Dissident AIDS Database

Co-factorsRecreational drugsNitritesKS
Risk factors for Kaposi’s Sarcoma in homosexual men.
 Marmor M, Friedman-Kien AE, Laubenstein L, Byrum RD, William DC, D'Onofrio S, Dubin N.
  “Patients [with Kaposi’s Sarcoma] reported significantly longer histories of ever having been exposed to chemicals or solvents at work (risk ratio = 7.5) [compared to matched patients without KS]...self-reports of ever having used various recreational drugs, including amyl nitrite, ethyl chloride, cocaine, phencyclidine (‘angel dust’), methaqualone, and amphetamines…[were each] associated with a risk ratio of 4 or greater [i.e. patients with KS were at least 4 times more likely to have used each of these drugs, than those without]...Significant dose-response relationships were found for amphetamines, amyl nitrite, cocaine, and ethyl chloride”. Amyl nitrite was the only drug that 100% of patients [with Kaposi’s Sarcoma] reported ever having used, although 1 patient reported using it only once in his life...Only amyl nitrite had significantly elevated risk ratios at the [99%] probability level in the time periods 5-9 and > 10 years before disease.”
  Lancet. 1982 May 15;1:1083-6.1982
Kaposi’s sarcoma and nitrite inhalants
 Haverkos HW.
  In 1985, and again in 1988, Haverkos analyzed the AIDS risks of 87 male homosexual AIDS patients with Kaposi’s sarcoma [47], Kaposi’s sarcoma plus pneumonia [20] and pneumonia only [20]. All men had used several sexual stimulants, 98% had used nitrites. Those with Kaposi’s sarcomas reported 2 times more sexual partners and 4.4 times more receptive anal intercourse than those with only pneumonia. The median number of sexual partners in the year prior to the illness was 120 for those with Kaposi’s and 22 for those with pneumonia only. The Kaposi’s cases reported 6-times more amylnitrite and ethylchloride use, 4-times more barbiturate use, and 2-times more methaqualone, lysergic acid and cocaine use than those with pneumonia only. Since no statistically significant differences were found for sexually transmitted diseases among the patients, the authors concluded that the drugs had caused Kaposi’s sarcoma.
  Psychological, Neuropsychiatric and Substance Abuse Aspects of AIDS, pp. 165-172, Bridge, T. P., Heather, H. and Johnson, M. (eds.) Raven Press, New York, 19881988
The Drug-AIDS Hypothesis
 Duesberg Peter, Rasnick David
  In 1988 the NIDA published a monograph entitled Health Hazards of Nitrite Inhalants that warns about the AIDS risks, particularly Kaposi’s sarcoma risks of nitrite inhalants (Haverkos HW, Dougherty J. Health hazards of nitrite inhalants. Am J Med 1988; 84: 479-482, Haverkos HW, Dougherty JA (eds.) Health Hazards of Nitrite Inhalants (1988), US. Dept. Health & Human Services, Washington, DC). As a result of the NIDA monograph, the US Congress banned the sale of nitrites in 1988 citing an "AIDS link" (Cox GD. County health panel urges 'poppers' ban, cites AIDS link. The Los Angeles Daily Journal (Los Angeles) 1986: Section II, p.1, Mar. 24)... In the summer of 1996 the Royal Pharmaceutical Society first banned the sale of nitrites in the UK citing: "Our primary concerns were the health risks associated with the drug, including the suggestive links between poppers and Kaposi’s sarcoma" (Pink Paper. Shops on their guard after poppers sale legal setback. The Pink Paper (London) 1996: June 28. ).
  Continuum Feb./March 19971997
An 8-year history of Kaposi’s sarcoma in an HIV-negative bisexual man.
 Marquart, K.-H., Engst, R. and Oehlschlaegel, G.
  No abstract / Pubmed
  AIDS 5: 346-348, 19911991
Kaposi’s sarcoma in a homosexual—10 years on.
 Archer, C. B., Spittle, M. F. and Smith, N. P.
  Here we describe a homosexual man who has developed many Kaposi's sarcoma tumours during the past 10 years. The disease has run a benign course and there is no evidence of infection with human immunodeficiency virus (HIV).
  Clin. Exper. Dermatol. 14: 233-236, 19891989
Kaposi’s sarcoma in HIV-negative homosexual men.
 Friedman-Kien, A. E., Saltzman, B. R., Cao, Y., Nestor, M. S., Mirabile, M., Li, J. J. and Peterman, T. A.
