Friday, November 25, 2011

Thirty Years of AIDS: The AIDS Alphabet--G is for Ganciclovir

Thirty Years of AIDS: The AIDS Alphabet--G is for Ganciclovir

Continuing the AIDS alphabet, after quite a break, we find ourselves at the letter G, for ganciclovir.

Ganciclovir: This is one of the earliest and first medications used for cytomegalovirus, CMV, treatment. This antiviral drug helps to treat or prevent infections caused by CMV by keeping the virus from multiplying. Ganciclovir comes in three forms: intravenous, intraocular insert, and capsules. The capsule form is used for maintenance and prevention therapy only.

I've talked to individuals who had to take ganciclovir to keep the CMV in check. I was impressed by the story of Kurt Weston, an award-winning photographer who lost most of his eye-sight to CMV. Here's how he describes the experience in an excerpt from JOURNEYS THROUGH DARKNESS

Kurt Weston’s vision loss didn’t happen overnight. The photographer experienced the first symptoms of CMV retinitis in 1993, while he was still working at Pivot Point. When preparing the room for a photo shoot, he would notice flashing spots on his backdrops or he would see shreds of cotton and start blinking, trying unsuccessfully to get rid of them. Only later he realized that those shreds of cotton floating in his view were floaters and one of the first signs of cytomegalovirus attacking his eyes.
Although Kurt always kept his doctor’s appointments and went for his regular checkups, his eye specialist kept misdiagnosing him. A few years later, in California, his new doctor determined that the virus had been doing extensive damage to his patient’s eyes. Parts of Kurt’s retina had been infected and then healed, while other scars on his retina were more recent, together causing permanent damage to his sight.
The virus also spread to Kurt’s esophagus. He started experiencing severe heartburn, so he went to see his doctor. An endoscopy showed that CMV had been making a huge hole in Kurt’s esophagus, causing serious damage… enough to make the doctor wonder how his patient could still manage to walk around.
Kurt’s first treatment for CMV retinitis involved a medication called ganciclovir. Twice a day, every day, a pump the size of a small tape recorder would administer the necessary dose of intravenous ganciclovir through a PICC line directly into Kurt’s vein.
The actual process of inserting the line in Kurt’s arm was extremely difficult and painful using a large needle that Kurt didn’t think would fit into his vein. A nurse had to insert a yard worth of intravenous tubing in his arm, and then guide it up his vein, all the way near his heart. An x-ray machine helped her monitor the entire process and the location of the intravenous tubing so that she could make sure that the line reached the large vein, where it needed to be for maximum infusion of the medication. 

Journeys Through Darkness: A Biography of AIDS
But Kurt Weston had to experience having a PICC line inserted in his arm before starting the ganciclovir treatment. Here's a short excerpt from JOURNEYS, describing Weston's experience with ozone therapy at a Nevada clinic:

The medical personnel at the Nevada clinic used the PICC line to administer the ozone. What followed was a hellish ten-day therapy that Kurt was determined to survive. “You get high fevers and your teeth are clutching,” the photographer recalls. “You start shaking [until you] feel like every muscle in your body starts knotting up, like getting into convulsions.”
Those who worked at the clinic prepared heated blankets to wrap around the patients to keep them from shaking. After completing the daily ozone sessions at the clinic, patients were taking ozone containers with them to the hotel where they were staying during the ten-day treatment. While in the hotel room, they had to pump the gas into their rectums.
During therapy, Kurt got hallucinating fevers of a hundred and four degrees. He became sick, enough to worry his father, who tried to convince him to stop the treatment altogether and go back home to Chicago. But Kurt refused to give up and insisted on finishing his therapy. And when he did, he saw his T cell counts soaring.
This gave the photographer some hope. He even came up with the idea of purchasing a small ozone generator and continuing his treatment at home. The only problem was that he didn’t have a PICC line in his arm anymore. The doctor at the Nevada clinic had taken out the tubing from his arm once he was done with his ozone therapy. The only other way he could self-administer ozone was to self-inject with the gas… but that was something he did not believe he was able to do.
Yet, the ozone home therapy opportunity was far from vanished. During the following years, between 1994 and 1996, the photographer was to go through some twenty-five PICC lines that medical professionals had to insert in and take out of his arms to administer intravenous ganciclovir medication for his CMV retinitis. Later on, he used those PICC lines to self-administer his ozone, using a home ozone generator that he ended up purchasing after all.

Alina Oswald