|
|
AZT Doesn’t Protect Infants Against AIDS When They’re Breast-Fed, Says UN Report By Neenyah Ostrom
JULY 2000 — The day before the
opening of the 13th International Conference on AIDS, the New York Times published a front-page
article projecting a grim prognosis for continued use of a widely-endorsed AIDS
preventative. The article, by Times reporter Lawrence K. Altman,
quoted a new United Nations-sponsored study which determined that giving AZT to
pregnant women often does not prevent the development of AIDS in their infants,
even when the babies continue to receive AZT immediately after birth. While the treatment of pregnant women with
AZT (sometimes combined with another antiretroviral drug, like 3TC) or the antiviral
drug Nevirapine reduces the number of infants who test positive for HIV at
birth, according to Altman, “the therapy appears to leave children vulnerable
to infection from breast milk."(1). For the moment, let us not discuss
the data suggesting that HIV positivity is not a very good marker for the
development of AIDS (data that include people who have AIDS but never test
positive for HIV, people who never develop AIDS despite testing positive for
HIV, and the discordance between blood and urine HIV antibody positivity, as
well as other data showing the HIV blood tests to be unreliable under many
circumstances), but examine instead how AZT, as Altman and the UN study point
out, makes infants “vulnerable" to developing immune dysfunction. In the summer of 1994, a coalition
of scientists led by the US Centers for Disease Control broadcast the results
of an unpublished, incomplete study with great fanfare (it was featured on page
one of the New York Times): Treating HIV-positive pregnant women with
AZT dramatically decreased the incidence of HIV passed from mother to infant,
without any serious side effects or
increase in rate of birth defects, they said.
The occurrence of “minor" birth defects like extra fingers and toes were
admitted when the study was published, as were some never-described “severe"
birth defects. (2) On the basis of this
single, truncated study, the US Public Health Service recommended in July 1994
that all pregnant women be tested for HIV and, if found to test positive for
HIV antibodies, treated with AZT throughout the rest of their pregnancies. Three studies
published in 1999, however, suggested that AZT does grave harm to fetuses
exposed to it: The first we will
examine, performed by scientists in the French Epidemiological Network, showed
that some babies exposed to AZT either while in the womb or immediately after
birth develop an extremely rare but fatal neurological disorder. These babies were not HIV-positive. The second
study, led by a US National Cancer Institute researcher, found that AZT is
incorporated into fetuses’ DNA because it resembles one of the components of
DNA (i.e., the nucleic acid thymidine).
These researchers expressed concern that the incorporation of AZT into
DNA might be cumulative over time, causing mutations that would result in
either birth defects or the development of cancers later in life. A third 1999
study performed by researchers from the Italian Register for HIV Infection in
Children was perhaps even more ominous.
It found that HIV-positive infants born to HIV-positive mothers treated
with AZT while pregnant were much more likely to develop “severe disease" than
were HIV-positive infants who’d not been exposed to AZT in utero. *** The French study, led by Stephane
Blanche at the Necker Hospital in Paris, was published in The Lancet. (3) Of 1,754
mother-child pairs exposed to AZT during the mother’s pregnancy (or just after
birth, for the child), Blanche and colleagues discovered eight children whose
mitochondria didn’t function properly.
