PAGE 8 THE WEEKLY NEWS MARCH 9, 1988

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LETTERS

FROM OUR READERS

AIDS/Syphilis Addressed

The following is a copy of a letter sent to Out Front, Denver's gay newspaper, regarding the Mike Smith commentary, "The New Syphilis: An AIDS Theory" which ran in The Weekly News 1/13/88, Vol. 11, No. 19.)

To The Editor: We read with interest Mike Smith's dialogue "Can AIDS be Another Form of Syphilis?" in the January 15th issue of Out Front. The recent attention given the possible connection between AIDS and syphilis has prompted us to clarify certain aspects of the biology, natural history and treatment of syphilis as well as HIV (AIDS virus) infection.

First, Mr. Smith contends that "syphilis invades T cells and suppresses the immune system." The immunologic host's response to syphilis is extremely complex and not well understood. It has been shown that the spirochete causing syphilis (Treponema pallidum) can be ingested by certain cells of the immune system; however, it has never been shown to invade T cells. On the other hand, there is a great deal of evidence to show that HIV does invade T cells, where it multiplies and may cause a marked reduction in the T cell count the hallmark of immunodeficiency in AIDS patients.

Furthermore, the recent study documenting the reduced mortality in AIDS patients treated with AZT, a drug with antiviral but not antisyphilis activity, indicates that inhibition of HIV improves survival in AIDS.

Second, Mr. Smith suggests that the standard recommended therapy of early syphilis is inadequate and that the increase in syphilis cases from selected areas in the country may be related to "a virulent strain brought back from S.E. Asia by the Vietnam vets" or a mutation in the syphilis spirochete. Syphilis infection can involve all major organ systems, including the eye and central nervous system; however, if penicillin therapy had become less effective over time due to the appearance of a virulent or resistant strain, the epidemic of early syphilis which occurred after World War II would have been followed by an epidemic of late neurosyphilis. Such an epidemic never occurred, and the results of treatment with

penicillin continue to be excellent. T. pallidum has remained exquisitely sensitive to penicillin over the last 40 years and there has never been a reported case of this organism acquiring resistance to penicillin.

The problem is not one of virulence of new strains or resistance to antibiotics, but of individual host response. Case reports from Seattle and Boston have demonstrated that patients with HIV infection who acquire syphilis may develop very early clinical manifestations of neurosyphilis (i.e. stroke) after being treated appropriately for syphilis presumably related to the immunosuppression of HIV infection. In other words, while syphilis may be worse in patients with HIV infection, it is definitely not the cause of AIDS.

Syphilis cases over the past seven years have not paralleled the dramatic increase in cases of HIV infection. In fact, cases of primary and secondary syphilis have been declining since 1982. The current increases reported appear to be largely among heterosexuals (relatively unaffected by HIV) compared with a 50 percent decrease in syphilis cases among gay men from California and New York City (greatly affected by HIV). In addition, if a connection between the two infections existed, one should see similar mortality statistics for each disease which has not occurred. The classic Oslo study of the natural history of syphilis infection (before penicillin was available) revealed that the probability of dying directly as a result of untreated syphilis used to be 17 percent in men and eight percent in women after 40 years of infection. The mortality in patients with fullblown AIDS ranges from 50 to 90 percent.

A great deal of emphasis has been placed on the fact that "standard syphilis tests are increasingly unreliable," and that such tests may no longer be valid particularly in persons with compromised immune systems." A recent case report of a patient with KS and syphilis and negative blood tests is often cited in support of this hypothesis; however, the patient did eventually develop a positive test for syphilis on the day treatment was begun albeit delayed. While such unusual cases may occur, they are distinctly uncommon, and we CONTINUED ON PAGE 13

Immediate Action Needed On Hate Crimes Bill

Since the House Judiciary Committee's landmark vote to favorably report the Hate Crime Statistics Act (HR 3193) to the house floor, the National Gay and Lesbian Task Force (NGLTF) has worked to set the stage for passage of the bill in March. The Hate Crime Statistics Act would mandate the collection of statistics on crimes that manifest prejudice on the basis of race, religion, sexual orientation and ethnicity. The bill represents the first time that congressional legislation containing the phrase "sexual orientation" has advanced beyond the committee level. "We have worked non-stop on this bill for the last year," said NCLTF lobbyist Peri Jude, "Because of our grassroots lobbying efforts combined with persistent pressure from NCGLTF on the Hill, we have been able to create momentum for a historic victory for the lesbian and gay community.

NGLTF has moved aggressively to secure additional sponsors of the act. To date, 100 house members have joined Rep. John Conyers as co-sponsors. Never before has a bill with sexual orientation language received so much house support.

NGLTF urges all supporters to take the following steps by mid-March to help secure the bill's

passage

1. Contact your congressional representatives and urge them to support HR-3193 without amendments to remove sexual orientation.

2. If your representatives are already co-sponsors of the bill, please write them a thank you note. Ask them to urge their colleagues from your state to support the bill.

3. Report back to NGLTF lobbyist Peri Jude any responses you receive from you representauves. This information will be useful in our final lobbying rounds with house members.

Send a copy of this letter to your representative as soon as possible.

Dear Representative

I am writing to urge that you support HR-3193, a bill that would mandate the collection of anonymous statistics on crime motivated on the basis of race, religion, sexual orientation and ethnicity

As you may know, in recent years there has been a considerable increase in reports of violence against Asian, black, gay/lesbian, Hispanic, Jewish and other Americans. Regardless of whether attacks are motivated by racial, ethnic, religious or anti-gay prejudice, they are intended to violate and isolate not only individual victims but their communities as well. Such violence strikes at the very heart of our pluralistic society and ultimately threatens all Americans.

Despite the pervasiveness of hate violence, there are no national official statistics on its nature and scope. I believe that official data are needed in order to promote an appropriate official response to crimes mouvated by bigotry. Accordingly, I hope that you will support HR-3193 and oppose any efforts to weaken the bill or reduce its scope.

Thank you very much. I look forward to your reply

Sincerely