May #23 : Bad Blood - by Phil Geoffrey Bond

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Table of Contents

Plastic Explosion

Who's Afraid of Reinfection?

Don't Call Him 'Poster Boy'

Saving Faces

Grandmother Theresa

Surgical Rotations

Fate Expectations

Mirror Image

S.O.S.

Mailbox-May 1997

On Native Ground

Move Over, Elmo

Devil's in the Data

Cheesehead Shalala

Don't Cry for Me, Marijuana

The Pot Thickens

Fellatio Felon

Diver Dissed

French Roast

AZT Linked to Cancer in Mice

The Philadelphia Story

Fashion Victims

Say What

Legacy-Tom Stoddard

Skin Deep

Fall

She's Going to Live!

Obitu-Parry

A Delicate Bully Pulpit

La Dolce Morte

A Delicate Bully Pulpit

Damned but Beautiful

Dressed for Arrest

POZ Picks-May 1997

Hymn to a Gym

Bodies of Work

Healing Beauty

Longtime Companion

For Doom, the Bell Tolls

Whatta Cut Up

Health Club Horrors

Detoxicology

Protein Power

The Missing Zinc

Bad Blood

Lovely Labs

The Biology of Beauty

It's My Party

Beauty



Most Popular Lessons

The HIV Life Cycle

Shingles

Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV


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May 1997

Bad Blood

by Phil Geoffrey Bond

A new study warns against the dangers of blood transfusions

"I think blood transfusions have been prescribed far too freely," says Dr. Stephanie Seremetis, a specialist in blood products for PWAs at Mount Sinai School of Medicine in New York City. Yet these therapies are widely used to treat anemia, a common problem in people with advanced HIV infection, which causes fatigue, shortness of breath and dizziness.

A new study links blood transfusions in PWAs with increases in HIV viral load. This isn't surprising, since past studies have linked transfusions in people with HIV to increased risk of cytomegalovirus (CMV) infection (not generally screened from the blood supply), Mycobacterium avium complex (MAC), wasting and reduced survival time.

The new data pose a dilemma for PWAs facing anemia caused by such treatments as AZT. Bactrium, dapsone and ganciclovir, or by opportunistic infections such as MAC. Any of these, or HIV itself, can reduce hemoglobin--the protein in red blood cells that transports oxygen from the lungs to the tissues--to dangerously low levels.

Transfusions behave differently in each individual, often resulting in the transmission of other viruses such as Epstein-Barr and hepatitis. Seremetis advises the immune-compromised to think carefully before risking exposure to more pathogens.

Erythropoietin (EPO) is the drug approved by the FDA to treat anemia caused by AZT, chemotherapy or chronic kidney disease. But the drug can cause high blood pressure, is expensive, must be self-injected and can take six to eight weeks to work. (EPO is marketed as Procrit or Epogen. Procrit's manufacturer, Ortho Biotech, has a patient-assistance program to broaden the drug's availability.)

The best solution is closer monitoring of hemoglobin counts (listed on lab reports as Hb) to identify anemia before it becomes so serious that transfusion is the only option. A protein-rich diet and blood-cell-building nutrients such as vitamin B complex (particularly B-12 and folic acid), iron and zinc can also be helpful in preventing anemia.



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