDA} as treatment for a given condition or population.

MG exposure Act or condition of coming in contact with, and perhaps being {infect}ed by, a {pathogenic} agent.

MG express In strict medical context, to produce or exhibit.

MG extracorporeal Outside of body.

MG exudate Inflammatory fluid (see {inflammation}), result of {infection} or other conditions Also called "pus." Contains dead {white blood cells}, {microorganism}s, and cellular debris that enters {tissue} at affected site.

MG Factor VIII (factor eight) {Protein}, normally present in blood, causes clotting (coagulation) at site of wounds, etc. {Hemophilia} is marked by an absence of this important component. In the early 1980's, there were instances of contamination of human blood components with HIV. Because the blood supply was not then tested rigorously, many hemophiliacs were {infected} with the disease. By 1985, ways were found to kill HIV in Factor VIII. Now it is possible to produce a {recombinant}, always- HIV- free Factor VIII.

MG false negative Erroneous test result that indicates no HIV {antibody} is present when, in fact, it is. Relatively rare but does occur.

MG false positive Erroneous test result indicating HIV {antibody} is present when, in fact, it isn't. Relatively rare but does occur.

MG fatty acids Group of {lipid}s found in animal fats. A certain level of fatty {acid}s is necessary for good nutrition.

MG FDA Food and Drug Administration, U.S. government agency responsible for licensing drugs and regulating their development. 10-92 FDA, under pressure to do so, is progressively relaxing restrictions and expediting procedures in efforts to help faster development of therapies vs. AIDS.

MG fetus Prospective infant, from 8-12 weeks after conception till birth.

MG fibroblast Any {cell} from which {connective tissue} is formed.

MG floaters Patterns or indistinct spots that seem to drift slowly across field of vision. May be part of normal aging process, but if persistent, may signal onset of disease requiring prompt attention from HIV- aware {opthalmologist}, possibility of {CMVR}.

MG fluoxymesterone (Halotestin) An androgenic {hormone} for use vs. delayed puberty, viewed as possible therapy vs. AIDS {wasting}. Has side FX that may be embarrassing and inconvenient.

MG folic acid Nutrient used by bone marrow in production of {red blood cells}. Closely associated w/ vit. B12.

MG free radical "Highly reactive" oxygen {molecule}, may be created during nerve cell activity or by other means. In excess, said to be capable of destroying {neuron}s. Attempts to give therapy vs. {rheumatoid arthritis} via {corticosteroids} have produced free radicals that appeared to cause injurious metabolic changes. See references in {superoxide dismutase}, {hydroxyurea}, {antioxidant}.

MG fundus Back wall of eye or {retina}. Pl. is fundi.

MG funduscopy Visual examination of the retina with an ophthalmoscope.

MG fungus Parasitic (see {parasite}) {microorganism}, seen in molds, mushrooms, yeasts, etc. Causes such HIV illnesses as {candidiasis}/ {thrush}, {PCP}, {cryptococcosis}, many others. In general population milder manifestations, such as "jock itch," "athlete's foot" are seen.

MG FX Effects, as in "side FX."

MG G-CSF (Granulocyte colony stimulating factor) Natural human {cytokine} that helps growth of blood- cell {precursor}s, also involved in their {differentiation.}

MG G6PD (glucose-6-phosphate dehydrogenase) An {enzyme} typically present in {red blood cells}, especially in {liver} and {kidney}s, important in converting {glycerol} to {glucose}. A deficiency of this enzyme poses problems to those who'd otherwise be able to take certain drugs such as Dapsone.

MG GABA Gamma-amino-butyric acid. Chemical normally found in {brain}, deficient in {parkinsonism}. Drugs which act like GABA (i.e., {baclofen}/ Lioresal) are sometimes able to help control side FX like {dystonia} or {dyskinesia} in persons being treated for parkinsonism with usual therapies.

MG gag Group antigen. See {HIV antigens}.

MG gamma globulin (IgG) Substance in blood {plasma}, contains {antibody}, sometimes administered to children who've been exposed to measles or other {infection}s. It tends to lessen effects of such a disease measurably. See {IgG}.

MG gamma interferon (INF-g) A natural {cytokine}, produced by activated {lymphocytes}; enhances functioning of {monocyte}s and {macrophage}s vs. {microbe}s. INF-g is an {infection}- fighting agent believed to have critical role in {cell-mediated immunity}. Gamma interferon increases production of, and sensitivity to, both {tumor necrosis factor} and {IL-1}. This is sometimes undesirable. 1-93 (IND) {Recombinant} INF-g (Actimmune) is FDA-approved for treating chronic {granuloma}tous disease. Seen as an {Immunomudulator} and {antiviral}, it does not seem effective vs. AIDS, {KS}. Is thought of as possible therapy for {MAC}, also as {adjunct} to {TMP/SMX} for therapy vs. {PCP}. {AMFAR} advises that, in vitro, gamma interferon induces monocyte/ macrophage activation and enhances natural killer cell cytotoxicity. In animals, aerosolized gamma interferon (A-GIFN) activates pulmonary macrophages. INF-g has been produced by {NK cell}s that were pre- stimulated by {tumor necrosis factor} alpha and {interleukin 12} in experiments with lab mice. In the mouse experiments, IL-12 augmentation prolonged survival of mice infected with T. gondii, the agent that causes {toxoplasmosis}.

MG ganglion Mass of nerve {tissue}, usually outside {CNS}. Made up of nerve cell {neuron} bodies.

MG gastric Refers to stomach, associated processes.

MG gastrointestinal (GI) Relating to stomach, {intestine}s. "GI intolerance" is inability to tolerate a drug due to digestive system problems, such as cramps or {diarrhea}.

MG gene A basic unit of {DNA} or {RNA}, found at a specific location on a {chromosome}, that carries {genetic code} for specific {cell} functions. To do this, it directs production of a {polypeptide} chain. Genes' {molecules} are composed of long sequences of {nucleotide}s called polynucleotides. Genes are responsible for many biological factors both good and ill, and our continued progress in understanding them and their workings may well hold out the most realistic hope for control, and cure, of AIDS. Types of genes include "architectural," which determine how {protein} will be made part of a cell; "regulator," which control the rate of protein {express}ion; "structural," responsible for type of protein expressed; "temporal," which control activities of other genes and determine where they'll take place -- and are responsible for {genetic} {differentiation}. See {genome}, {genotype}.

MG genetic Loosely, inherited medical and psychological factors. Precisely, refers to system of {gene}s, {genetic code}s.

MG genetic code {DNA} and "messenger" {RNA} bear encoded information, a series of {nucleotide} {codon}s in molecules of {nucleic acid}, which determines what kind of {protein}s are to be made by the cell of which these components are made. Composition of the code will be of pairs, with types A and T together or types C and G -- other combinations are not found in living matter. The combinations may sometimes be called "base pairs," and three of them together may form the code of a single {amino acid}. Strings of these acids found together are proteins. Though a single {gene} may contain several hundred base pairs or more, only the four kinds of nucleic acid are present, and one gene is "coded" for production of one protein. This code is translated (the process is also called "transcription," thus the mention of distinctive {reverse transcription} caused by HIV) -- which will result in {express}ion of appropriate protein. The way the nucleotide series is sequenced is important. Some diseases, many of them affecting {neurological}/ muscular systems, are marked by erratic sequences or "repeats" that should not be present. Genes can be "gimmicked" in the laboratory -- with sectors "spliced" into place instead of or between others. This is part of the fascination and power of genetic medicine. See {recombinant}, {chromosome}.

MG genital Related to male or female sex organ.

MG genome Full set of {chromosome}s (DNA code) determining the characteristics of an organism. Humans have a set of 23 "base pairs" (see {genetic}) of genomes, but more primitive living organisms may have just one. In this case, the genome may be called a plasmid.

MG genotype 1. Distinctive genetic character of a group or member of group. 2. genetic information borne by {allele}s. Contrast {phenotype}. See also {genome}.

MG GI {Gastrointestinal}, refers to stomach and {intestine}s.

MG gland An organ that produces specific chemicals ({hormone}s, etc.) which are released into bloodstream for use in body. Include {adrenal glands}, {lymph glands}, {pituitary gland}, others.

MG glia "Support cells" for peripheral {nervous system} and {CNS}, found in connective tissue. Also called neuroglia, and consisting of macroglia and {microglia}. It's long been believed that the glia help maintain proper functioning of {neuron}s (which help implement {brain}'s functions). They are not neurons themselves, however. There is now some evidence that they're involved in {metabolism}. May be involved in some CNS or brain disorders, including most importantly {AIDS dementia}.

MG globulin A group of simple {protein}s, some of which contain {antibody}, {molecule}s vital to function of {immune system}, others merely carrying {lipid}s or minerals in blood {serum}. Beta globulin is in that latter class. Of more significance for our purposes there are alpha, gamma and other globulins, {IgA} and {IgG} respectively. They're properly referred to as {immunoglobulin}.

MG globus pallidus A part of brain, located next to {striatum} and related in function to same. At one time, it was thought that surgical procedures done in this area could relieve symptoms of {parkinsonism}, but in practice the concept was never proven. (Also called "pallidum")

MG glucose Also known as dextrose, a simple sugar used by body for energy.

MG gluteal Refers to the 3 pairs of muscles that traverse buttock to thigh. Each pair has the prefix "gluteus." In acute {wasting}, these muscles are prone to {atrophy}.

MG glycerol Glycerine. A fat/ oil compound, usually of light consistency.

MG glycoprotein {Protein} that is combined with {glucose}/ {carbohydrates}. Certain {antigen}s, {hormone}s, {enzyme}s are glycoproteins. See {histocompatibility}, {glycosylation}.

MG glycosylation Process of adding a form of {glucose} to a protein. Result is a {glycoprotein}.

MG gm Gram.

MG Goodpasture's (Goodpasture's syndrome) A very severe and aggressive {autoimmune} {kidney} disease. It may be a development of antiglomerular basement membrane (anti-GBM) antibody-mediated disease. The latter is usually characterized by a rapidly progressive glomerulonephritis with or without {pulmonary} hemorrhage. Glomeruli (plural of glomerulus) are the web of capillaries used by the kidney for filtration of waste from blood. The kidneys are a very active site of chemical transformation, so it can be easily understood that the many {antigen}s and {antibodies} present there might allow or cause dysfunction. Glomerulonephritis is not very uncommon; it may become severe, causing inability to discharge urine, or blood in the affected person's urine (hematuria). Anti-GBM symptoms sometimes appear subsequent to a streptococcal infection, but in those cases they usually subside in a short time.

MG gp {Glycoprotein}. See {HIV antigens}, {gp120}, {gp160}.

MG gram About 1/28 of an ounce.

MG gram-negative bacteria Distinguished by wall structure comprised partly of lipopolysaccharide (LPS) {endotoxin}. (See {lipid}, {polysaccharide}.) Cause such {infections} as Klebsiella pneumoniae, Enterobacter aerogenes, Morganella morganii, Pseudomonas aeruginosa, Salmonella, Escherichia coli. These infections tend to producd higher {systemic} levels of {IL-1} and {tumor necrosis factor}. Implicated in AIDS {septicemia}.

MG gram-positive bacteria Distinguished by their lack of lipopolysaccharide (see {lipid}, {polysaccharide} in wall structure. Responsible for such infections as {MAC}, M. {tuberculosis}, {Mycobacterium kansasii}, {streptococcus}, {staphylococcus}. Contrast {gram-negative bacteria}.

MG granulocyte Part of {immune system}, this type of {cell} contains {toxic} chemicals in granular form that help them digest {microorganism}s. This class of cell include {eosonophil}s, {neutrophil}s, {basophil}s. See {mast cell}.

MG gray matter Component of {nervous system} which is within {white matter} traveling up {spinal cord}, forms {cerebral cortex}. In {CNS} is composed of {neuron}- related components.

MG gross In medical usage, general, preliminary, or overall.

MG growth factors Natural substance that controls {cell}s' growth, characteristics, and function. Some of them aid cells' survival, some cause cell migration, and some stimulate cells to produce {hormone}s. See also {Human growth hormone}, {rhIGF-1}.

MG GU Genito-urinary, referring to sex/urinary organs.

MG guanine One of components (other being adenine) which comprise {nucleotide}s of {DNA}, {RNA}. They are {purine}s.

MG H2 antagonists Drugs which treat long- term acid indigestion, ulcers.

MG half-life The time required for half the amount of a drug to be {excrete}d or eliminated by body.

MG hantavirus 3-94 A {respiratory} illness, not very common, but attention has been drawn by a recent outbreak of it in the southwestern U.S. For a brief time Centers for Disease Control and Prevention scientists were puzzled by the sudden appearance of hantavirus, thought they might be dealing with a new disease. The virus is often carried by rodents, and suspicion focused on the Norway rat, commonly found in large cities' blighted areas. But as they learned more about the illness and its ability to infect varied species of rodents, the researchers were then less than surprised to see it crop up elsewhere. "We're going to find hantavirus all over the US," predicts a CDC epidemiologist. "This is not a new disease, we're just newly recognizing it." There's no reason to panic. Hantavirus, in an even rarer form than that now under investigation, has infected rodents in the US for years without causing epidemics. And those infected with the newly discovered forms, most commonly deer mice, are usually either out in the woods or in the fields. Hantavirus is dangerous if unchecked, but can be treated readily.

MG haplotype Combination of molecular* markers (human leukocyte antigens) ({HLA}) useful to determine {tissue} compatability in organ transplants. One source believes there is a "protective" haplotype that can slow HIV. {Gene}s that "encode" HLAs exist in many different forms, enabling HLAs to have many varieties, called {allele}s. See {histocompatibility}, {Immune System}. * See {molecule}.

MG HCl Hydrochloride.

MG helper/killer ratio (Or helper/suppressor ratio, other variants) See {T4:T8 ratio}.

MG hema- Refers to blood or blood system.

MG hematocrit (Packed cell volume) Volume proportion of {red blood cells}, or erythrocytes, to {plasma} in whole blood. In men, it's normally about 40 to 54% of the whole blood; in women it's normally about 37 to 47%. "Hct" will be abnormal when {anemia}, {polycythemia} or other disorders are present.

MG hematogenous Carried in bloodstream. Some infections are thus classified, including HIV -- which is called a "bloodborne" pathogen for simplicity.

MG hematologic Refers to body's blood and its circulatory system.

MG hematopoiesis Refers to the body's production of blood cells, especially {platelet}s in {bone marrow}.

MG hematotoxic Describing an agent poisonous to blood or {bone marrow}.

MG hemo- Refers to blood or blood system.

MG hemoglobin The {protein} in {red blood cells} that carries oxygen to the {cell}s and carbon dioxide away from cells. Typical {CBC} findings: Men, 90- 105% ratio (14-17 gm.); women, 80-100% (12.75-15 gm.) Values may vary according to test procedure used. Shortage of hemoglobin: See {anemia}. Excess: {polycythemia}.

MG hemostasis Condition in which bleeding has stopped or been made to stop due to normal clotting or blood vessel contraction or other means.

MG hemotoxic Obscure term indicating that proccesses or agents, in or of the blood system, are {toxic}.

MG hepatic Related to functions of the {liver}.

MG herbal treatments Usually small amounts of plants ground or made into a paste. Roots, bark, leaves sometimes used, juices or teas. Some herbal treatments cannot be expected to bring good results, no matter what claims are made for them by enthusiasts. However, many of our most necessary modern medications are derived from plant substances, some of which are subjected to very little or no "processing."

MG hereditary Refers to condition passed to newborn from parents. Contrast with {congenital}.

MG HHS Abbreviation for US Department of Health and Human Services. See reference in {CDC}.

MG histamine A transmitter of chemicals or {hormone}s, involved in local {immune} responses; in regulating {allergy} reactions; in controlling stomach {acid} production. It causes {contraction} of smooth muscles, dilation of blood vessels; significantly, it's involved in allergy -- or anaphylactic -- responses.

MG histocompatibility Ability of {glycoprotein} {antigen} from two sources to coexist. See {haplotype}, {immune system}. (histocompatibility testing) Method for matching "self" {antigen} (HLA) (see {haplotype}) of {tissue} of a transplant donor with those of intended recipient.

MG histological Having to do with scientific study of {tissue}s, their {cell}ular makeup and organization. Often refers to exam'n. of {biopsy} subject tissue under microscope.

MG histoplasma capsulatum Type of {fungus}. May infiltrate {lungs} of those with AIDS or be more widespread.

MG HIV antibody (HIV-Ab) The antibody to HIV, which usually appears within 6 weeks after infection. Antibody testing early in the infection process may not produce accurate results, since some recently infected people have not yet begun producing antibodies and test negative even though they are infected. So a single negative antibody test result is not a guarantee that a person is free from infection. The change from HIV-negative to HIV-positive status is called seroconversion.

MG HIV antigens Major {antigen} groups found in HIV include the group- specific antigen (gag) region, which encodes for the structural {protein}s p18, p24, p55; the {envelope} (env) region, with gp ({glycoprotein}) 41, gp 120, gp160; the {polymerase} (pol) region, with {reverse transcriptase} p51, p66 and the endonuclease p31. ("p" = protein.)

MG HIV exanthem Macular or maculopapular* rash, probably without {pruritus}, often seen in acute primary HIV infection. *See {macule}, {papule}.

MG HIV testing There are a number of tests for the presense of HIV. The most basic is the "EIA," or {ELISA test}, which is a brief procedure involving very little discomfort while a small sample of blood is drawn. Results are typically available in about 2-4 days at most. There is a period between exposure and the time an ELISA will report antibodies to HIV. In this regard, the profiles of the ELISA and Western Blot tests are basically the same: -- After 6 weeks 80% of those infected will test positive -- After 3 months 90% of those infected will test positive -- After 6 months 99% of those infected will test positive. Only if there's doubt about an EIA result does the {Western Blot test} enter the picture. It's a more critical test, but no more difficult for the person being tested. There are other tests available -- using such techniques as radioim- munoprecipitation, hemagglutination. Common element to all these is that they find {antibody} to, not presence of, HIV. The virus' presence can be determined using HIV culture/ coculture and {PCR}. A new method, testing of oral mucosal transudate, shows some promise for the future. (See {OMT}.) There is also what's called the "{p24 antigen} capture assay." It has a problem with lack of sensitivity, and isn't commonly used. Another test, the delayed hypersensitivity reaction test ({DHR}), is new, and of apparently limited usefulness. See also {Murex}, {Recombigen}.

MG HIV treatments AIDS therapies fall into two main categories: (1) {antiviral} treatment and (2) {immune system} boosting treatment. Antiviral drugs focus on destroying or inactivating AIDS {virus} itself, and the primary ones are {AZT}, {ddI}, {ddC} and {d4T}. Their working principle is to inhibit HIV from carrying out its {reverse transcription} process. Immune boosters attempt to rebuild or stimulate immune system. Mostly, they're still in experimental stages, but their use could eliminate one problem caused by antiviral treatment -- serious or severe side FX. See also {AIDS}, {HIV preventive testing}, {HIV progression testing}.

MG HIV-negative Having shown no evidence of HIV. See {HIV-positive}.

MG HIV-positive (HIV+) Having shown evidence of {antibody} against HIV {infection} or presence of human immunodeficiency virus. Presence will have been confirmed by two successive {ELISA test}s and {Western Blot test}. See {HIV testing}.

MG HLA Human leukocyte antigens. A major overseer of {immune} activity. Name also applies to HLA use as {protein} markers in {histocompatibility} testing. See also {haplotype}. 11-93 Suggestions for an HIV vaccine based on HLA introduced. A study saying body recognition of certain "allo-antigens," as part of HLA activities, may be a factor in protecting a group of African prostitutes from HIV infection. Meanwhile a study of people with hemophilia has revealed that those with the HLA antigen called B35 were almost 3 times as likely to progress from {asymptomatic} to {symptomatic} AIDS over a given period. See {MHC}, essay on the {immune system}.

MG holistic medicine Considers the patient as a whole, comprised of certain systems working together; to some extent, places responsibility for health maintenance on the person being treated. Some points in common with {osteopathy}, only by coincidence.

MG homeopathy Old system of medicine whose main premise was "a hair of the dog that bit ye." Practitioners used small doses of drugs which were capable of causing symptoms much like those of the disease being treated. Today, the term seems to be used very loosely (if at all), sometimes referring to "folk" medicine, misc. antiquated medical practices, "alternative" approaches. See {allopathic} for contrast.

MG homeostasis Condition of stability of all bodily functions.

MG hormone Chemical that helps coordinate and regulate body mechanisms including growth, {metabolism} and thus energy, and reproduction. Found in various organs, bloodstream. Along with the {CNS} and {brain}, a major governing body system. {Corticosteroid}s, for example, are hormones of the adrenal cortex (see {adrenal gland}). Testosterone, estrogen are hormones related to sexuality. The pancreas produces the important hormone called {insulin}. See also {human growth hormone}; other hormones are active in relation to other sensory and regulatory roles. See {ACTH}.

MG host {Cell} or {organism} capable of supporting growth of {virus}es or {parasite}s.

MG HS In evening or at bedtime.

MG human growth hormone A {hormone} normally {secrete}d by {pituitary gland}. Increases the production of {protein} and thus muscle growth. Also promotes use of fats as energy source. Is used as therapy in children w/ endrogenous "G.H." deficiency., who are typically smaller and shorter than peers. Some believe GH stimulates the {immune system} via increased {T-cell}, {NK cell} activity, increased {differentiation} of {white blood cells}.

MG humoral immunity Counterpart to {cell-mediated immunity}, this is a human defense mechanism that involves production and circulation of {antibody}. "Humor" in this case refers to {body fluids}, especially {lymph}, blood {serum}, in which antibody travels. {Molecule}s of the humoral immune system are {protein}s, collectively called {immunoglobulin}s. A single such molecule is an antibody. See {immune system}.

MG Hx History.

MG hyper- More-than-normal.

MG hypo- Less-than-normal.

MG I-Kappa-B (4-93) A protein that normally helps regulate {T-cell} growth and monitor cell response to {antigen}. Usually inhibits NF-Kappa-B {protein}, but when the cell is attacked, I-Kappa-B releases captive NF-Kappa-B, which moves to {nucleus} to activate agents which help fight invader.

MG iatrogenic Refers to a condition that resulted from medical therapy, would not likely have occurred otherwise.

MG ICU Intensive Care Unit of a hospital, where body functions may be constantly monitored, patient condition checked readily and often.

MG idiopathic Of unknown origin.

MG idiotypes Uniqe identifying parts of an {antibody}'s {variable region}, which may themselves serve as {antigen}.

MG IDU Intravenous drug use(r).

MG IFA Immunofluorescence antibody serologic assay, uses antibody tagged by a fluorescent molecule. There is an HIV-specific IFA assay available to confirm the results of a positive HIV ELISA test.

MG IgA {Immunoglobulin} that protects body's orifices from {infection}. Found in {respiratory}, {GU} and {GI} tracts, tears, saliva. Especially effective in antimicrobial* protection at {mucosa}l sites. See {mucosal immunity}. * See {microbe}.

MG IgD An {immunoglobulin}, thought to participate in regulatory functions in some way. Found on surfaces of immature {B-cells}.

MG IgE An {immunoglobulin} with a potent {antibody} component, linked to the sensitization of skin and {allergic} reaction. It seeks the white blood cells called {mast cell}s and {basophil}s, which offer it 3 different kinds of receptors. Researchers are currently trying to defeat allergies by finding ways to block IgE from the receptors.

MG IGF-1 (rhIGF-1) Insulin-like growth factor 1. A naturally- occuring {polypeptide} {hormone} structurally like insulin -- helps with growth, may "{mediate}" actions of {human growth hormone}. 2. Produced by {recombinant} means, animal studies suggest it may prevent or reverse loss of {protein} or muscle mass in severe illness, may improve the functioning of {immune system} by moderating {pituitary gland}/ {thymus} interactions. Side FX: May cause glucose deficiencies, jaw pain, usually at high dosage levels.

MG IgG {Immunoglobulin} that circulates in blood and is found in {tissue}s. Major agent of bloodborne or "non- specific" {immunity}. "Gamma" is the most abundant member of its family, an important {antiviral} and {antibacterial} factor, and it can neutralize some {toxin}s. In presence of HIV, plasma levels of IgG are often elevated. See {gamma globulin}, {IVIG}.

