Mothering Magazine
September/October 2001
Special Report:
HIV, Families & Medical Justice.

By Neville Hodgkinson

Can the antiviral drug AZT, given to HIV-positive mothers in pregnancy and
to their newborn babies, protect against mother-to-baby transmission of
AIDS? The claim that it does so is entirely speculative. Yet the harm done
by the drug is extensively documented. [AZT stands for azidothymidine. It is
also called zidovudine by the manufacturer and marketed under the name
Retrovir.]

AZT treatment strategy is based on a number of beliefs. One is that certain
biological signals, such as elevated "viral load" and "HIV" antibodies,
signify HIV infection. Another is that HIV infection is the cause of AIDS.
If either or both of those suppositions are untrue, as some scientists argue
[see adjoining article "Molecular Miscarriage: Is the HIV Theory a Tragic
Mistake?"], then all mothers and babies treated in this way are being
uselessly exposed to an unquestionably dangerous chemical.

AZT's proven toxicities include severe muscle pain, weakness, and atrophy;
heart muscle changes and malfunctions; bone marrow suppression, with
consequent anemia and loss of all types of blood cells; liver failure; and
broad-ranging and sometimes irreversible loss and poisoning of mitochondria,
the energy "factories" within our cells. The drug also leads to permanent
DNA damage, and studies in mice and monkeys have raised concerns that babies
exposed to AZT in the womb will face an increased risk of cancer when they
grow up.(1)

A minority of infants born to HIV-positive mothers show elevated levels of
HIV antibodies. Among that minority, many lose their HIV-positive status
within about 18 months and are judged not to have been infected, but simply
to have inherited the elevated levels of antibodies from their mothers. A
European collaborative study by researchers from the Department of
Paediatric Epidemiology at London's Institute of Child Health found a
natural transmission rate of only 12.9 percent in 372 children, with the
researchers declaring, "Estimates in many earlier studies may have been
biased upwards."(2)

So even by conventional reckoning, nearly nine out of ten babies born to
HIV-positive mothers cannot receive any benefit from being exposed to AZT.

Screening mothers for HIV and treating both mother and baby with AZT and
other antivirals does reduce the proportion of babies who test positive --
to as low as 1 or 2 percent in some studies where more than one drug has
been used. But this may simply be a result of general suppression of the
immune system by the drugs, with resulting reduction in the signals thought
to represent HIV positivity. Since there are huge question marks over the
validity of the tests, over bias in the interpretation of results, and over
what a positive test result means, the crucial question is: What happens to
the babies afterwards? Do the antiviral drugs really help children live
longer or healthier lives?

The answer appears to be that they don't. US scientist David Rasnick, a
member of the South African Government's Advisory Panel on AIDS, told the
inquiry in July 2000 that he had "scoured the literature" for evidence of
such benefit but was unable to find any. On the contrary, the evidence
points in the opposite direction. In June 2000, researchers reported that
"rapid disease progression" (defined as occurrence of an AIDS-defining
disease or AIDS-related death before 18 months of age) was three times more
likely to occur in babies born to mothers treated with AZT than when the
mother was untreated. This was despite a halving in the purported infection
rate in the AZT-exposed babies.(3)

Similarly, an Italian study involving more than 200 HIV-positive children
found that at three years old, those born to mothers treated with AZT during
pregnancy were significantly more likely to have developed severe disease
than children whose mothers were not treated. They also had a higher death
rate.(4)

In France, researchers found mitochondrial damage in eight children exposed
to AZT in the womb and after birth. Two of the eight died and the others had
severe biological and neurological abnormalities.(5) Four of the eight had
been exposed to AZT and another antiviral drug, lamivudine, and four to AZT
alone; none was judged "HIV infected." The findings led the UK's Committee
on Safety of Medicines to issue a warning about the risks to babies, in
advance of publication of the French study.(6)

The study also prompted formation of the US Perinatal Safety Review Working
Group in February 1999. The group reviewed 353 deaths in more than 20,000
children with and without antiviral drug exposure, and in September the same
year reported that it had identified no deaths similar to those reported
from France.(7) That would be reassuring, were it not for clear evidence
from animal and other human studies that AZT and similar drugs are toxic to
mitochondria.(8) Moreover, the French researchers stated that the symptoms
in the children in their study were only identified through a specific
search for mitochondrial damage, "and may therefore have not been identified
as toxic effects of treatments. Prospective studies designed to investigate
this effect are essential."