  “349 homosexual or bisexual men with biopsy proven KS seen in a university hospital-based dermatology practice between 1981 and 1989 were tested for antibodies to HIV-1, and 343 were HIV-1 positive...Inhaled nitrite (poppers) use was reported by 5 [of the 6 who were HIV-1 negative].”
  Lancet 335: 168-169, 19901990
Epidemiologic Studies-Kaposi's Sarcoma Vs. Opportunistic Infections Among Homosexual Men With AIDS.
 Haverkos HW.
  “[This paper analyzed 6 studies related to nitrite use and Kaposi’s Sarcoma] [In Study 1, CDC, 1981-82] 84 of the 87 (97%) AIDS cases in the studies reported nitrite inhalant use…60% of KS patients and those with both diseases [KS and PCP] used nitrites more than 384 days compared with 10% of PCP patients…[Study 2, Mount Sinai School of Medicine, 1981-86] A longitudinal study of 42 homosexual men with persistent generalized lymphadenopathy…All 42 participants had used nitrites. The amount of nitrite use was statistically associated with the development of KS…[In Study 3, UCSF, 1983-86] Patients with KS were 2.2 times more likely to report greater than 4 ‘hits’ per night…[this was] the variable most strongly associated with KS…[In Study 4, NCI with 245 men, 1982-]Nitrite inhalant use…was not significantly associated with AIDS, Kaposi’s Sarcoma or Pneumocystis pneumonia [PCP]…[In Study 5, Multicenter AIDS cohort, 1984-] No association between [reported] nitrite inhalant use and KS was reported. Significant associations for KS were found for decreased hemoglobin level [possibly caused by nitrites], decreased T-helper lymphocyte count [ditto], and increased immunoglobulin A levels…[In Study 6, CDC, including 6,700 men, 1984-]No differences in nitrite use were found between disease groups…Studies begun in 1981 and 192 asked more detailed questions about nitrites than later studies…nitrite inhalant use may be declining since the AIDS epidemic. If so, questions asked in 1985 and 1986 about nitrite use in the previous 6 months or 2 years cannot reflect accurately the amount of nitrite use at earlier times.”
  Health Hazards of Nitrite Inhalants. NIDA Research Monograph. 1988;83:96-105.1988
The Drug-AIDS Hypothesis
 Duesberg Peter, Rasnick David
  A 27-58-fold higher consumption of nitrites by male homosexuals compared to heterosexuals and lesbians correlates with a 20-fold higher incidence of Kaposi’s sarcoma (San Francisco Department of Public Health, Lesbian & Gay Substance Abuse Planning Group. Lesbian, Gay and Bisexual Substance Abuse Needs Assessment. 1991, August; San Francisco Department of Public Health, Lesbian & Gay Substance Abuse Planning Group. Gay Men, Lesbians and their Alcohol and Other Drug Use: A Review of the Literature. 1991 September; Selik RM, Starcher ET, Curran JW. Opportunistic diseases reported in AIDS patients: frequencies, associations, and trends. AIDS 1987; 1: 175-182, Haverkos HW, Dougherty JA (eds.) Health Hazards of Nitrite Inhalants (1988), US. Dept. Health & Human Services, Washington, DC,)
  Continuum Feb./March 19971997
The Drug-AIDS Hypothesis
 Duesberg Peter, Rasnick David
  It appears that the nitrite-induced AIDS-Kaposi's sarcoma and the classic, spontaneous Kaposi's sarcomas are entirely different cancers under the same name. The "HIV-associated" Kaposi's sarcomas exclusively observed in male homosexuals are "aggressive and life-threatening", often located in the lung (up to 32% of Kaposi's sarcomas of homosexual men can be diagnosed as pulmonary Kaposi's sarcoma and lungs are the primary site of exposure to nitrite inhalants) and fatal within 8-10 months after diagnosis. The classic "indolent and chronic" Kaposi's sarcomas are only diagnosed on the skin of the lower extremities and hardly progress over many years. Nevertheless, the distinction between classic and AIDS-Kaposi's sarcoma is rarely ever emphasized and may have escaped many observers due to the "difficulty in pre-mortem diagnosis", and because "pulmonary Kaposi's sarcoma was indistinguishable from opportunistic pneumonia..." (Irwin DH, Kaplan LD, Pulmonary manifestations of acquired immunodeficiency syndrome-associated malignancies, Seminars in Respiratory Infections 1993; 8: 139-148, Gill PS, Akli B, Coletti P, Rarick M, Louriero C, Bernstein-Singer M, Krailo M, M. LA, Pulmonary Kaposi's sarcoma: clinical findings and results of therapy, Am J Med 1989; 87: 57-61, Meduri GU, Stover DE, Lee M, Myskowski PL, Caravelli JF, Zama MB, Pulmonary Kaposi's sarcoma in the acquired immune deficiency syndrome: clinical, radiographic, and pathologic manifestations, Am J Med 1986; 81: 11-18, Sloand E, Kumar PN, Pierce PF, Chemotherapy for patients with pulmonary Kaposi's sarcoma: benefit of filgrastim (G-CSF) in supporting dose administration, Southern Medical Journal 1993; 86: 1219-1224, Garay SM, Belenko M, Fazzini E, Schinella R, Pulmonary manifestations of Kaposi's sarcoma, Chest 1987; 91: 39-43)
  Continuum Feb./March 19971997
Nitrite inhalants: historical perspective.
