The Mind Boggles

Charlie Sheen was on the Dr. Oz show to talk about his HIV. Among the revelations is that he went to Mexico for alternative treatment and for a short period of time quit taking his meds.

It was not successful. Off of his highly active anti-retroviral therapy his viral load jumped up and he resumed his medications.

No surprise there.

Stop HIV medications and the virus comes back. Fortunately for Mr. Sheen his N of 1 experiment is unlikely to cause him any long term harm.

Mr. Sheen saw a Dr. Sam Chachoua, whose website is one of those alternative treatment sites that make me roll my eyes and shake my head. Nothing really new here.

It was conversation with Oz that was boggles the mind.

Oz, 55, shared part of an audio conversation he had with Chachoua, who revealed he was so confident in Sheen's treatment that he injected some of the actor's blood into himself.

"I drew some blood from him and I injected myself with it and I said, 'Charlie, if I don't know what I'm doing, then we're both in trouble now aren't we?' " Chachoua told Oz by phone.

Chachoua made sure there would be no doubt that he does not know what he is doing.

Even though what Chachoua did was totally nuts, it doesn't sound like a blood injection. What Charlie said was "I had a lump on my elbow that I had drained about a week prior to that and a little bit was still there so he pulled some out of that and he stuck it in the top of his forearm." Fortunately for people who do not know what they are doing, HIV is not that infectious.

Infectivity estimates following a needlestick exposure ranged from 0.00 to 2.38% [weighted mean, 0.23%; 95% confidence interval (CI), 0.00–0.46%; n = 21]. Three estimates of infectivity per intravenous drug injection ranged from 0.63 to 2.4% (median, 0.8%); a summary estimate could not be calculated. The quality of the only estimate of infectivity per contaminated medical injection (1.9–6.9%) was assessed. Instead we propose a range of 0.24–0.65%.

Although the estimated transmission rates in Uganda are higher and other data suggests

The median transmission risks for unsafe intravenous or intramuscular injections using equipment cleaned but not sterilized after use on a symptomatic pre-AIDS patient are 1.8% (95% confidence interval [CI] 0.1–3.2%) and 0.8% (95% CI 0.1–1.4%), respectively.

An intramuscular injection of a non-bloody body fluid, or even blood, from a patient with an undetectable viral load is unlikely to transmit HIV. Assuming he pushed the plunger.

So while Dr. Chachoua has alternative judgement to match his alternative therapies, fortunately for him he is unlikely to get HIV from Mr. Sheen. Not that we will ever know.

But it is still totally, deeply stupid thing to do.

For perhaps the first time on his show, Dr. Oz expressed disbelief at the actions of an alternative medicine provider. Of course it wasn't for the alternative therapies. But still. I can only hope. Chachoua has the courage of his deluded convictions.   And now Deepak Chopra has an inspiration for testing the courage of his convictions, and his concept of HIV pathogenesis and treatment. .

Points of Interest 01/13/2016
Points of Interest 01/12/2016