AIDS Trestment News
by John S. James
Jon Kaiser, M.D., an HIV specialist practicing in San Francisco for many years, focuses on combining mainstream and natural HIV treatment approaches. Five years ago he published Immune Power; now he has updated his recommendations in Healing HIV: How to Rebuild Your Immune System. Before reviewing the new book, we will first comment on its context -- the place of "alternative" treatments today when new antiretroviral combinations and other advances in mainstream medical care have greatly reduced AIDS-related deaths and illnesses, and justifiably captured the public's attention.
We believe that so-called alternative or complementary approaches will become more important over the next two or three years, for several reasons, but especially to help the mainstream therapies work better. Doctors are now beginning to see more clinical consequences of viral load which can no longer be controlled because some patients have "used up" all the available drugs, and new antiretrovirals are not being developed rapidly enough for many of these patients. Therefore it is very important to extend the effective life of the antiretroviral therapies for as long as possible, to avoid exhausting one's options too quickly.
One example of such a strategy is Dr. Kaiser's "elimination of cofactors checklist", which is referred to repeatedly in his new book. The eight cofactors listed are: Herpes infections; Intestinal parasites; Unhealthy intestinal environment; Low protein intake; Inadequate antioxidant vitamins; Hormonal imbalances; Substance abuse; and Emotional distress. For most patients who may need to change antiretrovirals, instead of rushing to switch, Dr. Kaiser will check these potential cofactors and treat if necessary, then re-test viral load, etc., to evaluate whether an immediate change of antiretrovirals is still required. Also, some patients who have not yet started antiretrovirals may be able to wait, instead of immediately beginning what may be a lifetime commitment to a difficult medical regimen.
If it works, this approach to improving health by controlling possible cofactors may be like having another antiretroviral drug available -- a drug with few or no side effects, no interactions with other drugs, and no viral resistance. But how confident can we be that treating these cofactors really has any effect on HIV?
Many of these potential cofactors listed (such as herpes infection, intestinal parasites, and of course malnutrition) have been suspected for years of contributing to HIV disease progression. But definitive trials are expensive, so we do not have data as good as that for FDA-approved drugs, which are developed at the cost of hundreds of millions of dollars each (and priced accordingly). Since the medical community has become accustomed to this level of data, potential treatments which do not have it are unlikely to become part of the standard of care, and may get little or no attention in a patient's treatment -- especially in this age of HMOs and cost-cutting medicine.
One way to approach uncertainty is to compare the costs of being wrong with the benefits of being right. Most of the respected "alternative" medical approaches have relatively little risk or expense (unless they are used to replace standard medical attention, in which case the health risk can be severe). Our impression is that such approaches -- based on some laboratory evidence, biological rationale, and clinical experience -- work well for some people. It is hard to rule out the possibility that seemingly good results are only coincidence or placebo effect -- but we doubt that all the success can be explained this way. And placebo effect is unlikely to account for measurable changes such as viral load or CD4 count improvement.
Below we mention a few of the many ideas in Dr. Kaiser's new book that may be useful. There is little certainty, but much room for exploration to find what does or does not work for oneself.
Healing HIV: How to Rebuild Your Immune System
This book's introduction describes its focus:
"I define a comprehensive approach as one which adds a program of aggressive natural therapies and emotional healing techniques to the standard medical treatment of an illness or condition [italics in original]. An aggressive natural therapies program includes a combination of diet therapy, vitamins, herbs, exercise, and stress reduction. Emotional healing encompasses a proactive program of psychological healing techniques that ideally include a spiritually oriented practice (prayer, meditation, yoga, etc.), combined with a significant level of social support." [from the Introduction]
The book has many specific practical suggestions. And readers will appreciate the effort that has gone into making them easy to understand and apply:
These principles are followed by lists of dozens of foods, in five groupings from most to least recommended.
There are many other parts of Dr. Kaiser's program -- some widely used by HIV physicians, and some not:
The book also has: over 20 case histories (sometimes of patients who are difficult to treat, due to poor CD4 and viral load numbers, and intolerance or apparent resistance to many antiretrovirals); outcomes comparisons of patients treated in Dr. Kaiser's program, vs. others who received mainstream HIV treatment without the natural-therapy component; information about certain major herbs from both Western and Chinese medical traditions (although Dr. Kaiser usually refers patients to herbalists experienced with HIV for specific prescriptions); a discussion of approved and experimental antiretrovirals; and an appendix explaining common laboratory tests.
A major area where Healing HIV: How to Rebuild Your Immune System does not offer much help is how to find an HIV-experienced physician in your area who is open to working with you on some of these approaches. While many of the suggestions can be applied on one's own, others require medical supervision, especially for patients with serious health problems.
Our other suggestion for improving this book would be to establish a Web site for new articles on treatment changes as they occur. (These updates could then also become the basis of more-frequent new editions of the printed book, which would then start with new updates on the Web.) A major obstacle to using natural treatments in HIV has been the lack of authoritative, comprehensive, and easy-to-use protocols which remain readily available and up to date. Healing HIV: How to Rebuild Your Immune System is a major contribution to making this treatment approach more accessible.