MG IgM {Immunoglobulin} whose main function is to destroy {bacteria} in bloodstream. Also called macroglobulin, it's the first {antibody} produced by activated {B-cells}.

MG IM (1) Intramuscular. (2) Infectious mononucleosis.

MG immune 1. Protected by {immunological} factors. 2. Generally refers to {immune system} phenomena.

MG immune complex (Circulating immune complex) Cluster formed when {antibody} and {antigen}s bind together.

MG immune system Complex system within the body that helps recognize and resist disease- causing {organism}s such as {bacteria}, {parasite}s, {virus}es, other possible causes of {infection}. System can produce {protein}s called {antibody} after noting the presence of {antigens}; it is often able to neutralize foreign agents, and recall the response later when confronted with identical agent. This "memory" is the system's second- most remarkable feature. Please note that there are many other components, be they cells, substances, or organs, which are also part of the design. This is a system of amazing complexity. It is capable of protecting us against "foreign" matter like bacteria while NOT mistakenly attacking its own elements. That last, by the way, is one of its most demanding tasks, and also its main identifying feature. System's overall activities are called "immune response" and its effect is generalized as {immunity}. See {Immune system -- More}.

MG immunity Resistance to disease. May be natural, acquired, or induced. May be partial or complete; may be temporary or permanent. "Active" immunity consists of the body's natural defenses against disease; "passive" immunity is available via drug therapy and also protects infants for a period of some months after birth.

MG immunize As commonly used, to protect against disease by {vaccine}, often using a weakened form of the {pathogen} that would otherwise cause the illness, or a variant of same. Relative to HIV disease/ AIDS such a simple approach doesn't seem viable, but because of the depth of concern over HIV, it is not being automatically ruled out. See also {vaccine}.

MG immunocompetent Able to develop good {immune} response.

MG immunogenicity Having the properties of an {antigen}.

MG immunoglobulin (Ig) One of a family of closely related {protein}s that can act as {antibodies}, attacking foreign {organism}s and working to help body destroy them. They also work to prevent {vaccines} from causing serious {infection} or graft-vs.-host disease after a blood transfusion. Ig's are produced by {plasma} cells derived from B- {lymphocyte}s and found in the blood and other body tissues. Increased levels of two types of immunoglobulins, {IgA} and {IgG}, are usually seen in those with HIV infection and are related to the HIV-induced activation of B-lymphocytes. Immunoglobulin A is found in high concentrations in {mucous membranes} and in secretions such as saliva. It does not cross the placenta. Immunoglobulin G is found in the {serum} and does cross the placenta. See also {IgD}, {IgE}, {IgM}.

MG immunological Refers to defensive response by {immune system} when {antigens} are present, most specifically to dispatch of {antibody} or {T-killer cell} lymphocytes. Also used loosely in reference to any other immune phenomena. (immunological tolerance) Dysfunction of the {immune system}'s distinctive "self/ not self" identification methods. Result will be lack of defensive ability, consequent disease.

MG immunology Branch of medicine dealing with body's "resistance" ({immune}) mechanisms against disease or invasion of foreign substances. Specialists in this field are typically called on when a person is affected by {cancer}, HIV or other serious {infection}s, {autoimmune} diseases, management of organ transplants (see {histocompatibility}), etc.

MG immunomodulator Sometimes called {BRM}, for "biological response modifier." An agent given to modify (usually enhance) response of the {immune system} to foreign stimulus, be it an {infectious} {organism}, {tumor}, etc. These agents differ from {vaccine}s in that latter modify immune response to specific stimuli, but "I.M.'s" are designed to have more broad effects. Biochemically, I.M.'s usually consist of naturally occuring {molecule}s such as {cytokine}s -- important in the natural immune system function -- or {analog}s or {inhibitors} of same. I.M.'s may have FX on a specific arm, or on all of, the immune system (arms in this context being the cellular, complement, and reticulo- endothelial systems). The most ambitious of them work to at least partially reconstruct a damaged immune system.

MG immunostimulant (Immunpotentiator) Any agent that triggers/ enhances body's defenses vs. {infectious} disease.

MG immunotoxin A {toxic} protein or radioactive substance linked to a {Monoclonal} {antibody} or to an {antigen}.

MG in vitro In test tube / laboratory conditions. Opposite of {in vivo}. This is one of the most important terms for the serious student of HIV/AIDS medicine to understand, for the majority of findings presented to him or her will be limited to in vitro results. Sad to say, evidence that an agent "exhibits in vitro activity against HIV" has almost no significance. It's amazing how many substances do work against HIV-1 in the test tube, yet almost all of them fail when tested in animal models. Still, the test tube stage is where all drug therapy tests must start, and test we must, until there is a cure.

MG in vivo In actual biological / human conditions. Opposite of {in vitro}.

MG incidence Frequency of occurrance. Used in medicine in reference to rates of illness or death in a population, expressed as a percentage of entire population.

MG incubation period The period of a disease between an initial {infection} and the first discernable reaction on the part of the body infected. HIV has been considered to have an incubation phase lasting at least a few weeks, sometimes as long as 6 to 10 months. An {ELISA test} performed during that time will return "negative" (healthy) results. Existance of this "window" period associated with HIV points to need for regular testing if one engages in any form of {high-risk behavior}. 4-93 There is now evidence of very early HIV present in {lymphatic} system. New concepts about the incubation period or "{latency}" will be forthcoming; old ones are obsolete. See also {dormant}, {latent}.

MG indication 1. In references to a drug, used to describe condition(s) for which agent is intended to be used, and for which it would likely be effective. 2. Also used here sometimes in non-medical sense.

MG inert Generally, inactive. A medication may contain inert matter as a filler material for convenience of the user. Also see {placebo}.

MG infectious Communicable -- with or without physical contact. Loosely, refers to agent that will produce {infection}.

MG inferential Refers to something that is implied or inferred. Loosely describes one condition or event influencing another condition, event.

MG informed consent Process by which those who think of participating in a drug trial are informed of risks and benefits of the proposed treatment, and voluntarily agree to participate in the trial. The consent form is a document saying that the the person signing understands the purposes and risks of the study. The term also refers to the process in which a person voluntarily consents to diagnostic testing and release of informtion (disclosure) after counseling.

MG infusion {IV} injection of medication or nutrients into bloodstream at a measured rate.

MG inguinal Related to the groin (crotch).

MG inhibitors Agents which slow or halt a biological process.

MG insulin Used in ongoing treatment of {diabetes}, which is a result of inadequate supply of the insulin one's own body is supposed to make. Insulin is a {protein} {hormone}, produced in the normal {pancreas}. It's responsible for regulating amount of sugar in blood. Too high a sugar level, in a diabetic person, causes {acute} illness.

MG integrase This is an enzyme that permits HIV to {bind} its {genome} into host cell {DNA} (see {integration}). Though it is a possible target for anti- HIV drug therapies, it remains little- studied relative to {reverse transcriptase} and {protease} factors.

MG integration In HIV, the process by which {viral} {DNA} enters the DNA of the {T-helper cell}. (It may remain in the cell without reproducing until the T-helper cell is stimulated.)

MG inter- Prefix meaning "between."

MG interaction In our context, often refers to effects of two or more drugs used more or less simultaneously. The interaction can disproportionately increase the effect of one or both drugs, or cause a decrease, or result in {toxicity}.

MG intercurrent Refers to condition present concurrently with other disease.

MG interferon A family of at least 20-25 naturally- occuring {protein}s or {lymphokines} made by body to "interfere" with {cell} {infection}. One source explains that "INF" acts by inhibiting {synthesis} of {viral} {RNA} and increasing {T-cell} and {NK cell} activity. Of all the {cytokine}s, this agent is perhaps the most reliable antiviral player. Almost any {viral infection} will produce interferon response, which is noted for, among other effects, preventing "superinfection" of affected cells by additional viruses. The value of this function shouldn't be underestimated! There are three major types of interferons ... {alpha interferon}, {beta interferon}, and {gamma interferon} -- INF-A, INF-B, INF-G. In the last form, "G" represents the Greek letter gamma. See {immune system}.

MG interleukin Natural component of body's {immune system}. There are more than 10 kinds of interleukins, some of which help produce {immunoblobulin}, some aid in {lymphocyte} growth, some serve as {immunomodulator}s. {Interleukin 2} and IL-9 assist in cell growth, while IL-10 is able to control {synthesis} of other {cytokine}s, giving the {immune system} a form of "reverse feedback." {interleukin 1}, IL-6, and IL-8 are "pro- inflammatory" and have other varied functions. IL-4 controls production of {TNF}, etc. The interleukins are distinguished from hormones, and from other cytokines, in that they have multiple functions.

MG interleukin 1 (IL-1) {Molecule} that is stumulated early in immune system response. It can cause {fever} and thus is sometimes called {progen}. It is known as a stimulator of {T-cell}s that would otherwise be inactive, and acts as a mediator of blood pressure. It prompts the release of corticotropin (see {ACTH}) by the {pituitary gland.} It is thought to be implicated in AIDS- related {septicemia} & {wasting} syndrome. A {cytokine}.

MG interleukin 12 (IL-12) 7-92 Recently discovered {immune} {protein}, believed to play pivotal role in an "alternative pathway" of immunity that's independent of {T-helper cell}s. This pathway accomodates {NK cell}s, which can be induced to {secrete} {gamma interferon}, an {infection}- fighting protein. The suggestion is that IL-12 might be able to help {immunocompromised} persons fight off infections. Basically, this substance is a naturally- occuring {cytokine}, serving mainly as an immune system cell- to- cell "messenger." 2-94 One researcher says IL-12 provokes a strong immune response, the {HLA} Type 1 reaction (see {immune system}). It's hoped that IL-12 or some synthetic variant thereof might have therapeutic use. IL-12's ability to cause release of other interleukins and interferons is confirmed; in vitro, it's seen to cause increased {T-cell count}s.

MG interleukin 2 (IL-2) Naturally- occurring {glycoprotein} {hormone} that is naturally produced when {T-lymphocyte} is stimulated by {antigen}, {mitogen}. A {cytokine} by nature, it helps control {express}ion and activity of {T-cell}s, {B-cells}, and {NK cell}s.

MG interleukin 3 Natural {Cytokine} that functions to control growth & {differentiation} of blood cells, is one of several colony- stimulating factors (see {CSF}).

MG interleukin 4 (IND) Natural {cytokine} {immunomodulator} derived from {mast cell}s. Controls production of {TNF}, IL-6. 10-93 {Recombinant} form being investigated for possible use as therapy vs. {KS}. Has been tried on non-HIV cancer, with results unknown at this time.

MG interleukin 8 This {cytokine}, like certain others, has "pro-inflammatory," or fever- inducing, effects. It is implicated with {TNF} and {IL-1} in some undesirable biochemical changes, but unlike them it does not down- regulate blood pressure.

MG intermittent Having an "on and off" character.

MG interstitial Describes tissue, etc. found within gaps between body organs or other internal components. May refer to {connective tissue}.

MG intestinal flora {Bacteria} native to {GI} tract, needed for normal {intenstinal} function. This is esp. true of bacteria within the large bowel.

MG intestine (intestines) Part of digestive system, extends from exit of stomach to termination of rectum ({anus}). One dysfunction sometimes affecting this organ in presence of HIV is intestinal malabsorption,a condition in which nutrients aren't {absorb}ed by body. Leads to weight loss if unchecked.

MG intolerant Refers to person's inability to withstand {regimen} of some kind, usually because of side FX. See also {compliance}.

MG intra- Prefix meaning "inside."

MG intralesional Into a {lesion}. May apply to drug administration.

MG intrathecal Injected into fluid surrounding {spinal cord}.

MG intravenous (IV) Within or into {vein}s, as in intravenous drug use, intravenous adminstration of nutrients or medication, etc.

MG intravitreal Within the eye. See {vitreous humor}.

MG intron Segments in {DNA} structure that have no apparent purpose. 7-93 A recent report speculates that these segments serve as "spacers," marking areas where breaks for {genetic} recombination (of, in at least some cases, {exon}s) may occur without producing some kind of {mutation}. Have been referred to inelegantly as "genetic junk," "genetic garbage," due to their haphazard character.

MG invasive 1. The spreading of {organism}s or {cancer}ous cells through body. 2. A medical {procedure} in which body must be entered as part of exam or treatment.

MG iris Colored disk between eye's cornea/ lens. Determines amount of light entering eye by adjusting pupil diameter.

MG iso- Prefix means similarity, regularity or uniform quality.

MG isolate (noun) Different {strain}s of disease. (verb) To separate.

MG -itis Suffix usually referring to an {inflammation}.

MG joint Place where two (or more) bones meet, usually in a flexible "cup and ball" arrangement. Cartilage (having a rubbery composition) enables smooth movement, prevents direct bone-bone contact. {Osteoarthritis} and other medical problems may cause {joint} dysfunctions.

MG Karnofsky score Measure given by a physician who is measuring a person's ability to perform certain ordinary tasks. A score of 90-100= normal, 50= medical care frequently required, 40= disabled, 30= hospitalized. See {ECOGPS}.

MG kg Kilogram. 2.2 pounds.

MG kidney Organ in upper rear area of {abdomen}, takes in waste products and water from bloodstream. {Excrete}s them as {urine}.

MG Kupffer's cells Specialized {macrophage}s found in {liver}.

MG laboratory marker Lab test results, most often heard in reference to blood tests.

MG lactic acid Result of {metabolism} of {glucose} without the mitigating effect of the presence of oxygen. It has an inherently low pH. Sometimes during strenuous exercise, {pyruvic acid} is reduced to lactic acid, resulting in pain, cramps. See {lactic dehydrogenase}.

MG lactic dehydrogenase (LDH) an {enzyme} in blood and certain {tissue}s that helps to break down the {lactic acid} found in milk and other foods. An elevated level of LDH may indicate damage to muscle or other tissues.

MG LAK cell (Lymphokine-activated killer cell) A {lymphocyte} that has been modified in laboratory into a killer cell that will attempt to attack {tumor} cells. See {LEU19}.

MG Langerhans cell (dendritic cell) Long cell, often travels through {mucous membranes}, found at or near surface of {genital} mucous membranes, but may be found in varying densities thoughout body's {tissue}s. Langerhans cells move from tissues, through circulatory/ lymph systems, toward lymph nodes; as they migrate they {differentiate} and are called {dendritic cell}s. They then move into {lymph node}s, where they present {antigen} to and nurture {T-cells}. Unfortunately, it is believed that circulating dendritic cells are 10- to 100- fold more sensitive to {infection} than are {T-helper cell}s or {macrophages}. The "dendrite" is capable of carrying {antigen} through membranes to {lymph glands} or other areas, so it is thus a potential flaw in the otherwise positive phenomenon of {mucosal immunity}.

MG latency Period when {virus} is in the body but rests in an inactive, or {dormant}, state. 4-93 Although it's been thought that HIV may have had some type of latency in early stages, studies indicate "massive" HIV activity, including replication, in {lymphatic} system. See {lymph glands}, {HIV}, {HIV -- the Basics}.

MG latent Present but inactive. See {latency}.

MG latitudinal Across body or other object.

MG lavage Washing.

MG lecithin (Phosphatidylcholine) May be a dietary {precursor} to {acetylcholine}. See also {Choline}.

MG lectins Substance that occurs naturally in plants, produces an action resembling {immunological} reaction. Used as {mitogen}s.

MG lentiviruses Sub- family of {retrovirus}es that includes the visna viruses of sheep, equine infectious anemia virus (horses), and caprine arthritisencephalitis virus (goats). Cytopathic, cause chronic disease. It's believed that HIV belongs in this sub- family.

MG LEU19 (CD56) Specialized {T-cell} receptor, marker for the subset of {T-killer cell}s called {LAK} or "lymphokine-activated killer cells", whose function is to kill {viral}ly-{infected} cells. It's thought that proliferation of CD56 cells may help {immunomodulators} reduce body's HIV "burden," perhaps also reduce HIV damage to {T-helper cell}s.

MG leukocyte {white blood cells} that can move from bloodstream to {tissue} and back again. They act as "scavengers" of undesirable particles, help combat {infection}. {Lymphocyte}s are a type of {leukocyte}. The two types of leukocytes most critical in HIV are {T-cell}s and {B-cells} -- also called {T-lymphocyte}s and {B-lymphocytes} respectively.

MG levo- Pertaining to left side.

MG levodopa (l-dopa) Natural amino acid, found in body and {brain}, is converted into {dopamine} by {enzyme} action. Sometimes used vs. {parkinsonism}.

MG LFT {Liver} function test.

MG linear Following a straight line or course.

MG lipid Fatty substance extracted from animal or vegetable {cell}s by solvents.

MG liposomal Containing, or having properties of, {liposome}.

MG liposome Tiny spheres of fatty material, which may be used to convey otherwise {toxic} medications to site.

MG Liposyn II-20% {Analog} of Lyposyn III-2% available in hospitals, helps supply fat to systems of severely undernourished persons.

MG Liposyn III-2% Compound containing phospatides (egg {lipid}s), given {IV}. Other stimulating agents also included. Said effective for nutrition "boost" for seriously ill PWA's. There's some discussion of this preparation having anti-HIV activity {in vitro} (e.g., {AL-721}), but {clinical trial}s have failed to verify same.

MG lisine An {amino acid}. Not to be confused with {lysin}.

MG -lisis Suffix usually indicates death of an {organism}.

MG liter 1000 cubic centimeters; 1.056 quart.

MG liver Body's largest {gland}, located in upper {abdomen}, has many varied functions which involve processing of food and blood, production of {bile}, etc. Regulation of blood sugar and {metabolism} of fats, {carbohydrates} and {protein} are also included in the liver's long list of tasks. {Hepatitis} is a major liver disease, one which in its way presaged HIV as a medical problem to some of the same {high risk groups}.

MG long terminal repeat {Genetic} sequence common to all biological structures, said to be an "enabler" in the case of HIV. See {tat}.

MG longitudinal Along length of body or other object.

MG lumbar puncture Withdrawal of cerebrospinal fluid (CSF) for examination, using syringe. Sometimes called "spinal tap." Though uncomfortable, use of sufficient anethetic and other factors can prevent the procedure from being as painful as is sometimes thought. Usually done to confirm presence of {infectious} dis. of {brain} or {CNS}. For about a day after procedure is done, one should plan to remain in bed, as raising head or {spine} may indirectly cause severe headaches. Sometimes an alternative procedure, called the cisternal puncture, may be used. This involves withdrawal of same fluids, but from neck.

MG lungs The respiratory organs, one on either side of chest, surrounding heart. The trachea (windpipe) enters two bronchi (pl. of bronchus), through which air (and less desirable items) may enter. The lungs' primary responsibility is to aerate, or infuse oxygen into, the blood. Their main import in our context is that they are vulnerable to {infection}s and {insult}s of various kinds, the worst of which is {PCP}, a type of {pneumonia} common in presence of HIV. The lungs cannot function properly if mucous caused by infection causes {congestion} within them; then, impaired breathing impacts the entire body to some extent. See also {tobacco}, {alveolar sac}.

MG lymph Clear yellowish fluid derived from blood which circulates throughout what is called the body's lymphatic system -- a comprehensive network rather like and at points mingled with the blood system. Lymph contains {white blood cells} ({lymphocytes}, naturally) from all parts of body, as well as electrolytes, water, {antibodies} and nourishing substances. Lymph is cleansed by {lymph glands}, returned to bloodstream via system of {lymphatic vessels}.

MG lymph glands Also called lymph nodes. Small organs, about the size of peas, they produce {lymphocytes} and {monocyte}s, and act as filters keeping particulate matter, especially {bacteria}, from entering blood stream. {Antigen} entering the body often find its way into lymph or blood and is carried to lymph glands or {spleen} at which sites they are attacked by the {immune system}. (Sometimes the antigen is "delivered" to the immune system by specialized organisms, "afferent lymphatics.") (4-92) Two new studies reveal that during what was previously thought of as a "{dormant}" or "{latent}," period, HIV actually accumulates and replicates on a large scale in lymph glands and lymphoid tissues. This indicates that future research will seek to arrest HIV before this early phase if possible, as many of the lymphocytes found in these areas have no experience fighting infection.

MG lymphatic Refers to {lymph glands}, {lymphatic tissue}, {lymph}, etc.

MG lymphatic tissue Tissues which are part of {lymphatic} system, therefore important {immunological}ly. Include gut ({intestine}s, {liver}), bronchus (lower {respiratory} tract), skin (via {dendritic cell}s,) and blood, which is considered a lymphoid organ in the purest scientific and literal sense.

MG lymphatic vessels System of channels for transport of lymph to {immune} organs, bloodstream. Similar to blood vessels.

MG lymphoblast Abnormal cell, likely an indicator of lymphoblastic {leukemia}.

MG lymphocyte A type of {leukocyte}, member of the family of {white blood cells} and the major cell type of the immune system. 20-50% of typical adult's white cells are lymphocytes, and there are typically 1.5-4.0 X 10(9) lymphocytes per {liter} of blood. During the course of {infection}s, {B-lymphocytes} are converted into plasma cells and produce circulating {antibody} that is specific to the {pathogen}; T-lymphocytes are mainly responsible for cell- {mediate}d immunity, carrying antibodies on their surfaces. T-lymphocytes are of three main types: the {T-helper cell} (target of HIV), {T-killer cell}, and {T-suppressor cell}.

MG lymphogogue Factor or {agent} that increases or begins {secretion} of {lymph}.

MG lymphokine Substance produced by {antigen} stimulation of sensitized cells (i.e., {t-lymphocyte} and {macrophage}) that helps produce {cellular immunity}. Said to have an "amplifying" effect. {IL-2} is one example of the lymphokine. See also {cytokine}.

MG lymphopoiesis Production of {lymphocytes}.

MG lysin Member of a family of {protein}s able to damage or kill blood {cell}s. Bacteriolysin targets {bacterial} cells, leukolysin attacks {leukocyte}s, etc. Not to be confused with {lisine}.

MG lysome Found mostly in {kidney}s, {liver}, this {cell}ular {cytoplasm}ic particle is responsible for breaking down cellular contents. This includes {bacteria}, other unwelcome agents.

MG m Meter. 39.37 inches.

MG m2 Square meter, the "2" is superscripted.

MG macrolide Class of {antibiotic} drugs.

MG macrophage Class of large "scavenger" {white blood cells} {phagocyte}s which identify and engulf degenerated (see {degeneration}) cells, {tissue}, and foreign particles, "marking" them chemically as {immune system} targets. Macrophages are found in large numbers throughout the body, and are important to development of {immunity} in a variety of {organism}s. Closely related to {monocytes}. Macrophages have capability to transmit HIV to other cells with which they come in contact, and/ or act as "reservoirs" of HIV. 9-93 Some sources believe early HIV infection involves invasion of macrophages, not of {T-cells}, and produces no {syncytia}.

MG macula Pigmented, most sensitive, central area of {retina}. It has no blood vessels and its function is to help nourish the rest of retina.

MG macule Discolored and/or hardened spot, appearing on skin or elsewhere.

MG maintenance therapy Treatment that sustains a desired state of health that has been reached.

MG malinger Verb indicates pretending to be ill, perhaps as an excuse to evade responsibilities, etc.

MG mast cell {Granulocyte} found in {tissue}. Contains (among other matter) {histamine}, which will emerge if {infection} or {allergy} strikes. Some of this cell's contents are also common to {basophil}s.

MG MATP Microhemagglutination assay for T. pallidum. A treponemal test for syphilis.

MG Mazzini test Test to detect syphilis.

MG mcg microgram, 1/1,000,000 of a gram.

MG MCV Mean corpuscular volume, average volume of {erythrocytes}, a test result given in terms of {red blood cells}/ {cc}.

MG mechanical ventilation Use of "ventilator" device to artificially maintain breathing for a person who's lost that capacity.

MG mechanism Loosely, the method or means by which a process is carried out. In references to drugs, "mechanism of action" means "here's how the drug achieves its effects." In our context, seldom implies something is "mechanical" in that sense.

MG mediate To act as an intermediary, possibly to effect changes making one component more acceptable to another.

MG mediator Any agent which takes an intermediate role between two other agents, possibly helping the others co- exist in system, having a regulatory effect.

MG megaloblast An unusually large form of {RBC} {precursor}s such as normoblasts, proerythroblasts. Their nuclei (see {nucleus}) do not mature properly, and they're involved in a form of {anemia} in which there's a shortage of folic acid/ vit. B12.

