VIRUSMYTH HOMEPAGE
WITH THERAPIES LIKE THIS, WHO NEEDS DISEASE?
By Bryan Ellison and Peter Duesberg
Inventing the AIDS Virus
Cheryl Nagel's dream was on the verge of becoming tangible reality in
late October of 1990. She and her husband Steve had wanted a child of their
own for a long time. Now her flight was arriving deep in the heart of Eastern
Europe, Romania. Steve could not take the time off, so her mother accompanied
Cheryl to the remote city of Timisoara. Cheryl felt out of place, having
traveled so far from her suburban home just outside Minneapolis; back home
Steve cooked for a restaurant, while she worked as a realtor's assistant.
But when they heard the news of turbulence in that country and then of
the orphanages full of desperate children, the Nagels knew where they had
to go.
Arriving turned out to be the easy part. Touring the surrounding area,
Cheryl and her mother soon met Lindsey, a baby girl only several days old.
She had been born in the small coalmining town of Petrosani, nestled
deep in the Transylvanian Alps. She had been given up by her impoverished
mother, who was already burdened by caring for three older daughters. But
Cheryl found the adoption process absurdly difficult, considering the desperate
economic and social condition of the country. Constant shortages of the
littlest things, even light bulbs, could cause delays, and a phone call
overseas took four hours to connect before she could hear the reassuring
sound of her husband's voice. After two weeks of paperwork, bureaucratic
stalling, and struggling with a strange language, Cheryl returned to the
United States to recoup her energy. Returning to Romania within a few weeks,
however, she overcame the final hurdles and retrieved the two-month-old
baby.
Lindsey was a happy, healthy child, her slightly small size reflecting
the norms for her original family. The Nagels took her for a complete checkup
with a clinic near Minneapolis. The doctor's battery of tests included
one for HIV. To everyone's astonishment, Lindsey was confirmed positive.
Upon investigation, the Nagels discovered that Lindsey's birth mother did
not have the virus. This left only one possible source-the blood transfusion
Lindsey had received (despite having had nothing more than a brief ear
infection) in Romania's backward medical system, where the method was carelessly
used as a treatment for almost any illness. Lindsey still seemed a picture
of health. However, the Nagels were now told she had the deadly "AIDS
virus."
Then the nightmare began. Steve and Cheryl agreed to treat Lindsey prophylactically,
that is, to delay the onset of symptoms as long as possible. They were
referred to a specialist at the Children's Hospital in Minneapolis, where
the doctor examined Lindsey and found no symptoms at all. No infections,
no abnormalities, nothing. "She is [a] very bright, smiling and happy
girl," noted the doctor, who nevertheless decided to head off a potential
AIDS pneumonia immediately. Lindsey was prescribed Septra, to be taken
three times each week.
The drug is known by dozens of brand names, including Bactrim. Septra
is a sulfa drug, a remnant of the era before penicillin and the other antibiotics.
Sulfa drugs do not target invading microbes as narrowly as the antibiotics
and so have become notorious for their side effects. According to the Physician's
Desk Reference, Septra can cause "nausea, vomiting, anorexia,"
and "bone marrow depression," and also includes "rash, fever,
[and] leukopenia" among its side effects. (1) Even the drug's manufacturer,
Burroughs Wellcome, strongly recommends against using Septra for more than
two weeks, in children or adults. Young Lindsey, however, would take the
drug for some nine months.
When the Nagels brought their daughter back a week later, the specialist
announced that Lindsey's Tcell count was perfectly normal. Nor had
any infections shown up. But given the HIV infection, the doctor wanted
to slow the presumably inevitable appearance of AIDS. This time she prescribed
the only drug approved for AIDS therapy-AZT (a chemotherapeutic drug designed
to kill growing cells; see below). Lindsey began swallowing a total of
120 milligrams of the drug every single day, in addition to her Septra.
AZT stands for azidothymidine, a drug often marketed under the names
Zidovudine or Retrovir. As with Septra, AZT is produced by the pharmaceutical
giant Burroughs Wellcome. Both drugs have toxic effects. But compared to
the sulfa drug, AZT amounts to poison. The doctor herself admitted some
of the effects in her medical report of the visit, stating that Lindsey's
"mother was explained the side effects of Zidovudine which are primarily
bone marrow suppression with anemia, sometimes nausea and vomiting and
rarely the cause of other symptoms like skin rash.", If anything,
this understated the effects. AZT kills dividing cells anywhere in the
body-causing ulcerations and hemorrhaging; damage to hair follicles and
skin; killing mitochondria, the energy cells of the brain; wasting away
of muscles; and the destruction of the immune system and other blood cells.
Children are affected more severely, because many more of their cells are
growing than in adults. (3) Amazingly, AZT was first approved for treatment
of AIDS in 1987 and then for prevention of AIDS in 1990.
Totally unaware of the toxicity of this controversial drug, the Nagels
faithfully fed their daughter the AZT syrup four times a day. At their
next visit the following month, the doctor strangely began praising Lindsey's
"improvement" (4) Upon reflection, the Nagels grew puzzled. What
"improvement" could the doctor have meant, since Lindsey had
suffered no medical problems at all before the treatment began? In fact,
their daughter was already changing for the worse. Despite gaining slightly
in weight, she was beginning to fall behind the proper growth rate for
her five months of age. She was also losing her appetite, feeling too sick
to drink her milk.
This process continued for months. Lindsey developed no infectious diseases,
but her appetite continued to decline. The doctor acknowledged that the
child was falling further behind the normal growth curve. By the time Lindsey
reached her first birthday on October 15, 1991, her adoptive parents began
to lose patience. The doctor seemed to believe the lack of growth had more
to do with HIV infection than with any drug effects of Septra or AZT. As
the Nagels began reading up on the officially recognized "side effects"
of these drugs, their uneasiness turned to outright anxiety when they found
perfect descriptions of their daughter's condition. Becoming suspicious
of their doctor for not admitting or discussing these side effects, Steve
and Cheryl took Lindsey to Dr. Margaret Hostetter at the University of
Minnesota clinic. They felt overwhelmed and wanted clearer advice.
Dr. Hostetter possessed all the poise and confidence of her twin appointments
as a university professor and director of the clinic's infectious disease
program. Exuding an urbane but authoritative charm, she at first appeared
much more professional and much friendlier than the other physicians. "Thank
you for referring this lovely family to me," she wrote to Lindsey's
first pediatrician after her November visit. (5) Running a complete battery
of tests, she decided to take Lindsey off the Septra immediately. But the
Nagels did notice that the doctor seemed to blame Lindsey's weight loss
on HIV, rather than on drug side effects.
As soon as the Septra prescription ended, Lindsey began rebounding.
Within one month her weight had again increased, though hardly back to
normal, and her appetite recovered slightly. Amazingly, Dr. Hostetter completely
missed the point. She had increased Lindsey's AZT dosage at the same time
as ending the Septra, so at the Nagels's next visit she credited the baby
girl's improvement to the AZT. In fact, she discussed plans to increase
the AZT yet again. Even the experimental drug ddI, another powerful drug
similar to AZT and just approved by the FDA, started cropping up among
the doctor's suggestions.
After the rapid side effects of the sulfa drug had disappeared, the
slower toxicity of the extra AZT began taking over. Lindsey stopped improving,
and her weight, though still rising slowly, could no longer keep up with
the normal growth rate for her age. She remained at the bottom end of the
healthy weight range. By March she virtually stopped growing altogether.
Her parents, fending off an increasing nervousness with each passing month,
nevertheless kept up the daily syrup-feeding routine. The doctor praised
Lindsey's nonexistent progress at each visit.
A few weeks later, the doctor had stretched the Nagels's patience by
pressuring them to put Lindsey on ddI (a chemotherapy like AZT; see below).
The young girl's T-cell levels were dropping, she said, and new drugs might
help combat the deadly HIV. Investigating for themselves, the Nagels discovered
that all children normally start with more than three thousand T-cells
per microliter at birth, declining to about one thousand before adulthood.
(6) Lindsey's counts were coming down near the standard, healthy rate.
Naturally, the Nagels refused ddI therapy. But now they were reconsidering
AZT as well.
The tension finally erupted a few days after Lindsey's second birthday
on October 15, 1992. Steve and Cheryl woke up one night to the tormented
screams of their daughter. Racing into her room, they found her sitting
up and tearfully clutching her legs. The muscle pains were unbearable.
Leg massages, Tylenol-they used anything that would allow Lindsey to sleep
again. The same thing happened the next evening. And the next one. Night
after night, the pain returned with ruthless consistency to deprive the
entire family of sleep for a whole month. The Nagels recognized precisely
what was happening to their daughter: Based on their own study, they had
already learned that AZT produces muscle wasting as one of its "side
effects." (7)
By chance they stumbled across an article discussing Peter Duesberg's
dissent against AZT treatment for AIDS. Upon tracking down his phone number
and calling, they received an earful about the drug's toxic effects. From
there the Nagels talked with several other scientists dissenting against
the HIV hypothesis. By early November the picture had become clear. The
day they received a letter from Duesberg with scientific documents on AZT
and on the shaky evidence for an AIDS virus, the Nagels stopped feeding
their daughter the drug. Lindsey's changes took even her parents by surprise:
After Lindsey was off AZT, she became a "new" child almost
overnight. She started sleeping much better, including longer hours...
Her muscle cramps went away. She started eating at least 2-3 times as much
every day as she had ever eaten before. She would now drink milk, and especially
around other youngsters, would drink as much as 6 ounces at a time. She
would never drink milk before unless we added chocolate syrup, not a very
nutritious drink...
She displayed a much calmer demeanor. Lindsey was described almost as
"hyperactive" by several people, including maternal grandparents
who babysat a lot. This was a night and day difference! Lindsey, before,
could not sit still for 5 minutes, and was seemingly agitated all the time...
After seeing our nutritionist for only 2 months, and ridding Lindsey's
body of toxic effects of being on AZT and Septra, Lindsey, now at 27 months,
had an upswing on the chart. Her weight has been going up ever since. Now
for the first time in 21 months, Lindsey is at 24 pounds, and is back on
the chart at the 10th percentile. (8)
Dr. Hostetter knew nothing about Lindsey's being off AZT. The Nagels
contacted the physician to demand an open discussion about the drug's merits
at their next visit, to take place in early December of 1992. They were
caught completely off guard by the doctor's reaction:
Dr. Hostetter looked very tense... We were verbally attacked, as if
we were 5 years old, and how dare we question her opinion, let alone the
use of AZT! She told us how lucky we were that Lindsey had tolerated AZT
so well, and had not needed to go on ddI up until now. Then, Dr. Hostetter
drew a large diagram on the black board, and told us (as she reminded us
that she had told us all of this before) which cells AZT affects and which
ones it definitely does not affect. If one of AZT's main side effects is
bone marrow toxicity, how does a doctor know which cells the AZT will affect?
(How does the AZT know?)... After our "lecture," Dr. Hostetter
gave us her 20 minute sales pitch for AZT. (9)
The parents felt too intimidated by the meeting to let the doctor know
they had ended the AZT treatment. In a letter written one week afterward
to the Nagels's private physician, Hostetter noted that Lindsey had grown
remarkably well during the previous two months, and warned that "we,
unfortunately, might well see a return of Lindsey's previous failure to
thrive were we to discontinue this drug."(10)
When the Nagels finally informed the doctor in writing and switched
Lindsey to a chiropractor and nutritionist, Hostetter's mood turned downright
ugly. Her response letter thundered a stream of dire warnings:
As we have discussed repeatedly, AIDS is a fatal disease... To take
Lindsey off Retrovir now will, I am afraid, hasten her decline and death.
As parents, you are responsible for your child's health and life...
Running away from qualified medical care will not help you, and it will
certainly jeopardize Lindsey's life. You must take Lindsey to a qualified
M.D. immediately. (11)
Hostetter followed up the letter with an angry call to the Nagels's
chiropractor-on New Year's Eve. "She wanted to warn our chiropractor
that she had no right to be seeing Lindsey," recalled Cheryl. "She
also said that there are foster homes to provide care for children who
were in Lindsey's predicament! (Living with parents who wouldn't give their
daughter AZT.)" (12)
Hoping to stall Dr. Hostetter and to get a second opinion, the Nagels
took their adopted daughter to another physician referred by Hostetter.
But all he gave them was the same opinion. He recommended they restore
Lindsey's treatment, and his nursepractitioner called AZT a "wonder
drug", a term even its manufacturer, Burroughs Wellcome, has never
dared use.
Lindsey remains off AZT and all other toxic drugs. Her healthy growth
pattern continues, she suffers no unusual diseases, and she is developing
normally. Two years after suffering from AZTinduced leg cramps in
1994, she became a budding star in a local ballet school. And on October
15, 1995, Lindsey celebrated her fifth birthday-with HIV and without AZT-in
excellent health. According to public health officials, she should already
have died of AIDS because babies with HIV are supposed to survive only
about two years.
Not everyone is so fortunate. In 1987 three years before Lindsey was
born in faraway Romania, Doug and Nancy Simon brought their daughter Candice
into the world, in a town south of Minneapolis. Their daughter certainly
seemed healthy enough, but by the time she reached one and a half years
of age, the doctor discovered she had antibodies against HIV. Investigation
traced the infection to her mother, who had contracted the virus from her
husband. He, in turn, had contracted it from a blood transfusion several
years earlier. None of them suffered from AIDS.
The Simons took Candice to the Minneapolis Children's Hospital, the
same one where Lindsey Nagel would be given Septra and AZT a couple of
years later. Candice, too, became a victim of AIDS medicine. Doctors there
prescribed interferon, a powerful anti-metabolic drug that shuts down cell
function. (13) They later added AZT to her regimen, a treatment that, unlike
in Lindsey's case, would last three and a half years. The constant testing
added to the parents, sense of being overwhelmed: Xrays, blood samples,
brain scans. For a while, Candice appeared to handle the therapy without
too many problems.
Then her condition took a nosedive. Her appetite declined to dangerously
low levels. The hospital became almost a second home, and by late 1992
she could no longer leave her bed. A new symptom, hauntingly reminiscent
of Lindsey's AZT poisoning, took effect: "When the pain hit she would
double over in her bed like a safety pin and, wild-eyed, grab her ankles
until it eased." (14) Soon the doctors found malignant cancer spreading
tumors throughout her stomach area. For the pain they prescribed morphine,
then surgically cut the nerves to her intestines. Candice could no longer
eat on her own, and the doctors began feeding her directly to her blood
through intravenous tubes. Though five years old, she had lost control
of her intestines and had to wear diapers.
In June of 1993, only three days before she turned six years old, Candice
died painfully. Nearby, Lindsey Nagel had already stopped AZT seven months
earlier and was recovering her health spectacularly. But Candice continued
the drug right up to the end. Now both her parents take AZT as well. (15)
The Nagels know of the Simons's situation and consider themselves lucky
for not having followed through on their daughter's AZT treatment.
The death and resurrection of AZT
The virus hunters have always aspired to the glories of their predecessors,
the bacteria hunters. Medicine still takes credit for eliminating bacterial
diseases with antibiotics such as penicillin. These drugs attacked their
bacterial targets with tremendous specificity, meaning they did little
direct damage to the host's body. Antibiotics became known as the "magic
bullet" for bacterial infections. Fire them into the body, and kill
only invading bacteria.
But for viruses the problem was different. These are nonliving microbes,
made of proteins, DNA or RNA, and sometimes even a tiny membrane-molecules
all made entirely by human cells inside a human body. How could any drug
possibly discriminate between the production of proteins and DNA made for
viruses and those made for their human hosts? Despite neverending
searches for "magic bullets" against viruses, the efforts have
produced little but failure. In principle, an antiviral drug may never
be possible. The only solution offered has been vaccination, which prevents
viruses from entering cells.