The mitochondria are our cells’ energy producing organelles; if they
malfunction, neurological development is delayed, and the result can be
fatal. Four of the children with
mitochondrial dysfunction had been exposed to a combination of AZT and another
anti-HIV drug, lamivudine; the other four had been exposed to AZT alone. “No child was infected with HIV-1," Blanche
and co-workers pointed out. Five of the eight children
developed “delayed" neurological symptoms (meaning they weren’t present at
birth, but became obvious later); two of these children died. The other three children “were symptom-free
but had severe biological or neurological abnormalities," according to the
French scientists. One of the two children with
neurological symptoms who died, Patient A, was partially blind. When Patient A was 4 months old, an MRI
showed that the child had demyelinating lesions in the brainstem (a primitive
part of the brain that controls basic life functions). Over time, these lesions—which were really just
areas of dead brain tissue—spread throughout the child’s brain. Patient A’s growth was “abnormal," according
to the doctors, and the child vomited frequently. At 13 months of age, Patient A died from heart and lung
disorders. Patient B died at the age of 11
months. At 4 months old, Patient B
developed epilepsy as well as suffering severe deterioration of cognitive and
motor abilities. This child, too, was
found to have “diffuse demyelinating lesions associated with massive cortical
necrosis," that is, widespread brain tissue death. The other children who developed
symptoms of mitochondrial dysfunction had seizures, heart dysfunction, brain
lesions (one child with, and one without, brain tissue death), blindness
associated with a too-small head (“microencephaly," a problem identified earlier
in babies treated in utero with AZT
[4]), and numerous biochemical abnormalities (including abnormal liver and
pancreatic enzyme levels, among others). In their discussion of how AZT
probably contributed to the illness and deaths of these children, Blanche and
colleagues noted that researchers at the US National Cancer Institute have
demonstrated that AZT crosses the placenta from mother to fetus. In monkey fetuses, AZT is incorporated into
the mitochondrial DNA. Fetal monkeys
dosed with AZT “for periods of time and with doses similar to those used for
pregnant women" developed mitochondrial dysfunction after birth, Blanche and
co-workers pointed out. They added,
“The experimental [monkey] model does not show whether the toxic effects are
reversible after birth. Also, it gives
no insight into the possible clinical impact of this type of dysfunction
throughout a tissue, especially a long time after the drug is stopped…. As with other drug-induced toxic effects in
mitochondria, these lasting abnormalities may be associated with a symptomless
constitutional dysfunction." In other
words: Many more children exposed to
AZT in utero may have mutations in
their mitochondria that we don’t detect because they don’t immediately produce
identifiable symptoms. The type of
mitochondrial illness observed in these eight children (out of 1,754 French
children treated with AZT) was found in only 21 children out of 12 million
studied in the United Kingdom.(5) “We are aware that the suggestion
that antiretroviral drugs are toxic raises delicate issues," the French
scientists wrote, concluding that “the current recommendations for zidovudine
[AZT] monotherapy prophylaxis should be maintained." They added, however, “Pregnant women should be informed of the
potential effects associated with these treatments during pregnancy."(6) The National Cancer Institute study of AZT’s incorporation
into infants’ DNA, led by NCI researcher Ofelina Olivero, was modeled after a
study that observed a similar effect in newborn mice exposed to AZT in utero. Olivero and colleagues studied non-pregnant adults exposed to
AZT, as well as pregnant women treated with AZT and their infants (who were
exposed to the drug while in the womb).
They found that 76% of all individuals
given AZT incorporated it into their DNA.
Olivero and co-workers warned that AZT’s presence in DNA might result in
increased levels of either birth defects or cancers.(7) And the Italian study of HIV-positive infants born to
HIV-positive, pregnant women treated with AZT suggested that these babies are
much more likely to develop “severe" AIDS than infants not exposed to AZT in
the womb. *** Faced with the results of these and other studies that show
giving AZT to pregnant women appears to be unhealthy not only for the babies
but also for the women, are AIDS researchers the world over calling for a
moratorium on this practice? Not according to the New
York Times. Instead, the
coordinator of the United Nations study reported in the Times on July 8, Geert Haverkamp (a sociologist at the Dutch
Academic Medical Center), told Altman that his team is now considering a study
in which new mothers will receive “three anti-HIV drugs (AZT, 3TC, and a third
to be chosen) for the entire period she breast-feeds" to attempt to stop
transmission of HIV through breast milk.
