Hello and welcome to my eleventh ‘CascAIDS’ post.
One of the major ‘canons’ of the ‘HIV causes AIDS’ orthodoxy was that AIDS was a new disease caused by a new virus.
Just how new was AIDS? My research quickly told me it wasn’t new at all. The only new thing about AIDS was the affected demographics and the branding.
Let me explain.
I have already mentioned that in the first five cases reported in the June 5th 1981 MMWR of PCP pneumonia, all five cases had evidence of CMV infection.
The Lancet of 12 December 1981 published details of a 49 year old homosexual man (a frequent visitor to Florida), who had reported to Brompton Hospital. He was diagnosed with PCP and cytomegalovirus (CMV) but had no underlying immune deficiency. This is widely regarded as the first report of a UK AIDS case. The paper’s headline was ‘Primary Pneumocystis Carinii and Cytomegalovirus Infections.’
Twenty years before this, October 29th 1960, another paper in the Lancet was published with the headline: ‘CYTOMEGALIC INCLUSION DISEASE AND PNEUMOCYSTIS CARINII INFECTION IN AN ADULT.’
New disease?
Let me quote extensively from the 1960 paper https://www.penroseinquiry.org.uk/finalreport/pdf/LIT0013977.PDF
‘In adults, cytomegalic inclusion disease is rare and takes a different form. It may be confined to a single organ in association with other diseases, notably those of the reticuloendothelial system. In a more generalised form, it is often accompanied by other systemic diseases.’ (For ‘other systemic diseases’ read opportunistic infections.)
The patient’s ‘general health was good until December, 1958; he then gradually developed breathlessness on exertion, nocturnal sweats, anorexia, loss of weight, tiredness, and fever. He had a cough, producing mucopurulent sputum.
He was wasted, febrile, and ill. There was moderate generalised gingivitis. A few scaly brownish lesions were seen on the skin of his back and shoulders.’ (Kaposi’s sarcoma?)
Post-death, ‘the body was severely emaciated. Numerous small lesions, some pustular, others dry and encrusted, were distributed irregularly over the skin of the thorax, abdominal wall, scapular regions, and inner aspects of thighs.
The main pulmonary lesion was a severe interstitial pneumonia associated with cytomegalic inclusion disease and a patchy Pneumocystis infection.
Generalised cytomegalic inclusion disease in the adult has been described in association with toxoplasmosis, Pneumocystis carinii infection and severe systemic diseases. (AIDS in all but name)
‘Steroid therapy…probably contributed to a decreased host resistance in this case, thus encouraging extension of the infections, and possibly allowing these saprophytic organisms to adopt a pathogenic role.
The pattern of generalised cytomegalic inclusion disease may vary, but the lungs, adrenals, liver, spleen, and kidneys are most commonly involved.
The association (of CMV) with Pneumocystis carinii infection was of further interest. Hamperl (1956) demonstrated the infection in a case of fatal inclusion (CMV) pneumonitis reported by McMillan (1947) and suggested the probability in two similar cases of Wyatt et al. (1953). Simultaneous Pneumocystis and cytomegalic inclusion infections have also been described by Berdnikoff (1959)i n a n infant. The association of these two apparently separate and normally saprophytic infections is interesting, and perhaps not entirely fortuitous, especially since the nature o f the Pneumocystis organism has not yet been determined. In due course a closer relationship may be established. It is important to recognise their potential pathogenicity and their ability to produce, either alone or in combination, fatal infections in man.
There is some evidence that this danger is increased by prolonged treatment with steroids and antibiotics. Possibly more cases will occur because of the increasing use of these drugs. At present, there is no effective treatment.
Very rarely both infections described have been found together in adults in association with serious underlying diseases; no underlying disease was identified in this patient.
The nature of the infections is discussed and reference is made to the risk of converting these saprophytes into pathogenic organisms by prolonged treatment with steroid drugs and antibiotics.’
A prophetic statement.
There was no lack of either steroid or antibiotic usage amongst gay males in the 1970s.
Next time, I will continue exploring the association between PCP pneumonia and CMV in the 1960s.
regards,
Paul