The 1975 Nobel Prize for Medicine, awarded for Howard Temin's discovery
of the protein "reverse transcriptase", popularized this unique
retrovirus enzyme. Many virus hunters switched into chasing retroviruses,
and the reverse transcriptase protein took on mythic proportions. It did,
after all, copy the virus, genetic information from RNA molecules "backward"
into DNA, this new copy integrating somewhere into the genetic DNA structure
of the infected cell. Normally, the cell keeps its genetic material in
DNA, copying selected genes into RNA as needed. This "reverse"
feature of the retrovirus protein inspired virus hunters to make it their
key target for "magic bullet", drugs. At least in diseases caused
by retroviruses, they speculated, some effective drug could be found. Once
AIDS was blamed on HIV, a retrovirus, the race was on to find a drug that
could inhibit the viral reverse transcriptase.
Drug development since World War II had also been heavily shaped by
cancer research. Cancer, too, fueled ambitions among doctors to find "magic
bullets" that could destroy the cancer tissue without killing the
host. First came surgery, the attempt simply to cut out the tumor; this
method has serious limitations. Radiation also became popular, based on
the hope that tumors could be burned away by Xrays or other highenergy
beams before destroying the body, but radiation therapy has mostly proved
disappointing. Chemotherapy, using powerful cellkilling drugs, came
into vogue during the 1950s. Starting in World War I, researchers observed
the destruction of blood cells by mustard gas, the chemical warfare agent
used to hideous effect in the trenches of Europe's battlefields. A few
attempts to use this drug against cancer turned up with minimal results,
largely because mustard gas was so toxic to the patient.
Shortly after James Shannon took over the NIH in 1955, he instituted
several major research programs to attract vast new budgets from Congress.
The largest of these became the VirusCancer Program, which ultimately
converted itself into the war on AIDS. The second largest project aimed
to develop chemotherapy agents to treat cancer. The 1950s and 1960s therefore
saw a proliferation of drugs designed to kill growing cells. At first,
the goal seemed straightforward: Since cancer is made of persistently dividing
cells, find a drug that prefers to kill cells that grow. The biggest problem
with this concept lay in the body's own tissues, many of which replenish
themselves constantly with rapidly growing cells. Therefore cancer patients
undergoing chemotherapy experience devastating side effects, including
hair loss; muscle wasting; severe weight loss due to intoxication of the
intestines and benign intestinal microbes; anemia and the need for blood
transfusions; and destruction of the immune system, composed mostly of
white blood cells. Decades before the appearance of AIDS, chemotherapy
patients often died of the same Pneumocystis carinii pneumonia
that later killed young homosexual men. (16)
AZT was invented under this program in 1964. Jerome Horwitz, heading
a lab at the Detroit Cancer Foundation and financed with an NIH grant,
created a chemically modified form of a DNA building block. Every time
a cell divides, it must copy its complete genetic code, allowing one copy
for each new cell. Genetic information is stored as a sequence of four
"letters" in long chains of DNA, known as chromosomes.
Each building block of DNA is linked to the one before it, almost like
train cars. But Horwitz's altered DNA building block, azidothymidine (AZT),
surreptitiously enters the growing DNA chain while a cell is preparing
to divide, and acts as a premature "caboose," blocking further
DNA building blocks from being added. In short, the cell cannot copy its
DNA sequence and dies trying. AZT was the perfect killer of dividing cells.
However, when he tested the compound on cancerridden mice, it failed
to cure the cancer. (17) Horwitz was so disappointed he never bothered
publishing the experiment and eventually abandoned that line of research.
The drug must have killed the tumors, which contain dividing cells, but
it so effectively destroyed healthy growing tissues that the mice died
of the extreme toxicity. (18) The drug was shelved, and no patent was ever
filed.
Twenty years later, Gallo's 1984 press conference announcing HIV as
the "AIDS virus" set in motion a new hunt, this time for a "magic
bullet" drug to act against the virus. The federal government had
promised treatment, and it had to deliver. Some virus hunters, including
Jonas Salk, scurried to invent an HIV vaccine. Others searched for an antiviral
drug and turned to the cancer chemotherapy program for alreadydeveloped
chemicals. The fastest way to put a drug to market would be to select one
that had finished some testing in the past.
Burroughs Wellcome became the pharmaceutical company positioned at the
right place and the right time. One of the giants in the industry, the
Britishbased company maintains a relatively unusual corporate structure
as a mostly nonprofit, charitable institution. Most of its profits are
paid, not to stockholders, but as grants and donations to biomedical research
institutions. By throwing so much money around, Burroughs Wellcome has
bought enormous influence throughout government and universities, especially
through its American branch. A large number of scientists and physicians
had developed informal ties to the company, having been paid to test its
pharmaceuticals many times over the years.
The company's head researcher in the United States, David Barry, recognized
the opportunity after Gallo's press conference. Barry knew his way around
the federal bureaucracy in getting a drug approved. He had originally worked
at the FDA during the 1970s as a virologist. His research had focused on
the flu viruses, and he occasionally dabbled in retroviruses after they
became popular. Upon switching to Burroughs Wellcome, he paid more attention
to herpes viruses, also a hot research item. He brought to his new job
a vast network of connections with fellow virus hunters and top FDA people.
(19) Upon hearing the official call for antiHIV drugs, Barry turned
to the company shelves for previously rejected substances. If one of these
could be approved, the company would save vast sums of research and development
money. The political pressure for a quick solution played in his favor.
The key lay in winning FDA approval, which counted for more than mere
permission to sell. The agency bans most potential drugs, automatically
suppressing the competition and granting treatment monopolies for approved
drugs. This monopoly alone can be worth hundreds of millions of dollars
to the pharmaceutical company holding the patent. Back in the days when
snake oil could freely be sold as a nostrum, drugs would sell only according
to the reputation of the producer and their effectiveness against disease.
Now the public depends on, and trusts, FDA screening procedures.
Barry selected a handful of drugs and quietly forwarded them to a couple
of Burroughs Wellcome's former collaborators. One of them was Dani Bolognesi,
a veteran retrovirus hunter and professor at North Carolina's Duke University,
who not only knew Barry but also was so close to Gallo he belonged to the
"Bob Club." Bolognesi tested the substances in his laboratory,
checking whether they would prevent HIV from multiplying while infecting
cells in the test tube. One of the drugs clearly proved most potent against
the virus- compound S, as it was codenamed. Its real name was
AZT.
Bolognesi then referred Barry to Sam Broder, the man in charge of Gallo's
laboratory at the National Cancer Institute. Broder had joined the NIH
in the early 1970s, just as Gallo's star was beginning to rise. Broder
made his career testing and developing cancer chemotherapy, but he also
allied himself to Gallo and thereby practiced a bit of virus hunting himself,
soon becoming a full member of the "Bob Club." Politically savvy,
he could see by the early 1980s that the time had come to switch his emphasis
from cancer to AIDS and immediately after Gallo's press conference he mobilized
NIH researchers to find a drug. According to Bruce Nussbaum, "The
hallmark of Broder's operation was... simple: Find a drug that had been
tested for a previous disease. Make sure it had a big corporate sugar daddy
behind it. Push the bureaucracy like hell to move it along. And talk it
up. Talk it up."(20)
Broder's tenacity made him a perfect advocate for AZT; Barry realized
that Broder, if properly recruited, would aggressively push through the
bureaucracy to get AZT approved. So Barry sent compound S to Broder late
in 1984, who discovered its powerful effect on HIV and waxed enthusiastic.
Broder was so completely hooked, he soon became known as "Mr. AZT."
Barry, Broder, and Bolognesi together published their laboratory experiments
on AZT. They reported that only a tiny concentration was needed to block
the virus from multiplying. Of course, this would mean nothing if the same
dose of AZT would also kill the Tcells in which the virus grew, in
which case it would destroy the immune system before the virus supposedly
could. Further tests gave an answer that sounded too good to be true: At
least one thousand times as much AZT was needed to kill the Tcells
as to stop the virus. (21) This theoretically meant doctors could use small
doses of the drug to stop HIV without seriously damaging their patients,
immune systems. No one bothered to check this fantastic result. The Burroughs
Wellcome and NIH researchers somehow had to explain their success, and
they billed AZT as a compound that specifically attacked reverse transcriptase,
the retrovirus enzyme. In other words, they quickly declared, they had
finally found a "magic bullet." (22)
AZT, however, did not really attack reverse transcriptase directly.
It only did what it had been designed to do originally- stop the synthesis
of DNA. Since reverse transcriptase copies retroviral genes into DNA, the
drug certainly interfered with its normal function. But the infected Tcell,
meanwhile, produces its own DNA. Every time the cell divides, it must copy
one hundred thousand times more DNA than the small virus, giving AZT one
hundred thousand chances to kill the cell for every opportunity to block
the virus. Since retroviruses can make viral DNA only in cells making their
own DNA, the drug could not possibly attack the virus without also killing
the cell, casting suspicion on the BolognesiBroder experiments. Recent
studies conducted by smaller laboratories have tested AZT on other samples
of Tcells, finding that the same low concentration that stops HIV
also kills the cells. According to these studies, the real cellkilling
dose is one thousand times lower than that reported by Broder, Barry, and
Bolognesi. AZT is definitely toxic, indiscriminately killing virusinfected
and uninfected Tcells alike. Broder and his collaborators have never
corrected their original reports, nor have they explained the huge discrepancies
between their data and other papers. To this date the Physician's Desk
Reference quotes the low toxicity of AZT reported by Broder, Barry, Bolognesi,
and colleagues in 1986, although the real toxicity of the drug is one thousand
times higher according to more than six independent studies published since.
(23)
They also overlooked two even more fundamental problems with their lab
experiment: (1) The virus against which Broder and colleagues tested AZT
was actively growing in the test tube. But in the body of an infected person,
antibodies neutralize HIV years before AIDS appears, if it comes at all.
In persons with antibody against HIV, the virus is inactive, not making
any viral DNA at all. Thus AZT in a human being cannot attack the virus
anyway, for it has already become dormant. It can attack only growing human
cells. (2) AZT, like all other chemotherapeutic drugs, is unable to distinguish
an HIVinfected cell from one that is uninfected. This has disastrous
consequences on AZTtreated people: since only 1 in about 500 Tcells
of HIV antibodypositive persons is ever infected, AZT must kill 499
good Tcells to kill just one that is infected by the hypothetical
AIDS virus. This is called a very bad therapeutic index in pharmacology!
It is a tragedy for people who already suffer from a Tcell deficiency.
A toxic chemotherapy was about to be unleashed on AIDS victims, but
no one had the time to think twice about its potential to destroy the immune
systems of people who might otherwise survive. The pressure was on to find
a drug. Barry used this as leverage when he began quiet negotiations with
key FDA officials, arguing that AZT should be rushed through the approval
process with reduced testing requirements. Broder was doing his bit, championing
the drug through every channel of NIH power at his disposal. FDA officials
relented and agreed to help the drug through in order to save time. Given
the toxicity of AZT, Burroughs Wellcome would need every break it could
get to win approval.
Barry and Broder were the right team to get that break. Says Nussbaum
in Good Intentions: "David Barry was the puppet master, and
his favorite marionette was Sam Broder. While Broder was charging around
promoting AZT at the National Institutes of Health, Barry was working quietly
behind the scenes orchestrating a whole panoply of actors who would ensure
the drug's ultimate commercial success." (24)
Broder rushed AZT through its Phase I trials, the tests to determine
its toxicity in humans. FDA cooperation allowed him to cut corners, making
the drug appear to have minimal side effects. Now they were ready for the
Phase II study, to see whether the drug would actually fight AIDS symptoms.
The AZT CoverUp
Doubleblind, placebocontrolled studies form one of the cornerstones
of medical science. This rigorous gold standard puts any promising new
treatment to the ultimate test: When applied to humans, does it really
work? If properly structured, such a study throws out the prejudices of
the researchers and yields the bottom line. A group of people with the
appropriate disease is carefully selected, then secretly divided into two
subgroups matched for every important characteristic. To test a therapy
for tuberculosis, for example, both groups would contain the same number
of tuberculosis patients. One group is given the treatment, the other a
placebo-a "sugar pill," meaning a sham treatment that appears
identical to the therapy itself. This removes any interfering effect of
patient psychology or actions. And the study is conducted in a doubleblind
fashion, so that neither the patients nor the doctors know who is receiving
treatment and who gets placebo, until the experiment is finished.
Under normal circumstances, AZT's Phase II trial would have been such
a doubleblind, placebocontrolled study. But the intense political
pressure to approve an AIDS drug, enhanced by fastspreading rumors
in the homosexual community of AZT's powerful benefits, forced FDA officials
to take shortcuts. Although the study was finally published as if it had
been a doubleblind, placebocontrolled test, it most definitely
was not. (25) The drug's toxicity inevitably unblinded the study within
weeks, its effects on patients being painfully obvious. (26)
David Barry structured the entire study from beginning to end. He tapped
Burroughs Wellcome's informal network of scientific collaborators, selecting
twelve medical centers around the country for participation. By providing
$10,000 per study patient to each clinic involved, he induced a whopping
fiftyone researchers to jump on board, a group heavily weighted with
old virushunting peers of Barry's. Just having that many wellconnected
medical scientists helped swing the political balance in his favor, and
it locked in their own loyalties to AZT. Even Michael Gottlieb, who reported
the first five AIDS cases, joined in. There was hardly a medical institution
left in the country that was not involved and that could have offered an
independent second opinion. Barry chose Margaret Fischl, a virologist at
the University of Miami, to head the experiment.
Thus, Burroughs Wellcome not only coauthored (Drucker, NusinoffLehrman,
Segreti, Rogers, Barry), but also paid for the licensing study of its own
product. But nobody seemed to mind this blatant conflict of interest-not
the many nonBurroughs Wellcome researchers on the study; not the NIH,
which cosponsored the study; not the FDA; not the editor of the New
England Journal of Medicine, which published the study.
A total of 282 AIDS patients was recruited, roughly half being put on
AZT and the other half receiving the placebo. The trial, conducted in 1986,
was scheduled to treat each patient for six months. After four months the
announced results seemed stupendous-so amazing, in fact, that the study
had to be aborted early. Fischl and her associates decided they could not
ethically continue to withhold such a wonderful drug from the placebo group.
Nineteen placebo recipients had died during the study, compared to only
one member of the AZT group. Fortyfive in the placebo group developed
oppor tunistic AIDS diseases, versus only twentyfour in the AZT group.
And while the Tcell counts of the placebo patients continued to decline,
the AZT group saw a temporary surge in their Tcells. Results like
these could propel almost any drug to FDA approval.
But even an inspection of the officially published data reveals some
grim problems. The study does not indicate that Fischl and colleagues sorted
their patients according to use of such recreational drugs as heroin or
poppers. Since most were homosexual men, this could complicate matters
if, for example, the placebo group contained more heavy drug users. Fischl
herself also admitted that an undocumented number of the patients were
allowed to take other medical drugs during the study, a factor that introduced
another wild card.
When pioneer AIDS researcher Joseph Sonnabend, from New York, "first
read the AZT study report, he had a lot of questions but the first one
had nothing to do with AZT: Why had so many placebo patients died? 'I was
suspicious of the study from the beginning because the mortality rate was
simply unacceptable', he said. 'My patients were simply not dying in those
sort of numbers that rapidly.' Sonnabend had an added difficulty. The causes
of death provided to the FDA did not match those in the research Fischl
had written for the New England Journal of Medicine. 'Sloppy research,'
Sonnabend said." (27)
Still, taking the results at face value, a shocking picture of AZT toxicity
emerges. Sixtysix AZT recipients suffered "severe" nausea-a
category that would have been mentioned only if this was clinically serious-as
compared to twentyfive in the placebo group. All AZT users saw their
muscles waste away, while only three placebo recipients suffered this symptom.