Healing HIV: How to Rebuild Your Immune System, by Jon D. Kaiser, M.D., 392 pages including index, $19.95, is published by HealthFirst Press, Mill Valley, California, 1999. Despite the 1999 publication date, some copies are now in stores in San Francisco. Copies can also be ordered by calling 888-432-5448.
[Note: Dr. Kaiser does have a Web site, http://www.jonkaiser.com, which may include updated treatment information in the future.
Also, Dr. Kaiser is beginning a nationwide referral list of physicians who are supportive of his treatment philosophy. For more information, send a self-addressed stamped envelope to: HealthFirst Press, 775 E. Blithedale, Suite #367, Mill Valley, CA 94941.]
AIDS Treatment News
Buyers' Club List,
How did we decide which to include here? We started with our list from previous years, and also looked at lists kept by some buyers' clubs, and at community consensus or recommendations. Most of those below have been involved with AIDS (or sometimes other immune illnesses) for years. Some organizations which might qualify were not listed because we could not reach anyone by press time. If you believe we have omitted a group which should have been included, please let us know.
We did not include cannabis buyers' clubs here, as we have listed them separately (AIDS Treatment News #296, June 5, 1998).
Notes: (1) All or almost all of the following organizations will provide a product and price list on request. Most will accept cash, check, money order, or credit cards, and can provide fast delivery options -- but policies differ, so ask for details. The list below indicates which will accept mail order and international orders. (2) Many focus on low prices, and several have lowered their prices recently. (3) Some buyers' clubs require membership (and keep a release form on file); some offer optional membership for product discounts and other benefits; others do not have membership at all. (4) The list below is alphabetical by state, then by city within the state, and then by name of the organization when there are more than one in the same city. (5) For donors, many of the 501(c)(3) buyers' clubs are part of larger AIDS organizations; in these cases, contributors usually can designate a donation to the buyers' club. Call for specific instructions on making a donation. (6) Office hours can change; call to confirm before visiting.
AIDS Treatment News
|4th Intl. Conf. on Drug Therapy||306|
|access to care||307, 301, 286|
|ADAP (AIDS Drug Assistance Prog.)||306, 305|
|adefovir dipivoxil||293, 288|
|AIDS Treatment News||307, 298|
|alpha interferon||302, 299|
|alternative/complementary treatment||309, 301, 295|
|AZT short course||290|
|Bartlett, Dr. John G||296|
|Becker, Dr. Stephen||301|
|Capaldini, Dr. Lisa||292, 291|
|clinical trials||308, 306|
|clinical trials - design||296|
|Clinton, President William||303|
|Deeks, Dr. Steven||289|
|developing countries||307, 301, 294|
|Dieterich, Dr. Douglas||295|
|dried blood spots||290|
|drug interactions||296, 290|
|drug pricing||305, 302|
|efavirenz||306, 304, 302, 299, 296, 292|
|expanded access||304, 293, 291, 288|
|Fair Price Working Group||302|
|funding||307, 306, 304|
|Gallo, Dr. Robert||302, 299|
|Glaxo Wellcome||304, 301|
|Gorter, Dr. Robert||305, 304|
|Healing Alternatives Foundation||300|
|Healing HIV (book)||309|
|HealthCare Communications Group||306, 290|
|Henry, Dr. Keith||304, 295|
|hepatitis C||302, 297, 295|
|HIV-specific immune responses||300, 298|
|human growth hormone||298|
|ICAAC Conference (1998)||308, 303|
|IDSA (Infectious Diseases Soc. of Am.)||308|
|Immune Response Corporation||297|
|Infectious Diseases Society of America||308|
|Institute of Human Virology||302|
|intellectual property||308, 307|
|international||307, 301, 294|
|International AIDS Vaccine Initiative||308|
|International Conf. (1998, Geneva)||300, 299, 298|
|Johns Hopkins University||296|
|Kaiser, Dr. Jon||309|
|lipodystrophy||306, 304, 303, 298, 295|
|Lungren, Dan||307, 287|
|marijuana, medical||307, 306, 305, 301, 300, 296, 290, 287|
|maternal-fetal transmission||290, 294|
|National AIDS Treatment Advocates Forum||306|
|NTZ||296, 295, 288|
|patient assistance programs||306|
|political organizing||297, 294|
|post-exposure prophylaxis||302, 296|
|prison||305, 304, 302, 288|
|proposition 215 (California)||290|
|protease inhibitors||291, 289|
|Retroviruses conference (1998)||289, 288|
|Retroviruses conference (1999)||301|
|returning to work||308|
|ribavirin||302, 297, 295|
|Roche Molecular Systems||303|
|Saba, Dr. Joseph||294|
|Salk HIV immunogen||297|
|T-20||306, 300, 299, 293|
|TAG (Treatment Action Group)||289|
|testosterone replacement||307, 306, 291|
|treatment "failure"||289, 286|
|UltraSensitive viral load||303|
|vaccine||308, 300, 295|
|World Wide Web||307, 306, 302, 300, 299, 298|
ISSN # 1052-4207
Copyright 1998 by John S. James. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used.