MG megalocyte Unusually large form of {red blood cells}, or {erythrocytes}.

MG meiosis Type of {cell} division that results in four descendants of original, each having only half the number of {chromosome}s of original. Process is sometimes called "reduction division" because of that latter. This is a compound process in which stages take place, and substages. Occurs as function of human reproductive process.

MG melanin Dark pigment found in hair, eyes, skin. "Freckles" are areas where skin melanin is not contiguous.

MG membrane Extremely thin layer of {tissue}. Types are: (1) fetal, surrounding embryo in {uterus} (2) mucous, which {secrete} {mucous}, lining nose, {lungs}, throat, urinary, {intestinal} and {genital} tracts (3) permeable, which allow passage of liquids (4) placental, separates flow of blood between mother/child in uterus (5) serous, as found in chest and {abdomen} (6) synovial, which line {joint}s (7) tympanic, used in eardrum.

MG memory cell {T-cell} that will proliferate upon exposure to a certain {antigen} because of having had prior exposure to it. "Memory" of prior exposure is one of the distinctive features of the {immune system}.

MG meninges {Tissue}s surrounding the {spinal cord} and {brain}. They serve protective and connective purposes, and {cerebrospinal fluid} flows between their components.

MG metabolic Refers to function of {metabolism}.

MG metabolism Chemical process by which body uses food, water, medications, oxygen, transporting them to sites where needed, especially for energy but also for other proper functioning -- blood circulation, digestion, and {respiratory} processes are ongoing metabolic actions. Metabolism's work in building body's molecular components is called ANABOLISM; it may also break them down to be {excrete}d, and that process is called CATABOLISM.

MG metabolite A product of {metabolism}, may act on body in a way that differs from likely effect of the original ingested material, called the {precursor}.

MG metenkephalin (MEK) An {endorphin} produced by {virus}- {infected} {lymphocytes}, by adrenal medulla or in {brain}.

MG methcathinone ("Cat") Unknown in the U.S. until about 1992, when it was said to have caused overdoses in the former Soviet Union, this is an illegal drug somewhat similar to methamphetimine. In 1993, clandestine laboratories in Wisconsin and Michigan had begun manufacturing it. Methcathinone is reputedly more powerful, and more addictive, than cocaine. It may be capable of producing "highs" whose duration exceeds those typically caused by ordinary abused drugs. The agent may produce hyperactivity, agitation, depression, and paranoid psychosis. Methcathinones are found naturally in the leaves of the khat (cathine) shrub of southern Arabia and East Africa. Those living in those areas sometimes chew the khat's leaves for a mild "lift," but the agent is far more powerful when produced synthetically.

MG methemoglobin Blood pigment similar to {hemoglobin} except that it contains iron and can't combine reversibly w/ oxygen. Usually present in blood in small amounts but injury, {infection} stimulate more conversion of hemoglobin into methemoglobin. Excessive levels of this substance produce condition called methemoglobinemia.

MG methodology Methods.

MG mg Milligram, 1/1000 of a gram. Standard unit of drug measurement.

MG mg/kg Milligrams ({mg}) per kilogram (kg = 1,000 grams = 2.2 pounds) of body weight, for drug dosage purposes.

MG MHC Major histocompatibility complex. Group of {gene}s important to the "self/ not self" feature of the {immune system}. Their task is to produce {histocompatibility} {antigen}s, markers present on every {cell} of the body. See {HLA}, human- specific MHC.

MG microglia One of the two forms of {glia}, these are seen as immune system cells, found in the brain's connective tissue. They are able to secrete and release various chemicals, some of which kill other cells -- in many cases cells that are injured or involved in disease. Thus the microglia are working, in a way, as "scavengers." But at the same time, we also find microglia ministering to other cells- in- trouble, transmitting substances that nourish or tend to restore functioning. This is the riddle of microglia, and the reason these wispy- looking cells are sometimes called "Jekyll and Hydes." Finally, recent research finds that microglia can be stimulated by some messenger {protein}s to {synthesize} the potentially dangerous oxygen molecules called {free radical}s -- but that certain chemicals (notably {acetylcholine} can halt the production.

MG microgram 1/ 1,000,000 of a gram.

MG microliter 1/ 1,000,000 of a liter

MG microorganism Living {organism} not visible except under microscope. Ex: {virus}es, {bacteria}, {protozoa}, fungi ({fungus}). Also called microbe. Some, called "{pathological}" microorganisms, can cause {infection}s. They're commonly called "germs."

MG mild Discernable and probably requiring therapy, but not of high priority. See {moderate}, {severe}, {acute}.

MG milligram (mg) 1/1000 of a gram. Usual unit of measurement for drugs.

MG mitochondria Structures within a {cell} that produce sugars and {protein} needed for direct energy, such as that req'd to move muscles.

MG mitogen Naturally occuring substance, instrumental in division of {cell}s. May in some cases cause {cancer}- like effects.

MG ml milliliter, 1/1000 of a liter. Although not same as a cubic {millimeter}, the two measures have been used for rough comparison.

MG mm millimeter. 1/1000 of a meter, 0.04 (less than 1/16) inch.

MG mm3 cubic {millimeter}, the "3" is superscripted.

MG modalities Methods or types, as in "treatment modalities." Similar to "methodologies."

MG moderate More significant than {mild}, not as serious as {severe}.

MG molecule Smallest amount of a given chemical that can exist alone.

MG monoamine-oxidase (monoamine-oxidase type B) {Enzyme} that normally acts to degrade and thus deactivate {dopamine} so it can no longer stimulate {brain}'s dopamine receptors.

MG monoclonal Made of or derived from a single {synthetic} {cell}.

MG monocyte Large member of family of {white blood cells}, acts as "scavenger" to destroy foreign matter including {bacteria}. "{Precursor}" to the {macrophage}. See {differential WBC count}.

MG motor Describes the way {brain} transmits signals through {nervous system} to control movements of body, extremities. Nerves involved in this process are "motor nerves." See {neuropathy}, {nerves}, {nervous system}. Contrast {sensory}.

MG MRI Magnetic resonance imaging. Technique using tunnel- like magnetic machine, not {x-ray} technology. Can produce 3- dimensional images of body's internal organs, tissue. Not to be confused with {CAT scan} or {PET scan}.

MG MTD Maximum tolerated dose.

MG MU Million units.

MG mucocutaneous Pertaining to {mucous membranes} and skin, e.g., lips, mouth, or vaginal, {anal} areas.

MG mucosa {Mucous membranes}.

MG mucosal immunity Concept that {mucous membranes} form an almost- perfect shield against {infectious} diseases; that more {antibody} is made mucosally than by other means; and that even the {lymphoid} {tissue}s beneath mucous membranes are highly- active sources of antibody. Immunoglobulin A ({IgA}) is called the "workhorse" of mucosal immunity, just as {IgG} is the major agent of bloodborne immunity. The Sabin oral polio vaccine works by simply helping induce immunity at the mucosal surfaces. Future vaccines, including a vaccine against HIV, might do likewise. As much as 70% of the immune system operates at the mucosal level, where {pathogen}s like HIV often strike first. See also {Langerhans cell}s.

MG mucosal tissues {Mucous membranes} and/ or layer of underlying flesh.

MG mucous Colorless fluid {secrete}d in {intestines}, respiratory tract, cervix, other {mucous membranes}. Sometimes sp. "mucus". Same as "phlegm."

MG mucous membranes Smooth {tissue}s lining inner eyelid, nose, mouth, {rectum}, {genital} parts, etc. Most are naturally moist. Has an {epithelial} layer, much like other skin except that it contains small {gland}s that produce {mucous}. Beneath this is a connective layer ("lamina propria,") and finally the pliable "muscularis mucosae." See {Mucosal Immunity} for part of relevance.

MG Murex (Murex SUDS test) This HIV test, approved in 1992, is done manually and is relatively easy to interpret. It takes perhaps 10 minutes to perform the test, but technician time to set it up may be 45 minutes to an hour. Like the rapid latex agglutination test, the Murex SUDS test uses latex particles coated with recombinant protein antigens. If antibodies are present in the blood, a blue dot appears on a hand-held, disposable testing unit. If a result is negative, no color will appear. If a blue dot appears, the test is repeated. If repeatedly positive, another test is performed to verify the result. The Murex test includes safeguards, such as a negative control area that remains white when chemicals used to perform the test are properly administered. Murex company researchers claim the test has a 99.9% sensitivity rate and a 99.9% specificity.

MG murine 1. Adjective referring to a mouse or mice. 2. Capitalized, trade name of eye cleansing/ wetting agent.

MG mutation Refers to a change in {cell} {DNA}, caused by whatever agent. The process may take form of the changing of a single {gene}, or even of kind/ quantity of {chromosome}s. Although a given mutation may occur due to "natural" events, they are by nature abnormal, and are regarded as uncommon as well.

MG myc- (or "myco-," "mycet," etc) Usually implies {fungus} involved.

MG mycobacteria Rod- shaped {bacteria} that cause serious {infection}s in presence of {immune} deficiency or otherwise. These include Mycobacterium avium, M. bovis, M. kansasii, and M. marinum -- any of which may cause localized infections (of {lymph glands} or skin -- or {lungs}, especially in those with pre- existing lung disease). M. tuberculosis is, of course, the organism that causes infection with {tuberculosis}, and leprosy (Hansen's disease) is of mycobacterial etiology as well. If HIV is also present, these infections commonly spread to other parts of the body. The history of mycobacterial therapies in AIDS disease points to a reliance on combinations of treatments, quick development of {resistance} to drugs. (See specific infections elsewhere, esp. {MAC}.)

MG mycobacterial (See also {mycobacteria}.) A mycobacterial {infection} may be any of a broad variety of disorders, but for our purposes, may point to diseases other than {TB} or {MAC}, which we usually categorize on their own due to their significance here. These infections may be seen in skin, {lymph glands}, {lungs}, etc. Include m. bovis, m. kansasii, m. marinum, m. smegmatis. May be CDC- defined AIDS marker conditions. (CDC-C)

MG mycobacterium kansasii Cause of {tuberculosis}- like disease in humans. See also {MAC}.

MG mycoplasma Thought to be the smallest free- living human {organism}s in the human body. There's some question as to whether they are or aren't {bacteria} by definition, but they behave as such in many ways, while having some of the trade marks of the {virus}. One of their identifying features is that they have no distinct cellular wall. Usually infect {lungs}, sex organs. There are many {strains}, but 2 types, {Mycoplasma incognitus} and {Mycoplasma penetrans}, are thought to contribute to deepening of HIV infection. Other strains include M. pneumoniae, M. genitalium, M. hominis, and Ureaplasma urealyticum.

MG myelin {Tissue} which covers nerve {axon}s or fibers (may be thought of as a form of electrical insulation, as signals carried by inner fibers are electrical in nature.) It is also believed to help speed impulses on their way. It's made by cells of the {glia} called oligodendrocytes. Damage to this material is fairly common, and the results are called {demyelinization}.

MG myelocyte Undeveloped type of {white blood cells}, normally found in bone marrow. If they are seen in bloodstream, disease may be indicated. See also {differential WBC count}.

MG myelodysplastic Usually refers to one of a group of syndromes also called "preleukemic" blood disorders (indicating {precursor} to a {leukemia}); may in time be fatal as the person succumbs to {infection} or bleeding.

MG myelotoxic Tending to harm, destroy {bone marrow}.

MG nanomole One billionth of a "mole," that being a quantity of chemical compound whose weight in grams equals its molecular weight. One mole is equivalent to approximately 18 grams of water.

MG narcotic Drugs of a class which induce feelings of lightness, well- being. May or may not have soporific (sleep- inducing) properties or induce stupor, but usually do. These drugs have many legitimate uses, and are also frequently abused, and they have the potential to cause {addiction}.

MG NARTI Nucleoside- analog reverse transcriptase inhibitors, {biosynthetic} compounds similar to one of the components of {DNA} or {RNA}, designed to work against the {reverse transcriptase} {enzyme} needed for HIV's development. They are used as {antiretroviral} drugs. See {AZT}, {ddC}, {ddI}, {d4T}, {nucleoside}.

MG natural killer cells {NK cells} Large granular {lymphocytes} that seek and destroy {cancer}ous and {infectious} body cells. The adjective "natural" comes from the fact that they take action without first having to recognize specific {antigen}s. They are only indirectly related to the {T-killer cell}, are believed to be more closely affiliated with the {T-suppressor cell}; they're known for the wide variety of invaders they will attack.

MG NCI National Cancer Institute. US Gov't.- sponsored research agency. See {NIH}.

MG NCP This is a device that helps resolve intractable convulsion disorders (see {epilepsy}). It's surgically implanted in the chest above the ribs. Experimental only at this time, we're advised it seems safe and effective, producing such side FX as a mild cough when it's actuated and an artificial sense of well-being on the part of the user. Some speculation has been heard it might be used to resolve seizures seen in neurological disorders of AIDS.

MG nebulize To aerosolize, turn into fine mist. See {nebulizer}.

MG nebulizer Mechanism for delivering medication into the {lungs} in the form of a mist. A liquid drug is converted by the device -- a small hand- held design or a larger machine w/ a compressor, plastic tubes, mouth mask. The nebulizer has often been used by HIV- infected persons to receive {pentamidine} in "aerosolized" form. This is done to cause rapid, direct contact of medication w/ receptive surfaces.

MG necrosis Death of {tissue}. {Etiology} usually {bacterial}.

MG nef The precise functions of this {protein} substance are still being investigated, but it seems to have an important role in regulating HIV activities, including reproduction, in either an upward or downward manner. (Nef) is a counterpart to the better- known {rev} and {tat}. The (nef) molecule was for a long time thought to stand in the way of HIV replication, but we're now hearing hints to the contrary.

MG neonatal First weeks of life after birth.

MG neopterin Substance {secrete}d by cells of {immune system} (generally by {macrophages}) in {urine}, blood {serum}, {CSF}. Level of neopterin is sometimes measured via blood test as a means of determining severity of HIV or effectiveness of therapies.

MG nephrology Specialty of medicine dealing with {kidney}.

MG nephrotoxic Poisonous to {kidney}s.

MG nerve Loosely used to describe a component of {nervous system}, most likely fibers ({axon}s), nerve endings {dendrites}. The context should help specify.

MG nervous system Means by which {brain} coordinates the messages received from sensory areas or organs of the body and actions to be taken in response if any. Components of system found throughout entire body, and range in size and complexity from single cells on up. Branch of medicine dealing with the "N.S." is called neurology, and most words that begin with "neuro-" relate to NS phenomena. See {nervous system -- more}.

MG neuro- Prefix indicating relevance to {nervous system}.

MG neuroleptic Refers to drugs ({dopamine} {antagonist}s) that block post- synaptic (see {synapse}) {dopaminergic} receptor sites and as incidental effect usually aggravate {parkonsinism} symptoms. May be used for treating various conditions. The phenothiazine drugs such as Triavil, Thorazine, Stelazine, Compazine and Prolixin are all neuroleptics.

MG neurological Refers to the {CNS} and/ or the outlying "peripheral" {nervous system}, and diseases thereof. Diseases brought on by HIV often produce unfavorable neurological effects. (Prime examples: {toxoplasmosis}, cryptococcal meningitis (see {cryptococcosis}). Neurological functions include all voluntary movement directed by brain, dysfunctions include {dementia} (centered in CNS), {neuropathy} (affects peripherals), and many others. Drugs that control AIDS or its manifestations (including all the standard {NARTI} agents) may produce neurological side FX. (neurological complications) HIV has the ability to directly infect cells of the {brain} and the {spinal cord}, and may produce symptoms similar to those of some of the {opportunistic diseases}. These include {motor} control problems, memory loss, mood swings, {seizure}s, confusion, dizziness and headaches. May be very difficult to diagnose.

MG neuron A nerve subsystem that integrates and routes information from all the receptor sites. In the {motor} nervous system, the {cell body} that contains and nourishes the neuron's {nucleus} is found near outer "receptor" networks called {dendrite}s, then a long structure, the {axon}, travels along until it terminates at a motor end plate. In the {sensory} nervous system, dendrites take in data from nerve endings and transmit it via an axon having its cell body at an intermediate site, on to the brain. Points of near- contact between the overall structure of the neuron are known as {synapse}s. Signals may be induced between two synapses by the agent called the {neurotransmitter}.

MG neuronyxis Insertion of {acupuncture} needle.

MG neuroradiological Study of {nervous system} w/ {x-ray}s.

MG neurotransmitter A chemical produced in {neuron}s, w/ specialized functions in sending information from one neuron to another. {Dopamine} and {acetylcholine} are thought of as neurotransmitters. See also reference to "autonomic" section under the heading {nervous system}.

MG neutralization In our context, means by which {antibody} {bind}s to specific {antigen}, then renders that {microorganism} harmless or "neutral."

MG neutrophil (Polymorphonuclear neutrophil, Polymorphonuclear leukocyte, PMN) A {cell}, produced in {bone marrow} able to kill {bacteria}. See {neutropenia}, {differential WBC count}.

MG NF Refers to a drug compounded according to the American Pharmaceutical Association's "National Formulary."

MG NIAID Nat'l Institute of Allergy & Infectious Diseases. One of the many institutes of the {NIH}, which in turn is part of federal government's Public Health Service. NIAID is responsible for federally funded national AIDS research programs, and supports many related functions.

MG nigro-striatial Refers to area between {substantia nigra}/ {striatum}. These are {nerve} pathways, normally rich in {dopamine}, subject to grave damage during course of {parkinsonism}, may be subject to {degeneration} due to various causes. (See {Basal ganglia}).

MG NIH National Institutes of Health, comprised of several component institutes. Most basic biomedical research in US is funded by NIH, which currently sets the nation's research agenda. Though all NIH are involved in some AIDS research, treatment research is concentrated at {NIAID}, and much is done at {NCI}. (301) 496-4000.

MG nitric oxide (NO) Gaseous molecule dilates blood vessels, is said to transmit messages between {neuron}s, kill some {parasite}s, etc. 9-93 It's suggested that NO may be used by {immune system} against {viral infection}s. Says NO shows activity against both poxviruses (ectromelia and vaccinia) and {HSV} type I, suggests that NO can be induced by {cytokine}s. A very important {cytokine}, gamma interferon {INF-G}, tends to stimulate cells to produce NO by directing {synthesis} of the enzyme NO synthase. Working with mice, researchers have established that if NO is blocked, subjects infected w/ ectromelia had higher mortality, autopsies showing "considerably" more virus in livers, spleens. NO, {nitROUS oxide} not same.

MG NNR Abbrev. for "New and Nonofficial Remedies," a booklet once published periodically by {AMA}. We are advised that it is no longer available, has been superseded by a similar publication priced at about $100.

MG NNRTI Non-{nucleoside} {reverse transcriptase} inhibitor. Category includes such drugs as BI-RG-587, pyridinone, nevirapine, TIBO derivatives, BHAP compounds. These have been shown to inhibit HIV replication {in vitro} by attacking the reverse transcriptase {enzyme}, which is needed by HIV if it is to reproduce. However, as of 1-94, trials of these drugs have not been rewarding. Our sources say high level {resistance} has generally developed in non test- tube trials within 6-12 weeks, and this may be an inevitable end- point of the NNRTI philosophy. Drugs such as {AZT}, {ddI} and {ddC} are {nucleoside}- {analog} reverse transcriptase inhibitors.

MG nocardia asteroides {Bacterial infection}, affects {brain} and {lungs}. May cause {abscess}es. Usual therapy is via {antibiotic}s.

MG node Round structure. Some, like lymph nodes ({lymph glands}), are normal and even necessary, while others are neither and may or must be given medical treatment.

MG Nonoxynol 9 Spermicide, said by some sources to work in conjunction with use of {condom} to decrease possibility of HIV transmission. That is NOT TRUE. No spermicide has, or is designed to have, any effect on HIV.

MG norepinephrine (noradrenaline) A {neurotransmitter} that can be released by the autonomic {nervous system}.

MG nosocomial Refers to events within a hospital or clinic environment.

MG NRC Nat'l Research Council, part of Nat'l Academy of Sciences, a private organization chartered by Congress to provide scientific advice to Federal Government. 2-93 Has issued a study incorrectly minimizing impact of HIV disease on U.S. in future. Some sources stunned by report's lack of insight and basic inaccuracy.

MG NSAID Non{steroid}al anti-inflammatory drug. These, in the class of aspirin, Excedrin, or Motrin, relieve low- level discomfort of inflammation and are generally safe except for possible {GI} side FX, etc. They are not always useful against {moderate} or greater pain. Origin of the pain is also a factor in NSAID effectiveness. See {Analgesics}.

MG nucleic acid Large natural {molecule}s made up of {nucleotide}s. {DNA} and {RNA} are the two forms of nucleic acid. See also {nucleoside}.

MG nucleoside Purine or pyrimidine compound connected to a sugar. Purine and pyrimidine are both nitrogen- based agents, purine being constituted of adenine or guanine ({nucleotide}s of nucleic acid) or uric acid (a product of purine metabolism). Pyrimidine is made up of other nucleic acid nucleotide rings -- thymine, cytosine and uricine. When joined to sugar, the resultant combinations include the substances cytidine, thymidine, guanosine, adenosine, uracil. Nucleic acid is recognizable as {DNA} and {RNA}, its ultimate form. See also {PurNA}, {PYNA}, {ThyMA}, {NARTI}.

MG nucleotide Links, having {nucleoside} characteristics, plus some phosphate, that make up long chains called {polynucleotide}s. In {DNA}, these chains contain the purine {base}s guanine and adenine, and the pyrimidines thymine and cytosine. In {RNA}, the thymine component is replaced by uracil. See {gene}.

MG nucleus Central part of {cell}, contains {protein}, {DNA}, {RNA}. Divided by "nuclear envelope" or membrane from {cytoplasm}.

MG occult Hidden, concealed.

MG ocular Related to the eye. May be used as suffix.

MG off-label A drug prescribed for conditions other than those in maker's list of {indication}s.

MG -oid Suffix means "like," "similar to."

MG oligo- Prefix means scant, little, slow.

MG OMT Oral mucosal transudate, a common natural fluid which has passed through {mucous membranes}. (7-93) Research indicates that OMT, which is taken from a person via easy, non- invasive means, is a good source of specimens for measuring {antibody} to HIV's {gp120}. Use of OMT instead of extracting blood for tests also safer for health care workers. It's said there's an excellent correlation between specific antibody {titer}s in {serum} and in OMT. It's noted, though, that serum should be used if response to HIV-1 major neutralization determinant or to {p24 antigen} is wanted.

MG on-off phenomenon Common side effect of regular {levodopa} therapy, usually in those who have had abnormal involuntary movement previously. Alternating {dyskinesia}, {akinesia} occur rapidly.

MG oncology Specialized in diagnosis and treatment of {tumor}s, {cancer}.

MG opiate Having qualities of or relationship to {opium}.

MG opiate antagonist Drug or substance in body that blocks {opiate receptors}, halting activity of opiates ({heroin}, {morphine}, {methadone}, & other {opium} derivatives) -- or activity of {endorphins} such as {beta endorphin}. The body can {secrete} an opiate antagonist, cholecystekinin. {Synthetic} opiate antagonists include naloxone, naltrexone.

MG opiate receptor Structures on {cell} surfaces that respond to and are targeted by {opiate} and {endorphin} molecules. Found in various types of cells in {brain}, but also {lungs}; {pancreas}; {endocrine glands} etc. Info of incidental interest under {brain stem}.

MG opportunistic Normally- harmless agent, capable of being a disease- causing {antigen} if body defenses are lowered.

MG opthalmologist Specialist in diseases of or injury to eyes. Not to be confused with {optometrists} or {opticians}.

MG optic nerves These nerves, at the back of the eye, carry visual signals from {retina} to {brain}.

MG opticians Those who manufacture and test lenses, assemble eyeglasses.

MG optometrists Those who conduct vision tests and prescribe glasses or contact lenses.

MG oral Having to do with the mouth.

MG orbit Bony cavity of the skull that contains eyeball and its associated components.

MG organism Any form of life. In our context, usually refers to the tiny ones called {microorganism}s.

MG oropharyngeal Related to central portion of {pharynx}, the passageway between mouth and {esophagus}.

MG -osis Vague suffix referring to illness or symptom(s).