And a full thirty in the AZT group survived only with multiple blood transfusions
to replace their poisoned blood cells, compared to five similar cases among
the placebo users. The lesspublicized "side effects" of
AZT more than abolished its presumed benefits. (28)
A followup study on those same patients found that Fischl's neat
picture mysteriously vanished once everyone was put on AZT. Within months,
the death rate of the original AZT test group rapidly caught up to the
former placebo group. After a year, onethird of both groups had died.
Fischl, "the Queen of AZT," (29) and her coworkers shrugged off
these new results, suggesting that AZT's miraculous effects somehow wore
off after a few months.
Or perhaps the benefits never existed in the first place. A flood of
previously concealed information has surfaced since the trial, all showing
that it became unblinded from the start. The controls completely broke
down.
The doctors certainly found out quickly who took AZT and who did not,
because AZT induces serious destruction of blood cells and the bone marrow
that produces them. Bruce Nussbaum, in his 1990 book Good Intentions,
described the mood in the trial's first month:
A move to stop the trial began immediately. The toxicity of AZT was
proving to be extremely high, much higher than indicated by Sam Broder's
previous safety trials. PIs [Principal Investigators] began to worry that
AZT was killing bone marrow cells so fast that patients would quickly come
down with aplastic anemia, a murderous disease. This was terrifying to
many PIs. "There was enormous pressure to stop," recalls Broder.
"People said, 'My God, what's going on, we're getting these anemias,
what's going on?' We never saw this level of anemia before." (30)
For those doctors who may have missed AZT patients vomiting up blood,
the routine blood tests gave away the secrets. Michael Lange was one of
the researchers in the trial, interviewed for a 1992 British television
documentary:
I don't think [the trials] were really blinded, because when you take
AZT, your red blood cells increase in size... You can notice that on an
ordinary blood count, and since blood counts were monitored and the information
fed back to patients, this information was available to the investigators.
(31)
The patients, needless to say, often found out what they were taking
by such clues. But they had other methods. For one thing, the AZT and placebo
pills tasted different at the study's beginning. When doctors finally caught
some patients tasting each other's pills, they fixed the problem. This
came too late, of course, for full damage control. The patients who missed
this opportunity discovered other ways around the controls. According to
Christopher Babick, an AIDS activist with the People With AIDS Coalition:
During the Phase II trials, we received many phone calls in our office
from individuals who wanted to determine whether or not they were using
the placebo or actually receiving AZT. There were three laboratories in
New York which would analyze the medication. We would refer individuals
there. If, in fact, they were on placebo, they would make arrangements
to acquire the drug AZT. Oftentimes they would share it with individuals
who were in the trials, thus really rendering the Phase II trials unblinded.
(32)
The patients had bought the early rumors of AZT's incredible healing
powers, and they really did not want to take a placebo. Some of the placebo
group secretly did use AZT, explaining the presence of its toxic "side
effects" among those patients. The AIDS activist group Project Inform,
originally an opponent of AZT, tried to dislodge the trial's internal working
papers to confirm that the "placebo group" members with toxicity
symptoms had used AZT; despite invoking the Freedom of Information Act,
they never could get the documents released. The trial's organizers pulled
one final stunt to help AZT succeed. The original plan had called for each
patient to participate for six months.
But long before the sixmonth "doubleblind, placebocontrolled
trial" was over, the "blinded," researchers saw that the
AZT group was doing better than the placebo group. How did they see this,
if the study was blinded? The researchers could monitor the tally of AZT
versus placebo either by AZT's toxicity or by something else.
As soon as the tally appeared to favor AZT over the placebo, the FDA
oversight committee aborted the trial. Insisting they were acting on ethical
considerations, the organizers immediately provided AZT to all patients.
Patients spent an average of about four months in the original study, some
less than one month. The final analysis included all patients, with projected
guesses to fill the gaps in the data. As the followup study later
observed, the death rate among the original AZT group quickly caught up
to the former placebo group. (33) Had the trial not been unblinded, or
had the FDA chosen to wait the full six months, the relative death rates
would have looked radically different. In any case, Fischl's pretense of
doubleblind controls smacks of dishonesty. (34)
Once the controls broke down, the study began to unravel. While some
"placebo" recipients were actually taking AZT, some of the "AZT"
recipients were being taken off the drug. Many of the patients simply could
not tolerate AZT, and the physicians had to do something to save their
lives. "Drug therapy was temporarily discontinued or the frequency
of doses decreased... if severe adverse reactions were noted," admitted
Fischl in the fine print of her paper. "The study medication was withdrawn
if unacceptable toxic effects or a [cancer] requiring therapy developed."
(35) This astonishing slip reveals that the doctors did indeed know who
was using AZT. But never did Fischl tell how many "AZT" patients
were taken off the drug, nor for how long.
Other patients dropped out of the trial altogether. Some 15 percent
of the AZT group disappeared, possibly including patients with the most
severe toxic effects. Fischl and her collaborators never bothered accounting
for the loss, fueling the suspicion that they could have even dropped the
sickest patients themselves.
This is a likelier possibility than it first sounds. Author John Lauritsen
succeeded in obtaining documents released under the Freedom of Information
Act and found many examples of incomplete or altered data. Causes of death
were never verified, as by autopsy, and report forms often listed "suspected"
reasons. (36) Naturally, Fischl and colleagues tended to assume that diseases
in the placebo group were AIDSrelated, while assuming diseases in
the AZT group were not. The symptom report forms looked even worse. Mysterious
changes appeared, often weeks after the initial report for a given patient,
including scratching out the original symptoms. The unexplained tamperings
generally had no initials indicating approval by the head researcher. Other
symptom reports were copied onto new forms but often lacked the original
form for comparison. And on some forms reporting toxic effects of AZT,
the symptoms were crossed out months later.
During the trial, an FDA visit to one of the test hospitals in Boston
uncovered suspicious problems. "The FDA inspector found multiple deviations
from standard protocol procedure," an FDA official later commented,
"and she recommended that data from this center be excluded from the
analysis of the multicenter trial." (37) Months after the trial had
finished, the FDA finally decided to inspect the other eleven centers.
By then much of the evidence had been lost in the confusion. Far too many
patients had been affected by test rule violations, and the FDA ultimately
chose to use all of the data, good or bad, including data from the Boston
center. One FDA official let the cat out of the bag on the hopeless mess:
"Whatever the 'real' data may be, clearly patients in this
study, both on AZT and placebo, reported many disease symptoms/possible
adverse drug experiences." (38)
Other than allegedly reducing death, the Phase II trial made two other
claims on behalf of AZT: (1) It raised the Tcell levels of immunedeficient
AIDS patients and reduced the number of opportunistic infections they suffered.
All testing violations aside, AZT can temporarily raise Tcell counts.
So can various other poisons and even severe bleeding after a long period.
When some tissue is attacked by a toxin, or blood is lost due to an accident,
the body tends to overcompensate for the loss by producing too many replacements-as
long as it can. (39) At some point even the ability to replace white blood
cells becomes overtaxed and the Tcell counts collapse downward, exactly
as observed in the Fischl study. A temporary increase in Tcells does
not necessarily indicate the patient is improving. (40) (2) AZT blocks
DNA production, not only in human Tcells or retroviruses, but also
in any bacteria that might exist in the body. Thus, it can act as an indiscriminate
antibiotic, killing opportunistic infections while destroying the immune
system. Even Burroughs Wellcome had previously billed the drug as an antibacterial.
This effect could explain the lower number of such infections in the AZT
group. But the effect lasts only a short time; once the body's immune system
is devastated by AZT, the microbes take over permanently.
Ignoring all the chaos, the FDA approved the drug on the basis of this
experiment. Apparently, the strategy of involving many medical researchers
from many institutions had paid off. There was only one critical voice
questioning a therapy that infiltrates a DNA chain terminator into human
bodies indefinitely, the voice of the retired bacteriologist Seymour Cohen:
"The severe toxicity of AZT to bone marrow, as well as unexpected
interactions of other drugs with AZT, indicate the importance of knowing
more about the effects of the compound.
We ask therefore, Which normal cells are severely damaged? Is the damage
reversible or irreversible? Are the celjs killed and the chromosomes fragmented,
as one might expect from a termination of DNA chains? Are AZT and DDC mutagenic,
or possibly carcinogenic? These questions have not yet been answered, to
my knowledge." (44)
Several leading scientists, even virologists, also felt uneasy about
the whole affair. But they preferred to remain silent or restricted their
concerns to informal comments to the press. For example, Jay Levy at the
University of California at San Francisco had been one of the first scientists
to isolate HIV. A Newsday article described his comments on the
drug: "I think AZT can only hasten the demise of the individual. It's
an immune disease," he said, "and AZT only further harms an already
decimated immune system." (43) Even Jerome Groopman, one of the Phase
II participating scientists, harbored serious reservations. The head of
a research group at a prominent Boston hospital, he quickly discovered
the effects of AZT on his patients. "When Groopman gave it to 14 patients
on a compassionate basis, only 2 were still able to take it after 3 months.
'We found it nearly impossible to keep patients on the drug,' Groopman
says." (43)
Sam Broder, on the other hand, never seemed to entertain a second thought.
"When the Wright Brothers took off in their first airplane it probably
would have been inappropriate to begin a discussion of airline safety,"
he nonchalantly told the Presidential HIV Commission in 1988. (44)
But Martin Delaney, founder and head of the AIDS activist group Project
Inform, San Francisco, was furious:
"The multicenter clinical trials of AZT are perhaps the sloppiest
and most poorly controlled trials ever to serve as the basis for an FDA
drug licensing approval... Because mortality was not an intended endpoint,
causes of death were never verified. Despite this, and a frightening record
of toxicity, the FDA approved AZT in record time, granting a treatment
IND [investigational new drug] in less than five days and full pharmaceutical
licensing in less than 6 months." (45)
David Barry had already negotiated behind closed doors with the FDA
for rapid approval. He held a strong bargaining position, given the political
climate. (46) But even that took too long for him, and he demanded special
permission for Burroughs Wellcome to sel1 AZT while waiting for the official
approval. FDA officials scrambled for an answer, dredging up a permit known
as the Treatment IND. This method had almost never been used. Within
days the technicalities were ironed out, and Barry had his permit to sell.
Next, he had to get the official permission. He wanted it fast, and
based on less scientific data than normally required. Again the FDA complied,
cutting the process down to several months. Even AZT studies on mice were
dropped from the requirements. The final hurdle lay in a meeting of an
advisory committee of scientists and doctors, whose recommendation would
likely determine AZT's fate. The panel met for a single day in January
of 1987. The dice were loaded in his favor, for two of the eleven panel
members were paid consultants for Burroughs Wellcome. (47) The FDA granted
special permission for those two researchers to remain on the committee
with full voting powers. (48)
Dozens of scientists from the Phase II trials showed up to argue their
case, packing the room with virtual cheerleaders. They spent hour after
hour flashing huge quantities of data past the committee, some of it so
new that no one had had the time to review it beforehand. The followup
results on the patients, showing higher death rates after everyone went
on AZT, were cleverly buried in an avalanche of confusing statistics. Dazed,
the members of the committee began to feel anxious that something had gone
wrong in the testing process. Then Barry played his ace: a highranking
FDA official, Paul Parkman, showed up and spoke, despite not having been
scheduled to do so. After only a minute of suggesting most of the panel's
concerns could be addressed, Parkman closed with a dramatic statement:
"I think we can probably arrive at a plan that will satisfy people
here." (49) Suddenly, the arguments stopped, and the mood shifted
from opposition to support for AZT. FDA officials had never before interfered
in these meetings, and the entire committee was shocked. "Did you
hear that?" the panel chairman said to an associate. "He's telling
us to approve it." (50)
Few in the room knew that Parkman was a personal friend of Barry; they
had once worked together on virology projects. The panel ended up recommending
AZT, with only the chairman voting against it. Burroughs Wellcome quickly
patented the drug, something no one else had ever bothered to do.
The FDA endorsement could seem a cruel joke perpetrated by heartless
AIDS scientists. Patients on AZT receive little more than white capsules
surrounded by a blue band. But every time lab researchers order another
batch for experimentation, they receive a bottle with a special label.
A skullandcrossbones symbol appears on a background of bright
orange, signifying an unusual chemical hazard. The label appears on bottles
containing as little as 25 milligrams of AZT, a small fraction (1/20 to
1/50) of a patient's daily prescribed dose. The adjoining warning on the
label reveals secrets not conveyed to the unwitting patient: "TOXIC.
Toxic by inhalation, in contact with skin and if swallowed. Target organ(s):
Blood Bone marrow. If you feel unwell, seek medical advice (show the label
where possible). Wear suitable protective clothing." (51)
ddI and other DNA chain terminators claim a piece of AZT's action
A different pharmaceutical giant, BristolMyers Squibb, produced
another DNA chain terminator, ddI. The company sorely wanted to pull this
drug off the shelf and into production, hoping to get a piece of the action
from Burroughs Wellcome. Sam Broder, after working in the mid1980s
to promote AZT, was only too happy to help along any such chemotherapy.
He performed lab experiments on cultured cells, again wrongly trying to
argue that the drug blocked HIV production more effectively than it killed
Tcells.
BristolMyers began sponsoring research on AIDS patients. But they
performed no controlled study, never comparing ddI's effects to placebo
in matched groups. (52) The studies did, however, reveal a couple of additional
toxic reactions not produced by AZT. It can cause fatal damage to the pancreas,
and it can destroy nerves throughout the body. (53) On an experimental
basis, a number of doctors began giving ddI to thousands of AIDS patients
who could not tolerate AZT. Hundreds of unexplained deaths occurred among
these patients, but the FDA managed to quell growing concerns. (54)
The FDA advisory committee, meeting to vote on ddI's approval, convened
in July 1991. On that day, the panel reviewed the sloppily gathered data
on the drug, which was compared to unmatched and untreated AIDS patients
from years earlier. On this questionable basis, the committee was told
ddI worked as well as AZT. Given the astonishing lack of a controlled study,
the panel leaned against approval. That is, until FDA director David Kessler
personally intervened on behalf of ddI and pressured the committee to "be
creative." (55) The members changed their minds, voting to license
the drug, albeit with restrictions. Doctors could prescribe it only for
patients they felt did not benefit from AZT, leaving ddI as a secondary
treatment and the second drug ever to win "fasttrack" FDA
approval.
But even four years after its approval for human consumption, Anthony
Fauci, director for AIDS research at the National Institute of Allergy
and Infectious Diseases (NIAID), stated to the New York Times: "ddI
had never been compared with a placebo in a large study." (56)
Since that time, the AIDS establishment has backed yet other DNA chainterminating
chemotherapies, including dideoxycytidine (ddC), a drug also developed
by Jerome Horwitz in the 1960s and now marketed by HoffmannLa Roche.
The FDA has approved ddC, but only for use in combination with AZT or ddI.
The consensus dissolves
In the years following AZT's approval, a flood of studies on AIDS patients
have poured forth, illustrating frightening toxicity. None have included
placebo groups, an omission rationalized by ethical concerns that patients
should not be denied such a miracle drug. But the numbers speak for themselves.
Two years after the end of the Fischl Phase II trial, a group of French
physicians working at the Claude Bernard Hospital in Paris published another
study on hundreds of AIDS patients. All used highdose AZT for an average
of seven months. Onethird of the patients experienced a worsening
of their AIDS conditions, and a slightly higher percentage developed new
AIDS diseases. By nine months, one of every five patients had died, a rate
far higher than in the Fischl study, which also used the high dose. "The
bone marrow toxicity of AZT and the frequent need for other drugs with
hematological [blood] toxicity meant that the scheduled AZT regimen could
be maintained in only a few patients," wrote the authors. This has
matched other findings; in most studies, half of any group of people suffer
an immediate reaction so severe that they must stop. The French doctors
cast a cloud of pessimism, noting that "in AIDS and ARC patients,
the rationale for adhering to highdose regimens of AZT, which in many
instances leads to toxicity and interruption of treatment, seems questionable."