Long-term consequences of exposing babies to AZT are unknown. In a 1999
study, American researchers found that the chemical becomes incorporated
into the DNA of most patients, "including infants exposed to the drug in
utero."(9) They commented that the biological significance of the immediate
damage to DNA, "and potential subsequent events, such as mutagenicity,
should be further investigated in large cohorts of HIV-positive
individuals." The same authors reported that AZT is "a moderate to strong
transplacental carcinogen in mice," leading to tumors in the lungs, liver,
and female reproductive organs; that it is readily incorporated into the
human placenta; and that "infants exposed to AZT even for short periods of
time during gestation may sustain genotoxic damage."(10)

Increasing the number of drugs used in pregnancy increases the risk to the
baby. In New York, an HIV-negative baby whose positive mother received AZT
and two other antivirals was born with congestive heart failure secondary to
profound, life-threatening anemia. Doctors said the cause was suppression of
the baby's bone marrow "by one or more of the antiretroviral agents
administered to the mother."(11) AZT damage to bone marrow can be long
lasting as well. A year after the drug was approved, a 1988 report stated,
"Bone marrow changes in patients on zidovudine seem not to be readily
reversed when the drug is withdrawn. These findings have serious
implications for the use of zidovudine in HIV-positive but symptom-free
individuals."(12)

In December of 1998, Swiss researchers reported, "Following combination
antiretroviral therapy administered during pregnancy, most HIV-positive
mothers and about half of their children developed one or more adverse
events." Of 30 babies, "the most common adverse event was prematurity (ten
infants), followed by anemia (eight)." Two babies had skin tumors, two
developed brain hemorrhage, one had a bile duct abnormality, and one had
transient hepatitis.(13)

Some studies have shown high rates of abnormalities in babies exposed to AZT
alone. Out of 80 babies born alive to AZT-treated mothers at a hospital in
India, 10 percent had birth defects including holes in the chest, abnormal
indentations at the base of the spine, misplaced ears, misshapen faces,
heart defects, extra digits, and albinism.(14) These were probably poor,
malnourished babies already at risk of abnormal development. But a New York
study showed higher risk of birth abnormalities in AZT-exposed babies than
in those born to HIV-positive mothers who were not prescribed AZT.(15)

To cap all of this, a 30,000-word review of the molecular pharmacology of
AZT, published in June 1999, presents evidence that AZT's claimed mode of
antiviral action cannot be as the manufacturers have proposed, rendering it
incapable of exerting anti-HIV effects. On the other hand, the authors
conclude, "A number of biochemical mechanisms...predicate the likelihood of
widespread, serious toxicity for the use of this drug."(16) According to
South African lawyer Anthony Brink, this "withering indictment" of AZT
"ought to sound its death knell in clinical practice. No doctor whose adult
or infant patient sickens or dies on AZT will be safe from damages actions
founded on medical negligence after this."(17)

Notes

1. A. Brink, "Debating AZT: Mbeki and the AIDS Drug Controversy"
(Pietermaritzburg, South Africa: Open Books, 2000), 42-45. This is an
extensive, up-to-date critical review of AZT by a South African advocate
(abrink@iafrica.com).

2. "Children Born to Women with HIV-1 Infection: Natural History and Risk of
Transmission," European Collaborative Study, The Lancet 337 (1991): 253-260.

3. R. S. De Souza et al., "Effect of Prenatal Zidovudine on Disease
Progression in Perinatally HIV-1 Infected Infants," Journal of Acquired
Immune Deficiency Syndrome and Human Retrovirology 24, no. 2 (June 1, 2000):
154-161.

4. Italian Register for HIV Infection in Children, "Rapid Disease
Progression in HIV-1 Perinatally Infected Children Born to Mothers Receiving
Zidovudine [AZT] Monotherapy During Pregnancy," AIDS 13 (May 28, 1999):
927-933.

5. S. Blanche et al., "Persistent Mitochondrial Dysfunction and Perinatal
Exposure to Antiretroviral Nucleoside Analogues," The Lancet 354 (September
25, 1999): 1084-1089.

6. "Perinatal AZT: New Warning on Potential Risk to Infants,"
www.aidsmap.com (July 21, 1999).