MG Osteopathy Branch of medicine following the premise that interdependence of function and structure of body's systems is one of the most important factors in successful diagnosis, treatment of illness. Often, osteopathic therapy involves manipulation, palpation and massage of muscles/ joints, but osteopathy is not same as {chiropractic}, and has "been around longer" than parallel concepts of {psychoneuroimmunology}.

MG OTC 1. "Over the counter" -- referring to preparations that are safe enough for someone with a minor ailment to choose as a treatment, but in no way effective enough to treat most serious medical problems.

MG oto- Prefix usually refers to ear.

MG oxidoreductase (oxidase, dehydrogenase, etc.) Type of enzyme able to precipitate oxidation reduction (reductase) process -- the breaking down of oxygen within body.

MG p Protein. See {HIV antigens}.

MG p24 antibody {Organism}s which react to the {p24 antigen}. See {antibody}.

MG p24 antigen "Core" {protein} fragment of HIV. Tests can detect this fragment, with a positive result for presence of p24 {antigen} suggesting active HIV replication or more likelihood of near future AIDS development. The test may not be very sensitive, and p24 is consistently present in only about 25 percent of HIV-infected persons, but the test is very specific. p24 is a group specific (gag) region "{Ag}", classed with p18, p55. See {HIV antigens}.

MG pain Primary signal delivered via {nervous system} that injury has occurred or illness has progressed to a certain point. Those who are basically healthy experience "acute" or extremely serious pain after some {insult} to body -- the pain will clear when causative injury or disease {remit}s or is cured. If pain is caused by injury, physicians will typically prescribe an {analgesic} of proper strength and/ or physical therapy, hot/ cold packs, etc. In case of end- stage illness, analgesics of appropriate strength or other measures may be used, depending on physician's judgement and philosophy. See {telalgia}, {endorphin}; also note {referred pain}. Chronic pain is often a factor in HIV disease.

MG palliative A therapy that offers some relief, but no permanent results or cure.

MG palpate To examine a person by touch, probing for irregularities such as swollen {gland}s, etc., noting any reaction of pain or discomfort when given areas pressed upon.

MG pancreas Organ connected to small {intestine}, just past stomach, which {secrete}s {protein}s (digestive enzymes), which go into the intestine for breaking food down into components. Anything related to pancreas is called "pancreatic."

MG pancreatic Related to {pancreas}.

MG pandemic Refers to {epidemic} of widespread prevalence. Suffix "pan-" means "across." AIDS is a pandemic by any standards.

MG pap smear (Papanicolaou smear) Examination, under microscope, of cells scraped from cervical (see {cervix} or vaginal lining. This procedure should be done regularly as it apprehends cervical cancer and other HIV factors at an early stage.

MG papovavirus Virus causing (usually {benign}) growths or {tumor}s.

MG parasite A plant or animal organism that lives, grows, and/ or feeds on or within another living organism and provides no benefits in return. These are usually but not always amoebae, tapeworms, roundworms, certain small insects, etc. Some are harmless while others produce illness. Parasites most often associated with humans are worms, the {protozoa}, the {virus}, the {fungus}, {bacteria}.

MG parenchyma Essential components of a given organ.

MG parenteral Drug administration via route other than mouth. (Usually {IV}, {IM}, {SC}.) "Total parenteral nutrition" is used for those with severe bowel dysfunction -- see {TPN}.

MG parvovirus (B19 P.V.) {Virus} present in about 50% of a given population, usually harmless but may cause {bone marrow} failure in {immunocompromised} persons, may cause {aplastic anemia} in PWA's. Possible therapy: {IgG}.

MG path- Prefix denoting disease. See {pathological}, {pathogenic}.

MG pathogen Any {microorganism} capable of causing disease. See also {parasite}.

MG pathogenesis Refers to origin, progression of disease

MG pathogenic Indicates ability or relative aility to cause disease.

MG pathological Refers to an abnormal condition believed to be brought on by disease and not other factors.

MG Pathology Medical specialty determining exact causes of disease by study of {tissue}s, {cell}s, etc. This very precise discipline studies samples of blood, {urine}, diseased tissue, {feces} for diagnostic clues. (See references to {HIV progression testing}, {HIV preventive testing}, {culture}, {CBC}, etc. "Clinical" pathology applies the acquired knowledge toward curing disease.

MG -pathy 1. Vague suffix applied to a disease name. 2. Suffix of branch of medicine, i.e., osteopathy, allopathy.

MG PBL {Peripheral} blood {lymphocytes}.

MG PBMC {Peripheral} blood mononuclear (having 1 {nucleus}) {cell}s.

MG pcg picogram, 1 X 10 (12) of a gram.

MG PCR In our context, the Polymerase Chain Reaction is a relatively new discovery making possible a sophisticated and sensitive test of HIV disease progression. It identifies the nucleic acid sequence of HIV in cells and determines the amount of circulating {virus}, or actual "viral load," present in blood. Often used to test infants, per one source who states that those born to seropositive mothers may have HIV {antibodies} but not HIV itself. It's said this method can determine the point at which a person's system begins to develop {resistance} to a drug and/or when HIV {mutation} is occurring. It might also be helpful in evaluating {vaccine}s and {antiviral} therapies. Also called "Quantitative Competitive Polymerase Chain Reaction." 5-93 One source says periodic routine PCR testing of persons taking antivirals would pay off handsomely, allowing physician and person being treated to switch drugs in a more timely way. PCR can also be used to replicate biological matter, as does {recombinant DNA} technology. See {HIV progression testing}.

MG PDR Physician's Desk Reference. Comprehensive listing of available drugs, w/ details of chemical composition "{indication}s" (condition for which used), "{contraindication}s" (cautionary info), {mechanism} (method) of action, representative test results, etc.

MG pelvic exam Regular pelvic exams are a must for women, as they reveal presence of {STD}s, discharges, {lesion}s, other possible {cofactor}s of HIV disease.

MG peptidase Digestive enzymes (endopeptidase, exopeptidase) that break down food.

MG peptide A {molecule} having at least two {amino acid}s, which will be connected by links between the amino and the carboxyl families (carboxyls facilitate union of carbon dioxide w/ other chemicals). Peptides are used in the construction of {protein}s. {Thymic} peptides are {hormone}s in function, just as {pituitary} hormones have peptide components. (See {IGF-1}. Some familiar names among peptides are {dopamine}, the {endorphin}, {enkephalin} -- essential as neurotransmitters. There are theories that peptides may have use vs. HIV in that they seem to "block HIV fusion" with uninfected cells, among other mechanisms. Peptides are said to have both homologous and heterologous (harmonious and complementary) anti-HIV action. See also {peptide T}, {peptide vaccine}.

MG perianal Around the {anus}.

MG perinatal Occurring in the period around, during, or just after birth.

MG peripheral Away from center. Characterizes certain blood vessels, nerves, etc.

MG peripheral nerve Describes nerves that are outside the {CNS}. It's possible to be much more precise; see {axon}, {neuron}, {nervous system}.

MG peroxidase {Enzyme} that facilitates oxidation, or dehydrogenation, of various substances. Found in plant/ human life. In humans is seen in {leukocyte}s, milk.

MG PET scan Imaging technique using positron emission tomography. Not used as a diagnostic method so much as for research, though this balance appears to be shifting. PET -- unlike the {CAT scan}, {MRI}, and {x-ray} -- can display functional disorders where no anatomic abnormalities are present. One application for this technique would be in detecting tumors of the head or neck, where tissue planes might not seem to be distorted and adjacent structures might not have been invaded. Technology other than PET is typically not helpful in these cases. Another benefit can come from use of PET scans to monitor effectiveness of chemotherapy or radiation treatments. As with some other uses of the method, it's not feasible to do this routinely -- but it can be done. PET images reflect distribution of decaying radioisotopes.

MG pft {Pulmonary} function test.

MG PHA A {mitogen} that can be used to test condition of a person's {CD4} cells.

MG phagocyte White cell that attacks, ingests {antigen} (i.e., {bacteria}, {protozoa}). Prefix literally denotes "eating."

MG pharmacokinetic Study of how a drug is used as it passes through body; extent and rate of {absorption} from stomach, distribution, location in {tissue}s, excretion (see {excrete}).

MG pharynx Passageway between mouth and {esophagus}.

MG phenotype Quantifiable effect of the distinctive combination of an organism's {genotype} and environment on the organism itself. See also {Strain variation}.

MG phenytoin Therapy for many forms of {epilepsy}.

MG phlebotomy (Bloodletting) Drawing of blood by making incision in {vein}.

MG photosensitivity Excessive {dermal} reaction to sunlight. May take form of tingling, burning sensations or hypersensitivity to hot, cold temperatures.

MG pituitary gland One of most important {endocrine glands}, its {hormone}s ({ACTH} just one example) regulate growth and help control {thyroid}, {adrenal gland} activity. Located at base of skull.

MG placebo Inert or inactive substance. In {placebo}- {controlled trial} of a drug, a placebo resembling test drug is given to one group while the real article is given the others. Results obtained in the two groups are then compared. Validity of this is due to fact that the taking of anything thought to be a drug may psychologically "suggest" relief so strongly to a person that actual physical relief may occur to some extent. This is called the "placebo effect."

MG plasma Fluid in which blood cells and nutritive substances are moved through the body. Also carries away waste products of {metabolism} from organs, and works as a carrier of chemical "communications" between various parts of body. Blood components may easily be "separated" from plasma, which is itself made up of mild {salt}s, calcium, other minerals, suspended {protein}. Unlike {serum}, also contains essential clotting ingredients.

MG plasma cell Large cell, descendant of {B-cells}, capable of production of {antibody}.

MG plasmapheresis Selective removal of some {protein}s, {cell}s or {antibody} contained in blood {plasma}, then restoration of remaining fluid to bloodstream. It's said this process has in past been used in treating some types of {peripheral neuropathy}. If so, {efficacy} unknown.

MG platelet (thrombocyte) A small circular/ oval disk present in blood, necessary for ability of blood to clot. It's small relative to red or white cells, is sometimes called a cellular "fragment." Mentioned in {CBC}, in which normally 200,000- 300,000 platelets (per {cc}) are found.

MG platelet factor 4 {Biosynthetic} replica of a {protein} that can inhibit blood vessel formation. May be useful vs. {KS}.

MG PO By mouth.

MG poiesis Refers to process of production. Used as fragment within many medical terms, e.g., {hematopoiesis}.

MG pokeweed mitogen {Protein} from pokeweed plant, used in {immunology} research to stimulate "{differentiation}," or maturation from primitive cells, of {T-cell}s and {B-cell}s.

MG pol Polymerase. See {HIV antigens}.

MG poly- Prefix means "having many", or "having more than one".

MG polyclonal Having in origin more than one type of ancestor cell.

MG polymer A substance formed by a combination of lesser {molecule}s. It will thus have a relatively high molecular weight. Sugars may form polymers called {glucose}, which may form polymers called starch.

MG polymerase An assemblage, partly or wholly of {enzyme}s.

MG polypeptide A molecule that depends on {peptide}s to bind together its multiple amino acid components.

MG polysaccharide Implies presence of multiple forms of {glucose}/ other sugars as a compound. See also {sulfated polysaccharide}, {peptidoglycan}.

MG potentiate Interaction between, among drugs/ other agents causing {synergistic} response exceeding individual responses to any single component.

MG PPD (purified protein derivative of tuberculin) Purified protein derivative. Test used to ascertain prior exposure to {TB}.

MG ppm Parts per million.

MG pre-clinical Very first stage in drug testing.

MG precursor (1) A chemical substance which the body will convert to a different substance -- a {metabolite}. See also {prodrug}. (2) previously existing disorder that led to a later disease. (3) Any phenomenon that precedes another.

MG premalignant Refers to {cell}s which are just beginning to assume {cancerous} (malignant) properties.

MG present In medical usage, verb refers to initial assessment of appearance. A person "presents with" a given symptom or set of symptoms. Or, a disease "presents as" (given symptoms). Sometimes heard in the phrase, "presenting symptom(s)," which emphasizes preliminary quality of what is seen.

MG primary prophylaxis {Prophylaxis} done before person has experienced a given disease. secondary prophylaxis is done after disease, treatment, {remission}.

MG prion protein (PrP) See {prion diseases}.

MG prn As needed.

MG procedure In general, synonym for "surgery." May however refer to lesser therapeutic activities of a physician.

MG proctosigmoidoscopy (proctoscopy, "procto") Examination of the first several inches of the {rectum} with a hollow, lighted tube.

MG prodrome Early symptom that marks onset of a disease.

MG prodrug A drug which, after administration, is modified into a different drug by {metabolism}.

MG progen Agent which can induce {fever}. (Ex: See {interleukin 1}).

MG progenitor Broadly refers to ancestors or parents.

MG prognosis Physician's estimate of course of disease. Will in most cases be a prediction of how a course of treatment will progress. In terminal illnesses may refer to an estimate of time remaining before patient's demise, though contrary to what one sees on TV, only in certain limited circumstances can a physician deliver this latter type of announcement. (8-93) In the first few years since HIV disease was first defined, typical life expectancy of affected persons has risen from about 18 months to well over a decade. This is due to medicine's advances and to better communication among all concerned as to questions of survival.

MG proliferation Increased quantity. Often used in reference to {cell}ular multiplication.

MG proline An {amino acid} found in various {protein}s.

MG proopiomelanocorten Natural "Prohormone" ({progenitor} to hormone) found in {anterior} of {pituitary gland}. At specified times it will be converted to {ACTH}, {beta endorphin}, and MSH (melanin stimulating hormone). Such conversion typically occurs during middle of night or under high- stress conditions.

MG prophylactic (1) adj. describes preventive treatment against disease. See {prophylaxis}. (2) formal term for condom, when used as noun.

MG prophylaxis Preventive treatment against disease. As of 6-92, i's held that adults with HIV require {primary prophylaxis} vs. {cryptococcosis} (when {CD4 T-cell count} below 100) ... {PCP} (CD4 below 200) ... {toxoplasmosis} (when CD4 below 100-200 with positive serolological tests) ... {MAC} (CD4 below 100). Secondary (recurrance- prevention) prophylaxis vs. above (except MAC), plus {Herpes} simplex, {CMV}, {oral} or vaginal {candidiasis}. Early treatment of oral "thrush" may prevent {esophageal candidiasis}. Time at which prophylaxis is to begin varies approximately as shown, consult physician. {Syphilis} screening recommended, also {pap smear}s, {CD4 T-cell count} monitoring. See also {HIV preventive testing}.

MG prostaglandin (PG) A {hormone} found throughout the body as a {fatty acid}, often in the various fluids but also in tissues, etc. In women, this substance helps cause muscular movements of the womb; in both genders, it helps regulate blood pressure and maintain normal body temperatures. One type of prostaglandin, called "E2," seems to appear at slightly elevated levels in the presence of HIV. However, there are indications that this chemical has a role in the control of viral infection. It has long been known that prostaglandin appears at sites of {inflammation}. In low and moderate concentrations, the substance appears to be pro-inflammatory, but higher amounts of PG have the opposite function. Researchers have tried using the substance as an antiviral, against HTLV-1, with affirmative results in test tube trials. Types A1 and J2 prostaglandin at first showed no activity, then suppressed "late cell proliferation" (from day 8 onward). Finally, other experiments established some {in vitro} inhibition of HIV replication by PGA1 and PGA2. Number and size of virus-induced {syncytia} and the amount of viral antigen were reduced. PGB1, PGE1 and PGE2 were inactive. "Previously," say the authors of that study, "intravenous infusion of PGA1 into human volunteers has shown no significant deleterious side- effects and thus these observations suggest that PGAs might have potential as antiviral agents in humans."

MG prostate gland Gland found in males below urinary bladder. Involved in sexual activity, it helps in secreting what's loosely termed "semen," the {alkaline} fluid which serves as a "carrier" for {sperm}, which is itself not plentiful or bulky enough to be projected reliably into female's body and onto eggs. In later years, the prostate is subject to enlargement, causing {kidney} problems, and is frequently a site of {cancer}.

MG prosthesis (prosthetic) Any manufactured device which replaces a missing body part or compensates for reduced physical capacity due to medically- related factors. Technically, eyeglasses, hearing aids are "prostheses."

MG protease (proteolytic enzyme) 1. Generally, an {enzyme} that helps in digestive process, breaking down {protein}s. 2. Enzyme that makes possible the assembly and ultimate replication of HIV. As part of HIV's production of new viral matter, freshly-produced proteins emerging from the outer envelope, in the form of a long, unwieldy string, must be reduced in size. Protease has been likened to a chemical "cleaver" that serves this purpose. Its activity takes place immediately after the so-called "budding" process terminates, and is absolutely necessary for HIV's survival as an invading organism. This is seen as a weak spot in the viral life cycle, and it's already been shown that agents called {protease inhibitors} can work to some extent against HIV progression. They lock onto the protease blade and wrap about it, not destroying but effectively blunting it. Protease is a member of the aspartyl- protease enzyme family, which also includes the major human enzymes renin (regulator of kidney activity) and pepsin (digests protein in the stomach). These human enzymes have a somewhat different, asymmetric structure than that of HIV's helper protease, though, and the drugs that target the latter should not affect innocuous forms of enzyme.

MG protein Group of complex {amino acid} compounds, linked by rings of {peptide}s, occurring in {cell}s of living {organism}s including humans, and providing the actual material of which living things are made -- beginning with chemical components and ranging all the way to the very fibers and tissues of the human body and its organs. Proteins are used not just in forming but also in repairing damage to these complexes. Their chemical makeup is such that they also help regulate certain body functions, and they also produce energy used for exertion and endurance. In some contexts, proteins are regarded as polypeptides.

MG prothrombin Substance in blood {plasma} from which the {enzyme} called {thrombin} is formed when blood coagulates. See {prothrombin time}.

MG prothrombin time One of four tests that measure coagulating abilities of several blood factors. Normal test value is 14-16 seconds. See {prothrombin}.

MG protoplasm Combination of {nucleus}, {membrane}s, {cytoplasm}; the living {cell}.

MG protozoa Generally, simple {organism}s composed of only one {cell}. Some of them are {parasite}s, capable of causing disease. Just 2 of many examples: {Toxoplasmosis} and {cryptosporidiosis} are caused by protozoan {infection}.

MG provitamin Substance that can be transformed into a {vitamin}.

MG prozone phenomenon A reaction that occurs in undiluted or slightly diluted {serum}, in which {antibody} is present in such high concentration that it interferes with precipitation reactions with {antigen}. The phenomenon may interfere with obtaining a correct result from a test, especially a test for syphilis.

MG PSRO Professional Standards Review Organizations. Groups of local doctors who work to apportion and report on community health resources and their usage. Their work is intended in part to control expenditures by Medicare and Medicaid.

MG psychomotor Related to conscious, voluntary movements performed with coordination of the {nervous system} and brain.

MG psychotropic Drug that changes a person's behavior. May be part of certain religious ceremonies, or used for purpose of "getting high," or prescribed by a physician, in which case see {psychotherapeutic drug}.

MG pt. Abbreviation for "patient." For use in clinical setting only.

MG PTT Partial thromboplastin time. A test for blood clotting dysfunction.

MG Public Health Service Part of the US Dep't of Health & Human Services, or {HHS}. Is central decision point when health emergencies arise. Encompasses {NIH}, {FDA}, {CDC}, and Alcohol, Drug Abuse and Mental Health Admin'n.

MG pulmonary Having to do with the {lungs}.

MG PurNA Purine {nucleoside} analog. Replicas of two natural nucleosides, 2-deoxy-adenosine and 2-deoxy-guanosine. These synthetic {analog}s may be capable of blocking HIV {viral} production if introduced into {DNA} during that process. One "PurNA" is {ddI}. Another, {vidarabine}, shows promise vs. {herpes simplex virus} production. In combination with 2 pyrimadine nucleosides ({thymidine} & 2-deoxy-cytidine) the two named nucleosides are the building blocks of {DNA}, the basic {genetic} material. (See also {PYNA}.

MG purulent Containing {exudate}.

MG PYNA Pyrimidine nucleoside analog. Replicas of two natural pyrimidine {nucleoside}s ({thymidine}, cytidine). Along w/ 2-deoxy-adenosine and 2-deoxy-guanosine, these substances are the building blocks of {DNA}, the basic genetic material. {Synthetic} PYNA such as {AZT}, {ddC}, and {d4T} seem to slow growth of HIV in a way similar to action of {PurNA}s.

MG pyruvic acid Natural substance based on {carbohydrates}, oxidized by body producing carbon dioxide and energy. (See reference in {lactic acid}.)

MG Q Each.

MG Q4H Each 4 hours.

MG QD Each day.

MG QID 4 times daily.

MG QOD Every other day or 3 times/ week.

MG radiation therapy Treatment vs. {cancer}, using radiation.

MG radiologist a specialist in use of {x-rays}.

MG rebound effect Unfavorable response of body to withdrawal of an agent to which it has become accustomed. Commonly seen after use of {corticosteroid}s, anti{histamine} nose drops. Parallel to but not same as {withdrawal}.

MG rechallenge Administration of drug a second time after the person has not responded to it, or has experienced side FX.

MG Recombigen (Recombigen Latex Agglutination Test) In 1988, FDA approved this HIV test, which can produce a result within five minutes. It's the first to use {recombinant} pieces of HIV antigen; this reduces possibility of false positive or false negative results. This test's sensitivity may not be optimal -- it's been measured at as low as 92%. The latex agglutination test is not widely used because many believe it is not as simple to use or interpret as the {ELISA test}.

MG recombinant Produced by {genetic} engineering. Syn.: {biosynthetic}.

MG recombinant DNA Refers to technology that provides a method of "cloning" or copying a biological substance precisely, using {DNA}. DNA of certain cells can be changed so that they become "factories" that make a desired substance. Recombinant DNA technology is used to make large amounts of things that are found naturally in limited quantity, such as {insulin}. In AIDS research, a number of agents are being made by this method -- {CD4} protein (see {rCD4}), {alpha interferon}, {gamma interferon}, {rhGM-CSF}, others. 10-93 See also {PCR}.

MG rectum Tubular organ above {anus} through which solid waste is ejected.

MG recurrent Subject to {relapse}s.

MG red blood cells (erythrocytes) Primary function is to bear oxygen to {cell}s. Contain {hemoglobin}, which accounts for their coloration. {CBC} should find about 4.2-5.5 X 10 (12) erythrocytes per cubic liter. {Secrete}d in {bone marrow}.

MG referred pain When {insult} or disease in one defined area of body produces pain in another part, which does sometimes happen, this is called "referred" pain. It's often due to mixing of signals in {nervous system}. See {synapse}, {nervous sytem}, {neuron} for clues as to how this might happen. See also {telalgia}, same.

MG reflex Muscular action of an involuntary kind, response to stimulation of {nervous system}. "Unconditioned" reflexes are present by nature, whereas "conditioned" ones have been ingrained by experience. Tests for presence of normal reflexes is one of the primary {neurological} diagnostic tools.

MG refractory Refers to illness that will not {remit} after therapy.

MG regimen Course of therapy or practical measures recommended by physician.

MG relapse Return of symptoms or disease after period of {remission} or improved health.

MG remission Complete disappearance or satisfactory resolution of the signs and symptoms of a disease; also used to describe the period of time during which a temporary remission takes place. Is not necessarily regarded as equivalent to a "cure."

MG renal Pertaining to {kidney}s.

MG resistance 1. Ability (inherent or developed) of a person's system to "resist" actions of a therapeutic drug, with result that drug is no longer effective. Common problem in AIDS therapy 2. Loosely used to describe body's {immunity} or ability to fight off mild disease.

MG respiratory Pertaining to breathing system or components such as {lungs} or airways.

MG reticular Having a structure similar to a network.

MG reticuloendothelial Refers to the cells of {tissue}s that have both {reticular} and {endothelial} characteristics, i.e., {spleen}, {liver}, {lymph glands}.

MG retina Innermost covering of eyeball, where images are formed.

MG retrosternal Behind breast/ collar bone region.

MG retroviral Refers to {retrovirus}.