(57)
In England, one group of researchers described the medical consequences
of AZT in thirteen patients; all thirteen developed severe anemia (Mir
and Costello). A subsequent Australian study reported the consequences
of treating more than three hundred patients for one to oneandahalf
years. More than half developed a new AIDS disease during the first year,
and exactly half needed blood transfusions to survive. Nearly onethird
died. A Dutch study found still deadlier results: After little more than
a year, most of their ninetyone patients needed blood transfusions
and almost threequarters died. The Dutch researchers despaired at
prescribing AZT, warning that most of their patients simply could not stay
on the drug for loss of blood cells. (58)
A new complication surfaced in 1990. The National Cancer Institute analyzed
the status of AIDS patients who had participated in Broder's Phase I trial
and uncovered the fact that of all the people using AZT for three years,
half were developing lymphoma. (59) This is a deadly cancer of white blood
cells, akin to leukemia but forming solid tumors in the body, and also
happens to be included on the official list of AIDS diseases blamed on
HIV. Since AZT was killing and damaging those same white blood cells, the
drug stood out as the likely culprit. Virus hunters rushed to the drug's
defense. Some massaged the statistics to lower the lymphoma rate, while
others turned the news completely upsidedown by claiming AZT actually helped
patients live longer-long enough to get lymphoma! (60) Paul Volberding,
one of the leading organizers in the Phase II trial, told one interviewer,
"So we see the Iymphomas as an unfortunate reflection of our success
at this point rather than a reason for real caution." (61)
Certainly AIDS officials can hardly be accused of caution when it comes
to AZT. Nor does their explanation wash, since only 3 percent of all AIDS
patients tend to get lymphoma as their AIDSdefining disease (62)_not
(50) percent as in Broder's AZT trial. AZT, furthermore, has given evidence
of cancercausing abilities when tested. (63)
A few small studies have tested the reverse to see what happens to AIDS
patients who stop AZT use. In one group of four patients who developed
massive blood cell loss weeks after starting AZT, three recovered after
the doctor took all four off the drug. (64) Another group of five patients
suffered muscle wasting, a symptom that disappeared in four cases only
a couple of weeks after stopping AZT; two of these patients lapsed back
into the condition after restarting the drug. (65) In the most dramatic
such experiment, a doctor took eleven of his worsening AIDS patients off
AZT. The immune systems of ten immediately rebounded, and several continued
improving. (66)
Yet no amount of warning data could dissuade AIDS officials from abandoning
their 'antiviral" compound. Having won approval for treating AIDS
patients, Burroughs Wellcome and the NIH moved to have AZT recommended
as a preventive drug, for HIVpositive people without symptoms. This
time Anthony Fauci directed the experiment as a project of NIAID, the NIH
division he headed. Burroughs Wellcome again financed much of the study,
paying hospitals for participating, and several of its consultants again
joined in. Margaret Fischl and many other Phase II researchers signed up,
and Paul Volberding secured the top position as organizer. But now a stupendous
number of scientists were recruited: The final paper mentioned 130 authors,
which Volberding called "a partial list." The investigators read
like a who's who among leading virus hunters and medical doctors involved
in AIDS research. With that many prominent researchers involved, few colleagues
remained to act as independent reviewers. The study's political success
was virtually guaranteed, regardless of its outcome.
Volberding and his colleagues enrolled more than thirteen hundred HIVpositive
healthy persons from AIDS risk groups, none of whom had AIDS diseases.
The subjects were divided into three groups-placebo, highdose AZT,
and, because of growing worries about the drug's toxicity, a lowdose
AZT group. Protocol o1g, as Fauci designated it, quickly degenerated into
a repeat performance of the Phase II trial. More cancers, including Kaposi's
sarcoma, occurred in the placebo group, hinting that more users of poppers
or other recreational drugs may have ended up there, biasing the results
in favor of AZT. The doubleblind controls broke down again, a fact that
was covered up publicly. But in the text of the paper, Volberding acknowledged
that the dropout patients tended to come from the AZT treatment groups,
removing some of the sickest victims. Having also anticipated sharing of
AZT between patients, he had their blood tested for the actual presence
of the drug. Nine percent of the "placebo" group were caught
with traces of AZT, while almost 20 percent of the AZT groups showed no
evidence of ever having used the drug.
The study was terminated early, after patients had been treated for
an average of one year. The final analysis showed the AZT groups with fewer
AIDS diagnoses than the placebo, but the toxic "side effects"
of AZT swamped this small difference. The lowdose group had as many sick
people as the placebo group, although their blood disorders and immune
deficiencies were not called "AIDS." The highdose group
suffered by far the most, having dozens of deathly ill patients. (67) By
calling diseases in the placebo group "AIDS," while avoiding
that diagnosis for the AZT groups, Volberding successfully won an FDA recommendation
for using the drug on healthy HIVpositive people.
In 1994 Volberding published a stunning aftermath to Protocol 019. The
Tcells of 29 percent of the men in the placebo group had increased
gradually over two years, while those of the AZT recipients had decreased.
(68) It is probable that under clinical surveillance the 29 percent whose
Tcells increased, despite the presence of the alleged Tcell killer
HIV(!), had given up or reduced their recreational drug use.
After studying patients for another five years, Volberding, the father
of AZT prophylaxis, came to a new conclusion about AZT: "Zidovudine
[AZT]... does not significantly prolong either AIDSfree or overall
survival." (69) Stated otherwise, hundreds of thousands of healthy
people had taken AZT for five years for no "significant" reason,
assuming that DNA chain termination is indeed "not significant."
In an article entitled "Early Intervention: An Idea Whose Time
Has Gone?" the New York Native writes on Volberding's latest
insight: "The same group of people that has continued to insist that
'early intervention' with AZT is necessary and beneficial- despite data
showing that people who take AZT earlier also die earlier and that their
quality of life is so diminished as to negate completely any alleged benefits
from AZT-have now published research showing that, after all, AZT does
not prevent progression to 'AIDS, or delay death. The magnitude of this
aboutface cannot be overstated." (70)
Not totally convinced by Volberding's original trial, other researchers
put together two longterm studies on AZT's preventive effects. An
American research group sponsored by the Department of Veterans Affairs
ran a twoyear trial comparing patients who used AZT before symptoms
(the "early" group) to those using it afterward (the "late"
group). These scientists found that the early group actually died slightly
more often and a bit faster than the late group, but the differences were
small. They concluded AZT showed no survival benefits whatsoever when used
for prevention. (71) The news hit the stock market with force, knocking
down the value of Burroughs Wellcome shares some 10 percent in one day.
British and French scientists organized a similar study, known as the
Concorde trial, while Volberding's study was still in progress.
The Concorde study treated two groups with AZT, one before AIDS symptoms
(the early group) and the other after (the late group). Only people without
AIDS symptoms were recruited into the study, the late group receiving a
placebo until after they contracted AIDS. Apparently, the researchers were
seeing enormous toxicity as the study progressed, for midway through, a
minor crisis erupted. The scientists became divided over whether to continue
or abort early. At a meeting behind closed doors, an audience member secretly
recorded Chairman Ian Weller as he voiced the increasing concerns: "If
there is benefit [to AZT therapy], is it maintained, or will it wear off?
In which case we may do more harm than good." (72) The study organizers
voted to continue, albeit nervously.
After each patient had participated for three years, the researchers
came out in 1994 to announce publicly that they could find no difference
in survival between the early and late treatment groups. In reality, the
early AZT group had done worse than estimated. The death rate in the AZT
group was 25 percent higher than in the control group hardly a recommendation
for AZT prophylaxia. (73) The doubleblind controls again seem to have
dissipated, for symptomfree patients could easily know they were on
AZT by its potent toxicity. Many of these AZT patients could no longer
tolerate the nausea, vomiting, and anemia, but they did not have the courage
to confront their doctors. So, according to at least one report, "They
have thrown their tablets down the toilet." (74) This would artificially
lower some of the apparent toxicity in the early group.
But the news of no positive benefits did stun the AIDS establishments
in all countries, sending various officials scrambling for excuses to explain
away the Concorde results. This study has provided the heaviest blow yet
against AZT, and the first signs of retreat are beginning to emerge. Based
on a preliminary report on the Concorde study, on June 25, 1993, an NIH
panel formally announced new guidelines for AZT use, recommending that
doctors and patients use more caution. "AZT has benefits, but we are
admitting that it is not as good a drug as we thought it was," said
the committee chairman. (75)
Further bad news came from America. One investigation of AZT, as prophylaxis
against AIDS dementia, showed in 1994 that contrary to expectation-there
was twice as much dementia in AZTtreated homosexuals than in untreated
counterparts. (76) Also in 1994, a large American study reached an even
more damning verdict on AZT prophylaxis. It found that HIVpositive
hemophiliacs had 2.4 times higher mortality and a fourandahalftimes
higher AIDS risk rate than untreated HIVpositive hemophiliacs. (77)
It may not have been just a coincidence that Sam Broder resigned, apparently,
at the height of his career, as director of the National Cancer Institute
in December 1994. (78)
In April 1995 an American study found that AZT treatment doubled or
quadrupled the risk for HIVpositive male homosexuals to develop Pneumocystis
pneumonia. (79) In July 1995 the British Medical Journal published
that AZT prophylaxis reduces the time to death of HIVpositive AIDS
patients from three years without AZT to two years with AZT. (80)
The emerging concerns about AZT treatment are summarized dramatically
in a letter from a German doctor to the editor of Nature:
To the Editor: As a hospital doctor I come face to face every day with
the disaster that Gallo and his colleagues have brought about. In the case
of each patient with tuberculosis, each patient with herpes zoster, each
patient with toxoplasmosis or cytomegalo viral infections, I am confronted
with the thought that if these patients were HIV positive, they would,
as things currently stand, have to undergo antiviral therapy. The
substances available are pure chemotherapeutic agents, which means that
in treating them I bring about the very illness I seek to bring under control.
In effect, this means leading the patients to their deaths. As a result
of the AIDSvirus hypothesis, things have now reached the stage where treatment
of the disease itself gives rise to the bleak prognosis for the disease.
CLAUS KOEHNLEIN, M.D. Kiel, February 28, 1995
In his response to Koehnlein, John Maddox, the editor of Nature, wrote
on September 20, 1995:
But it seems to me that there are two separate issues-is AZT dangerous
in itself and does HIV cause/not cause AIDS? Only physicians such as yourself
can establish the first point, but it seems to me that by now there must
be a great deal of clinical data on which you and your colleagues could
draw to reach a substantial conclusion that could be published.
You say that the Ho and Wei papers we published in February [sic-it
was January] are unconvincing because their work is based on the "AIDSvirus
hypothesis," but how can you dismiss their finding of very large quantities
of virus in the blood of people with HIV infection? And the temporary effectiveness
of the protease inhibitor, whose design is specifically determined by the
sequence of HIV, used in their study?
I should add that a haemophiliac relative of my wife died of AIDS this
year. He was infected before 1984 and diagnosed with antibodies against
HIV in 1985. His first symptoms of AIDS appeared about 1989.
American gay activists from ACT UP San Francisco who used to conform
with the HIV orthodoxy have recently also begun to protest AZT therapy
with violence. Crashing the tenyear anniversary party of Martin Delaney's
AIDS organization, Project Inform, and turning over tables at the plush
Hyatt Regency Hotel in San Francisco, protesters shouted into the faces
of Delaney and his guests Larry Kramer and Anthony Fauci: "Tony Fauci,
you killed our friends! This is where the murder ends!"
According to Spin reporter Celia Farber, the protesters picked
the occasion because "Project Inform, they insist, has become so entrenched
with authoritarian, establishment, oldboynetwork views on AIDS
that it has betrayed the community." (81)
In a press release the ACT UP protesters listed their complaints of
May 6, 1995:
"The past decade of human tragedy has shown us that trying to kill
the AIDS virus with high priced drugs like AZT and ddI harms the people
who take them. These compounds make people sick, are not created to be
taken for prolonged periods of time and are immunosuppressive. Enough is
enough! This ongoing circus of death must be questioned...
Government sponsored clinical trials of drugs are obviously not meant
to save our lives. These trials are meant to document the drug's effect
on laboratory markers that have little, if any, correlation to the health
or survival of people with HIV disease. People with HIV need to concentrate
on activating their cellular immunity in order to control the opportunistic
infections that threaten our lives. Fauci knows this, has admitted it and
still does nothing... With 270,000 dead from AIDS and millions more infected
with HIV, you IFauci] should not be honored at a dinner. You should be
put before a firing squad." (82)
On July 22, 1995, even the establishment media sent out a signal of
distress. The New York Times published the following letter condemning
AZT studies:
To the Editor: The recent study casting doubt on azldothymidine's [AZT]
alleged therapeutic benefits for carriers of the human immunodeficiency
virus (news article, July 16) [from the British Medical Journal
cited above] contrasts with the majority of AZT studies, in which the drug
is claimed to be beneficial.
The best way to resolve the AZT disagreement might be to gather as many
of the original articles as possible to see if the experiments were done
well. In AIDS research, funding sources can also be illuminating. Here
is what I found after reviewing more than 25 studies on AZT:
Evidence of AZT's inefficacy and toxicity has been around a long time,
well before the 1994 Concorde studies or the 1992 Veterans Affairs cooperative
study. Negative data on AZT were published in the Lancet, the British
Medical Journal, in December 1988. Those data were not highly publicized.
While the absolute number of studies casting doubt on AZT is small,
they tend to have two things in common: good experimental design and "independent"
funding.
The more numerous studies supporting AZT's benefits tended to use inappropriate
experimental designs and very short followup times.
Moreover, these studies were financed, at least in part, by the drug's
maker, the Burroughs Wellcome Company.
TIMOTHY H. HAND Atlanta, July I7, 1995 (83)
Considering the faithful commitment of the New York Times to
the HIV orthodoxy since 1984, the publication of this letter assumes outstanding
significance. In this era of centralized, government sponsored science,
an article against politically correct science can be fatal for a journalist.
In such a climate the publication of a letter is a journal's last resort
of expressing a dissenting opinion.
AZT, known for decades as a failed and toxic cancer chemotherapy, was
resurrected for political reasons and rushed through the FDA's first fasttrack
approval. By its very nature, such a drug could only worsen AIDS, if not
cause some AIDS diseases by itself. (84) One experiment after another,
despite flaws, has confirmed the drug's toxicity in humans, yet only now
is the AIDS establishment slowly backing down. The virus hunters bring
tremendous political and financial momentum behind each of their projects,
and AIDS treatment is no exception.
Preventing HIV infection - the last stand of the AZT lobby
The recent growth of opposition to AZT may save lives in the future,
but it is coming too late for some victims. Convinced of the drug's alleged
success, the AIDS establishment has aggressively promoted AZT wherever
it could despite the drug's poor performance. Often the treatment is paid
for by one federal program or another, creating an indirect subsidy of
Burroughs Wellcome by the taxpayers. In 1992 at least 180,000 people worldwide
took the drug every day. (85)
Frustrated with its failures to cure AIDS, and then even to prevent
it, the AZT lobby has concentrated on a last front to save its drug: the
prevention of infection. As usual in the rush to "save lives"
there was no time for theory. To prevent HIV infection, a drug would have
to shut down all cell growth in the body for several weeks. This is because
retroviruses like HIV depend on cell division for reproduction and therefore
infection. If only a few cells continue to divide, the defense against
HIV would be useless. But to achieve a complete shutdown of cell division,
so much AZT must be administered that survival is impossible. Even the
highest doses ever prescribed would not suffice. Given the choice between
lethal doses of AZT that could prevent infection but would likely kill
the patient and not to use AZT at all, the AZT establishment chose to compromise.
By treating with the known doses, most patients would survive long enough
to obscure all drugmediated diseases by HIVmediated diseases
that are "expected" to occur late after infection.