 Newell, G.R., Spitz, M.R., Wilson, M.B.
  “There are important reasons for considering nitrite inhalation as a factor in the development of AIDS-related KS[Kaposi’s Sarcoma] in young male homosexuals. These are (1) the pharmacologic properties of amyl, butyl and isobutyl nitrites, which are toxic; (2) the mutagenic, teratogenic and carcinogenic products resulting from metabolism of N-nitroso compounds; (3) the potent carcinogenicity of N-nitroso compounds in 39 different animal species; and (4) the deleterious effects of volatile nitrites on human lymphocytes both in vitro and in vivo…there are additional reasons for pursuing the connection between nitrite inhalation and development of KS. These include: (1) the timing of the production and sales of volatile nitrites for use as recreational drugs and the subsequent outbreak of the AIDS epidemic (7 to 10 years); (3) the extensive use of nitrities among male homosexuals; (3) the virtual universal history of nitrite use by young male homosexuals in whom KS has developed during the past 3 years; and (4) the age group in which KS is developing is consistent with a cohort initially exposed 7 to 10 years ago.”
  Health Hazards of Nitrite Inhalants. NIDA Research Monograph 83, eds.: Haverkos, H.W., Dougherty, J.A. U.S. Dept. Health & Human Services, Washington, DC, pp. 1-14 (1988).1988
Preface
 Haverkos HW, Dougherty JA.
  “…the areas where absorbed concentrations of volatile nitrites would be expected to be highest - the skin surround the nose and in the nasal/pulmonary mucosa - are also reported to be the areas in which KS occurs in persons with AIDS. This association logically leads to the hypothesis that there is a causal relationship between nitrites and KS, perhaps mediated by the formation of N-nitroso compounds.”
  Health Hazards of Nitrite Inhalants. NIDA Research Monograph. 1988;83:vii-xi.1988
Increased tumor growth in mice exposed to inhaled isobutyl nitrite
 Soderberg LS.
  "Epidemiological studies have correlated the incidence of Kaposi's sarcoma (KS) in AIDS with a history of abuse of nitrite inhalants. To determine if exposure to nitrite inhalants could alter tumor growth, syngeneic PYB6 tumor cells were injected into groups of mice. Exposure of these mice to inhaled isobutyl nitrite increased both the tumor incidence and the tumor growth rate by almost 4-fold. Following only five daily exposures to the inhalant, the induction of specific T cell mediated cytotoxicity was inhibited by 36%. Similar inhalation exposures inhibited the tumoricidal activity of activated macrophages by 86%. The data suggest that exposure to abuser levels of a nitrite inhalant compromised tumor surveillance mechanisms."
  Toxicol Lett 1999 Jan 11;104(1-2):35-411999
Disease manifestation among homosexual men with acquired immunodeficiency syndrome: a possible role of nitrites in Kaposi’s sarcoma.
 Haverkos, H. W., Pinsky, P. F., Drotman, D. P. and Bregman, D. J.
  In 1985, and again in 1988, Haverkos analyzed the AIDS risks of 87 male homosexual AIDS patients with Kaposi’s sarcoma [47], Kaposi’s sarcoma plus pneumonia [20] and pneumonia only [20]. All men had used several sexual stimulants, 98% had used nitrites. Those with Kaposi’s sarcomas reported 2 times more sexual partners and 4.4 times more receptive anal intercourse than those with only pneumonia. The median number of sexual partners in the year prior to the illness was 120 for those with Kaposi’s and 22 for those with pneumonia only. The Kaposi’s cases reported 6-times more amylnitrite and ethylchloride use, 4-times more barbiturate use, and 2-times more methaqualone, lysergic acid and cocaine use than those with pneumonia only. Since no statistically significant differences were found for sexually transmitted diseases among the patients, the authors concluded that the drugs had caused Kaposi’s sarcoma. “Multivariate analysis showed that the variable most strongly associated with Kaposi's sarcoma was the use of large quantities of nitrite inhalants...This study suggests that the use of nitrite inhalants may be a cofactor in the development of Kaposi's sarcoma”
  J. Sex. Trans. Dis. 12: 203-208, 19851985
Kaposi's sarcoma among persons with AIDS: a sexually transmitted infection?