MG retrovirus Class of {virus}es containing {genetic} material in {RNA} instead of {DNA}, with ability to copy or insert this RNA into {DNA} inside an {infected} {cell}. The AIDS virus, {HIV}, is a retrovirus, which helps to explain why dealing with it medically is so difficult and complex a matter. One source suggests this simile -- a regular virus produces "offspring" just like itself, but a retrovirus can enter a host cell and force it to produce "mutants" (see {mutation}), each with a slightly different retrovirus. This overwhelms {immune system} capabilities. Although HIV, the retrovirus, is quite distinct from regular viruses in activity, it is all right when speaking in generalities to call HIV a "virus." See also {lentivirus}, of which HIV is one example; {HIV replication} for details of HIV's use of a cell as {host}, reproduction of itself for dissemination, destruction of host.

MG rev An HIV regulatory {protein.} Rev is important to viral reproduction partly because of its role in producing the {envelope}. The (rev) molecule is a counterpart to {tat} and {nef}. One possibility advanced in discussions of gene therapy against HIV and AIDS would involve synthesizing a "transdominent rev," which could be injected into stem cells, the body's cell factories. It would, theory says, help create a natural systemic resistance to HIV.

MG reverse transcriptase (RT) {Retroviral} {enzyme} capable of copying {RNA} into {DNA} -- an essential step in life cycle of {HIV}. A "reverse transcriptase inhibitor" is an agent that's been designed to interfere with the {reverse transcription} process, and so far this approach is the only one that has been effective at holding back advancing HIV. (See {NARTI}.)

MG reverse transcription Process by which {HIV} in {RNA} of {T-helper cell} is copied back into host {DNA}, using {reverse transcriptase}. See notes re: HIV replication process in {HIV replication}.

MG reversible Subject to successful treatment and return to normal healthy state. Opposite of {chronic}, {refractory}, {intractable}.

MG ribosome A combination of protein and RNA. It is found most commonly where there is cellular {synthesis} of {protein} and/or within cells.

MG ricin A derivative of castor- oil seeds. This agent is highly toxic in the human system, has adverse affects of the production of protein.

MG Ringer's Solution A balanced "neurological" liquid, i.e., having correct biochemical properties, and in this case capable of simulating the osmotic pressure of blood {serum}. It is used in our context vs. {dehydration}, though it's also commonly used to maintain live human organs outside body.

MG RNA Ribonucleic acid. Counterpart to {DNA}, this is a complex {protein} that carries genetic instructions within a {cell} for control of the cell's activities. {Retrovirus}es, including HIV, encode their information in {RNA}, which then "translates" the information backward into DNA, using the {enzyme} called {reverse transcriptase}.

MG RT {reverse transcriptase}.

MG salivary glands {Tissue} components in mouth & {GI} tract that produce {protein}s ("digestive {enzyme}s") for digestion of food.

MG salmonella {Bacteria} found in contaminated food, water. See {salmonellosis}.

MG salt In our context, generally an {acid}/ {alkaline} compound.

MG salvage therapy Treatment for those who don't respond to, or can't tolerate, other available therapies.

MG SC Subcutaneous(ly). Just beneath skin.

MG scavenger cells Any of a varied group of cells which can engulf and destroy foreign matter, dead {tissue}/ {cell}s.

MG SCID-HU mouse Laboratory test animal, {immunocompromised} by definition, with human hematolymphoid (blood/lymph) components implanted. Used in exploring early HIV activity in and against {lympatic} system.

MG SCR (Serum cortisol response) Extent of the rise of {cortisol} in {serum} in response to injection w/ {ACTH}.

MG secondary 1. A medical condition brought on by a prior illness or {insult}, which will be specified; disorder that wouldn't have occured except for weakened health due to earlier illness. 2. Also as in {secondary prophylaxis}, protection vs. recurrance of disease.

MG secondary prophylaxis Preventive treatment vs. return of a disease that has {remit}ted. Primary {prophylaxis} comes before any incidence of disease.

MG secrete To make a substance, usually from bodily or self- produced ingredients.

MG secretion Product of a bodily organ such as a {gland}.

MG semen {Alkaline} fluid which serves as a "carrier" for the relatively sparse sexual {organism}, {sperm}.

MG senescence Advanced age; the aging process.

MG sense 1. See {sensory}. 2. Strand of biological material ({RNA}) used in assembly of {protein}. HIV requires viral protein produced in this way if it is to replicate. New treatments may take advantage of this requirement, see {antisense}.

MG sensory 1. Relating to any of the senses. 2. Relating to the "input" side of {nervous system} -- which supplies {brain} with perceptions of cold, touch, etc. 3. Used in describing a form of {neuropathy}, see point 2. Contrast {Motor}.

MG septum Refers to almost any dividing wall within body.

MG SeroCard Experimental rapid whole- blood HIV test, using sample from finger- prick and said by maker to effectively perform an ELISA test in under 8 min. 7-93 Being tested on tentative basis in Brazil. Mfr: Dis. Detection Int'l, CA. See also {HIV testing}.

MG seroconversion Point at which {antibody} to specific {antigen} becomes detectible in blood. {HIV} seroconversion usually takes place within a few weeks or a very few months after infection. Until then, {infected} persons will be {carrier}s of virus, perhaps infecting others. See {Dormant}, {latent}, {HIV testing}, {ELISA test}, {silent infection}.

MG serologic Pertaining to the clear, liquid component of blood, {serum}. Serologic (or "serological") tests may be used to detect presence of {antibodies} in blood.

MG serology Specialty which {assay}s blood {serum} and its components, especially in respect to their ability to protect against disease.

MG seronegative ({Antibody}-negative), therefore free of {infection}. Opposite of {Seropositive}.

MG seropositive Condition in which {antibody} to a particular disease- producing {organism} are found in the blood. (The presence of antibodies indicates that the person has been exposed to the organism but does not distinguish between an active infection and a past infection -- but this point, as it relates to HIV, is academic only.

MG seroreversion Relates to possibility of HIV or other infection disappearing from or being neutralized by system. In the case of HIV, this is considered only hypothetical, though everyone has heard at least one anecdotal account of it having happened.

MG serostatus In our context, HIV state, either positive or negative.

MG serotonin Derivatives of this agent are extremely popular today. One example of usage is sertraline {HCl} (Zoloft), an antidepressant. This drug is taken over a relatively long period at dosages between 25 mg- 100 mg/ day and is considered quite safe compared to other regimens. It is not a controlled substance though it is dispensed by prescription only. Adverse physical effects are mostly of the {GI} variety. It sometimes causes tremors, dizziness, difficulty in sleeping or excess sleepiness, dry mouth, sweating, or male sexual dysfunctions.

MG serum The fluid which separates from solid components when blood isn't moving about. See reference under {plasma}.

MG serum cholesterol Level of cholesterol in blood. When very low, it may reflect serious nutritional problems and/ or advanced HIV disease. Typically 130-240 {mg}/ 100 {cc}.

MG serum half-life Period during which a substance in blood {serum} decreases to half its original value. Used for testing purposes.

MG severe Less serious than acute, more serious than moderate.

MG SGOT Serum glutamic oxaloacetic transaminase. An {enzyme} released into bloodstream in modulated manner when certain organs (especially {liver}) are damaged or muscle {tissue} is injured. Typically less than 40 IU when tested. See {SGPT}.

MG SGPT Serum glutamic pyruvic transaminase. {Enzyme} produced by {liver} cells for normal functioning. Some of the enzyme normally escapes into bloodstream; when liver is damaged, this effect is increased. Elevated levels of "SGPT" are more specific indicators of liver damage than SGOT. SGPT is also called {ALT}".

MG SI strain One of the most dangerous variants, or {strain}s, of HIV -- "{syncitia} inducing." It's likely that AZT doesn't have nearly as much {efficacy} against this type. One source phrases it thus: "SI acts like a magnet which draws t-cells together and causes widespread dissemination of the virus. The result is a rapid decline in T-cell count and what researchers have termed an Ôimmunological crash'." Though this strain is linked to faster disease progression, there's no evidence that its presence affects longevity of the affected person. In one study, 29% of the HIV positive persons tested were found to have SI strain HIV along with other strains in the system. See also {strain variation}.

MG sign Evidence of disease or injury that is apparent to medical professionals but not the person being examined.

MG spasticity Muscle contractions, implying those that are involuntary.

MG sperm Cellular component of male sexual fluid (semen) which contacts female's egg(s), resulting in reproduction. Technically, spermatozoon if singular, spermatozoa if plural.

MG spermicide Any substance used as a contraceptive for its ability to kill {sperm}. WARNING: There is no likelihood that any spermicide protects in any way against transmission of HIV.

MG spinal column The backbone, made up of disc- shaped bony items called vertebrae connected by cartilege, a material like gristle found in meat. Through the hollow centers of these components run fibers of the nervous system, the {spinal cord}. At some junctures, nerve fibers are routed out between gaps between vertebrae. This protective arrangement is a wondrous design, however when the spinal column is injured, the damage may extend to the enclosed nerves, with consequences whose potential seriousness is self- apparent.

MG spinal cord Bundles of {axon}s -- impulse- carrying {nerve}s/ {neurons} -- running from {brain} downward through center of {spinal column} toward their destinations, where they'll receive incoming signals of sensation or pain, deliver messages for movement, both strenuous and delicate, of body parts. See {nervous system}.

MG spirochete Class of bacteria having distinctive corkscrew- like appearance when seen under microscope. {Syphilis} is caused by a member of this class.

MG spleen An organ in the upper left of {abdomen}. Acts like a "{lymphoid} filter." Can produce {red blood cells}, contains many {lymphocytes}, and is an important site of {antibody} production in response to intravenous particulate {antigen} such as {bacteria}. Thus the spleen, though regarded as "secondary" lymphoid tissue, is very important to {immune} function.

MG splenectomy Surgical removal of spleen. Required if there's {hemorrhage} of {spleen}, {cancer} of {lymph glands}, certain blood disorders. Doesn't lead to any permanent disabilities in adults.

MG spontaneous Of own free will or volition; suddenness may be implied. 1. Sometimes refers to remission of illness without intervention. Has other clear usage in describing physical states. 2. From psychological standpoint, a person's ability or inability to behave in a spontaneous way is a useful diagnostic guidepost.

MG sputum induction Less invasive substitute for {bronchoscopy}.

MG sputum test A study of cells from {lungs} contained in material coughed up in sputum.

MG -stasis Suffix indicates lack of movement; stabilization.

MG stat. Abbreviation for statim, meaning "immediately."

MG stem cells The cells from which all blood {cell}s derive. {Bone marrow} is rich in these cells.

MG steroid 1. Substance usually of hormonal (see {hormone}) origin, often from {pituitaty}, {adrenal glands}. 2. {Synthetic} steroids may be used in therapy. vs. disease, esp. {inflammation}. {Cortisone}, {ACTH} are common examples of this. Improperly used, can have catastrophic effects, and must never be used except under a doctor's supervision. See {Anabolic Steroid}, {Corticosteroid}.

MG stool Solid human waste, {excrete}d via {rectum}, {anus}. If not solid see {diarrhea}.

MG stool culture The taking of a fecal ({stool}) sample and culturing (see {culture}) {organism}s found within it. May be used to diagnose cause of {diarrhea}.

MG strain 1. A particular type, variant, or descendant of a known disease or disease- causing {organism}. A {phenotype}. Ex: There are many known strains of HIV -- of which almost none reportedly has marked differences from others. Possible exception: The "SI" or {syncytia}- inducing strain, held to be most destructive. See {vaccine therapy}, {isolate}, {strain variation}. 2. Verb meaning to stress muscle/ skeletal system. 3. Result of mild muscular {insult}. Note: 11-93 There is a possibility that the "SI" strain mentioned above is more resistant to AZT than other strains, and that AZT cannot prevent occurrence of SI strains. There is no practical way to test persons for presence of SI strains in the clinical setting.

MG striato-nigral {Nerve} paths from {striatum} to {substantia nigra}. {Degeneration} of paths can cause symptoms similar to those of {parkinsonism}, but does not respond to drug therapy useful in the latter disease.

MG striatum The caudate nucleus (center) and the putamen, important areas of brain's {basal ganglia} structures rich in {dopamine}. See {striato-nigral}.

MG sub- prefix means "beneath," "below."

MG subacute State of disease possibly more serious than {severe}, definitely less so than {acute}.

MG subcutaneous (SC) Just beneath skin.

MG sublingual In lower part of mouth, at or near salivary glands.

MG substantia nigra A region of the brain with densely concentrated cells that produce {dopamine}. Is darkly pigmented. In {parkinsonism}, these cells are known to die.

MG superantigen Investigators have proposed that a molecule known as a superantigen, either made by HIV or an unrelated agent, may stimulate massive quantities of CD4+ T cells at once, rendering them highly susceptible to HIV infection and subsequent cell death. See also {anergy}.

MG surrogate markers Lab tests which may predict clinical outcome or indicate drug effectiveness without having to rely on "endpoints" of death or development of major {OI}.

MG susceptible Vulnerable or predisposed to a disease.

MG suspension Uniform mixture of insoluble particles in liquid.

MG sx Symptom(s).

MG symbiosis Formation of a mutual relationship between two organisms, be it of the sinister kind where a {parasite} is involved or a beneficial one. The parasitic relationship is marked by its one- sided nature. Cooperative symbiosis could be termed a {sympathetic} or {synergistic} action.

MG sympathetic In our context, cooperative or reciprocal in action. See also {symbiosis}.

MG symptomatic 1. Broadly referring to symptoms. 2. Describing relief of symptoms without cure of cause. 3. Commonly, in our context, describing person w/ HIV who is experiencing illness associated with HIV.

MG synapse Point of connection between {nerve}s, conductive of impulses across a minute gap.

MG syncytium Collection of {protoplasm} having a number of nuclei (see {nucleus}). Muscle fibers are one example of syncytia (pl. of syncytium). One source states that some syncitia are "dysfunctional clumps" where infected cells meet and infect non- infected ones.

MG synergism Harmonious action of two or more agents, such as drugs, producing an increased effect that either could not produce alone. Adjective form is "synergistic." Also used in reference to items or phenomenon other than drugs.

MG synergistic Having {synergism}. See {sympathetic}, {symbiosis}.

MG synthesize To produce, usually a substance. Most general use implies artificial manufacture, but natural biological processes may synthesize a product also ({biosynthesis}). In medical literature, you will not know the type of synthesis mentioned unless/ until author specifies it or you're already familiar with it.

MG synthetic Artificially produced.

MG syringe Device for injecting drugs into muscle or {vein}s. Commonly supplied as "disposable" unit, and in fact once used -- under any circumstances -- a syringe or "needle" should NOT EVER be reused.

MG systemic Affecting entire body, or at least non- localized. See also {diffuse}, {disseminate}.

MG T-cell (T-lymphocyte) One of the {white blood cells} that mature in {thymus} {gland}. Called "thymus-dependent." Subsets of t-cells have varied special functions within {immune system}. See {T-helper cell}, {T-killer cell}, {T-suppressor cell}.

MG T-helper cell A type of {lymphocyte} (also see {white blood cells}), also called T4 cell, which like other {T-cells} is formed in the {thymus} and is an important part of {immune system}, helping body fight off certain {infection}s. On their surface, they {express} the {CD4} receptor, to which {HIV} is attracted and may attach itself. HIV invades T-helper cells, weakens or destroys them by using them as hosts, otherwise destroys them when it has replicated and then bursts out into bloodstream. Regular monitoring of the {CD4 T-helper cell count}s in HIV- infected persons provides an idea of the progression of HIV infection. 10-93 It has been learned that the T-helper cell also {express}es an "inner gateway" that HIV must pass after attachment to the CD4 receptor -- called {CD26}. See also {HIV progression testing}. See {T-helper cell -- more}.

MG T-killer cell {Cytotoxic} cell that kills foreign organisms. Recognizes {antigen}, including those of the {major histocompatibility complex} class I. Is a major factor in graft rejection, also. This cell is distinguished by its {express}ion of {CD8} marker. See {T-killer cell -- more}.

MG T-suppressor cell A cell having a "modulating" effect in the human {immune system}. Its action is almost certainly {antigen}- specific, and it's thought that it's critical in terms of peripheral tolerance, {autoimmune} phenomena and what's called immunoregulation. Many suppressor cells bear {CD8} marker, and it's thought they operate by virtue of "secretion of free T-cell receptors." They seem to control development of the {T-killer cell} and {B-cells}. See {T-Suppressor cell -- more}.

MG T4:T8 ratio The normal ratio of T4 {T-helper cell}s to T8 {T-killer cell}s and {T-suppressor cell}s is around 60% : 40%. This ratio becomes inverted in people with AIDS, but may also become abnormal for awhile in non- HIV+ persons for various reasons.

MG tat Transactivator of transcription. A {viral} {protein} -- believed to "upregulate" rate of HIV gene {express}ion through interaction with the (tar) portion of the virus' genetic "{long terminal repeat}." This is concurrent with an increase in amount of viral {RNA} within a cell. It's unknown whether (tat) is essential for HIV's successful replication, but believed that it is. In fact it's suspected that (tat) works with the protein (rev), at the direction of the invading HIV, as accomplices in viral reproduction. (Tat) may also be a factor in early- stage {KS}.

MG telalgia Refers to spreading or transmission of pain from one part of body to another. See also {referred pain}, same.

MG testosterone Male sex {hormone}. See also {steroid}.

MG TGFB (transforming growth factor beta) A {cytokine} that promotes healing of tissue, but at the same time tends to suppress B- and T- {lymphocyte} reproduction in body.

MG thalamus The part of {brain}'s cerebrum where sensations of heat, cold, pressure and pain originate. The thalamus also sends sensations received from sensory {nerves} to higher brain centers in {cortex} of brain.

MG therapeutic index As relates to anticancer agents, ratio of dosage necessary for effectiveness to dosage that produces cellular damage.

MG therapy Any treatment of disease or injury; an approach to enhancing and maintaining health.

MG THF Thymic humoral factor. Injectable {thymus} {hormone} derivative. See {thymopentin}, {humoral immunity}.

MG thoracic duct Area in chest that contains {lymph} rich in mature {T-cell}s, along with a few {B-cells}. Chronic thoracic duct drainage will cause T-cell depletion, subsequent {immunosuppression}.

MG thrombocyte Blood {platelet}, responsible for clotting.

MG ThyMA Thymidine nucleoside {analog}. Thymidine is a {nucleoside} component of {DNA}, one of the primary {genetic} materials. Its modified variant or {analog} seems to halt {viral} production if incorporated into DNA during HIV's reproductive process. {d4T} uses this principle.

MG thymic peptides {Hormones} involved in regulation of {immune} function.

MG thymocyte {Lymphocyte} found in {thymus}.

MG thymus A central {lymphoid} organ important to {immune} capacity. Located beneath breastbone, and at one stage the producer of some 30 varied {hormone}s, its early development begins during the embryonic stage and continues for a couple of years after birth. At one time it was thought to go {dormant} at that point, but we now know that the thymus is a primary site of {lymphocyte} development. Various processes in this organ result in {differentiation} and maturation of the {T-cell}, which is sent out to "colonize" the body as a vital {immune system} component. 6-93 We now know that the thymus is an early target for HIV infection. Once invaded by HIV, the thymus is severely disrupted, which could mean that science will need to rethink strategies for reconstituting the immune system of HIV-infected individuals. HIV infects and destroys at least three types of thymic {precursor} cells, CD4+, CD8+ and CD4+/CD8+ {thymocyte}s. HIV also infects thymus {epithelial} cells. Infection of and damage to these cells may interfere with their normal ability to guide maturation of T-cells. Finally, thymic damage may be one mechanism of the CD4+ T-cell depletion that leads to AIDS- related {OI}'s and complications thereof.

MG thyroid Large endocrine gland. Located in throat, it regulates metabolism. It {secrete}s the substance called thyroxine, a {hormone}. See {endocrine glands}.

MG TIBC Total iron- binding capacity.

MG TID Three times/ day.

MG tine test Simple test that determines whether a person has been {infected} w/ {TB}.

MG tissue A group of similar cells, acting together. The body contains four basic types: muscle, {nerve}, {epithelial} and {connective tissue}. To generalize, the tissues are constructed of and maintained by {protein}.

MG titer (titre) Laboratory measurement of amount or concentration level of a given component (e.g., an {antibody}) in a solution, or point where dilution no longer causes reaction of {antigen}.

MG TIW Three times each week.

MG tobacco 5-93 At least one small study suggests that use of tobacco measurably hastens the progression of HIV disease. In that five- year survey, 84 HIV+ persons were studied. Half were smokers, others had never smoked or had quit at some past time. Smokers developed AIDS at a median of 8.17 months, nonsmokers at a median of 14.5 months. 11-93 Smokers with HIV acquire PCP more readily. It is also true that smoking seems to deplete vitamin C levels in the body. Relatively new (12-93) figures indicate that where the recommended daily requirement for vitamin C is 60 milligrams, smokers need 200 mg of vit. C. -- obviously by supplementation -- to escape risk of deficiency. Vitamin C seems to help protect against carcinogens, give something of a boost to the immune system, and have antioxidant and other functions, mentioned in {Nutritive Supplements 1}.

MG tolerance In our context, situation in which body has acclimated itself to effects of a drug, and the desired effect can no longer be achieved except by using larger or more frequent dosages, or by switching drugs. Not to be confused with drug {dependence} though related to {habituation} or {resistance}.

MG tone Elastic property of healthy muscles. Muscles which are diseased or subject to {wasting} are said to be {atonic}.

MG topical To be applied directly to accessible skin or membrane.

MG tortuosity Having bends, sharp curves, indirect route.

MG total parenteral nutrition (TPN) For those with severely restricted bowel function, this is a means of feeding a person liquids via central {IV} catheter. The liquids are specially formulated for the purpose.

MG toxic Poisonous or capable of causing ill effects. Spectrum of toxicity is so broad as to often requiring qualifiers; however this adjective always applies to something that's undesirable.

MG toxicity In drugs, capability to damage to body's systems, or poisonous qualities. Broad term, connotations always undesirable.

MG toxicology Study of medically undesirable effects of certain substances upon the body. Specialists in this field determine level of {toxicity} of substances, cause of it, and how it may be averted or managed. Highly toxic substances are poisonous, mildly toxic ones cause illness or high levels of side FX.

MG toxin A poison, of variable potency, produced by {organic} or other agents. In humans, it sets off production of {antibody} called {antitoxin}s.

MG toxoid A {toxin}, or poison, which is at a given time inactive, but is capable of stimulating body's production of {antitoxin}s. Potentially helpful in preventing disease.

MG TPN Total parenteral nutrition, or "hyperalimentation," feeding a person exclusively via {IV} means.

MG transaminase 1. An {enzyme} measurement that indicates state of health of {liver}. 2. More technically an {enzyme} {catalyst} involved in a genetic action that transforms certain {amino acid}s.

MG transamination A metabolic transformation of amino acids requiring {transaminase} and pyridoxal phosphate.

MG transfection Transfer of {DNA} molecules into cell by direct means.

MG transfer factor 1. Portion of population of {white blood cells} that apparently "transfers" its ability to mount an {immune} response to specific {antigen}. 2. Substance produced by white cells that transfers ability to recognize invaders from one cell to another.

MG transfer RNA Specialized RNA that assists in ribosome protein sequence assembly. Its role is to bind specific {amino acid}s in the sequence.

MG transfusion {IV} administration of blood, {serum}, {plasma}, etc.

MG Treponema Group of parasitic (see {parasite}) {bacteria}. Are anaerobic (don't need air) and some but not all cause disease. T. palladum causes {syphilis}; T. pertenue, yaws; etc. Blood tests may come back "negative" in cases involving PWA. T. palladum usually treated w/ benzathine {penicillin}, 3 wkly IM doses of 2.4 million Units.

MG triage Form of medical intake process whereby -- formally stated -- most seriously diseased or wounded are singled out for first attention. Off the record, medical personnel will say, tongue in cheek of course, "triage" is a fast and rough means of sorting people into three groups: Those who will get worse no matter what you do, those who'll get better no matter what you do, and those you will take in for treatment. On a more somber note, in one recent medical study long waiting periods in clinics were used as a form of "triage by attrition." In theory, only the very needful would be willing to wait several hours to be seen. At the end, the survey's sponsors learned what patient advocates already hold as gospel: Those most in need were often the most easily discouraged by this tactic.

MG triglycerides Combinations of {glycerol} w/ fatty {acid}s.

MG troche Pill or lozenge to be taken {PO}.