The early months of 1989 brought an unusual notice posted in the buildings
of the NIH. Entitled "HIV Safety Notice," it announced a new
policy established by the director himself. Any employee of the NIH who
underwent accidental exposure to HIV, as for example by a needlestick injury,
would be offered preventive AZT. According to the notice, "The advisory
group in providing their recommendations emphasized that administration
of AZT should be initiated as soon as possible, preferably within hours
following the exposure." (86) Only first aid for the injury itself
would precede AZT. Numerous medical institutions have since adopted this
policy, and a 1993 report in Lancet revealed the practical application.
The paper described a doctor who was accidentally stuck by a needle and
thus exposed to HIVinfected blood. The doctor began taking AZT within
the hour, and continued for six weeks-too quickly even to do an HIV test.
(87) Thus, medical workers may use AZT even if they never become infected
with HIV. (88) But this doctor became HIVpositive despite the toxic
prophylaxis.
A second and more disturbing announcement reached the public in the
summer of 1989. NIAID, the NIH division under Anthony Fauci, declared it
would be conducting trials of AZT on pregnant mothers infected with HIV.
A drug that interferes with growth can lead only to physical deformities
in babies developing in the womb. The study, financed through the NIH budget,
ironically recruited mothers who had been injection drug addicts. Apparently
Fauci believes heroin addiction poses less of a threat to children than
does HIV; some of their babies, moreover, may never even contract the virus
from their mothers but will receive AZT anyway. Following his lead, the
French joined Fauci's trial, and the British government, in 1993, began
on its own a study of AZT effects on HIVpositive babies. (89)
However, to prescribe a known mutagenic drug to a pregnant woman was
a risky departure from the foremost medical principle,: "First, do
no harm." According to AIDS reporter Celia Farber in April 1995:
Though AZT is widely claimed to have been deemed "safe" in
pregnant women, in fact, the FDA did not think so and never allowed pregnant
women to take it prior to this study, primarily because it was classified
as mutagenic. Another mutagenic drug, Thalidomide, was prescribed as a
sedative throughout Great Britain and Germany in the 1950s but was never
approved in the U.S. Thalidomide was responsible for over 10,000 birth
defects in children born to mothers who had taken the drug during gestation.
Many of the infants were born with missing or partially missing limbs.
From that point on, no potentially mutagenic chemical was to be taken by
pregnant women, for any reason. AZT in pregnant women represents a radical
break in this tradition. (90)
In February of 1994, Fauci's AmericanFrench trial on pregnant women
was abruptly terminated. Fauci and his collaborators claimed victory because
AZT had reduced "maternal HIV transmission rate by twothirds"-from
25 percent without treatment to 8 percent with AZT treatment. (91) This
euphemism was chosen for the net result that out of 180 babies born to
AZTtreated mothers, 13 had been found HIVpositive, compared to
40 out of 184 born to placebotreated mothers. (93) In other words,
to save 27 babies (17%) from HIV infection, 180 mothers and 153 of their
unborn infants (who either did not pick up HIV from their mothers or picked
it up despite AZT) were first treated for six to twenty weeks every five
hours with 100 mg AZT and then again intravenously during delivery. In
addition, the newborn babies were given 2 mg AZT every six hours for the
first six weeks of their lives. (93)
In view of the possible genetic damage from AZT, Fauci acknowledged
"longterm follow up of all of the children... is essential to
learn more about the risks and benefits of the treatment beyond these encouraging
early results." Recommendations on treatment were said to be "pending
developments of consensus on the balance between known benefits and unknown
risks." (94)
There is of course a double irony in this apparent caution. First, the
benefit of being HIVfree is currently not known, because there is
no proof that HIV causes AIDS. (95) Second, the risk of AZT is certainly
not "unknown"-thirty years after it was first developed to kill
human cells for cancer chemotherapy.
After declaring victory against HIV transmission, the doubleblind controls
were officially broken prematurely and AZT was offered to all mothers.
(96) Clearly, the 124 primary and secondary authors of the maternal transmission
study achieved "consensus" on playing down the "adverse
experiences" of babies on AZT, acknowledging only that the level of
"hemoglobin at birth in the infants in the Zidovudine group was significantly
lower than in the infants in the placebo group." (97) However, the
"neutropenia, high bilirubin levels, and anemia" reported prior
to final publication (98) were not documented in the consensus paper. (99)
The AZTinduced neutropenia, the medical term for a critical shortage
of the majority of immune cells in the blood, could very well be the explanation
for the AZTmediated reduction of HIV transmission. Since HIV replicates
in blood cells, and blood cell synthesis is inhibited by AZT, it is no
surprise that HIV is less likely to be transmitted if the cells in which
it replicates are killed by AZT, troth in the mother and the unborn child.
An editorial in Lancet did not share Fauci's optimism: "The
most worrisome aspect is the possibility of longterm adverse effects
on children exposed to Zidovudine (AZT) during fetal life, especially since
the vast majority would not have been infected anyway." (100) Indeed,
the asyetunpublished side effects of the AmericanFrench
study confirm this sinister projection. According to Farber's article:
"There were two birth defects: One had extra digits and a heart defect,
the second had an extra digit on both hands. The report concluded that
neither case was related to AZT therapy." (101)
A formal request by the New York Native for an official account
of the unpublished birth defects was denied by the Assistant Secretary
for Health, Dr. Philip R. Lee. Lee advised the reporter on January 6, 1994,
to "sue the federal government." (102)
But a study from outside the United States provided a clearer picture:
Eight spontaneous abortions, eight "therapeuti", abortions, and
eight serious birth defects including extra digits were recorded among
babies of 104 HIVpositive pregnant women treated with AZT. (103)
The trust in medical authority breaks down
Long-term survivors of AIDS know better than to use AZT. Michael Callen
was diagnosed with fullblown AIDS in 1982 before HIV had even been
isolated. Given little time to live, he discovered Joe Sonnabend and switched
doctors. Callen had participated in the fasttrack homosexual scene
for a decade, including sex with more than three thousand partners and
the attendant drug abuse. His lifestyle changed radically on Sonnabend's
advice, although he began taking enormous amounts of antibiotics and sulfa
drugs. Because of his cleanedup lifestyle and his ongoing refusal
to take AZT, Callen lived twelve years with an AIDS diagnosis until he
died with pulmonary Kaposi's sarcoma in 1994. He told his story in his
1990 book Surviving AIDS, along with the stories of several other
longterm survivors who tend to avoid AZT. For that matter, the CDC
estimated that one million Americans had HIV by 1985, but twothirds
of those have not developed AIDS at all in the past ten years. Most HIVpositives
have never received AZT.
In New York, Michael Ellner runs a selfhelp group to help AIDS
patients live. Named HEAL (HealthEducationAIDS Liaison), it strongly
advises members against AZT. And a 1990 article in Parade magazine
profiled thirteen AIDS cases who had survived their diagnosis for five
years. They rejected AZT as counterproductive. "It's incredible, isn,t
it, that the drug designed to save you can also kill you," says Mike
Leonard, a survivor. "It can make you anemic, and you end up having
to get blood transfusions." (104)
In London HIVpositive male homosexuals ar risk for AIDS formed
a survivor group called "Continuum." In August 1993 there was
no mortality during 1.25 years in all 918 members of that group who had
"avoided the experimental medications on offer" and chose to
"abstain from or significantly reduce their use of recreational drugs,
including alcohol." (105) Assuming an average tenyear latent
period from HIV to AIDS, the virusAIDS hypothesis would have predicted
at least 58 (half of 918/10 x 1.25) AIDS cases among 918 HIVpositives
over 1.25 years. Indeed, the absence of mortality in this group over 1.25
years corresponds to a minimal latent period from HIV to AIDS of more than
1,148 (918 x 1.25) years. As of July 1, 1994, there was still not one single
AIDS case in this group of 918 HIVpositive homosexuals. (106)
Other individuals began to take their health in their own hands rather
than rely on medical authority for the "treatment" of HIV. In
terms of notoriety, the list is led by one of the nation's top basketball
stars, Earvin '"Magic" Johnson. In November 1991, Magic proved
to be HIVpositive when he applied for a marriage license. Magic was
totally healthy until AIDS specialists Anthony Fauci, from the NIH, David
Ho, now director of the Aaron Diamond AIDS Research Center in New York,
and Magic's personal doctor advised AIDS prophylaxis with AZT. Magic's
health changed radically within a few days. The press wrote in December
1991: "Magic Reeling as Worst Nightmare Comes True-He's Getting Sicker."
Only after he began taking AZT did Magic's health begin to decline. He
"had lost his appetite and suffered from bouts of nausea and fatigue"
and complained. "I feel like vomiting almost every day." (107)
But then suddenly Magic's AIDS symptoms disappeared-and so did all further
news about his AIDS symptoms and treatment. Had Magic's virus suddenly
become harmless, or was Magic taken off AZT? No paper would mention whether
Magic was taken off AZT. Nobody knew, except those who joked, "There
is no magic in AZT, and there is no AZT in Magic.," Indeed. it is
very unlikely that he could have won the Olympics in 1992 on AZT, considering
his strong reactions to the toxic drug in 1991. The silence of the AIDS
establishment seems to confirm this assumption. Nothing would have been
a better advertisement for the troubled AIDS drug than having returned
AIDS patient Magic to an Olympic victory. But no such announcement was
made. At last Magic broke the silence himself. After a "motivational"
AIDS talk in Tallahassee, Florida, in the spring of 1995, Magic responded
to a teacher that "He had been taking AZT for a while, but has stopped."
(108) The media preferred not to mention the news.
About six years earlier another young man fought the battle of his life,
having been discharged by the U.S. Navy for being HIVantibodypositive.
Raphael Lombardo has won his oneman campaign against the Navy and
the AIDS establishment all by himself. His letter proves that true science
does not depend on institutional authority:
To: Dr. Peter Duesberg
From: Raphael Sabato Lombardo
Date: May 30, 1995
Subject: Life without AZT !!!!!!!!!!!!!!!!!!!!!!!!
Dear Dr. Duesberg,
My name is Raphael Sabato Lombardo, 33 years old and from Cape Coral,
FL. I am writing in regards to the enclosed magazine article from this
month's issue of Men's Style. I was thrilled to read that there was someone
in the medical profession who shared the same views I've had for so many
years.
I am an HIV positive individual. I learned of my HIV status while in
boot camp in the U.S. Navy back in 1985 (I could have very possibly been
HIV positive 7 years before that). The Navy wanted to discharge [me] and
others and dishonorably at that. Feeling my constitutional rights were
being violated, [I] and several others dragged the U.S. Navy into the Federal
District Courts of Washington, D.C. for one of the very first AIDS litigation
cases ever. I was acting spokesperson for the group. The enclosed newspaper
articles will give you some insight into exactly what transpired during
this time. (109)
Going back to my small hometown after all of this publicity was not
easy. Remember, this was 1985, a time when HIV was called the HTLV III
virus and anything and everyone associated with it meant complete and utter
doom (physically, spiritually, societally, politically, etc.-or so they
thought)! After discharge, my parents and family insisted I come home and
finish school. Education was always stressed in our household and looked
upon as the only means of moving ahead in life. My parents, who were at
great risk of losing their Mom and Pop Italian deli business (which still
exists today) also wanted me home so I could do the most important thing,
maintain my health. Although met with discrimination and much verbal and
physical abuse as well, I did go home and received my bachelor's in business
from the University of South FloridaFt. Myers. The past 6 years I
have been working as a field auditor for the largest and oldest newspaper/magazine
circulation auditing firm in the world (The Audit Bureau of Circulations-ABC).
I love the work and the job is 100% travel which has afforded me the opportunity
to see and experience all that this great country has to offer. It was
the love, encouragement and support of my family that pulled me through
and the faith in our Lord that sustains us all.
Myself and the other recruits (those who are left) still remain a closeknit
group. The bond will forever exist. Several have died of AIDS and several
have AIDS. As for myself I've remained completely asymptomatic thank God!
To be honest, in regards to HIV, I haven,t seen a doctor since the day
I was discharged. While in the Navy, we were subjected to incompetent Navy
doctors who often gave us inaccurate medical results. As a result, I came
to trust no one in the medical profession. I decided to take things into
my own hands. I spent countless hours in the medical library at the Bethesda
Naval Hospital which is where we were being held and did research on one's
immune system and all AIDS information available up to that point in time.
Since no drugs had yet been approved by the FDA, there were no forms of
treatment available. I came up with my own form of natural healthcare which
I follow to this very day. I guess you could say that the General Nutrition
Center-GNC, Reebok step, weightlifting and good pasta is what keeps me
going.
Shortly after discharge, AZT was approved by the FDA. My family and
friends wanted me to jump on the bandwagon immediately! I can't explain
why, but I outright refused. There was this inner voice that kept telling
me, and continues to tell me, to just stay away from medication. Even back
then I had a feeling that taking this medication and going on drug experimental
trials would do nothing more than provoke the onset of the disease. Again,
this feeling was based not on medical data or research, just an inner gut
feeling. I guess you could say my spirit guides or guardian angels have
been working overtime. By not going on medication, my family and friends
felt I was exhibiting the same "ignorance" and "foolishness"
that got me into this mess in the first place. We had countless heated
argument over this, but I told them my mind was made up and that was that-period.
We Italian men can often times be quite stubborn! Actually, my dad is the
only one who agrees with me. That is reflective in our conversations which
last no longer than a couple of seconds. He only has 2 questions for me.
First, are you still eating a lot? Second, are you still hitting the gym?
If I answer yes to both of these questions, then he knows I,ll be OK. Sounds
like such a simple philosophy for such a complex virus, but Jesus was such
a simple man and people make him out to be so complex.
I learned about "love" and "relationships" in the
underground gay subculture in New York's West Greenwich Village while in
my teens. Unfortunately, very unfortunately, that was all that was available
to gays at that time. I would have much rather have asked out someone my
own age for a date and taken a nice drive down to Fort Myers Beach or
Sanibel Island like all kids my age did, but society wouldn,t hear of
it. Society still wouldn't hear of it. I hope to change all that.
During those years of experimenting, exploring and even rejoicing in
my God given sexuality, I did the bathhouse scene, the "Saint"
parties, the S&M sex clubs, the backroom bar scenes, the group sex,
etc. I guess you could say that sexually, I did it all. I was curious,
knew exactly what I wanted to do and experience, and did just that. Something
I'm proud of? No! It's just the way it happened. Again, this was all society
felt, and still feels, gays are worthy of. While I was part of the "gay
scene" in this respect, I always felt I wasn't at all in other respects.
At about the same time as my Navy situation, I began hearing more and
more of guys I had dated in N.Y.C. who had died or were dying of AIDS.
I speak of approximately z dozen friends (that I am aware of, there's probably
more) who have died of AIDS from 1985 to 1995. They are all gay men (except
for 1 woman). These men were also very much into recreational drugs (steroids,
poppers, marijuana, cocaine, ecstasy, etc.). They ranged in age from mid
twenties to mid forties. I don't know at what point they started using
the drugs such as AZT, ddI etc. I found out my HIV status while I was in
the Navy and didn't even know I was being tested and had not experienced
any signs or symptoms of the disease. I don't know if these other friends
of mine had already progressed to ARC and fullblown AIDS before finally
deciding to get tested and go on medication or they took it upon themselves
early on to have the test done before experiencing any symptoms and then
progressed from simply testing HIV positive and then progressing to ARC,
fullblown AIDS and eventually death. My personal suspicion is that
these individuals were not aware of their HIV status until they started
experiencing physical complications. My friends who were sick and died
since the late eighties were taking mega doses of AZT (approximately 12
pills a day). I hear that dosage has been greatly reduced. My friends today
take several pills of AZT daily. I'm not sure what the dosage is for any
other drugs that they're on.