7. L. Mofenson and J. McIntyre, "Advances and Research Directions in the
Prevention of Mother-to-Child HIV-1 Transmission," The Lancet 355 (June 24,
2000): WA27-WA34.

8. K. Brinkman et al., "Adverse Effects of Reverse Transcriptase Inhibitors:
Mitochondrial Toxicity as Common Pathway," AIDS 12 (1998): 1735-1744; M. C.
Dalakas et al., "Mitochondrial Myopathy Caused by Long-Term Zidovudine
Toxicity," New England Journal of Medicine 322 (1990): 1098-1105.

9. O. A. Olivero et al., "Incorporation of Zidovudine into Leukocyte DNA
from HIV-1 Positive Adults and Pregnant Women, and Cord Blood from Infants
Exposed in Utero," AIDS 13 (May 28, 1999): 919-925.

10. O. A. Olivero et al., "[AZT] Transplacental Perfusion Kinetics and DNA
Incorporation in Normal Human Placentas Perfused with AZT," Third Conference
on Environmental Mutagens in Human Populations, February 18, 1999.

11. Watson et al., Pediatric Infectious Diseases Journal (May 1998), as
quoted in Brink (See Note 1), 21.

12. Mir and Costello, The Lancet (1998). Study quoted in Brink (See Note 1),
21.

13. Brink (See Note 1), 33-34.

14. R. M. Kumar et al., "Zidovudine Use in Pregnancy: A Report on 104 Cases
and the Occurrence of Birth Defects," Journal of Acquired Immune Deficiency
Syndrome and Human Retrovirology 7 (1994): 1034-1039.

15. C. J. Newschaffer et al., "Prenatal Zidovudine Use and Congenital
Anomalies in a Medicaid Population," Journal of Acquired Immune Deficiency
Syndrome and Human Retrovirology 24, no. 3 (2000): 249-256.

16. E. Papadopulos et al., "A Critical Analysis of the Pharmacology of AZT
and Its Use in AIDS," Current Medical Research and Opinion 15, Supplement 1,
(1999).

17. Brink (See Note 1), 97.

-----

For More Information:

=> Christine Maggiore's book "What If Everything You Thought You Knew About
AIDS Was Wrong?" is an accessible introduction to problems in AIDS science
and policy. Maggiore is the founder/director of Alive & Well AIDS
Alternatives, a nonprofit education, action, support, and research
organization founded by a group of HIV-positive diagnosed people who live in
health without AIDS drugs and without fear of illness. Phone and Fax:
1-877-92-ALIVE. Web: www.aliveandwell.org.

=> Health Education AIDS Liaison (HEAL) is a nonprofit network organization
informing people of the evidence challenging many common beliefs surrounding
HIV and AIDS. President: Michael Ellner. Contact: HEAL-NY, Old Chelsea
Station, P.O. Box 1103, New York, NY 10113. Phone: (212) 873-0780. Fax:
(212) 873-0891. See also www.healtoronto.com.

=> Continuum magazine began in 1992 as a UK-based self-help newsletter
questioning HIV/AIDS dogma and developed into an international journal of
culture, science, and alternative health. It is now an Internet publication:
www.continuum-magazine.org. Editor: Huw Christie.

=> "Rethinking AIDS" is the monthly publication of the Group for the
Reappraisal of AIDS, a network of hundreds of scientists and AIDS analysts
who have been pressing for ten years for an inquiry into AIDS science.
Contact editor Paul Philpott, 1354 East Avenue, Suite R-120, Chico, CA
95926-7385. Web: www.rethinkingaids.com.

=> Robert Laarhoven, co-organizer of the first international conference on
alternative perspectives on AIDS (Amsterdam, 1992), has developed a website
offering more than 250 articles on the HIV/AIDS controversy, including
groundbreaking papers by Peter Duesberg and by the Perth group of
scientists. Web: www.virusmyth.net/aids/.

=> "AIDS and Stressors" (Medellin, Columbia: Fundacion Arte y Ciencia), by
New York-based physician and independent AIDS researcher Roberto Giraldo,
argues that AIDS signifies a worldwide increase in immunological stressors
including toxins in food and the environment, recreational and medical
drugs, and mental and emotional stress. The book can be ordered on HEAL
Toronto's website: www.healtoronto.com.

TORONTO

tel/fax:(416) 406-HEAL

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