MG tumor necrosis factor (TNF, TNF-alpha) {Antineoplastic} {cytokine} {protein}, naturally produced by {macrophage}s/ peripheral {monocyte}s. Induces hemorrhagic necrosis (a form of cell death), which can destroy {tumor}s. (See {hemorrhage}.) Is thought to be implicated in AIDS- related {septicemia} & {wasting}. TNF seems to stimulate HIV replication, is often elevated in those w/ low {CD4 T-cell count}s, seems to be an {AZT} {antagonist}. TNF-alpha has {immune system} functions of great variety. 1-93 (IND) TNF, {biosynthetic} in trials vs. {KS}.

MG tx Treatment, therapy.

MG ul microliter, 1/1,000,000 of a liter, a liter being around a quart. The "u" is an attempt to simulate a the appearance of a symbol with a curved "descender" bef. the shape of the "u," which is the correct format.

MG uric acid Substance found in blood and {urine}, a product of {protein} digestion, {excrete}d via {urine}. Its presence is normal, though if found in excessive amounts, other testing or medical attention is required for possible diagnosis of {gout}, etc. In {CBC}, a level of about 4-8 {mg}/ 100 {cc} is normal.

MG urine Liquid waste, expelled via genitourinary organ.

MG urology Medical specialty which treats urinary tract -- {kidney}s, urethra, bladder, etc. In males, this includes {prostate gland}.

MG USP Refers to drug compounded per standards of "United States Pharmacopeia," a semiofficial pharmacological publication.

MG uterus (womb) Female organ where development of embryo takes place. Above vagina, below ovaries.

MG V3 loop HIV's "V3 loop" is important for its role in stimulating antibodies, and some investigational drugs seek to take advantage of the fact. The loop is part of {gp120}, a major protein found on the surface of HIV.

MG vaccine Generally, a substance containing the {antigen} of an organism. The vaccine is supposed to stimulate {active immunity}, which includes the {immune system}'s unique "memory" of past exposures, and give protection vs. the {organism} involved. Advances in biotechnology are producing different approaches to vaccine technology, some of which it's hoped will result in a preventive or a therapeutic vaccine against HIV, or both. 12-93 Progress in attaining this last item has been very unrewarding so far. See also {vaccine therapy}.

MG vaccinia virus Used in "prime-boost" HIV vaccine strategy. Volunteers' immune systems are primed with a live {vector} vaccine, a bacterium or virus genetically "rigged" with a gene for an HIV protein such as gp160 but not capable of infecting the person with HIV. A popular vector is vaccinia virus, once used in smallpox vaccines. Vaccinia transports the HIV gene into the body, where it makes a protein that the system perceives as foreign, stimulating production of protective antibodies.

MG variable region The part of an {antibody}'s structure that differs from one antibody to another.

MG vascular Having to do with body's blood delivery system -- {arteries}, {vein}s, capillaries, blood, blood {cells}. (vascular tortuosity) Often describes a condition in which there is indirect, curved or bent routing of the eye's {retina}l blood vessels. Seen in people w/ HIV or other {systemic} disease where blood is thickened or vitreous outflow of eye (natural moisture to surface) is compromised.

MG vector An agent, often an insect or animal, that carries and passes along a disease- causing {organism}. Humans may be vectors in some cases. Meaning parallel to {carrier} but not same. In medical literature, the means of transmission, no matter what it is, will be called a "vector."

MG vein Vessel carrying blood inward toward heart.

MG ventral Front.

MG vesicle Sac or globe- shaped organ containing air or natural matter; blister.

MG viral Adjective refers to presence of {virus}, or a property shown by a virus. (viral culture) Laboratory method for growing {virus}es for testing via {culture}.

MG viral DNA In our context, this is the {DNA} produced when {RNA} is inserted via {reverse transcription}. May exist in host {cell} for prolonged time or become integrated into {genetic} material of host cell.

MG viral proteins In our context, core and {envelope} of HIV are composed of {viral} {protein}s. Core includes proteins p24 and p18; the envelope, gp41, gp 160 and gp120. The lower-case "p" in descriptors stands for "protein." See also {HIV antigens}.

MG viricidal Able to destroy a {virus}.

MG virion {Virus} particle that exists freely outside a host {cell}.

MG virology Study of {virus}es and viral disease. Viruses are tiny living {organism}s that invade {cell}s and alter their chemistry so that the cells are compelled to produce more virus particles. Viruses cause a host of diseases, ranging in seriousness from colds or {influenza} to AIDS.

MG virulent Relative power to cause disease, or disease of greater severity; or referring to ease of transmission of an infectious disease.

MG visceral Deeper, more inward.

MG vitreous humor The colorless, transparent gelatinous matter which makes up most of the mass of the eyeball, from lens in front to retina in back.

MG wean Sometimes used to describe removal of {dependence}- producing drug from a person's access. Usually gradual, so as to diminish unfavorable effects of {withdrawal}.

MG Western Blot Test A blood test used to detect {antibody} to the AIDS virus. Compared to the {ELISA test}, the "W.B." is more specific and more expensive to administer. It can and should be used to confirm results of an ELISA test in ALL cases. In the Western blot assay, individual proteins of an HIV-1 lysate are separated according to size, via a process called "polyacrylamide gel electrophoresis." The viral proteins are then transferred onto nitrocellulose paper and reacted with the person's {serum}. Any HIV antibody from the serum is detected by an antihuman immunoglobulin G {IgG} antibody {conjugate}d with an enzyme that will produce a colored band in the presence of substrate. Positive and negative control serum specimens are run simultaneously to allow identification of the viral proteins.

MG white blood cells {Cell}s that protects the body vs. foreign substances such as disease- producing micro{organism}s, and an important part of the {immune system}. A {CBC} should find about 5000-8000 WBCs per cubic mm.

MG white matter {Tissue} of the {nervous system}, usually containing denser nerve fibers and {myelin} than its counterpart, {gray matter}. In {brain}, it's within the gray matter of {cerebral} {cortex}.

MG withdrawal Process by which a person dependent, habituated, or addicted to a given substance readjusts, physically and psychologically, to unavailability of substance. Can work extreme hardship on the person involved for a variable length of time, even though it is done in a gradual way. See also {dependence}, {habituation}, {addiction}, {wean}.

MG x-ray Radiant energy of extremely short wavelength (high frequency), used as a tool for diagnosis, producing photographic depiction of some internal body masses, and sometimes used to treat {cancer}. See {cat scan} and {MRI} for other "imaging" methods.

SD ABV / ABVD {Chemotherapy} agent combination, {cytotoxic}. {Doxorubicin}, {adriamycin}, {bleomycin}, {vincristine}. "ABVD" is same w/ {dacarbazine}.

SD acebutolol {Beta blocker} commonly used vs. hypertension/ high blood pressure, {arrhythmia}.

SD acyclovir (Zovirax, ABV) established treatment for {herpes simplex virus I} and {herpes simplex virus II}, {herpes zoster}. {256U87} is a {prodrug} of acyclovir. 8-93 Some herpes infections are resistant to this agent in presence of AIDS. One source suggests switching to {foscarnet} in such cases. Has been tried in combination w/ AZT vs. AIDS. 7-94

SD albendazole 9-93 (IND) {Antiviral} / {antibiotic} from U.K., used vs. {parasitic} {intestinal} infections, available in U.S. under {compassionate use}, may be useful vs. {microsporidiosis}. Main side FX are {GI}- related or of headache/ dizziness type.

SD amantadine (Symmetrel) Drug believed to help those w/ {parkinsonism} by decreasing rate of {dopamine} breakdown. A {dopaminergic} {agonist} that allows dopamine to remain in {synapse} region to activate receptor sites.

SD amikacin (amikacin sulfate) (Amikin) {Aminoglycoside} {antibiotic}, part of experimental multi-drug {MAC} therapy used {IM} or {IV} with {rifampin}, {ethambutol}, {clofazamine}, {ciprofloxacin}. This component may be added to regimen at week 4 at discretion, depending on response to {oral} regimens. Multi- drug regimen is subject to {toxicity} problems. Pron. aah-muh-KAY-sun. 12-92 see also {azithromycin}, {clarithromycin}, {sparfloxacin}, {TLC-G-65}, {trospectomycin sulfate}. 3-93 Lipsomal amikacin, pat. as MiKasome, to be tried vs. "drug- resistant" {TB}. Fatty lipsomal coating may mitigate toxicity. Mfr. claims good {in vitro} results. Use of amikacin may cause {renal}, auditory disorders.

SD amithiozone Drug used vs. {Hansen's disease}, and with {isoniazid}, vs. {TB}.

SD amitriptyline (Elavil) A relatively safe mood elevator having some tranquilizing properties, very commonly used in mild cases of {depression}. Also for some {symptomatic} relief of {neuropathy}, etc. as it seems to help alleviate pain brought on by {CNS}- associated {trauma} and has other benefits whose {mechanism} of action is unknown. See also {peripheral neuropathy}.

SD amoxicillin Form of {penicillin}. Sometimes used for sinus, {respiratory} {infection}s.

SD amphotericin B (Fungizone) used (usually {IV}) vs. severe forms of {cryptococcosis} (cryptococcal meningitis), used also for other systemic {fungal} {infection}s including {histoplasmosis}. IV administration is usual. May cause vomiting, chills, fever, {phlebitis}, headache, {renal} problems, {anemia}, potassium deficiencies, and very rarely, seizures. Sometimes used in combination w/ {flucytosine}. See also {Itraconazole}, {fluconazole}, {ABLC}. {AMFAR} states that "a {liposome}- encapsulated form of amphotericin B is under investigation. Liposome encapsulation might reduce toxicity and improve treatment response."

SD ampicillin (Unasyn) A form of {penicillin}.

SD antabuse (Disulfiram) Drug used to treat alcohol addiction. Is broken down by {metabolism} in part to diethyldithiocarbamate (DTC), which is also manufactured separately as a drug. DTC is thought of as a potential {immune} stimulant and trials began in U.S. in Ô87. Favorable reports are said to have been heard from European tests, but that is not concrete enough to go on.

SD ara-c (Cytarabine) 9-93 {Antineoplastic} drug used as part of combination therapy vs. acute nonlymphoblastic {leukemia}. Highly {toxic}, causes {myelosuppression}, {GI} side FX.

SD AZT Mainstay AIDS therapy. An {antiretroviral} drug originally called {azidothymine}, patented by Burroughs Wellcome under name {Retrovir}. It is a {NARTI}, seeking to inhibit the {reverse transcriptase} enzyme. Its action, after conversion in the body, is to interfere with certain HIV viral activities including, as expected, replication. Those taking AZT may exp. side FX: nausea, night sweats, {chronic} fatigue, etc. In 1989, evidence was produced proving that AZT does slow progression of HIV to "full- blown" or {symptomatic} AIDS. In April Ô92 a large study indicated that early treatment with AZT prolongs life of the affected person. (4-93) Survival benefits of AZT questioned by results of the 4- year "Concorde" study, but AZT's ability to help maintain or elevate the {T-cell count} for periods of time remains unquestioned. 5-93 AZT- resistant HIV {strain} is said to have appeared in at least one case. HIV- negative male had sex with HIV- positive male taking AZT. Former individual is said to have developed HIV unresponsive to AZT. 12-93 One report conjectures that of a possible 170 {strain}s of HIV, some 15% may be resistant to any or all currently available therapeutic drugs, not limited to although including AZT. 9-93 Mfr. warns of 2 rare syndromes, might be associated w/ AZT use. Lactic acidosis ({lactic acid} having abnormally high acidity), {heptatomegaly}. For technical info see {zidovudine}.

SD baclofen (Lioresal) Agent that is said to increase {GABA} activity. Has been used to help control some side FX of {chronic} {dopaminergic} therapy, especially {dystonia}s.

SD Bactrim (Roche's {TMP/SMX}) Established therapy for Pneumocystis carinii pneumonia, {PCP}.

SD bleomycin An FDA- approved {chemotherapy} agent, used {IV}. It's active, alone or in combination, against a wide spectrum of tumors including, to some degree, the lesions of {KS}. Seems to function by inhibiting DNA synthesis. Has caused {interstitial} pneumonitis, in elderly persons at cumulative doses above 400 units. Otherwise, most frequent side FX are reddening, rash, tenderness of skin. {Alopecia} sometimes occurs.

SD capreomycin sulfate (Capastat sulfate) {antimycobacterial}, generally used when other therapy not effective or practical.

SD capsaicin (Zostrix) {Topical} treatment for temporary relief of {peripheral} {neuralgia}, {Herpes} Zoster. One anecdotal report of this agent providing significant relief from pain of HIV {peripheral neuropathy}. Maker states that agent "renders joints and skin insensitive to pain by depleting and preventing reaccumulation of Substance P ... in peripheral sensory {neuron}s ... Substance P is ... an {endogenous} {neuro-} {peptide} involved in transmission of pain impulses ... thought to be a chemo- {mediator} of pain impulses from periphery to {CNS}."

SD cefadroxil {Antibiotic}, often used {PO} vs. urinary tract and other {infection}s.

SD cephalosporin An {antibiotic} used when therapy w/ {sulfa drugs} or {penicillin} are unsuccessful, i.e., gentimicin, etc. See {Gentamicin, lipsomal}.

SD cimetidine (Tagamet) Drug for treatment of peptic (stomach) ulcers, inhibits production of {acid} in stomach. One source says this agent is being used as an {alternative therapy}, see {cimetidine}.

SD ciprofloxacin (Cipro) A quinolone- class {antibiotic}, part of experimental {MAC} therapy, apparently not useful against all M. avium strains. Perhaps best suited to use as part of combination therapy. Side FX include rash, {GI} problems, {CNS} manifestations. Not approved for use by pregnant women, children. See also {amikacin}.

SD cisplatin {Chemotherapy} agent.

SD clarithromycin (Klacid, Biaxin) an {antimycobacterial} of macrolide class, may be useful vs. {MAC} and treatment of {toxoplasmosis} if other therapy not effective or practical. 5-93 Although this drug is being marketed aggressively, the history of mycobacterial therapies in AIDS diseases points to a reliance on combinations of treatments, quick development of {resistance} to drugs. 8-93 In trials w/ {ethambutol}, {rifabutin} vs. MAC {bacteremia}. 1-94 {FDA} has approved agent as therapy {PO} vs. disseminated MAC. {AMFAR} warns that this agent can cause severe abdominal pain at high doses (>2000 mg {BID}).

SD Cleocin Trade name for {clindamycin} or {pyrimethamine} + clindamycin.

SD clofazamine (CFZ, Lamprene) 9-92 Anti- {Hansen's disease} drug has been used in treatment of {MAC}, but at least one study has been stopped because drug lacked {efficacy}. Side FX include {GI} problems, stomach pain, rashes/ skin discoloration. See also {amikacin}. 8-93 Agent being investigated as part of combination therapy vs. MAC, by self for {MAC} {prophylaxis}.

SD clotrimazole (Mycelex, Lotrimin, Gyne-Lotrimin) Supplied as a cream for {topical} use vs. {fungal} {infection}s, especially of skin, vagina. Available without prescription; for more serious infections may use {fluconazole}. Also supplied in oral formulation as lozenges, which are indicated for {candidiasis}. In clinical trials, elevated SGOT levels were reported in about 15% of patients using the lozenges.

SD codeine {Analgesic}, derived from {opium}. Use must be controlled so as to limit potential for {dependence}, {tolerance}.

SD colchicine An {anti-inflammatory}, derived from the lily plant, used for treatment of gout. It's claimed this substance shows activity {in vitro} vs. HIV.

SD COMP 9-93 {Chemotherapy} combination: {cyclophosphamide}, {vincristine}, {methotrexate}, {prednisone}.

SD cyclophosphamide {Antineoplastic} often used as part of combination therapy vs {cancer}, {myeloma}. Also has {immunosuppression} qualities, sometimes used during transplant process. Side FX may include {leukopenia}, nausea, {thrombocytopenia}, hair loss, and per one report, hemorrhagic cystitis. See {PRO-MACE/MOPP}.

SD cycloserine (Seromycin) an {antimycobacterial}, generally used when other therapies not effective or practical.

SD cyclosporin Helps prevent rejection of transplanted organs and slows {fungal} {infection}s. Attaches to a {protein} called {cyclophilin}, and the combination suppresses unwanted {immune system} response. It's thought that they do so by interacting with an {enzyme} called {calcineurin}. It has been established that w/o cyclophilin's help, cyclosporin is ineffective.

SD dacarbazine {Chemotherapy} agent vs. {melanoma}s, {Hodgkin's disease}.

SD danazol Agent used vs. {thrombocytopenia} ({ITP}). Supresses {pituitary gland} activity.

SD dapsone 10-93 (IND) This oral sulfa based {antibiotic}/ {antiparasitic} (see {sulfa drugs} is in trials as preventive/ treatment vs. {PCP}, has been used as therapy vs. {Hansen's Disease}. Some favorable reports compared to other agents. Some warnings against taking dapsone, {ddI} together, suggested dapsone as PCP {prophylaxis} be taken 2 hours before taking ddI. Antacid buffer in ddI may inhibit {absorption} of dapsone, which requires {acid}ity for dissolution. Otherwise, side FX may include dose- related {hemolysis} (especially in {G6PD}- deficient persons), also {methemoglobinemia}.

SD Darvon (dextropropoxyphene) An {Analgesic}.

SD ddC (HIVID, dideoxycytidine) (7-92) A {NARTI} {antiretroviral}. Despite hopes, this {antiviral} has not generally proven superior to AZT. Hopes rested on the outcome of ACTG 155, just released. Is FDA approved in combination w/ AZT for those w/ advanced HIV who've demonstrated great deterioration. Current generic name zalcitibine. 10-93 Internal FDA panel urges approval of ddC, activists say approval now would be too hasty. See {ddC -- more}.

SD ddI (didanosine, Videx) {Antiretriviral}, a {PurNA}. Said to have relatively few "overlapping" side FX, i.e., for those with impaired {kidney} function. Said to reduce {p24 antigen} levels, increase {CD4} levels. Like {ddC} and others, is an {NARTI}, intended to interrupt HIV replication by stopping {reverse transcriptase} and {viral} {DNA} {synthesis}. Trials have not shown ddI superior to {AZT}, ddC, but studies comparing doses of ddI, as well as a study of ddI versus AZT in patients who have not received prior antiretroviral therapy, are ongoing. Main side FX have been dose- related {pancreatitis} and {peripheral neuropathy}. Approved for those who can't tolerate or no longer respond to {AZT}. Recommended dosage (4-92) is 200 mg bid. See {ddI -- more}.

SD demeclocycline (Declomycin) This {antibiotic} is an established therapy for various {bacterial infection}s. May produce diarrhea, nausea, dizziness.

SD Demerol {Narcotic} {analgesic}. Habituating/ addictive.

SD deprenyl {Inhibitor} of the {enzyme} {monoamine-oxidase} type B, which normally acts to degrade and thus deactivate {dopamine} so it can no longer stimulate {brain}'s dopamine receptors. Deprenyl is an {antagonist} to this breakdown sequence, and prolongs dopamine activity.

SD desciclovir A drug that is converted by {metabolism} into {acyclovir} after {absorption} into body.

SD dexamethasone Natural {steroid} with potent {anti-inflammatory} FX vs. many {organic} system disorders.

SD dextran Natural substance, a poly{saccharide} {polymer}, able to "trigger" {B-cells}' {immune} reaction without assistance of {T-cell}s. It thus falls into a class called "T-independent antigens." It's not however thought of as a very powerful immune factor.

SD Diflucan Pfizer's {fluconazole}.

SD dilantin Drug used to prevent seizures in {epilepsy}.

SD Donnagel Drug used vs. {diarrhea}. May be habituating.

SD Donnatal A drug which helps combat stomach, {intestine} {spasm}.

SD doxepin Antipruritic drug. See {pruritus}.

SD doxycycline (Vibramycin) Type of {anti-infective} drug.

SD DSP A rather powerful immunosuppressive drug that can prevent graft rejection.

SD elPV Enhanced-Potency Polio Vaccine. For use instead of {oral} vaccine in presence of HIV.

SD erythromycin {Antibiotic}, often used vs. {respiratory} {infection}.

SD ethambutol (Myambutol) {antimycobacterial}/ {chemotherapy} agent, part of an experimental combination therapy vs. {MAC}; used {PO} vs. {TB}, MDR-TB, sometimes as substitute for {streptomycin}. Side FX may include decreased, distorted vision. See {amikacin}.

SD ethionamide (Trecator-SC) an {antimycobacterial}, generally used when other agents not effective or practical.

SD etoposide (Bristol- Myers' VePesid, aka "VP-16") Common {chemotherapy} agent, usually given {PO}. Is thought to inhibit {DNA} {synthesis}, according to {AMFAR} listings. (7-93) In trials vs. {KS}, {CMVR}, {CMV} {pneumonitis}. May cause {myelosuppression}, nausea. Can cause hair loss. See {PRO-MACE/MOPP}.

SD Fansidar Combination of 2 {oral} agents, {pyrimethamine} (25 mg) and sulfadoxine (see {sulfonamides}) (500 mg), the latter an anti- malarial/ anti- {Hansen's Disease} agent. Has been studied as a {prophylaxis} for {PCP}, {toxoplasmosis}. {AMFAR} tells us that severe skin reactions have been associated with Fansidar use, including Stevens-Johnson syndrome; {toxic} skin {necrolysis}; and {Erythema multiforme}, making Fansidar less desirable in its {toxicity} profile than some other sulfonamide- based combination regimens. At least one of our sources, in fact, recommends against consideration of use of this agent.

SD fluconazole (Diflucan) Triazole- class agent for the prevention, sometimes the treatment, of {fungal} {infection}s -- especially {thrush}, {cryptococcosis} and attendant meningitis etc., which might otherwise be prevented w/ {ketoconazole}, etc. and treated w/ {amphotericin B}. Fluconazole's merits vs. {candida}/ {thrush} are under debate. Regarding cryptococcal meningitis, it's said ketaconazole has {toxicity} problems, not very compatible with {ddI}, thus the possible preference for fluconazole in that case. Agent also may be tried vs. HIV-related {pulmonary} {coccidioidomycosis}. Side FX may include {GI} pain, headache, nausea, rash, slightly elevated liver functions. Fluconazole used as prophylaxis in bone marrow transplants is associated with "increased risk of Candida krusei (normally non-pathogenic fungus not sensitive to fluconazole)," according to AMFAR notes. 12-93 Tests indicate fluconazole may be more effective than {clotrimazole} for typical fungal infections in presence of advanced AIDS. It's mentioned that {rifampin} impedes fluconazole's achievement of optimal serum levels. See also {itraconazole}.

SD flucytosine (5-FC, Ancobon) {Antifungal} usually given as {adjunct} to {amphotericin B} to decrease emergence of resistant {fungus} {strain}s. When thus used may produce {kidney} {toxicity}. In trials w/ {fluconazole}/ {itraconazole}, also as adjunct. Listed side FX: {diarrhea}, vomiting, rash, {bone marrow} suppression.

SD foscarnet (Foscavir, phosphonoformic acid, trisodium phosphonoformate, PFA) Pronounced foss- CAR- nay. This {antiviral} is approved for treatment of {CMV}/ {CMVR}. Survival in tests better than {ganciclovir} but PFA is relatively {toxic}, expensive. Alternative to {acyclovir} in treatment of {herpes} simplex/ zoster. Side FX include {electrolyte} imbalance, elevated {creatinine} to point of {nephrotoxic}ity, {anemia}, possible {CNS} toxicity. May administer saline solution to mitigate nephrotoxicity.

SD framycetin {Topical} {antibiotic} sometimes used vs. infections of ear, eye, skin. In another form used {PO} as last- line therapy vs. {GI} problems. {Resistance} to agent and other side FX cited.

SD furazolidone (Furoxone) Broad spectrum antimicrobial (see {microbe}) for use vs. {giardiasis}, might be tried vs. Isopora belli infections. Side FX: fever/ rash, low blood pressure, {urticaria}.

SD ganciclovir (Syntex' Cytovene) (DHPG) A {nucleoside} {analog} {antiviral} for treatment of {CMV} and eye damage due to {CMVR}. Main side FX are {bone marrow} suppression, {granulocytopenia}; but instances of {neutropenia} have also been seen. Side FX may preclude concurrent use of AZT or other agents with myelotoxic tendencies. There've been some suggestions of administering agent intravitreally or by intraocular implant for best toxicity/ efficacy ratio. Agent also in trials administered {PO} 1000 mg {tid} x 28d. 12-93 Early results of those tests apparently encouraging. Still, {foscarnet} may be superior, except for those w/ impaired {kidney} function, though it is more expensive. {AMFAR} comments that "an association has been found between the prevalence of resistant CMV strains in patients receiving ganciclovir and progression of CMV disease." See also {G-CSF}. Ganciclovir (DHPG, Cytovene)

SD Heptavax Vaccine for use vs. hepititis B.