In regards to the woman I mentioned, she was a heterosexual, and in
her late twenties. I am not certain how she contracted the disease. She
was married with a set of twins that were merely a few years old at the
time of her death last year. I believe she suffered approximately 3 years
and was on AZT and several other drugs for most of that time. An unfortunate
tragedy! Her husband and children test negative.
I started to ask myself why I wasn't developing any of the classic symptoms?
I literally sat down and made a chart of the similarities between myself
and all of these guys who had become sick. I've duplicated it here for
you:
|
Raphael |
Friends |
oral sex (giving) |
great amount |
great amount |
oral sex (receiving) |
great amount |
great amount |
anal sex (giving
no rubbers) |
moderate amount |
uncertain |
anal sex (receiving
no rubbers) |
limited amount |
uncertain |
fisting (giving) |
several times |
limited |
fisting (receiving) |
never |
uncertain |
deep mouth to
mouth kissing |
very heavy |
moderate to heavy |
rimming (giving) |
very heavy |
moderate to heavy |
rimming (receiving) |
very heavy |
moderate to heavy |
poppers |
never |
heavy use |
marijuana |
never |
moderate to heavy |
cocaine |
never |
moderate to heavy |
special K |
never |
moderate to heavy |
ecstasy |
never |
moderate to heavy |
alcohol
consumption |
don't drink |
moderate to heavy |
smoking |
zero |
moderate to heavy |
steroid use |
never |
heavy |
weightlifting |
great amount |
great amount |
nutrition |
excellent |
pretty good |
vitamins |
heavy use |
uncertain |
sleep habits/rest |
excellent |
fair |
AZT |
zero |
heavy, heavy use |
ddI |
zero |
heavy, heavy use |
other experimental
drugs |
zero |
heavy, heavy use |
Looking at this, the only commonality with myself and the others is
the sex. In regards to the drug issue, I'm probably the only gay male who
could answer the way that I have (those answers still hold true for me
today a decade later). As I said, my spirit guides or guardian angels have
certainly been working overtime for me.
My reason for not succumbing to the ill temptations of drugs is simple.
I never, ever had the desire or curiosity to try them. Where as with sex,
the desire and curiosity was there and I went out and did exactly what
I was looking to do. But with drugs, that desire or curiosity was never
there. I have my 2 older sisters to thank for that. You see, I lived and
spent the first 10 years of my life in the slums of New York City-East
Harlem. This was at one time a very closeknit Italian neighborhood
that my grandparents settled in when they immigrated from Italy. In the
early 1970's, the neighborhood started to change drastically (crime, drugs
etc.). My sisters and I (I have 3 great sisters) attended the Catholic
grammar school up the street from the tenement building in which we lived.
When we would leave our building in the morning we would more often than
not be greeted by junkies rolling around in the gutter, shooting up their
drugs, clothes all torn, battered and bruised bodies, etc. It was horrifying!
My 2 older sisters would shield my younger sister and I when passing by.
Each day my older sisters would say, "You see that's just what happens
to you when you try drugs." That is all it took. Those words stayed
with me for life. As a result, the desire or curiosity to experiment with
drugs was never there for me. I guess something could be said for scare
tactics.
With regards to HIV, I've always sensed that drugs, or lack of them,
has played a big part in keeping me going while so many others have been
less fortunate. Another thing I'd like to add is that as a workout enthusiast,
I've never experimented with steroids, which unfortunately runs so very,
very rampant amongst gays and in my opinion is ravaging the gay community.
Amongst other things, it severely compromises one's immune system. To me,
there's nothing wrong with good old fashioned, honest hard work.
Several months ago, USA Today ran a story about a talent agency
out in California which last year opened a modeling division which strictly
promotes HIV models. The name of the agency is the "Morgan Agency"
and it's located in Costa Mesa, CA. The owner of the agency is Mr. Keith
Lewis. Mr. Lewis wanted to dispel the myth that HIV individuals are all
emaciated looking people on their deathbeds. He named this division "Proof
Positive" and within one year it has been the fastest growing division
in his talent agency. Some big name advertisers (such as Nike) have used
his models. He feels this segment is going to boom. Well, after reading
this article, I wrote Mr. Lewis and sent him some recent snapshots (which
l've enclosed for you). Well, Mr. Lewis called me a few weeks ago. He said
he couldn't think of anyone who embodies the spirit or philosophy any better
than me and would love to have me as part of his "proof positive"
family. He's started to promote me to advertisers immediately. I certainly
hope something comes of that.
According to the article I've read, it sounds as though you've had a
pretty rough time of things in trying to gain support in the medical community
and gay community as well. I just wanted to let you know that I share the
same views and sentiments as you. If you have any questions at all or would
like to contact me for whatever reason or if I could be of any help to
you, feel free to contact me. At the time of discharge I said that if the
Good Lord sustains me for 1o years, then I would once again come forward
and open myself up to the glare and scrutiny of the public eye and media
and serve as an inspiration to millions!
This year, 1995, marks the 10 year anniversary of my Navy situation,
a milestone in many, many ways.
Respectfully,
Raphael Sabato Lombardo
The stories of those who believed in AZT
Not all AIDS victims are fortunate enough to question medical authority.
The resulting tragedies can sometimes turn into a media circus promoting
the HIV hypothesis. Of all the cases hyped up for their AIDS scare value,
the Florida woman who supposedly caught AIDS from her dentist has become
the most notorious.
Kimberly Bergalis: The story began in late 1986, in the small
town of Stuart on Florida's Atlantic coast. David Acer, a dentist who had
begun his private practice five years earlier, felt a bit under the weather
and saw a physician. Acer was also an active homosexual, a fact that led
him to seek an HIV test. The result came back positive. Although disturbed
by the news, he still felt reasonably healthy and saw no reason to stop
his dental practice, nor apparently his fasttrack lifestyle.
One year later he experienced worsening symptoms and a visit to his
doctor confirmed the diagnosis: fullblown AIDS. A Kaposi's sarcoma
covered the inside of his throat and his Tcell count had fallen dangerously
low. Both symptoms suggested the extensive use of poppers and other drugs
so common in the homosexual bathhouse scene. Acer could see his life slowly
wasting away. He continued practicing dentistry while remaining discreet
about his sexual life and failing health, making sure to follow the standard
guidelines for protecting his patients from infection.
That December, in 1987, he pulled two molars from a nineteenyearold
college student, Kimberly Bergalis. At the time he had no idea the business
major would one day be touted as his hapless victim.
The story picks up again in May 1989, when Bergalis developed a transient
oral yeast infection. Later that year, during the emotional stress of preparing
for an actuarial exam for the state of Florida, she felt some ongoing nausea,
and she became dizzy during the test itself. Afterward, the symptoms disappeared.
But a brief pneumonia that December sent her to the hospital, where the
doctor decided out of the blue to test her for HIV. As chance would have
it, she had antibodies against the virus.
Up to this point, none of her occasional diseases differed from the
common health problems many HIVnegative people encounter. But the
positive HIV test changed her whole attitude, as well as her medical treatment.
Within three months the CDC had heard of her case, possibly aided by the
presence of several EIS members in the Florida health department, and sent
investigators to probe further. The CDC team included such EIS members
as Harold Jaffe, Ruth Berkelman, and Carol Ciesielski. Bergalis denied
any intravenous drug use or blood transfusions and insisted she was a virgin.
During the prolonged examination, the CDC officers stumbled across David
Acer's positive HIV status and made the connection to Bergalis. Before
the HIV hypothesis of AIDS, no medical expert in his right mind would ever
have entertained the slightest thought that a dentist with a Kaposi's tumor
and a patient with a yeast infection had anything in common. But in the
era of AIDS, doctors tended to discard common sense. That the dentist and
patient both carried a dormant virus was enough.
Excited by its discovery, the CDC boldly advertised its results in its
weekly newsletter, the same one that nine years earlier had broadcast the
first five AIDS cases. The July 27, 1990, issue prominently featured their
amazing leap of logic-that the dentist must somehow have infected Bergalis.
Naturally, the CDC's speculation leapt straight to the front pages and
primetime television news broadcasts.
Acer died in early September 1990. Bergalis meanwhile sought medical
care at the University of Miami, where she was treated with an unidentified
"experimental" method. Certainly this was the appropriate place
for such therapies. Margaret Fischl, the head of the Phase II AZT trial,
worked at that medical center, which had served as one of the twelve facilities
sponsored by Burroughs Wellcome for the study. So Bergalis was prescribed
AZT. (110)
Suddenly she started a precipitous decline in health. In an angry letter,
she partly acknowledged her symptoms resulted from the toxic drug:
"I have lived through the torturous ache that infested my face
and neck, brought on by AZT. I have endured trips twice a week to Miami
for three months only to receive painful IV injections. I've had blood
transfusions. I've had a bone marrow biopsy. I cried my heart out from
the pain." (111)
This represented only the beginning. Her yeast infection worsened and
became uncontrollable, she lost more than thirty pounds, her hair gradually
fell out, her blood cells died and had to be replaced with transfusions,
and her muscles wasted away. Her fevers hit highs of 103 degrees, and by
late 1990 her Tcell count had dropped from the average of 1,000 to
a mere 43. She looked just like a chemotherapy patient which she
now was.
The CDC saw its golden opportunity in the Bergalis case. It publicized
a second report on the Bergalis case, announcing its belief that four of
Dr. Acer's other patients had also been infected by him, and even surveyed
the patients of other HIVpositive doctors and dentists suggesting
that all HIVpositive patients had also been infected by their doctors.
Such CDCfunded organizations as Americans for a Sound AIDS Policy
aggressively promoted public fear with these speculations. A media feeding
frenzy resulted, with every major television talk show, and every national
magazine, running scare stories. (113) The CDC's relentless publicity had
its expected effect: By mid1991, more than 90 percent of the public
believed HIVpositive doctors should be forced to inform their patients
of their status, and a clear majority favored banning such doctors from
medical practice. (113) Many doctors, angered by the publicity campaign,
"accused the federal Centers for Disease Control of unduly alarming
the public." (114)
The CDC certainly had an agenda behind its campaign. In July of 1991,
the agency issued a set of proposed rules that would require doctors to
follow extraordinarily burdensome measures. supposedly to protect their
patients from HIV infection. By hyping up the Bergalis case, the CDC had
created enough public panic and backlash to favor its proposed regulations.
To dramatize the point, Bergalis was brought in to testify before a stunned
Senate in October of 1991. Her muscles largely destroyed by AZT, she had
to be brought in a wheelchair. Her furious testimony, whispered into the
microphone, made a powerful emotional impact on the attentive congressmen
and the television audience.
Congress soon passed a new law requiring the states to adopt the CDC
guidelines-or else begin losing federal funds. When the medical profession
resisted the new rules, the Occupational Safety and Health Administration
(OSHA), which works closely with the CDC, stepped in with parallel rules
of its own. On threat of criminal prosecution, laboratory and medical workers
must now follow incredibly restrictive regulations on their practices and
equipment, and must deal with extra bureaucratic red tape.
Blaming her deteriorating condition on the latent virus supposedly passed
on by her dentist, Bergalis sued the Acer estate. She received a $1 million
award, plus unannounced compensation from the dentist's insurance company.
She parceled out the money to a variety of friends, family members, and
AIDS organizations, and told her father to purchase '"a new, red Porsche
and deliver it to my aunt with a large bow on top." (115) Had she
known better, she could have instead sued Burroughs Wellcome.
Bergalis died in December 1991 at twentythree years of age, having
taken AZT for up to two years. Her death became the ultimate symbol of
the deadly powers of HIV. No one pointed out that, according to the HIV
hypothesis, the virus should take ten years to kill its victims, particularly
someone like Bergalis with no other risk factors. She had died within four
years of her initial visit to Dr. Acer. As her symptoms would indicate,
AZT must have killed her instead.
In December 1992, another former patient of Dr. Acer tested positive
for HIV, but had no symptoms. Two months later, eighteenyearold
Sherry Johnson began taking AZT. She has since begun wasting away, admitting
she periodically feels sick.
The CDC continued to exploit the Bergalis story as proof of the risk
of doctortopatient HIV transmission. Some eleven hundred of Acer's
two thousand former clients volunteered for HIV tests. Seven of these were
positive, including Bergalis, two of them having standard risk factors
for AIDS. That left five people who supposedly caught the virus from Acer.
Expanding its search, the CDC tested almost sixteen thousand total patients
of some thirtytwo HIVpositive doctors around the country, finding
eightyfour infected patients. Though admittedly baffled by how HIV
could pass from doctors and dentists to the patients, the CDC nonetheless
advertised the alleged threat. Curiously, when confronted with an unexpected
outcome for an unproved test, the CDC did not proceed with caution. It
published its findings in July 1990 without further verification.
Apart from HIV being a harmless virus, the evidence that this virus
has ever been medically transmitted remains dubious. Based on their own
research, insurance companies concluded that the HIV strains in the five
patients were different from that in Acer, meaning each caught it from
a different source. (116) A study out of Florida State University has backed
this conclusion. (117) Even the CDC acknowledged this evidence, though
it still preferred to believe the dentist had infected Bergalis. But the
CDC's own numbers give away the reality. An estimated 1 million Americans
have HIV, in a total population of 250 million. Thus, 1 in 250 Americans
have the virus. Five HIVinfected patients of Dr. Acer, out of 1,100
tested, comes to 1 in 220, virtually identical to the national average.
So does the proportion of HIVpositives from the patients of the 32
doctors, which works out to 1 in 188. These HIVpositive patients merely
represent random samples from the general population.
And where did these people get the virus? HIV is probably transmitted
much as other retroviruses, from mother to child during pregnancy. There
is no evidence that Kimberly Bergalis's mother has never been tested for
HIV antibodies, nor that the mothers of Dr. Acer's other patients were
tested. Perhaps Kimberly carried the harmless virus for twentythree years.
The CDC's theory that AIDS was transmitted from Dr. Acer to his patient
began to crumble in the mainstream press in 1994 when an investigative
reporter researched the alleged victims of Dr. Acer. "He found weak
evidence, shoddy science, and the work of a very accomplished malpractice
attorney." (118)
The report first casts doubt on the time course of AIDS transmission
from Dr. Acer to his patients. "She developed AIDS just two years
after the surgery, and only 1 percent of HIV positive patients develop
the fullblown disease that quickly." (119) The investigation
disclosed that one of the six other patients that Acer presumably infected
had visited the dentist's office only once for a cleaning by a hygienist,
not by Acer himself. (120) The report further calls into question the exclusive
reliance of the CDC and the malpractice attorney of the "Acer six"
on the DNA fingerprinting technique to match Acer's virus with those of
his patients. This same technique had also been used to determine that
the NIH researcher Gallo had claimed HIV obtained from his French rival
Montagnier as his own. Several experts have directly challenged the DNA
fingerprinting that linked Acer to his patients, claiming that instead
Bergalis's virus matched other HIV strains much more closely. (121) In
view of this, a writer in the New York Times commented, "The
CDC owes it to the public to reopen [Acer's] case." (122)
The reinvestigation of the "Acer six" provides unknowingly
yet another reason why the "CDC owes it to the public to reopen [this]
case": It supports the hypothesis that AIDS is caused by recreational
drugs and AZT. Only three of the "Acer six" have developed AIDS,
and every one of them was on drugs: Bergalis was on AZT; a thirtyyearold
male was involved with "drug dealers, and a homosexual relationship;"
and another male was a "notorious crack head." (123)
While on AZT, Bergalis once told a reporter she hoped to also get dideoxyinosine
(ddI), another experimental AIDS drug. This drug and ddC, two products
of cancer chemotherapy research, work in precisely the same way as AZT.
Chemically altered building blocks of DNA, they enter the growing chain
of DNA while a cell is preparing to divide and abort the process by preventing
new DNA building blocks from adding on. So, like AZT, ddI and ddC kill
dividing cells and have similar toxic effects. They destroy white blood
cells and therefore can cause AIDS. The only difference between ddI, ddC,
and AZT lies in how easily each is absorbed into the body; people who absorb
one evidently may not be equally affected by the other.