 Beral V, Peterman TA, Berkelman RL, Jaffe HW.
  Kaposi's sarcoma was commoner among those who had acquired the human immunodeficiency virus (HIV) by sexual contact than parenterally, the percentage with Kaposi's sarcoma ranging from 1% in men with haemophilia to 21% in homosexual or bisexual men.
  Lancet 1990 Jan 20;335(8682):123-8.1990
Survival of hemophilic males with acquired immunodeficiency syndrome with and without risk factors for AIDS other than hemophilia.
 Holman RC, Rhodes PH, Chorba TL, Evatt BL.
  "Between January 1, 1981, and June 30, 1990, 1,514 hemophilia-associated acquired immunodeficiency syndrome (AIDS) cases in males were diagnosed in the United States. In 1,394, hemophilia was reported as the sole risk factor. For an additional 120, other risk factors were reported: of 101 of these, 40 had homosexual/bisexual activity, 53 had a history of intravenous drug use, and 8 had both of these risk factors. We examined the demographic data and the survival data of two principal groups: males for whom hemophilia was the sole reported risk factor for human immunodeficiency virus (HIV) exposure, and hemophilic males for whom homosexual/bisexual activity, intravenous drug use, or both of these additional risk factors were reported... Kaposi's sarcoma was among AIDS indicator diseases more commonly found in the multiple risk factor group..."
  Am J Hematol 1992 Apr;39(4):275-821992
An 8-year history of Kaposi's sarcoma in an HIV-negative bisexual man.
 Marquart, K.-H., Engst, R., Oehlschlaegel, G
  Studies that have measured toxicity of recreational drugs over time, have documented that about 10 years of nitrite use are necessary to cause Kaposi's sarcoma or pneumonia
  AIDS 5. 346-348 (1991).1991
Volatile nitrites: Use and adverse effects related to the current epidemic of the acquired immune deficiency syndrome.
 Newell, G.R., Mansell, P.W.A., Spitz, M.R., et al
  Studies that have measured toxicity of recreational drugs over time, have documented that about 10 years of nitrite use are necessary to cause Kaposi's sarcoma or pneumonia
  Am J Med 78, 811-816 (1985).1985
NIDA Meeting Calls For Research Into : THE POPPERS-KAPOSI'S SARCOMA CONNECTION
 Lauritsen John
  The first speaker of the 2nd day of the Gaithersburg meeting (sponsored by he National Institute on Drug Abuse "Technical Review: Nitrite Inhalants", held outside Washington, DC on the 23rd and 24th of May, 1994) was Harry Haverkos of the NIDA, who began by showing a slide indicating that there appear to be four kinds of KS: 1. Classic KS, occurring among older men, indolent. 2. African KS: 25-40 age group, first indolent then fatal in 5-8 years. 3. Iatrogenic KS (e.g., renal transplant): indolent or fulminant. 4. Epidemic or AIDS KS: gay white males, fulminant, survival 1-3 years. And he posed the question: "Are these all the same?" Haverkos cited the cases of HIV-negative cases of gay men with KS (16 in the practice of one physician alone). Haverkos presented a slide: REASONS TO CONSIDER NITRITE INHALANTS A COFACTOR IN THE PATHOGENESIS OF KAPOSI'S SARCOMA (KS) IN AIDS: 1) Four epidemiologic studies have demonstrated a strong association. 2) Decline in proportion of cases among gay men parallels Decline in nitrite inhalant abuse among gay men. 3) Distribution of KS lesions correlates with areas of nitrite vapor exposure (nose, face, chest) in many cases. 4) Plausible mechanisms of action have been proposed: - Formation of cholesterol nitrite (carcinogen) - Immune suppression. 4) Very little KS reported outside gay male population. 6) Among gay men, KS is associated with white race and high socioeconomic status. 7) KS in women with AIDS no more likely among sexual partners of bisexual men that sexual partners of heterosexual drug abusers. 8) No one can find hiv
  New York Native 13 June 19941994