SD heroin ("smack," etc.) Diacetylmorphine, a commonly abused {narcotic} drug, usually injected {IV}. Produces mental state of (imagined) great well- being, allows user to distance self entirely from unpleasant aspects of life. After a very few trials generally produces {addiction}. Related to {morphine}, but unlike its precursor is illegal even for medical use in U.S. Is usually injected by {syringe} into {vein} or {SC}. Because of that, heroin use is one of the common ways AIDS is spread. Important: See {BLEACH}, {intravenous drug use}.

SD indomethacin {NSAID}, provides {symptomatic} relief from {fever} and {diarrhea}, tends to reduce {synthesis} of certain {prostaglandin}s (especially prostaglandin E2) which appear w/ elevated levels in persons w/ HIV.

SD iodoquinol (Yodoxin) An {antiparasitic}.

SD isoniazid (isonicotinic acid hydrazide, INH, Nydrazid, Teebaconin, Laniazid) {Antibiotic} originally used {IV}/{PO} as {prophylaxis}/ therapy vs. {TB}, now administered PO in combination with other drugs. Possible side FX include {CNS} dysfunction, elevated {enzyme} levels in {liver}. Rash, {hepatitis}, {peripheral neuropathy} sometimes also seen. Has been used w/ {rifampin}. 12-92 seems to have no activity against {MAC}, although often classed as {antimycobacterial} in function.

SD isoprinosine {Antiviral} / {Immodulator}, has been tried vs. {molluscum}, not effective.

SD itraconazole (ITR) Janssen's (Sporanox). An {antifungal}, simalar to {fluconazole}, less expensive. Generally less {toxic} than {amphotericin B}. 9-92 {FDA} approves itraconazole for the treatment of {blastomycosis} and {histoplasmosis} in {immunocompromised} and non-immunocompromised persons. Studies to investigate the efficacy and safety of itraconazole, including optimal dosage and duration in HIV-infected persons, are ongoing. May be effective vs. {cryptococcosis}/ cryptococcal meningitis. 1-93 (IND) Approved for use in Europe, S. America. 7-93 This agent not readily {absorb}ed in systems of {PWA}s, serum levels reduced w/ concurrent {rifampin}, antacids, etc.

SD ketoconazole (Nizoral) used as therapy vs. {fungal} {infections} ({esophageal}, {oropharyngeal}, chronic {mucocutaneous} {candidiasis}; {oral} thrush; candiduria; {blastomycosis}; {coccidioidomycosis}; {histoplasmosis}; chromomycosis; paracoccidioidomycosis; etc.) Is FDA-approved for use as a general systemic/ topical agent and provided in both tablet and cream forms. Not readily {absorb}ed into {CSF}, thus not indicated for use vs. fungal {meningitis}. Efficacy concurrent with {isoniazid}, {rifampin}, and some antacids not optimal. Some reports of {liver}- associated side FX. See also {fluconazole}.

SD leucovorin Folinic acid, used sometimes to protects cells from inherent folic acid {toxicity} of {pyrimethamine}, {trimetrexate}. See {PRO-MACE/MOPP}, also {antifolate}.

SD leucovorin calcium Member of vit. B complex, this salt of {folic acid} is used to treat {severe} {anemia}. It may also help reduce {toxicity} of {TMP-SMX}, other drugs.

SD levofloxacin (fluoroquinolone levofloxacin) 5-93 new drug to be tried vs. {TB}. Trials will be using subjects who are {HIV- positive}. 8-93 Auspices {NIAID}.

SD lincomycin An {anti-infective} agent.

SD lomotil Agent used vs. {GI} irritation, resultant {diarrhea}.

SD malidone Drug used to help prevent siezures of {epilepsy}.

SD megestrol acetate 9-93 (Megace) An appetite stimulant now ok'd for marketing. Active ingredient: Synthetic progesterone, a {hormone} previously used to treat breast cancer. However it's said progesterone also tends to hold back production of {cytokine} {IL-1}, which is thought to be a "mediator" of {anorexia} and so is being used vs. {wasting}. Early reports from our sources highly affirmative.

SD Mellaril Tranquilizing drug, sometimes used to calm agitated persons.

SD mesalimine Drug used vs. {inflammation} of bowel in presence of AIDS.

SD Mesopin Anti{spasm}odic, relaxant drug.

SD methadone Prescription drug, sometimes used in drug- withdrawal therapy. Its use has to be carefully managed as it is itself addictive and potentially dangerous, w/ FX similar to those of {morphine}, {heroin}.

SD methotrexate {Antineoplastic}, used {PO} or {IV} vs. forms of {cancer}, {leukemia}. Said to inhibit the {enzyme} dihydrofolate reductase and thus limit {DNA} {synthesis}. Side FX include {diarrhea}, {stomatitis}, nausea, {leukopenia}, {thrombocytopenia}. See {PRO-MACE/MOPP}, {trimetrexate}.

SD methylphenidate HCl (Ritalin) A {CNS} stimulant, used vs. attention deficit disorders in children, but may also have use against {AIDS dementia}. Can produce feelings of "nervousness," agitation, difficulty in sleeping.

SD metronidazole (Flagyl) listed variously as an {antibacterial} or an {antiparasitic}. Used, per {AMFAR}, vs. {bacterial vaginosis}, {giardiasis}. May be tried vs. {microsporidiosis}. Side FX: {GI} problems, also possibly seizures, {peripheral neuropathy}, alcohol intolerance. Administered {PO}.

SD mexiletine {Chemotherpy} agent used vs. {arrhythmia}. May be useful vs. HIV- related {neuropathy}. Side FX include {GI} problems, dizziness.

SD mitoxantrone {Chemotherapy} drug used {IV} vs. leukemia, advanced local and {metastatic} breast {cancer}. Being tested in lab vs. {KS}, lymphoma. Side FX may include {granulocytopenia}, {alopecia}.

SD morphine A high- potency {analgesic} used against {severe} pain. Can produce side FX including nausea, constipation, disorientation, etc. May cause feelings of euphoria for at least a brief period of time. Has addictive properties. See {addiction}, {opium}.

SD Nembutal Drug of barbituate class, used to produce long periods of sedation/ sleep.

SD nicotinic acid (niacin) A pyridine derivative, technically a B vitamin.

SD nimodipine (Nimotop) A calcium- channel blocker associated with therapy vs. {hemorrhage}s of {meninges}, 2-93 in experiments, in combination w/ {AZT} vs. {AIDS dementia}.

SD nitric acid A strong acid, sometimes used to {cauterize} protruberant {lesion}s such as warts.

SD nitrous oxide ("Laughing gas") General anesthetic often used in dentistry. Contrary to general impression, its use can be "modulated" so that hysteria and unconsciousness do not result, but the patient will be tranquilized.

SD ofloxacin (Floxin) an {antimycobacterial}, may be useful when other therapies ineffective or impractical.

SD opium Substance found in juice of poppy plant, Papaver somniferum. Opium has a trance- or sleep- inducing {narcotic} action; due to its {morphine} content also has {analgesic} properties.

SD paramomycin (Humatin) Broad spectrum {antibiotic} sometimes used as therapy vs. {amebiasis}, {giardiasis}, being studied as possible therapy vs. {cryptosporidiosis}.

SD PAS (Rezipas, Teebacin) Para-aminosalicylic acid. Anti- {mycobacteria}l, generally for use when other therapies not effective or possible. Related to aspirin.

SD penicillin Extremely common {antibiotic}.

SD pentamidine (Pentam, Pentam 300, NebuPent) An aromatic diamidine thought to hold back {synthesis} of {protozoa}l {DNA} and {RNA}, used as {prophylaxis} and therapy for {PCP}. (PCP, Pneumocystis carinii pneumonia, is caused by {infection} of {lungs} and is one of major causes of death among those with AIDS). As prophylaxis, this agent is usually given in {aerosolized} form; as therapy is often given as {IV} or {IM} injection. May cause side FX including {leukopenia}, {renal} insuffiency, dyglycemia, low blood pressure, cardiac arrhythmia. Also it's believed aerosol pentamidine is a significant risk factor for {pneumothorax} independent of a history of PCP. 5-93 The two most popular agents used vs. PCP are pentamidine and {TMP/SMX}. TMP/SMX is widely held to be superior, especially for preventing recurrences, but it presents a higher probability of side FX (weakness, {abdominal} pain). {Dapsone} also has its adherents. More discussion of this topic elsewhere.

SD Percodan {Narcotic} {analgesic}. Likely to produce {habituation}, {addiction} if not monitored w/ care. "Percocet" is a variant on Percodan.

SD phenobarbitol {Narcotic} {CNS} {depressant}. May be used as very strong tranquilizer or as sedative. High addiction/ habituation potential.

SD Pneumopent {Pentamidine} isethionate.

SD Pneumovax Vaccine used vs. some 25 {strain}s of bacterial (pneumococcus) {pneumonia}.

SD prednisone (Orasone, Deltasone) A {synthetic} {corticosteroid} {hormone} used as {anti-inflammatory} agent. Has {immunosuppresive} properties. One possible application for this agent is in cases where a person with AIDS is experiencing fatigue linked to hypoadrenalism, or poor function of the {adrenal glands}. This would have been be confirmed by tests for low sodium and chloride levels, along with low blood pressure. Dosages totalling perhaps 5-15 mg/day of prednisone might be tried in such an instance. As always with corticosteroids, a close watch will be maintained for side effects such as central nervous system or gastric problems -- or {immunosuppression}. Prednisone has also been used against {myopathy} and other results of {neuropathy}, often with success. See {PRO-MACE/MOPP}.

SD primaquine {Antiparasitic} originally for {prophylaxis} vs. malaria. 2-93 in combination drug experiments (w/ {clindamycin}) vs. {PCP} in those intolerant of other drugs. Combination said to be effective. At one time CDC bought out existing US stock for use vs. malaria and drug was available (presumably through {buyers' clubs}) from England.

SD PRO-MACE/MOPP Chemotherapy combination w/ courses of {prednisone}, {methotrexate} (w/ leucovorin "rescue"), {doxorubicin}, {cyclophosphamide}, etoposide/ mechlorethamine, {vincristine}, {prednisone}, {procarbazine}.

SD procarbazine (Matulane) an {antineoplastic} drug, part of MOPP therapy vs. Hodgkin's disease. See also reference to {oral combination chemotherapy}. May cause {myelosuppression}, nausea. See {PRO-MACE/MOPP}.

SD promazine (Sparine) A tranquilizer. Sometimes used during {alcohol} or drug {addiction} therapy "withdrawal" process.

SD propoxyphene (Darvocet-N) a pain relief medication. Like its "cousin," Darvon, is considered safer albeit, for some persons and situations, perhaps less efficient than {codeine}.

SD prothipendyl Tranquilizer/ sedative.

SD pyrazinamide (PZA) 10-92 {Antimycobacterial}, approved by {FDA} vs. {TB}. Has been available. since 1955 as alternative to {streptomycin}. Current CDC recommendation is that adults and children w/ active TB be treated with {pyrazinamide}, {isoniazid}, and {rifampin} for 2 months, isoniazid and rifampin for another 4 mos., after which most ordinary TB will have cleared. Those w/ HIV may need to take the drugs for longer than 6 mos. For any updates see {TB}. PZA's main side FX are {liver} damage and hyperuricemia (excess acid in blood). Sometimes {GI} problems, rash. Must be used w/ caution in those w/ history of {diabetes mellitus}, or who are at risk for {hepatitis}, or are older than 65 years. Not indicated for those w/ severe hepatic damage or {gout}.

SD quinacrine HCl (Atabrine) an {antiparasitic}.

SD quinolone antibiotics {Synthetic}, broad- spectrum {antibacterial} drugs. {Ciprofloxacin}, {sparfloxacin}, etc.

SD ranitidine (Zantac) See {cimetidine}.

SD Retrovir Current trade name of Burroughs Wellcome's AZT, the mainstay {antiviral} used to inhibit progression of HIV disease. (See {AZT} for general info, {zidovudine} for technical info.)

SD rifabutin (Ansamycin, Rifabut, Mycobutin) (IND) taken {PO} for control of {MAC}. Is said to cross {blood-brain barrier}, thus may be useful in treating various AIDS-related {neurological} diseases. Also see {clarithromycin}, {amikacin}. 12-92 {FDA} approves for {MAC} {prophylaxis}, see also {TLC-G-65}. 1-93 Adria's name for agent is Ansamycin. Developmental name was "LM427." Side FX may include rash, {arthralgia}, {hemolysis}, {leukopenia}, {GI} problems.

SD rifampin (Rifadin, Rimactane, Rifocin) a partly {synthetic} {antibiotic} with {antimycobacterial} and anti- TB activity, one component in experimental {MAC} therapy. May be useful as TB prophylaxis as well as treatment. Side FX mostly {GI} and {liver} problems, temporary {thrombocytopenia}. May also cause dicolored body {secretion}s. See also {amikacin}. 8-93 See {TB}.

SD salacylic acid Type of {acid} for {topical} use vs. {venereal wart}s, etc.

SD Sporanox Janssen's {itraconazole}.

SD stanozolol (Winstrol) {Anabolic steroid} sometimes used in aplastic {anemia}, osteoporosis. May be used in androgen- deficient males to help in development of secondary sex characteristics.

SD stavudine 11-92 FDA announces drug has been made available for "expanded investigational use." 6-94 Approved for treatment of adults with advanced HIV who are no longer responsive to, or are intolerant of, other antiviral drugs. See {d4T}.

SD streptomycin 5-93 {Antibiotic}/ {antimycobacterial}, recently reformulated, approved by {FDA} vs. {TB}. This agent's main drawbacks are that it's only truly effective as {IM} injection, and it produces sharp burning sensations at injection site. Other poss. side FX include {renal} {toxicity}, ear problems. 8-93 Part of {CDC}- recommended therapy vs. MDR-{TB}, may substitute {ethambutol} if neccessary. 3-94 Although Eli Lilly and Co. has been purchasing this drug from France's Rhone- Poulenc Rorer, a recent FDA inspection found the latter supplier's standards wanting. This has led to loss of the main source of supply for streptomycin, and it's not known how long current U.S. stocks will last. Though the agent is now regarded as second- line for ordinary TB, it's often critical in therapy for multi-drug resistant TB. MDR-TB, like its regular counterpart, is a serious threat to the person with AIDS.

SD sulfa drugs A group of drugs, known also as {sulfonamides}, that inhibit certain {bacterial infection}s. Derived from a red dye (sulfanilamide), a wide variety of sulfa drugs are available, each having its own properties.

SD sulfadiazine {Sulfonamide} {antibiotic} used {PO} with {pyrimethamine} vs. {toxoplasmosis}, sometimes for {KS}, {meningitis}. Also used in combination with {trisulfapyrimidine}. 1-93 During temporary shortage, Physicians Assoc'n for AIDS Care recommends {clindamycin} as alternate. {CDC} is attempting to locate and secure a supply of this drug, states that clindamycin + pyrimethamine is viable alternate to sulfadiazine for toxoplasmosis, says combination approach such as pyrimethamine + {sulfadoxine} (Fansidar) or pyrimethamine + {dapsone} may be better than single- agent regimens for secondary maintenance. 2-93 CDC has obtained some sulfadiazine, physicians call (404) 488-4928 -- and it's also available from some buyers' clubs, try PWA Health Group, NYC. Side FX include {bone marrow} suppression, rash, fever. May produce crystalluria if rehydration, urine alkalization not provided.

SD sulfadoxine An {antibiotic}. See {sulfonamides}, of which sulfadoxine is one.

SD sulfonamides ({sulfa drugs}) Class of {antibiotic} drugs. May be recognized by their "sulfa-?" prefix. They include {sulfamethoxazole}, as well as less familiar agents as sulfamethazine, sulfamethizole, and sulfasoxazole (urinary tract infections); sulfaguanadine ({GI} infections); sulfalene, sulfadoxine, sulfaphenazole are others.

SD tetracycline Broad- spectrum {antibiotic}.

SD TMP/SMX (Bactrim, Septra, Co-Trimoxazole, Cotrim, Proloprim, Trimpex) 12-93 Trimethoprim/ sulfamethoxazole. An {antibiotic}/ {antiparasitic}, some sources' therapy of choice for {PCP} (instead of {pentamidine}. Provided as double strength tablet containing 160 mg of {trimethoprim} + 800 mg of {sulfamethoxazole}. Not recommended for those w/ prior history of {allergy} reactions, or w/ severe {neutropenia}, or pregnant, especially in last trimester. Some pt's. cannot tolerate in general. Second choice is {Dapsone}, given 50-100 mg daily (must get G6PD level, especially in pt's. of Mediterranean ancestry.) Usual dose of TMP/SMX for {prophylaxis} 1 double strength tab daily to 3X/ wk. May also treat or prophylax against {toxoplasmosis}. TMP/SMX side FX include rash, fever, {leukopenia}, hyponatremia, elev. {liver} {transaminase} levels, nausea, confusion. See {atovaquone}.

SD Toradol A non-steroidal anti-inflammatory drug (see {NSAID}). It inhibits the synthesis of {prostaglandin}s and is an {analgesic} with no known effect on opiate receptors. Toradol is indicated in the short-term management of pain. Contraindications include hypersensitivity to the drug itself, nasal polyps, angioedema, and bronchial reactivity to aspirin and other NSAID's. My produce {GI} side FX.

SD trimethoprim (Proloprim, Trimpex, TMP) An {oral} dihydrofolate reductase inhibitor used w/ {sulfamethoxazole} or {dapsone} vs. {PCP}. See {TMP/SMX}.

SD trimetrexate (trimetrexate glucuronate, Neutrexin, TMTX) This {antineoplastic} agent is indicated mainly for therapy against {PCP} when standard therapies ({pentamidine}, {TMP/SMX}) aren't well- tolerated, but also against enzymes of {Toxoplasmosis}. It is able to enter cells by passive diffusion to inhibit dihydrofolate reductase. It may cause elevated transaminase levels; rash; temporary forms of {neutropenia} or thrombocytopenia, mucositis; {leukopenia}, {GI} distress or {hepatic} difficulties. Guard against mucositis and {bone marrow} {toxicity} by coadministration of {leucovorin calcium} (folinic acid). Shouldn't be used by pregnant or lactating women. 2-94 Agent has been approved as indicated by FDA.

SD trisulfapyrimidine (triple sulfa) See {sulfa drugs}, {sulfadiazine}.

SD valproic acid Drug used as "mood stabilizer," of help in mild forms of manic- depressive disturbance.

SD vancomycin (Vancoled, Vancocin) {Antibiotic} sometimes used in treatments against {gram-positive bacteria}, sometimes after failure of other agents; is derived from Streptomyces orientalis.

SD vinblastine (Velban) Used {IV} as {chemotherapy} vs. {KS} in some cases. Said to block certain {amino acid} pathways used by {neoplastic} development. Possible side FX include {myelosuppression}, especially {leukopenia}, and {alopecia}. A derivative of parts of periwinkle plant.

SD vincristine (Oncovin) Drug sometimes used in {chemotherapy} vs. {KS}, {leukemias}, solid {tumor}s, and {lymphoma}s. Seems to interfere w/ cell {mitosis}. Possible side FX include {neurological}/ muscular problems, memory loss, {paresthesia}, difficulty in walking. See {PRO-MACE/MOPP}. Derived from periwinkle plant, as is {vinblastine}.

SD warfarin (Bishydroxycoumarin) Drug that prevents blood clotting, embolisms. Highly {toxic} above a certain usage level. Warfarin sodium is a derivative of coumarin, inducing its anticoagulant effect by inhibiting vitamin K epoxidereductase. In addition to its medical applications, a form of the substance is used as a rat poison in some locales.

SD zalcitabine 10-92 new name for dideoxycytidine {ddC}.

SD zidovudine {Thymidine} type {NARTI}, inhibits replication of some {retrovirus}es, include HIV. For general and update info see {AZT}, {Retrovir}. See {zidovudine -- more}.

SS 2-deoxy-adenosine See {PurNa}.

SS 2-deoxy-cytidine See {PurNa}.

SS 2-deoxy-guanosine See {PurNa}.

SS 3-NOBA-Cysteine Sulfinic Acid adduct See {NOBA/NOBP}.

SS 3TC See {lamivudine}.

SS 5-fluorouracil See {fluorouracil}.

SS 566c80 See {Atovaquone}.

SS 6-nitroso-1,2 benzopyrone See {NOBA/NOBP}.

SS 8-aminoquinolone analog See {WR 6026}.

SS 8-MOP See {photophoresis}.

SS AAV See {adeno-associated virus}.

SS abdomen See {abdominal}.

SS ABLC See {Amphoteracin B lipid complex}.

SS abscesses See {abscess}.

SS absolute CD4 T-cell count See {CD4 T-cell count}.

SS absorb See {absorption}.

SS ABV See {acyclovir}.

SS ACD See {anemia}.

SS acid-labile alpha interferon See {alpha interferon}.

SS acid-stable alpha interferon See {alpha interferon}.

SS acquired immunodeficiency syndrome See {AIDS}.


SS adenine arabinoside See {vidarabine}.

SS adrenal glands See {adrenal gland}.

SS Adriamycin See {doxorubicin}.

SS adsorb See {bind}.

SS aerosolized pentamidine See {pentamidine}.

SS aetiology See {etiology}.

SS AFB See {Acid-fast bacilli}.

SS akinesia See {Bradykinesia}.

SS alanine aminotransferase See {ALT}.

SS aldosterone See {corticosteroid}.

SS allele See {haplotype}.

SS allergen See {allergy}.

SS allopathy See {allopathic}.

SS alpha interferon 2-A, recombinant See {alpha interferon}.

SS alpha interferon 2-B, recombinant See {alpha interferon}.

SS alpha interferon w/AZT and ddC See {alpha interferon}.

SS alpha lipoic acid See {thioctic acid}.

SS American Association of Blood Banks See {AABB}.

SS American Foundation for AIDS Research See {AMFAR}.

SS American Medical Association See {AMA}.

SS Amikin See {amikacin}.

SS amphetamines See {Methamphetamines}.

SS amphotericin B lipid complex See {amphotericin B}.

SS amyotrophic lateral sclerosis See {ALS}.

SS anabolism See {metabolism}.

SS anal See {anus}.

SS analogue See {analog}.

SS anaphylactic See {allergy}.

SS Ancobon See {flucytosine}.

SS anemia of chronic disease See {anemia}.

SS ankylosing spondylitis See {spondylitis}.

SS ansamycin See {rifabutin}, etc.

SS antibodies See {antibody}.

SS antibody-dependent cell-mediated cytotoxicity See {ABDCC}.

SS antigen presenting cell See {APC}.

SS antigen-dependent cell-mediated cytotoxicity See {AGDCC}.

SS antigen-presenting cell See {APC}.

SS antigenic drift See {antigenic diversity}.

SS antigens See {antigen}.

SS antiretroviral See {antiviral}, {retrovirus}.

SS apoplexy See {Stroke}.

SS ARC See {AIDS related complex}.

SS artery See {arteries}.

SS AS2-1 See {antineoplaston AS2-1}.

SS Aspartate aminotransferase See {AST}.

SS aspergillomycosis See {aspergillosis}.

SS asymptomatic seropositive See {asymptomatic}.

SS Atabrine See {quinacrine HCl}.

SS autoimmunity See {autoimmune}.

SS autonomic nervous system See {nervous system}.

SS AZDU see {Azidouridine}.

SS azidothymidine See {AZT}, {zidovudine}, {Retrovir}.

SS AZM See {azithromycin}.

SS B-cells See {B-lymphocytes}.

SS bacterial permeability increasing protein See {BPI}.

SS baicalin See {bioflavonoids}.

SS base See reference in counterpart, {acid}.

SS Betaseron See {beta interferon, recomb't.}.

SS Biaxin See {clarithromycin}.

SS biological response modifier See {BRM}.

SS bisheteroarylpiperazine See {BHAP}.

