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M. Patrick O'Meara, MD
VA Medical Center Palo Alto, Calif

JAMA. 1991;266(6):795-796.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Hersh et al¹ demonstrated in a controlled study that oral sodium diethyldithiocarbamate (ditiocarb), given once weekly, reduced the incidence of opportunistic infections by approximately 50% in patients with symptomatic human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS).

Patients were advised to avoid alcohol for 12 hours before and 48 hours after the weekly dose because of "disulfiram (Antabuse)—like effects." Ditiocarb is the principal metabolite of disulfiram. After absorption in the gut, disulfiram is rapidly reduced to two molecules of ditiocarb.

Disulfiram and ditiocarb are similar in many biologic effects, including effectiveness in chelation therapy of nickel poisoning² and potentiation of hyperbaric oxygen poisoning in rats.hyper³

Disulfiram is inexpensive, widely available, and has a well-defined and acceptable side-effect profile based on more than 40 years of extensive use in alcoholism. Should there not be clinical trials of this agent in HIV infection and AIDS? . . . [Full Text PDF of this Article]

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