A SUBMISSIVE fetishist may have died after the anti-HIV drug he was taking interacted with party drugs he binged on during a bondage session, a court heard.

Dohoon Kim, 36, was diagnosed with HIV which was medicated, but also indulged in recreational drug-taking including mephedrone, GHB and meth amphetamine which were used to fuel S&M games.

He was found dead by casual sex partner Kevin Adams, 53, who is charged with killing him by gross negligence.

Kim, the "submissive" partner, was trussed up in restraints with his hands and ankles tied and a gas mask over his head when he stopped breathing.

Adams was accused of manslaughter after 'falling asleep' leaving Kim drugged and helpless, but denies the charge, claiming he passed out.

His defence barrister told the court it was possible Kim could have freed himself from the velcro restraints and that they were a "red herring in the case."

Paramedics who rushed to the scene found Kim was in a state of rigamortis.

Adams was taken to hospital after appearing dizzy and confused, with his skin turning blue.

He had methemoglobinemia - a condition which can be caused by using poppers, and was close to the "danger level."

But after being given oxygen his condition stabilised, the court heard.

A top pathologist who gave evidence at the trial said he had dealt with three 'chemsex' cases this year, and it was possible Kim's anti-HIV drug Eviplera had reacted to the M-Kat he snorted, as well as doing shots of GHB.

Home Office pathologist Dr Fegan Earl said: "There were no injuries from sadomasochistic sex which may have contributed to Kim's death."

The cocktail of drugs found in Kim's blood included M-Kat, date rape drug GHB, viagra and meth amphetamine.

Dr Earl said: "It is also worth highlighting when there is more than one drug, there can be complex interactions between these drugs that can have serious effects.

"One might see drugs which individually do not cause death, but when combined cause co-toxicity.

"I agree a combination of GHB and mephedrone may have contributed to death.

"The effects of GHB would have had an effect on his heart. Further more the level of mephedrone is high.

He told the court he had dealt with three 'chemsex' deaths so far this year.

Dr Earl sought advice from toxicology experts on whether anti-HIV drug Eviplera, which Kim was prescribed, could have interacted with the party drugs he was taking.

He said: "Some studies have suggested adverse effects when combining party drugs with HIV treatments.

"I have seen evidence of an early study that shows drugs used in HIV treatment and the party drugs may lead to irregular heart rhythm."

Adams' defence barrister, Pavlos Panayi QC, questioned the pathologist about the impact of the restraints Kim was bound with.

Dr Earl said: "I can't be certain. Even if restraints had been removed death might have occurred.

"Given the level of drugs that were present and allowing for interaction, they alone could explain this gentleman's death."

The men started getting high at about 8pm when Kim arrived in Swindon, where he had visited Adams 12 times before.

At 11pm they were still "playing," according to a text Adams sent to a pal, but by 2am Kim was dead.

The pathologist was asked if the drugs the pair took could have had a different effect on Adams than on Kim.

He said: "If taken in combination unusual reactions may occur, one may die and another may survive."

Fellow pathologist Dr Basil Purdue said: "To a certain extent, it depends on the individual.

"Some people remain conscious and alert, some people become sleepy, and some people die."

Kim's cause of death was recorded as partial airway obstruction and mixed drugs, mephedrone and GHB, after a post-mortem examination was carried out.

Dr Purdue said the airway obstruction was "relatively mild" and there was no fluid in the lungs which is often seen when airways are fully blocked.

He added: "Ideally in a court of law you would have black and white answers.

"The two factors were restriction of the airways and significant quantities of drugs.

"I can't tell this court what the balance was between the two, and I don't think anybody could."

The trial continues at Bristol Crown Court.