SS bitter melon See {Momordica charantia}.

SS blood poisoning See {septicemia}.

SS blood-brain barrier See {blood-csf barrier}.

SS blood-cerebrospinal fluid barrier See {blood-csf barrier}.

SS bone marrow suppression See {bone marrow}.

SS bovine anti-cryptosporidium See {BACI}.

SS BRL39123A See {famciclovir}.

SS Brovavir See {BV-ara-U}.

SS BUN See {Blood urea nitrogen}.

SS butyl-DNJ See {butyldeoxynojirimycin}.

SS butylated hydroxytoluene See {BHT}.

SS c-nitroso compound See {NOBA/NOBP}.

SS cachchectin See {tumor necrosis factor}.

SS calcineurin See {cyclosporin}.

SS California disease See {coccidioidomycosis}.

SS calymmatobacterium granulomatis See {Donovan bodies}.

SS cannabinoid receptors See {brain stem}.

SS capastat sulfate See {capreomycin sulfate}.

SS carrisyn See {aloe vera}.

SS catabolism See {metabolism}.

SS catechin See {bioflavonoids}.

SS CD4% See {HIV progression testing}.

SS CD4 receptor protein See {CD4}, {T-helper cell}, {CD26}.

SS CD4+ T-cell See {T-helper cell}.

SS CD4-pseudomonas exotoxin See {CD4-PE40}.

SS CD56 See {LEU19}, {LAK cell}.

SS CD8 cell See {T-killer cell}.

SS CD8 cell therapy See {cell therapy}.

SS cells See {cell}.

SS cellular immunity See {cell-mediated immunity}.

SS Centers for Disease Control and Prevention See {CDC}.

SS cerebrovascular disease See {cerebrovascular}.

SS Chancroid See {chancre}.

SS cholecystekinin See {opiate antagonist}.

SS choroiditis See {choroidretinitis}, {choroid}.

SS chromosomal See {chromosome}.

SS chronic fatigue syndrome See {CFS}.

SS chronic idiopathic demyelinating polyneuropathy See {CIDP}.

SS chrysin See {bioflavonoids}.

SS Circulating Immune Complexes See {Immune complex}.

SS cisapride See {cisapride}.

SS clinical comparison study See {clinical comparison}.

SS cluster of differentiation See {CD}.

SS Coccidioides immitis See {coccidioidomycosis}.

SS coccidiosis See {isoporiasis}.

SS Cognex See {tacrine}.

SS cold sore See {Herpes Simplex Virus I}.

SS colony stimulating factors See {CSF}.

SS Community Research Initiative See {CRI}.

SS community-based clinical trial See {CBCT}.

SS compound Q See {GLQ223}.

SS conjugate See {conjugation}.

SS conjunctivitis See {conjunctiva}.

SS Consumer Health Information Research Institute See {CHIRI}.

SS controlled trial See {controlled study}.

SS convergent combination therapy See {convergent combination}.

SS CoQ10 See {Coenzyme Q10}.

SS corticoid See {corticosteroid}.

SS corticotropin See {ACTH}.

SS corynebacterial infections See {corynebacteria}.

SS costatolide See {Calanolide A}.

SS CPK See {Creatine phosphokinase}.

SS CRDS See {curdlan sulfate}.

SS Creutzfeldt-Jakob disease See {Creutzfeldt-Jakob}.

SS cryptococcal meningitis See {cryptococcosis}.

SS cryptococcus neoformans See {cryptococcosis}.

SS cryptosporidial diarrhea See {cryptosporidial}.

SS cryptosporidium See {cryptosporidial}.

SS cryptosporidium immune colostrum See {cryptosporidium I.C.}.

SS CT scan See {Cat scan}.

SS CTL See {cytotoxic T-lymphocyte}.

SS curry See {Curcumin}.

SS cyclophilin See {cyclosporin}.

SS cysteine See {cysteine precursors}.

SS Cytarabine See {ara-c}.

SS cytocidal See {cytocide}.

SS Cytomegalovirus Retinitis See {CMVR}.

SS cytotoxicity See {cytotoxic}.

SS Cytovene See {ganciclovir}.

SS Daraprim See {pyrimethamine}.

SS Darvocet-N See {propoxyphene}.

SS Deca-Durabolin See {anabolic steroid}.

SS Declomycin See {demeclocycline}.

SS Delavirdine See {BHAP compounds}.

SS delayed hypersensitivity reaction See {DHR}.

SS dementia See {AIDS dementia}, {prion diseases}.

SS dendritic cell See {Langerhans cell}.

SS deoxyoligonucleotide inhibitor See {deoxyoligonucleotides}.

SS desert rheumatism See {coccidioidomycosis}.

SS dextropropoxyphene See {Darvon}.

SS dextrose See {glucose}.

SS DFMO See {Eflornithine}.

SS DHPG See {ganciclovir}.

SS diclazuril See {letrazuril}.

SS didanosine See {ddI}.

SS dideoxycytidine See {ddC}.

SS diethyldithiocarbamate See {antabuse}.

SS differential leukocyte count See {differential WBC count}.

SS differential white cell count See {differential WBC count}.

SS differentiate See {differentiation}.

SS Diffuse Undifferentiated Non-Hodgkin's Lymphoma See {DUNHL}.

SS Diflucan See {fluconazole}.

SS dinitrochlorobenzene See {DNCB}.

SS Disulfiram See {antabuse}.

SS DMP-323 See {protease inhibitors}.

SS DNJ See {butyldeoxynojirimycin}.

SS Doxil See {doxorubicin}.

SS DRG-0161 See {fluorouracil}.

SS dronabinol See {Marinol}.

SS drug- induced neuropathy See {neuropathy}.

SS drug-induced parkinsonism See {parkinsonism}.

SS DTC See {antabuse}.

SS dystrophin See {muscular dystrophy}.

SS E. coli See {Escherichia coli}.

SS Eastern Coordinating Oncology Group performance status See {ECOGPS}.

SS EBV See {Epstein-Barr virus}.

SS EEG See {electroencephalogram}.

SS efficacious See {efficacy}.

SS EIA See {ELISA test}.

SS EL-10 See {dehydroepiandrosterone}.

SS Elavil See {amitryptiline}.

SS electroencephalogram See {electroencephalograph}.

SS encephalin See {enkephalin}.

SS enterocytozoon bieneusi See {microsporidiosis}.

SS epicatechin See {bioflavonoids}.

SS epinephrine See {adrenaline}.

SS EPO See {epoetin alfa}.

SS Epogen See {erythropoietin}.

SS erythrocytes See {Red blood cells}.

SS exacerbated See {exacerbation}.

SS exclusion criteria See {inclusion criteria}.

SS exfoliation See {necrolysis}.

SS feces See {stool}.

SS feline immunodeficiency virus See {FIV}.

SS FFAA See {free-form amino acid}.

SS FIAU See {fialuridine}.

SS Flagyl See {metronidazole}.

SS flame retinal hemorrhage See {hemorrhage}.

SS flavan See {bioflavanoids}.

SS flavanone See {bioflavanoids}.

SS flavone See {bioflavinoids}.

SS Floxin See {ofloxacin}.

SS fluoroquinolone levofloxacin See {levofloxacin}.

SS folinic acid See {leucovorin}, {antifolate}.

SS Food and Drug Administration See {FDA}.

SS Foscavir See {foscarnet}.

SS free-form amino acid See {amino acid}.

SS fungal See {fungus}.

SS Fungizone See {amphotericin B}.

SS Furoxone See {furazolidone}.

SS gallocatechin See {bioflavonoids}.

SS gamma-amino-butyric acid See {GABA}.

SS gamma-linolenic acid See {EPA}.

SS garlic See {Nutritive Supplements}.

SS gastrointestinal intolerance See {gastrointestinal}.

SS genital warts See {Human papillomavirus}.

SS gentamicin See {Gentamicin, lipsomal}.

SS Gerstmann-Straussler-Scheinker syndrome See {prion diseases}.


SS Glucocorticoids See {corticosteroid}s.

SS glucose-6-phosphate dehydrogenase See {G6PD}.

SS Glyceron See {glycoprotein}, {glycyrrhizin}.

SS gp41 See {envelope}.

SS Granulocyte colony stimulating factor See {G-CSF}

SS granulomas See {granuloma}.

SS Gyne-Lotrimin See {clotrimazole}.

SS hairpin ribozyme See {genetic knife theory}.

SS Halotestin See {fluoxymesterone}.

SS Hct See {Hematocrit}.

SS helper T-cell See {T-helper cell}.

SS hemophilus ducreyi See {chancre}.

SS Herpes Virus 6 See Human Herpes Virus 6.

SS Hgb See {hemoglobin}.

SS HHV-6 See {Human Herpes virus 6}.

SS HHV-7 See {Human Herpes virus 7}.

SS Hickman catheter See {catheter}.

SS histocompatibility testing See {histocompatibility}.

SS HIV+ See {HIV-positive}.

SS HIV- See {HIV-negative}.

SS HIV immunotherapeutic vaccine See {RG-83894}.

SS HIV immunotherapeutic vaccine See {Salk HIV immunogen}.

SS HIV transmission methods See {HIV transmission}.

SS HIV-immunogen See {Salk HIV immunogen}.

SS HIVID See {ddC}, {dideoxycytidine}, {zalcitibine}.

SS HPV See {human papillomavirus}.

SS HSV See {Herpes simplex virus}.

SS HTLV-4 See {HIV-2}.

SS human granulocyte macrophage colony stimulating factor See {rhGM-CSF}.

SS Human Immunodeficiency Virus See {HIV}.

SS human leukocyte antigens See {HLA}.

SS human spongiform encephalopathy See {prion diseases}.

SS Humatin See {paramomycin}.

SS hydrocortisone See {cortisol}.

SS hydroxamate See {hydroxyurea}.

SS hydroxyethoxy methyl phenylthiothymine See {HEPT}.

SS idiopathic CD4 T-lymphocytopenia See {ICL}.

SS Idiopathic Thrombocytopenic Purpura See {ITP}.

SS Ig See {immunoglobulin}.

SS IL-1 See {interleukin 1}.

SS IL-2 See {interleukin 2}.

SS IL-3 See {interleukin 3}.

SS IL-4 See {interleukin 4}.

SS IL-8 See {interleukin 8}.

SS immune modulator See {Immunomodulator}.

SS immune response See {Immune system}.

SS immunological crash See {SI strain}.

SS immunological tolerance See {immunological}.

SS Immunopotentiator See {immunostimulant}.

SS INF See {interferon}, {gamma interferon}.

SS infarcts See {infarct}.

SS infections See {infection}.

SS inflammatory bowel disease See {IBD}.

SS INH See {isoniazid}.

SS Institutional Review Board See {IRB}.

SS Insulin-like growth factor 1 See {IGF-1}.

SS intestinal See {intestine}.

SS intestinal malabsorption See {intestine}.

SS intolerance See {intolerant}.

SS intravenous immunoglobulin See {IVIG}.

SS Intron A See {alpha interferon}.

SS invasive cervical cancer See {cervical cancer}.

SS isonicotinic acid hydrazide See {isoniazid}.

SS IV See {intravenous}.

SS kidneys See {kidney}.

SS killer T-cell See {T-killer cell}.

SS Klacid See {clarithromycin}.

SS l-dopa See {Levodopa}.

SS Lamprene See {clofazamine}.

SS Laniazid See {isoniazid}.

SS LAV-2 See {HIV-2}.

SS LDH See {lactic dehydrogenase}.

SS lesions See {lesion}.

SS Leucomax See {molgramostim}.

SS leukine See {rhGM-CSF}.

SS leukocytopenia See {ICL}.

SS levodopa-induced dyskinesia See {dyskinesia}.

SS Lioresal See {baclofen}.

SS LIP See {pneumonia}.

SS lipoic acid See {Thioctic acid}.

SS liposomal stealth doxorubicin HCl See {doxorubicin}.

SS lipsomal gentamicin See {Gentamicin, lipsomal}.

SS liters See {liter}.

SS lomustin See {oral combination chemotherapy}.

SS Lotrimin See {clotrimazole}.

SS Lou Gehrig's disease See {ALS}.

SS lymph node See {lymph glands}.

SS lymphadenopathy-associated virus See {LAV}.

SS lymphoblastoid interferon See {interferon}

SS lymphocytes See {lymphocyte}.

SS lymphocytic interstitial pneumonia See {pneumonia}.

SS lymphogranuloma venereum See {chlamidia trachomitis}.

SS lymphoid See {lymphatic}, {lymphatic tissue}.

SS lymphoid interstitial pneumonia See {pneumonia}.

SS lymphokine-activated killer cell See {LAK cell}.

SS macrocyte See {megalocyte}.

SS macroglobulin See {IgM}.

SS macrophage colony stimulating factor See {M-CSF}.

SS magnetic resonance imaging See {MRI}.


SS major histocompatibility complex See {MHC}.

SS marijuana See {Marinol}.

SS MDR-TB See {tuberculosis}.

SS mean corpuscular volume See {MCV}.

SS Megace See {megestrol acetate}.

SS MEK See {metenkephalin}.

SS Mepron See {atovaquone}.

SS methemoglobinemia See {methemoglobin}.

SS microbe See {microorganism}.

SS microcyte See {microcytosis}.

SS MiKasome See {liposomal amikacin}, {amikacin}.

SS Mineralocorticoids See {corticosteroid}s.

SS mistletoe See {Iscador>.

SS monoamine-oxidase type B See {monoamine-oxidase}.

SS monoclonal anti-idiotype antibody vaccine See {anti-idiotype vaccine}.

SS motor neuron disease See {motor nerve disease}.

SS MS See {multiple sclerosis}.

SS mucous membrane See {mucous membranes}.

SS mucus See {mucous}.

SS Myambutol See {ethambutol}.

SS Mycelex See {clotrimazole}.

SS mycobacterial infection See {mycobacterial}.

SS Mycobacterium Avium Complex See {MAC}.

SS mycobacterium avium intercellulare See {MAC}.

SS mycobacterium avium intercellulare bacillemia See {MAI bacillemia}.

SS Mycobutin See {rifabutin}.

SS Mycostatin pastille See {nystatin}.

SS myelodysplastic syndromes See {myelodysplastic}.

SS N-butyl DNJ See {butyldeoxynojirimycin}.

SS NAC See {n-acetylcysteine}.

SS naloxone See {opiate antagonist}.

SS nandrolone deconate See {anabolic steroid}.

SS National Cancer Institute See {NCI}.

SS National Research Council See {NRC}.

SS Nebupent See {pentamidine} (aerosolized).

SS NegGram See {nalidixic acid}.

SS neisseria gonorrhoeae See {gonorrhea}.

SS neomycin See {aminoglycoside}.

SS neonate See {neonatal}.

SS nerve cell See {neuron}.

SS neuroglia See {glia}.

SS neurological complications See {neurological}.

SS Neutrexin See {trimetrexate}.

SS night sweats See {diaphoresis}.

SS nigro-striatial degeneration See {nigro-striatial}.

SS Nimotop See {nimodipine}.

SS Nizoral See {ketaconazole}.

SS NK Cell See {natural killer cells}.

SS nodule See {node}.

SS Non-Infectious Enteropathy See {Enteropathy}.

SS non-nucleoside reverse transcriptase inhibitors See {NNRTI}.

SS noradrenaline See {norepinephrine}.

SS nucleoside-analog reverse transcriptase inhibitors See {NARTI}.

SS Nydrazid See {isoniazid}.

SS olivo-ponto-cerebellar degeneration See {OPC degeneration}.

SS Oncolysin B See {anti-B4-blocked ricin}.

SS Oncovin See {vincristine}.

SS Open Study See {Compassionate use}.

SS opportunistic disease See {opportunistic diseases}.

SS opportunistic infection See {opportunistic disease}.

SS oral combination chemotherapy See {chemotherapy}.

SS oral mucosal transudate See {OMT}.

SS orphan disease See {rare diseases}.

SS orthostatic hypotension See {hypotension}.

SS oxothiazolidine carboxylate See {OTC}.

SS Packed cell volume See {hematocrit}.

SS Papanicolaou test See {pap smear}.

SS para-aminosalicylic acid See {PAS}.

SS parasympathetic nervous system See {nervous system}.

SS partial thromboplastin time See {PTT}.

SS passive hyperimmune therapy See {PATH}.

SS pathological organism See {microorganism}.

SS PEG See {interleukin 2}.

SS peliosis hepatitis See {bacillary angiomatosis}.

SS peptide-t See {peptide t}.

SS Peridex See {chlorhexidine gluconate}.

SS persistent generalized lymphadenopathy See {PGL}.

SS person with AIDS See {PWA}.

SS PFA See {foscarnet}.

SS phagocytic activity See {phagocyte}.

SS phenothiazine See {neuroleptic}.

SS phlegm See {mucous}.

SS phosphonoformic acid See {foscarnet}.

SS phosphorodithioate See {deoxyoligonucleotide}.

SS phosphorodithioate DNA oligomers See {phosphorodithioate}.

SS photopheresis See {photophoresis}.

SS PHS See {Public Health Service}.

SS Physician's Desk Reference See {PDR}.

SS placebo effect See {placebo}.

SS Pneumocystis Carinii Pneumonia See {PCP}.

SS polymerase chain reaction See {PCR}.

SS polymorphonuclear leukocyte See {neutrophil}.

SS Polymorphonuclear neutrophil See {neutrophil}.

SS polynucleotide See {gene}, {nucleotide}.

SS polyproteins See {protease inhibitors}.

SS polysaccharide-peptidoglycan, sulfated See {peptidoglycan}.

SS Procrit See {erythropoietin}.

SS procysteine See {OTC}.

SS Professional Standards Review Organizations See {PSRO}.

SS progressive coccodioidomycosis See {coccodioidomycosis}.

SS Progressive Multifocal Leukoencephalopathy See {PML}.

SS progressive supranuclear palsy See {palsy}.

SS Proloprim See {trimethoprim}.

SS proteolytic enzyme See {protease}.

SS protozoal See {protozoa}.

SS PRP See {prion diseases}.

SS pseudohypericin See {hypericin}.

SS pseudomonas CD4 exotoxin A See {Soluble CD4-PE 40}.

SS purified protein derivative of tuberculin See {PPD}.

SS purine See {nucleoside}.

SS purine nucleoside analog See {PurNA}.

SS pus See {exudate}.

SS pyridinone See {L-697,661}.

SS pyrimidine See {nucleoside}.

SS pyrimidine nucleoside analog See {PyNA}.

SS pyruvate oxidation factor See {Thioctic acid}.

SS PZA See {pyrazinamide}.


SS Quantitative Competitive Polymerase Chain Reaction See {PCR}.

SS R 18893 See {alpha-APA}.

SS R 89439 See {alpha-APA}.

SS r-Granulocyte Colony Stimulating Factor See {r-gCSF}.

SS RBC See {red blood cells}.

SS recombinant DNA technology See {recombinant DNA}.

SS recombinant human interleukin-3 See {interleukin III}

SS Reiter's Syndrome See {Reiter's}.

SS remit See {remission}.

SS resistant See {resistance}.

SS reticuloendothelial cells See {reticuloendothelial}.

SS retinal vascular tortuosity See {vascular tortuosity}.

SS retinoic acid See {all-trans retinoic acid}.

SS retinol See {all-trans retinoic acid}.

SS reverse transcriptase inhibitor See {reverse transcriptase}.

SS rhIGF-1 See {IGF-1}.

SS ribonucleic acid See {RNA}, {nucleic acid}.

SS ribozyme See {genetic knife theory}.

SS Rifabut See {rifabutin}.

SS Roferon-A See {Alpha interferon} 2-A, recombinant.

SS RPR 103611 See {triterpine derivative}.

SS Saccharomyces boulardii See {S. boulardii}.

SS Sandostatin See {Octreotide acetate}.

SS scintillating scotoma See {scotoma}.

SS Septra See {TMP/SMX}.

SS Seromycin See {cycloserine}.

SS sertraline See {serotonin}.

SS Serum cortisol response See {SCR}.

SS serum glutamic oxaloacetic transaminase See {SGOT}.

SS serum glutamic pyruvic transaminase See {SGPT}.

SS severe combined immunodeficiency disorder See {SCID}.

SS sexually transmitted disease See {STD}.

SS shiitake See {lentinan}.

SS shingles See {Herpes Zoster}.

SS Simian Immunodeficiency Virus See {SIV}.

SS single-agent continuous infusion See {SACF}.

SS smoke bush See {Conocurvone}.

SS SMS 201-995 See {sandostatin}.

SS sodium tetradecyl sulfate See {sodium tetradecyl}.

SS Somatostatin see {octreotide acetate}.

SS spinal tap See {lumbar puncture}.

SS spine See {spinal column}.

SS SQ 32,756 see {BV-ara-U}.

SS SQ 34,514 See {Cyclobut-G}.

SS Squamous intraepithelial lesion See {SIL}.

SS St. Johns Wort See {Hypericin}.

SS St. Johnswort See {Hypericin}.

SS Stevens-Johnson syndrome See {erythema multiforme}.

SS streptococcus pneumoniae See {streptococcus}.

SS striato-nigral degeneration See {striato-nigral}.

SS sulfamethoxazole See {TMP-SMX}.

SS Symmetrel See {amantadine}.

SS sympathetic nervous system See {nervous system}.

SS syncytia See {syncytium}.

SS synechia See {adhesion}.

SS synergy See {synergism}.

SS synthesis See {synthesize}.

SS systemic lupus erythematosus See {lupus}.

SS T-cell count See {CD4 T-cell count}.

SS T-cells See {T-cell}.

SS T-lymphocyte See {T-cell}.

SS T4 cell See {T-helper cell}.

SS T8 cell See {T-killer cell}.

SS Tagamet See {cimetidine}.

SS TB See {Tuberculosis}.

SS Teebaconin See {isoniazid}.

SS THC See {Marinol}.

SS thioate deoxyoligocytidine See {deoxyoligocytidine}.

SS Thioctacid See {Thioctic acid}.

SS thrombin See {prothrombin}.

SS thrombocyte See {platelet}.

SS thymic See {thymus}.

SS Thymic Fractions 1402 See {Immunoplex 402}.

SS thymidine nucleoside analog See {ThyMA}.

SS tissues See {tissue}.

SS TLC G-65 See {gentamicin, liposomal}.

SS TMTX See {trimetrexate}.

SS TNF See {Tumor Necrosis Factor}.

SS Toxoplasmic encephalitis See {Toxoplasmosis}.

SS TP-1 See {thymostimulin}.

SS TP-5 See {thymopentin}.

SS Transforming growth factor Beta See {TGFB}.

SS transient ischemic attacks See {TIA}.

SS treatment IND see {IND}.

SS Trecator-SC See {ethionamide}.

SS Trental See {Pentoxifylline}.

SS Treponema palladum See {Treponema}.

SS trichosanthin See {GLQ223}.

SS trimethoprim/sulfamethoxazole See {TMP/SMX}.

SS Trimpex See {trimethoprim}.

SS triple sulfa See {sulfa drugs}, {sulfadiazine}.

SS U-87201E See {ateviridine}, {BHAP compounds}.

SS U-90 See {BHAP compounds}.

SS U-90152 See {BHAP compounds}.

SS ubiquinone See {Coenzyme Q10}

SS Uendex See {dextran sulfate}.

SS ulceration See {ulcer}.

SS ulcers See {ulcer}.

SS Unasyn See {ampicillin}.

SS vaginal yeast infection See {yeast infection}.

SS valley fever See {coccidioidomycosis}.

SS VaxSyn See {rgp160}.

SS VD See {STD}.

SS Velban See {vincristine}.

SS venereal disease See {STD}.

SS venereal wart See {condyloma}, {herpes}.

SS Venus' flytrap See {carnivora}.

SS VePesid See {etoposide}.

SS Videx See {ddI}.

SS Viscum album mistletoe See {Iscador}.

SS vitamin See {Nutritive Supplements 1}.

SS VP-16 See {etoposide}.

SS WBC See {white blood cells}.

SS Winstrol See {stanozolol}.

SS womb See {Uterus}.

SS Yodoxin See {iodoquinol}.

SS Zerit See {d4t}.

SS zinc fingers See {NOBA/NOBP}.

SS Zithromax See {azithromycin}.

SS Zoloft See {serotonin}.

SS Zostrix See {capsaicin}.

SS Zovirax See {acyclovir}.



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