Alison Gertz: Both ddI and ddC have begun to claim their victims.
In 1988, twentytwoyearold New York socialite and aspiring
graphic artist Alison Gertz entered the hospital for a fever and diarrhea.
At some point the doctor decided to test for HIV and found antibodies against
HIV. Gertz's transient illness was rediagnosed as AIDS. She had not injected
drugs, although her wilder days at Studio 54 bespoke the cocaine and other
free drugs available to patrons. A process of elimination traced her infection
to a onenight stand with a bisexual male-six years earlier. The announcement
left her feeling depressed, but she began a lecture circuit at high schools
and colleges, admonishing students that AIDS could come from a single sexual
encounter. Television talk shows followed, as did the cover of People
magazine and Woman of the Year for Esquire. Even the World Health
Organization circulated a documentary featuring her story.
Gertz started AZT treatment in 1989. The 1990 People magazine
profile recounted the consequent disaster:
Last October she was hospitalized with a severe allergic reaction to
AZT. When doctors called for a lung biopsy, Ali balked. "I told them
if they put me to sleep, I'd never wake up," she says. '"My strength
was gone." Released after 17 days, she recuperated at home, where
her mother and girlfriends took turns nursing her around the clock. "They'd
help me to the bathroom, feed me, see that I didn't fall in the shower,"
says Ali. '"My knees were so bony' I had to sleep with a pillow between
them."(124)
The doctors switched her to the stillexperimental ddI, which Gertz
apparently did not absorb as well and thus allowed her partly to recover.
She mixed the powder in her drink twice every day. Her immune system and
general health declined, though more slowly. "Gertz remains susceptible
to infections like thrush, a fungus that frequently affects the mouth,"
stated the People article. "She has lost 30 lbs. since last
summer, naps each afternoon and continues to visit her doctor every 10
days." (125) Ultimately, the ravages of the chemotherapy took her
life in August 1992, the news media advertising her death as AIDSrelated.
She was only twentysix.
A backlash is now rising against the toxic and irrational treatment
approaches to AIDS. In 1993, during the Ninth International AIDS Conference
in Berlin, Germany, medical reporter Laurie Garrett was interviewed on
the MacNeilLehrer News Hour. She described the growing discontent
among scientists and patients alike:
Most drug trials were terminated early. The AZT trial was terminated
early, ddI, ddC, and so on, and people were allowed as soon as there was
any sign that something showed promise to jump out of the placebo arm and
get into the treatment arm...
Dr. Anthony Pinching, who was really the leader of most of the clinical
research related to AIDS in the United Kingdom, gave a very important speech
this morning. I think if he had given this precise same speech a year ago,
he would have been booed off the stage, and this morning, he was applauded
heavily. And what he basically was saying was we have no idea what drugs
work. We have no idea what we're doing in treatment, and it's time to return
to the use of placebo trials. He went a step further and said that at least
in Europe a lot of AIDS activists and patients now agree, because they're
shocked to find out that the drugs they've been taking, thinking they would
be helpful, might even be hurtful. (126)
Arthur Ashe: This lesson almost saved the life of the late Arthur
Ashe, the tennis star and onetime Wimbledon champion who died in 1993,
supposedly of AIDS. Ashe's medical problems surfaced in 1979 with a heart
attack, despite his young age of 36. In December he underwent quadruplebypass
surgery. His chronic heart condition continued plaguing him, and by 1983
he had doublebypass surgery. A blood transfusion during either one
of the operations may have carried HIV.
His heart condition and its complications nagged him for several years.
Then in 1988 he entered the hospital for toxoplasmosis, a protozoa! disease
relatively uncommon in humans. The germ resides in cattle and household
pets, and in 17 percent to 50 percent of the U.S. population, but most
people never succumb to the disease because of healthy immune systems.
This also happens to be one of the many diseases on the AIDS list, so the
doctor tested and found Ashe to be HIVpositive. Although his toxoplasmosis
soon disappeared, Ashe was pronounced an AIDS victim. His disease was retroactively
blamed on HIV, not on his heart condition.
Yet his condition hardly seemed contagious. Neither his wife nor his
daughter, born three years after his second transfusion, ever developed
any AIDS conditions. Indeed, his immune system must have neutralized HIV
quite effectively, as Ashe never transmitted the virus to his family.
His daily medicine intake expanded to a virtual pharmacy. He continued
to take several drugs for his heart problems, one to lower cholesterol
by interfering with liver function, another to slow down the heartbeat,
and three others, including nitroglycerin, to lower blood pressure. To
these his doctors added a spectrum of antibiotics, all with mild to serious
side effects, to prevent the possibility of opportunistic infections. Ashe
took Cleocin to fight further toxoplasmosis, nystatin to slow down yeast
infections, and toxic pentamidine to stave off Pneumocystis pneumonia.
Two other drugs were prescribed against possible brain seizures. Eventually
his daily regimen included some thirty pills, only a few of them vitamins.
But just as soon as Ashe received his AIDS diagnosis in 1988, his doctor
pushed him into taking AZT. He started on an unbelievably high dose, nearly
double the seriously toxic levels used in the Phase II trial. His doctor
only gradually lowered the dose over the next four years. "I refuse
to dwell on how much damage I may have done to myself taking the higher
dosage," Ashe later admitted. (127)
In early 1992 he established an acquaintance that came close to rescuing
him. A close friend arranged a series of meetings with Gary Null, a New
Yorkbased radio talk show host and nutritionist. Null introduced Ashe
to the evidence of AZT's toxicity and against the HIVAIDS hypothesis,
desperately trying to convince him to halt the therapy. For the next ten
months, Ashe "'wrestled with the possibility of breaking away from
the medical establishment to seek alternative treatment for AIDS,"
according to one columnist. Ashe never met Peter Duesberg, but became familiar
with his arguments. "He read everything; he studied what we gave him
and asked lots of questions," recalled Null. (128) In October, Ashe
announced the lessons he was learning in a column he wrote for the Washington
Post: "The confusion for AIDS patients like me is that there is
a growing school of thought that HIV may not be the sole cause of AIDS,
and that standard treatments such as AZT actually make matters worse. That
there may very well be unknown cofactors but that the medical establishment
is too rigid to change the direction of basic research and/or clinical
trials." (139) But psychological pressure stopped Ashe short from
rejecting AZT. As Null stated, "He wanted to do it, but he would say,
"What will I tell my doctors?,"(130)
In his 1993 book, Days of Grace: A Memoir, Ashe openly acknowledged
his interest in alternative AIDS hypotheses:
But AZT was controversial in other ways. A gift from heaven to many
desperate people, it was poison to others. Developed for use in cancer
chemotherapy to destroy cells then in the process of actively dividing,
AZT was only later applied to AIDS. Some scientists believe that AZT, which
relentlessly kills cells but cannot distinguish between infected and uninfected
cells, is as harmful as AIDS itself. After all, HIV is present in only
1 of every 10,000 Tcells, which are vital to the immune system; but
AZT kills them all. Dr. Peter Duesberg, the once eminent and now controversial
professor of molecular and cell biology at the University of California,
who bitterly disputes the notion that HIV causes AIDS, has called AZT "AIDS
by prescription."
Dr. Duesberg argues that the use of recreational drugs, not sex, led
to AIDS. It is well known that many gay men used- and many of them continue
to use-drug stimulus in sexual activity or to facilitate intercourse. "Natural
and synthetic psychoactive drugs," he has argued (drugs such as cocaine,
amphetamine, heroin, Quaaludes, and amylnitrites and butylnitrites, or
"poppers"), "are the only new pathogens around since the
1970s and the only new disease syndrome around is AIDS, and both are found
in exactly the same populations. " (131)
Ashe faithfully summarized the main points against the HIV hypothesis
and for the drugAIDS hypothesis and explained the deadly effects of
AZT and the flaws of its Phase II trial. "Some tolerate [AZT] for
a while, then must give it up. Still others cannot tolerate it at all,"
wrote Ashe. "To my relief, I tolerate AZT fairly easily." (132)
With that rationalization, he sealed his fate.
During 1992, his doctors placed him on ddI. Each morning he sprinkled
the powder on his cereal, in addition to the AZT pills he swallowed throughout
the day. By this time he was wasting away rapidly, his underweight frame
hidden by loose clothes. He began rotating in and out of the hospital.
January of the following year brought more bad news: Now he had a serious
case of Pneumocystis pneumonia that his poisoned immune system could
no longer fight off. He never recovered. On February 6, 1993, he breathed
his last.
The list of celebrity AIDS patients who died on AZT for their belief
in medical authority includes ballet star Rudolf Nureyev, who died in 1993,
Randy Shilts, the author of the bestseller And the Band Played On,
who died in 1994 and many more.
As a thoroughly politicized epidemic, AIDS began with a falsehood and
ended in tragedy. Virus hunters in the CDCdirected public health movement
first made the new syndrome appear contagious. Virus hunters in the NIHfunded
research establishment then blamed AIDS on a retrovirus. And virus hunters
in the NIH, CDC, FDA, and pharmaceutical industry exploited the situation
by resurrecting failed cancer chemotherapeutic drugs for AIDS treatment.
In the crisis atmosphere created by the CDC, which allowed no time to think
before acting, such toxic drugs as AZT, ddI, and ddC could bypass the normal
review procedures and achieve a sanctified monopoly status. The final results
have been an unnecessary death toll and an artificially expanding AIDS
epidemic.
To make all this possible, the virus hunters from all fields first had
to join forces. They have used their combined influence, often behind the
scenes, to mobilize the government, media, and other institutions behind
a global war on AIDS. Few outsiders have realized just how coordinated
the whole strategy has been. The story behind this war, and how its leaders
are actively suppressing dissent, is told in the rest of the book Inventing
the AIDS Virus (Regnery Publ. Inc., Washington D.C. 1996). *
References:
1. Physician's Desk Reference, 1993.
2. K. Belani, medical report on Lindsey Nagel, Park Nicollet
Medical Center, 15 Feb. 1991.
3. D. Chiu and P. H. Duesberg, "The Toxicity of Azidothymidine
(AZT) on Human and Animal Cells in Culture at Concentrations Used for Antiviral
Therapy" Genetica, 95 (1995): 103109; P. H. Duesberg, "AIDS
Acquired by Drug Consumption and Other Noncontagious Risk Factors"
Pharmacology and Therapeutics, 55 (1992): 201277; R. Yarchoan, J.
M. Pluda, C.F. Perno, H. Mitsuya, and S. Broder, "AntiRetroviral
Therapy of Human Immunodeficiency Virus Infection: Current Strategies and
Challenges for the Future," Blood, 78 (1991): 859884; G. X. McLeod
and S. M. Hammer, "Zidovudine: Five Years Later," Ann. Intern.
Med., 117 (1992): 487501.
4. K. Belani, medical report on Lindsey Nagel, Park Nicollet
Medical Center, 14 March 1991.
5. M. Hostetter, letter to Joseph McHugh, 13 Nov. 1991.
6. R. Yogev and E. Conner, "Management of HIV Infection
in Infants and Children," Mosby Year Book (St. Louis, 1992).
7. Physician's Desk Reference; Merck Research Laboratories,
The Merck Manual of Diagnosis and Therapy (Rahway, N.J.: Merck & Co.,
Inc., 1992); M. C. Dalakas, I. Illa, G. H. Pezeshkpour, J. P. Laukaitis,
B. Cohen, and J. L. Griffin, "Mitochondrial Myopathy Caused by LongTerm
Zidovudine Therapy," New England Journal of Medicine, 322 (1990):
10981105; R. J. Lane, K. A. McLean, J. Moss, and D. F. Woodrow, "Myopathy
in HIV Infection: The Role of Zidovudine and the Significance of Tubuloreticular
Inclusions," Neuropathy and Applied Neurobiology, I9 (1993): 406413;
Duesberg, "AIDS Acquired by Drug Consumption."
8. S. Nagel and C. Nagel, appeal to the Minnesota Board
of Medical Practice, 31 March 1993.
9. Ibid.
10. M. Hostetter, letter to Joseph McHugh, 11 Dec. 1992.
11. M. Hostetter, letter to Mr. and Mrs. Steve Nagel,
29 Dec. 1992.
12. Nagel and Nagel, appeal.
13. J. Parsons and K. Chandler, "Girl in Family Stricken
with AIDS Virus Dies at Age 5," Minneapolis Star/Tribune, 28 June
1993.
14. Ibid.
15. Ibid.
16. M. Samter, D. W. Talmage, M. M. Frank, K. F. Austen,
and H. N. Calman, eds., Immunological Diseases, I (Boston/Toronto: Little,
Brown and Company, 1988); Merck Index; L. S. Young, Pneumocystis Carinii
Pneumonia (New York/Basel: Marcel Dekker, Inc., 1984).
17. B. Nussbaum, Good Intentions: How Big Business' Politics,
and Medicine Are Corrupting the Fight Against AIDS (New York: Atlantic
Monthly Press, 1990).
18. S. S. Cohen, "Antiretroviral Therapy for AIDS,"
New England Journal of Medicine, 317 (1987): 629; J. Lauritsen, Poison
by Prescription-The AZT Story (New York: Asklepios Press, 1990).
19. Nussbaum, Good Intentions.
20. Ibid., 234 1 .
21. P. A. Furman, J. A. Fyfe, M. St. Clair, K. Weinhold,
J. L. Rideout, G. A. Freeman, S. NusinoffLehrman, D. P. Bolognesi,
S. Broder, H. Mitsuya, and D. W. Barry, "Phosphorylation of 3'azido3'deoxythymidine
and Selective Interaction of the 5'triphosphate with Human Immunodeficiency
Virus Reverse Transcriptase," Proceedings of the National Academy
of Sciences, 83 (1986): 83338337; P. H. Duesberg, "HIV, AIDS,
and Zidovudine," Lancet, 339 (1992): 805806.
22. Nussbaum, Good Intentions.
23. Duesberg, "AIDS Acquired by Drug Consumption,"
201277; Chiu and Duesberg, "Toxicity of Azidothymidine,"
103109.
24. Nussbaum, Good Intentions; E. A. Wyatt, "Rushing
to Judgment," Barron's, 15 Aug. 1994, 2327.
25. M. A. Fischl, D. D. Richman, M. H. Grieco, M. S. Gottlieb,
P. A. Volberding, O. L. Laskin, J. M. Leedon, J. E. Groopman, D. Mildvan,
R. T. Schooley, G. G. Jackson, D. T. Durack, D. King, and the AZT Collaborative
Working Group, "The Efficacy of Azidothymidine (AZT) in the Treatment
of Patients with AIDS and AIDSRelated Complex," New England Journal
of Medicine, 317 (1987): 185191.
26. D. D. Richman, M. A. Fischl, M. H. Grieco, M. S. Gottlieb,
P. A. Volberding, O. L. Lasking, J. M.Leedom, J. E. Groopman, D. Mildvan,
M. S. Hirsch, G. G. Jackson, D. T. Durack, S. NusinoffLehrman, and
the AZT Collaborative Working Group, "The Toxicity of Azidothymidine
(AZT) in the Treatment of Patients with AIDS and AIDSRelated Complex,"
New England Journal of Medicine" 317 (1987): 192197; Duesberg,
"AIDS Acquired by Drug Consumption"; Duesberg, "HIV, AIDS,
and Zidovudine."
27. E. Burkett, "The Queen of AZT," Miami Herald
Tropic, 23 Sept. 1990, 814.
28. Duesberg, "AIDS Acquired by Drug Consumption.",
29. Burkett, "Queen of AZT."
30. Nussbaum, Good Intentions.
31. "AZT-Cause for Concern," Dispatches, Channel
Four Television (London: Meditel, 12 Feb. 1992).