Sociologist Haverkamp appears to be unaware that toxic chemicals, like
viruses, can be passed from mother to child through breast milk. Coincidentally, one of the studies establishing this was performed in South Africa, the target of much of the United Nation’s maternal transmission AZT research as well as the site of this year’s International AIDS Conference. In 1992, a World Health Organization bulletin reported that
the pesticide DDT, used in South Africa to kill the mosquitoes that transmit
malaria, was being transferred to infants through breast milk. Controlling for numerous environmental
exposures—such as contact with the DDT applied each year to the inside walls of
every home—the South African researchers concluded that the high levels of DDT
found in the blood of infants could only be coming from the breast milk of
their mothers. (9) In addition, the South African researchers pointed out that
babies who experienced developmental delays (measured by standard tests used on
infants) not only had higher mean levels of DDT their blood but also had been
breast-fed. “It is therefore possible
that infants thus exposed are at risk," they suggest in the WHO bulletin. “…Many workers have expressed concern about
the possible higher susceptibility [to DDT toxicity] of various body systems,
e.g., the nervous, immunological and renal systems of infants, which reach
maturity after birth."(10) As this is being written, the 13th International
Conference on AIDS opened in Durban, South Africa. It is accompanied by numerous controversies: the questioning by South African President
Thabo Mbeki of whether HIV is the sole cause of AIDS; the signing by some 5,000
AIDS researchers of the “Durban Declaration" asserting HIV to be the sole cause
of AIDS (published in the July 6, 2000, issue of Nature (http://www.durbandeclaration.org);
the appearance of a similar declaration, sponsored by AmFAR, in a full-page
advertisement in the July 9 New York
Times, signed by government officials, including Anthony Fauci of the
National Institutes of Health; a protest led by former South African First Lady
Winnie Mandela demanding free access to AZT and other anti-retroviral drugs;
and a widely-criticized speech by President Mbeki in which he refused to assert
(unlike the signers of the Durban and AmFAR declarations) that HIV is the sole
cause of AIDS. Leaving aside that controversy,
and the corollary assertion by Peter Duesberg and others that toxic chemicals
like AZT contribute to the development of AIDS not its cure, let us step back
for a moment and take the long view of whether it’s a good idea to give a
chemical like AZT to pregnant women and their unborn, and just barely born,
children. In a study published in July 1994,
Indian researcher Rachana Kumar and colleagues reported a very high rate of
extremely serious, sometimes fatal, birth defects in children born to women
taking AZT while pregnant . Their study
left them both concerned and reflective. “Put simply, from a fetal
viewpoint the risk of intervention needs to be less than the risk of vertical
transmission" of HIV from mother to infant, Kumar and co-workers pointed
out. “…Teratogenic [birth defect-causing]
potential of Zidovudine [AZT] in humans is still unknown," they continued.
“While animal studies have shown a direct toxic effect on mouse embryos,
high-dose administration to pregnant rats and rabbits reportedly failed to
demonstrate any fetal effects. However, the potential for cross-species
differences tragically exemplified by thalidomide cannot be forgotten."(11) Six years after these words were
written, considerably more information about the teratogenic potential of AZT
is available. South African President
Mbeki is coming under intense international criticism for refusing offers of
free AZT for pregnant, HIV-positive women because he is concerned about its
toxic effects on babies in the womb.
Instead of attempting to silence Mr. Mbeki by publishing long lists of
prestigious scientists who all agree with each other, perhaps the world AIDS
research community should both listen up and read the medical literature. References (1) Altman,
Lawrence K.; “Report Dims Hope for AIDS Therapy to Protect Babies"; New York Times, July 8, 2000. (2)
Connor, Edward M., Rhoda S.
Sperling, et al.; "Reduction of Maternal-Infant Transmission of Human
Immunodeficiency Virus Type Infant Transmission of Human Immunodeficiency Virus
Type 1 With Zidovudine Treatment"; The
New England Journal of Medicine 331(18):1173, November 3, 1994. (3)
Blanche, Stephane, et al.;
“Persistent Mitochondrial Dysfunction and Perinatal Exposure to Antiretroviral
Nucleoside Analogues"; The Lancet
354:1084, September 25, 1999. (4)
Kumar, Rachana M., Phillip F.
Hughes, and Ashok Khurranna; "Zidovudine Use in Pregnancy: A Report on 104
Cases and the Occurrence of Birth Defects"; Journal of the Acquired Immune Deficiency Syndromes 7:1034, July
1994. (5)
Blanche et al., op cit. (6)
Blanche et al., op cit. (7)
Olivero, OA 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
13:919, May 1999. (8)
The Italian Register for HIV Infection in Children;
“Rapid Disease Progression in HIV-1 Perinatally Infected Children Born to
Mothers Receiving Zidovudine Monotherapy During Pregnancy"; AIDS 13:927, May 1999. (9)
Bouwman, H., et al.; “Transfer of DDT Used in Malaria
Control to Infants Via Breast Milk"; Bulletin
of the World Health Organization 70(2):241, 1992. (10)
Ibid. (11)
Kumar, Hughes, and Khurranna, op cit. |
