HIV-Related
Fatigue and Hyperbaric Oxygen Therapy
Reillo,
M, R.N., B.S.N., Myers, R., M.D., HBO Staff, MIEMSS, Baltimore,
Maryland, USA
Objectives:
Hyperbaric Oxygen Therapy (HBO) is being evaluated to determine the
effectiveness in relieving HIV-related fatigue and determine the
clinical and immunological effects on HIV-infected individuals.
Methods:
Twenty-five patients have been enrolled over a two-year period.
Admission criteria include chief complaint of fatigue, seropositivity as
confirmed by ELISA and Western Blot for HIV infection, 500 CD4 cells or
less, and absence of active opportunistic infections which might
compromise pulmonary or neurologic function.
Twenty
patients received 2 ATA, for 90 minutes, three times per week.
Five
patients voluntarily received surface air at the same parameters to
control for a placebo effect, and then received 100% oxygen; all
patients were treated simultaneously in the HBO chamber. Withdrawal of
HBO therapy for one month was completed for 21 patients, secondary to
chamber construction.
Laboratory, clinical assessment, and Karnofsky Performance Scores were
completed monthly on all patients.
Results:
All
patients indicated relief of debilitating fatigue within two weeks.
Karnofsky Scores improved 10% to 30% within one month. Weights for all
patients remained stable or increased; CD4, Hemoglobin, and Hematocrit
counts remained stable and/or increased.
Tumor
Necrosis Factor decreased in 13 patients. P-24 antigens remained
non-reactive or decreased if reactive. Withdrawal of therapy for one
month secondary to new chamber construction for all but four patients
correlated with return of baseline fatigue levels.
Additionally, two patients developed PCP and were treated outpatient
with dapsone and HBO via monoplace chamber.
One
patient developed herpes zoster and was treated with zovirax and HBO via
monoplace chamber. After resuming HBO therapy, all remaining patients
returned to their six month Karnofsky Score, which indicated significant
improvement in their fatigue levels.
Twenty-three of the twenty-five patients have shown no clinical disease
progression; 80% of patients enrolled in the study have 50 CD4 cells or
less.
Further,
HBO appeared to relieve pain associated with peripheral neuropathy in
two patients and was a beneficial adjunct to the treatment of mild PCP;
the investigators have established protocols to further investigate
these findings.
Conclusion:
The study
is ongoing. HBO appears to be effective in relieving HIV- related
fatigue and improving the quality of life of individuals with HIV/AIDS.
Preliminary research indicates a probable correlation with an increase
in length of employment capability, delayed disability requirement, and
reduction in number and length of hospitalizations by incorporating HBO
as a component in the medical management of HIV disease.
The
investigators believe HBO may relieve fatigue by inhibiting the activity
of certain cytokines, enhancing red blood cell production, and enhancing
the ability of HIV-impaired monocytes to absorb and utilize oxygen.
The
Center for Advancement of Hyperbaric Medicine is a Washington
corporation and has filed for IRS non-profit status as a 501(c)(3)
organization. CAHM's goals are:
1. To promote the acceptance
and broadest appropriate application of hyperbaric oxygen therapy in the
professional medical community.
2. To research and promote
the research of promising applications of hyperbaric oxygen therapy in a
manner that will insure its highest professional recognition and
acceptance.
3. To collect, organize and
disseminate all available information about hyperbaric oxygen therapy so
as to insure its most knowledgeable application and implementation.
4. To discover, research,
develop and introduce new medical applications for hyperbaric oxygen
therapy.
5. To distinguish
inappropriate, ineffective or fraudulent application of hyperbaric
oxygen therapy and to discourage their practice.
Hyperbaric oxygen therapy consists of sitting in a closed chamber in
which the pressure is elevated to twice that at sea level (14.7 PSI X 2
= 29.4 PSI 'pounds per square inch'), and then breathing pure oxygen
(while in the chamber).
The
typical course of treatment is about 90 minutes two to three times per
week. This therapy is an established therapy for 13 recognized
conditions and experimental in may more. It is practiced in hospitals
throughout the United States and the world.
The
Center for Advancement of Hyperbaric Medicine can provide treatment on
your physicians prescription. This is *NOT A COMMERCIAL VENTURE* the
application to AIDS/HIV is experimental and investigatory in nature.
CAHM can be reached at 1720 130th Ave. NE.,
Suite 103,
Bellevue, WA 98005,
Phone (206) 883-7819
FAX (206) 881-1795
or rapid
pass along on INTERNET at wombat@u.washington.edu
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June 6, 1993 |