32. Ibid.
33. Duesberg, "AIDS Acquired by Drug Consumption."
34. Burkett, "Queen of AZT."
35. Fischl, Richman, Grieco, Gottlieb, Volberding, Laskin,
Leedon, Groopman, Mildvan, Schooley, Jackson, Durack, King, and the AZT
Collaborative Working Group, "Efficacy of Azidothymidine" 185191.
36. Burkett, "Queen of AZT"; J. Lauritsen, The
AIDS War: Propaganda, Profiteering, and Genocide from the MedicalIndustrial
Complex (New York: Asklepios, 1993).
37. Lauritsen, Poison by Prescription, 34.
38. Ibid.
39. Duesberg, "AIDS Acquired by Drug Consumption.",
40. M. Seligmann, D. A. Warrell, J.P. Aboulker, C.
Carbon, J. H. Darbyshire, J. Dormont, E. Eschwege, D. J. Girling, D. R.
James, J.P. Levy, P. T. A. Peto, D. Schwarz, A. B. Stone, I. V. D.
Weller, R. Withnall, K. Gelmon, E. Lafon, A. M. Swart, V. R. Aber, A. G.
Babiker, S. Ihoro, A. J. Nunn, and M. Vray, "Concorde: MRC/ANRS Randomized
DoubleBlind Controlled Trial of Immediate and Deferred Zidovudine
in SymptomFree HIV Infection", Lancet 343 (1994): 871881;
Duesberg, "AIDS Acquired by Drug Consumption.",
41. Cohen, "Antiretroviral Therapy," 629.
42. L. Garrett, "AIDS: The Next Decade," New
York Newsday, 12 June 1990, 1, 5.
43. G. Kolata, "Imminent Marketing of AZT Raises
Problems," Science, 235 (1987): 14621463.
44. Presidential Commission on the HIV Epidemic, hearings,
19 Feb. 1988,28.
45. Lauritsen, Poison by Prescription, 27.
46. Nussbaum, Good Intentions.
47. Nussbaum, Good Intentions; Lauritsen, Poison by Prescription.
48. Nussbaum, Good Intentions, 173.
49. Ibid.
50. Ibid.
51. Sigma Co., Zidovudine product label.
52. Wyatt, "Rushing to Judgment"; Lauritsen,
AIDS War; M. Chase, "DDI Decision Heralds a New FDA Activism,"
Wall Street Journal, 22 July 1991.
53. Merck Index.
54. Lauritsen, AIDS War.
55. Ibid.
56. L. K. Altman, "Experts to Review AZT Role as
the Chief Drug for H.I.V.," New York Times, 17 Sept. 1995, 38.
57. E. Dournon, S. Matheron, W. Rozenbaum, S. Gharakhanian,
C. Michon, P. M. Girard, C. Perrone, D. Salmon, P. DeTruchis, C. Leport,
and the Claude Bernard Hospital AZT Study Group, "Effects of Zidovudine
in 365 Consecutive Patients with AIDS or AIDSRelated Complex,"
Lancet, ii(1988):12971302.
58. Duesberg, "AIDS Acquired by Drug Consumption."
59. J. M. Pluda, R. Yarchoan, E. S. Jaffe, I. M. Feuerstein,
D. Solomon, S. Steinberg, K. M. Wyvill, A. Rabitschek, D. Katz, and S.
Broder, "Development of NonHodgkin Lymphoma in a Cohort of Patients
with Severe Immunodeficiency Virus (HIV) Infection on LongTerm Antiretroviral
Therapy," Ann. Intern. Med., 113 (1990): 276282.
60. Ibid.
61. "AZT-Cause for Concern."
62. Centers for Disease Control and Prevention, "U.S.
HIV and AIDS Cases Reported Through December 1993; YearEnd Edition,"
HIV/AIDS Surveillance Report, 5 (1994), 133.
63. Cohen, "Antiretroviral Therapy," 629; H.
I. Chernov, Document on New Drug Application 19655 (Washington, D.C.:
Food and Drug Administration, 1986), cited in Lauritsen, Poison by Prescription.
64. P. S. Gill, M. Rarick, R. K. Byrnes, D. Causey, C.
Loureiro, and A. M. Levine, "Azidothymidine Associated with Bone Marrow
Failure in the Acquired Immunodeficiency Syndrome (AIDS)," Ann. Intern.
Med., 107 (1987): 502505.
65. M. Till and K. B. MacDonnell, "Myopathy with
Human Immuodeficiency Virus Type 1 (HIV1) Infection: HIV1 or
Zidovudine?" Ann. Intern. Med., 113 (1990): 492494.
66. M. Scolaro, R. Durhan, and G. Pieczenik, "Potential
Molecular Competitor for HIV," Lancet, 337 (1991): 731732.
67. Duesberg, "AIDS Acquired by Drug Consumption."
68. M. D. Hughes, D. S. Stein, H. M. Gundacker, E T. Valentine,
J. P. Phair, and P. A. Volberding, "WithinSubject Variation in
CD4 Lymphocyte Count in Asymptomatic Human Immunodeficiency Virus Infection:
Implications for Patient Monitoring," Journal of Infectious Diseases,
169 (1994) :2836.
69. P. A. Volberding, S. W. Lagakos, J. M. Grimes, D.
S. Stein, J. Rooney, T.C. Meng, M. A. Fischl, A. C. Collier, J. P.
Phair M. S. Hirsch, W. D. Hardy, H. H. Balfour, R. C. Reichman, and the
AIDS Clinical Trials Group, "A Comparison of Immediate with Deferred
Zidovudine Therapy for Asymptomatic HIVInfected Adults with CD4 Cell
Counts of 500 or More per Cubic Millimeter," New England Journal of
Medicine, 333 (1995): 401407.
70. N. Ostrom, "Early Intervention: An Idea Whose
Time Has Gone?" New York Native, 28 Aug. 1995, 3539.
71. J. D. Hamilton, P. M. Hartigan, M. S. Simberkoff,
P. L. Day, G. R. Diamond, G. M. Dickinson, G. L. Drusano, M. J. Egorin,
W. L. George, F. M. Gordin, and the Veterans Affairs Cooperative Study
Group on AIDS Treatment, "A Controlled Trial of Early Versus Late
Treatment with Zidovudine in Symptomatic Human Immunodeficiency Virus Infection"
New England Journal of Medicine, 326 (1992): 437443.
72. "AZT-Cause for Concern."
73. Seligmann, Warrell, Aboulker, Carbon, Darbyshire,
Dormont, Eschwege, Girling, James, Levy, Peto, Schwarz, Stone, Weller,
Withnall, Gelmon, Lafon, Swart, Aber, Babiker, Ihoro, Nunn, and Vray, "Concorde:
MRC/ANRS Randomized DoubleBlind Controlled Trial.",
74. N. Hodgkinson, "The Cure that Failed," Sunday
Times of London, 4 April 1993.
75. L. K. Altman, "Treatment Guidelines for HIV Amended,"
San Francisco Chronicle, 28 June 1993.
76. H. Bacellar, A. Munoz, E. N. Miller E. A. Cohen, D.
Besley, O. A. Selnes, J. T. Becker, and J. C. McArthur, "Temporal
Trends in the Incidence of HIV1Related Neurological Diseases:
Multicenter AIDS Cohort Study: 19851992," Neurology, 44 (1994):
18921900.
77. J. J. Goedert, A. R. Cohen, C. M. Kessler, S. Eichinger,
S. V. Seremetis, C. S. Rabkin, F. J. Yellin, P. S. Rosenberg, and L. M.
Aledort, "Risks of Immunodeficiency, AIDS, and Death Related to Purity
of Factor VIII Concentrate," Lancet, 344(1994):791792.
78. "Head of National Cancer Institute to Quit,"
San Francisco Chronicle, 23 Dec. 1994, A12.
79. A. J. Saah, D. R. Hoover, Y. Peng, J. P. Phair, B.
Visscher, L. A. Kingsley, L. K. Schrager, and the Multicenter AIDS Cohort
Study, "Predictors for Failure of Pneumocystis carinii pneumonia prophylaxis,"
Journal of the American Medical Association, 273 (1995): 11971202.
80. K. Klinger, "Early AIDS Treatment Questioned,"
United Press International, 13 July 1995; M. C. Poznansky, R. Coker, C.
Skinner, A. Hill, S. Bailey, L. Whitaker, A. Renton, and J. Weber, "HIV
Positive Patients First Presenting with an AIDS Defining Illness: Characteristics
and Survival, British Medical Journal, 311(1995):156158.
81. C. Farber, "AIDS: Words from the Front,"
Spin, 11 Sept. 1995, 103104.
82. ACT UP, press release, San Francisco, 1995.
83. T. Hand, "Forced H.I.V. Testing Won't Help Newborns;
Flaws in AZT Studies" (letter), New York Times, 22 July 1995, 18.
84. Duesberg, "AIDS Acquired by Drug Consumption."
85. Ibid.
86. National Institutes of Health, Office of AIDS Research
and Division of Safety, "HIV Safety Notice," 23 Feb. 1989.
87. "HIV Seroconversion After Occupational Exposure
Despite Early Prophylactic Zidovudine Therapy," Lancet, 341(1993):10771078.
88. J. I. Tokars, R. Marcus, D. H. Culver, C. A. Schable,
P. S. McKibben, C. I. Bandea, and D. M. Bell, "Surveillance of HIV
Infection and Zidovudine Use Among Health Care Workers After Occupational
Exposure to HIVinfected Blood," Ann. Intern. Med., 118 (1993):
913919.
89. "Zidovudine for Mother, Fetus, and Child: Hope
or Poison?" (editorial), Lancet, 344 (1994): 207209.
90. Farber, "AIDS Words from the Front,"
189193, 214215.
91. "Zidovudine for Mother."
92. E. M. Connor, R. S. Sperling, R. Gelber, P. Kiselev,
G. Scott, M. J. O'Sullivan, R. VanDyke, M. Bey, W. Shearer, R. L. Jacobson,
E. Jimeniz, E. O'Neill, B. Bazin, F.F. Delfraissy, M. Culnane, R.
Coombs, M. Elkins, J. Moye, P. Stratton, J. Balsley, and the Pediatric
AIDS Clinical Trials Group Protocol 076 Study Group, "Reduction of
MaternalInfant Transmission of Human Immunodeficiency Virus Type 1
with Zidovudine Treatment," New England Journal of Medicine, 331 (1994):
11731180; P. Cotton, "Trial Halted After Drug Cuts Maternal HIV
Transmission Rate by Two Thirds," Journal of the American Medical
Association, 271 (1994): 807.
93. Connor, Sperling, Gelber, Kiselev, Scott, O'Sullivan,
VanDyke, Bey, Shearer, Jacobson, Jimeniz, O'Neill, Bazin, Delfraissy, Culnane,
Coombs, Elkins, Moye, Stratton, Balsley, and the Pediatric AIDS Clinical
Trials Group Protocol 076 Study Group, "Reduction of MaternalInfant
Transmission"; Cotton, "Trial Halted"; "Zidovudine
for Mother."
94. Cotton, "Trial Halted."
95. Duesberg, "AIDS Acquired by Drug Consumption,";
C. A. Thomas Jr., K. B. Mullis, and P. E. Johnson, "What Causes AIDS?"
Reason, 26 (June 1994): 1823; P. H. Duesberg, "How Much Longer
Can We Afford the AIDS Virus Monopoly?" in AIDS: Virus or Druglnduced?
eds. Kluwer and Dordrecht (The Netherlands: Genetica, in press).
96. A. Caplan, "Just as Simple as AZT," San
Diego UnionTribune, 8 Nov. 1994, B7; Cotton, "Trial Halted,"
807.
97. Connor, Sperling, Gelber, Kiselev, Scott, O'sullivan,
VanDyke, Bey, Shearer, Jacobson, Jimeniz, O'Neill, Bazin, Delfraissy, Culnane,
Coombs, Elkins, Moye, Stratton, Balsley, and the Pediatric AIDS Clinical
Trials Group Protocol 076 Study Group, "Reduction of MaternalInfant
Transmission."
98. Cotton, "Trial Halted."
99. Connor, Sperling, Gelber, Kiselev, Scott, O'Sullivan,
VanDyke, Bey, Shearer, Jacobson, Jimeniz, O'Neill, Bazin, Delfraissy, Culnane,
Coombs, Elkins, Moye, Stratton, Balsley, and the Pediatric AIDS Clinical
Trials Group Protocol 076 Study Group, "Reduction of MaternalInfant
Transmission"; Caplan, "Just as Simple as AZT."
100. "Zidovudine for Mother."
101. Farber, "AIDS-Words from the Front."
102. N. Ostrom, "Nightmare on AZT Street," New
York Native, 4 Sept. 1995, 34 36.
103. R. M. Kumar, P. F. Hughes, and A. Khurranna, "Zidovudine
Use in Pregnancy: A Report on 104 Cases and the Occurrence of Birth Defects,"
Journal of Acquired Immune Deficiency Syndromes, 7 (1994): 10341039.
104. B. Gavzer, "What We Can Learn from Those Who
Survive AIDS," Parade, 10 June 1990, 47.
105. J. Wells, "We Have to Question the SoCalled
'Facts'" Capital Gay, 20 Aug. 1993, 1415.
106. J. Wells, personal communication, London.
107. J. Nelson, J. Rodack, R. Fitz, and A. B. Smith, "Magic
Reeling as Worst Nightmare Comes True-He's Getting Sicker" National
Enquirer, 10 Dec. 1991, 6.
108. Paul Philpott, personal communication, Tallahassee,
Fla.
109. Anderson, Independent Mail, 16 Feb. 1986; Boston
Globe and Washington Post (without dates).
110. Duesberg, "AIDS Acquired by Drug Consumption."
111. Lauritsen, AIDS War, 324.
112. J. Weisberg, "The Accuser: Kimberly Bergalis,
AIDS Martyr," New Republic, 21 Oct. 1991, 1214.
113. M. Rom, "HealthCare Workers and HIV: Policy
Choice in a Federal System." Publius, Summer 1993, 135153.
114. B. Hilton, "CDC Accused of Alarming the Public,"
San Francisco Examiner, 10 Feb. 1991, B5.
115. "AIDS Victim's Will Is a Moving 'GoodBy'"
San Francisco Chronicle, 15 Jan. 1992.
116. Duesberg, "AIDS Acquired by Drug Consumption";
J. Palca" "The Case of the Florida Dentist," Science, 255
(1992): 392394; "No Trial to Come in Florida Dentist Case,"
Science, 255 (14 Feb. 1992), 787.
117. "Study Questions Whether Dentist Spread AIDS,"
Orange County Register, 25 Feb. 1993, AI4, describing a study by Ronald
DeBry and his colleagues published in the 22593 issue of Nature.
118. S. Barr, "The Flawed Case Against Dr. Acer-In
defense of AIDS Dentist," Miami Herald, 31 March 1994a; S. Barr, "In
Defense of the AIDS Dentist," Lear's, 2 April 1994b: 6882; S.
Barr, "What If the Dentist Didn"t Do It?" New York Times,
16 April 1994c, 21.
119. Barr, "What If"; Barr, "In Defense."
120. Barr, "What If."
121. Palca, "Case of the Florida Dentist," 392394;
Barr, "In Defense."
122. Barr, "What If."
123. Barr, "In Defense."
124. K. McMurran and M. Neil, "One Woman's Brave
Battle with AIDS" People, July 1990, 6265.
125. Ibid.
126. MacNeilLehrer News Hour, 10 June 1993.
127. A. Ashe and A. Rampersad, Days of Grace: A Memoir
(New York Alfred A. Knopf, 1993), 214.
128. E. Caldwell, New York Daily News, 10 Feb. 1993.
129. A. Ashe, "More Than Ever, Magical Things to
Learn", Washington Post, 11 Oct. 1992.
130. Caldwell, New York Daily News.
131. Ashe and Rampersad, Days of Grace.
132. Ibid., 213.
VIRUSMYTH HOMEPAGE