At least 75% of babies born to HIV positive mothers will test HIV negative without medical intervention. (90) Studies have shown that for properly nourished HIV positive expectant mothers receiving regular prenatal care, over 90% of their children test negative with no drug therapy. (91) Mainstream medical experts acknowledge that children need up to 18 months to develop their own immune response and discard the antibodies passed on to them from their mothers, and note that HIV testing before 18 months of age does not yield conclusive results. (92) Despite this widely accepted fact, several states require mandatory HIV antibody testing for newborns in public hospitals. (93)
As explained previously, HIV antibody tests do not indicate the presence of actual virus and are unable to determine if the antibodies it detects are even HIV antibodies. Newer "viral load" tests do not detect actual virus and are not approved for diagnostic use. Even when administered after 18 months of age, neither test can determine if a child is actually infected with HIV. Despite these facts, the tests are routinely used to diagnose HIV infection in newborns and children. The results of these inaccurate and improperly applied tests are the basis for all claims regarding transmission rates of HIV from mother to child, and for declaring that a baby "has HIV."
Expectant mothers who test HIV positive are commonly advised to abort or to take AZT, a highly toxic chemical compound originally created for use as a cancer treatment. AZT works by blocking the formation of DNA -- a process essential to sustaining life -- and destroying all growing cells, particularly new cells produced in the bone marrow where the immune system is generated. AZT is a known carcinogen, mutagen, and teratogen, and until recently it was contraindicated for use during pregnancy. (94)
AZT was approved for expectant mothers based on the conclusions of a single trial, ACTG076, a trial sponsored by AZT's manufacturer. According to this study, transmission rates of HIV were 25.5% for infants of untreated mothers and 8.3% for children born to the AZT-treated women.
The results of ACTG076 have proved impossible to duplicate in further studies on pregnant women treated with AZT. In fact, other reports have shown that expectant mothers using prenatal multivitamins experienced lower rates of transmission than the lowest rate of those treated with AZT. One study determined that use of vitamin A correlates with a transmission rate of 7.2%. (95)
The effects of AZT on expectant mothers include muscle deterioration, severe anemia, nerve damage, liver damage, muscle wasting, lymphoma, acute nausea, diarrhea and dementia. The effects of AZT on developing infants include misshapen heads, extra fingers, triangular faces, albinism, misplaced ears, cavities in the chest, webbed fingers, anemia, spontaneous abortion, chromosomal damage, and can result in the need for therapeutic abortions of severely deformed fetuses. (96)
Routine HIV antibody testing for pregnant women raises particular concerns as pregnancy itself can cause positive HIV test results. (97) Although cross-reactions due to pregnancy are documented in the medical literature and acknowledged by test manufacturers, HIV antibody tests have become part of standard prenatal screening, and are even mandatory in some states.
A fundamental problem of routine screening using even the most accurate test is that low risk groups will have the highest rates of false positives. This occurs because the accuracy of a test deteriorates when administered to populations among which the microbe being tested for is rarely found. Since the incidence of HIV positivity among American women who describe themselves as risk-free is 0.01%, a consequence of routine HIV screening of all expectant women is widespread false positive results. (98) One study of premarital HIV screening reported that HIV antibody tests with an alleged specificity of 99.8% and sensitivity of 98.3% had an accuracy of less than 15% when administered to this low risk group. (99) And these figures are based on invalid and/or loose definitions of specificity, sensitivity, and accuracy that do not involve tests validated by identifying actual HIV infections.
Another troubling consequence of requiring HIV tests for pregnant women is the emerging issue of obligatory drug treatment. While CDC guidelines state that "discussion of treatment options should be non-coercive, and the final decision to accept or reject AZT for herself and her child is the right and responsibility of the woman," such discussions rarely include objective data on the toxic effects of AIDS drugs or any information that would support a decision to reject them. (100) Most health practitioners promote the notion that a positive test indicates infection with a lethal virus, and portray AIDS medication as particularly urgent and necessary for expectant women.
Although the CDC says that "a [mother's] decision not to accept treatment should not result in punitive action," suggested standards of care have been legally mandated in some instances and children have been taken from parents who choose not to accept treatment. (100) In one recent case, public health officials in Eugene, Oregon intervened when an HIV positive mother declined AZT therapy for her HIV negative infant son. (101) As a result of her decision, both parents were charged with neglect, and the state took legal custody of their healthy newborn boy who was given six weeks of AZT treatment. (102)
Another HIV positive mother in Bangor, Maine faced charges of "serious parental neglect" for declining to provide her son with AIDS drugs that had previously caused him harm. (103) Her four-year-old boy, HIV positive since birth, had become so anemic during 10 weeks of AIDS treatment as to require blood transfusions, and experienced a host of adverse effects that left him unable to walk and in almost continual pain. (104) His mother discontinued treatment after noting that his health returned when she stopped giving him the drugs. After a District Court found in her favor, an appeal was brought before the State Supreme Court challenging the decision. In this case, the mother was granted the right to keep her son off AIDS medications and in her custody. (105)
As this book went to press, authorities in Montreal, Canada seized the children of a woman who has been HIV positive, healthy and unmedicated for 13 years after she declined HIV treatment for her two boys. The Quebec Superior Court agreed to delay administration of drugs to her sons, ages three and seven, pending the determination of a custody hearing. The mother told the court that HIV treatments are experimental and highly toxic, and that her family has been healthy without using drugs. (106)
Whose Benefits Outweigh the Risks? |
"HIV-1 infected children with mothers who were treated with zidovudine had a 'higher probability of developing severe disease' compared with untreated children. These children also had a higher probability of severe immune suppression and lower survival." Reuters Health, June 2, 1999 on a report in the "Concerns are being fueled by a study from a team at the National Cancer Institute near Washington, DC. In the journal AIDS (Vol 13 p 919), the researchers report that AZT is incorporated into the DNA of white blood cells in people treated with the drug-including pregnant women and their babies. This is because AZT mimics thymidine, one of the four nucleosides that make up the genetic code. Olivero and her colleagues warn that the changes may increase the chance of developing cancer." Michael Day, New Scientist, June 26, 1999 "In reviewing the frequency of birth defects in this population [of HIV positive women taking AZT during pregnancy] we noted eight birth defects (10%) out of 80 live births." Kumar et al, Zidovudine Use in Pregnancy: A Report on 104 Cases and the "Concerns stem from a study led by StÅ1⁄2phane Blanche of the Necker Hospital in Paris. He has examined the cases of around a thousand pregnant women with HIV and found that eight gave birth to babies who, though HIV-negative, suffered from a neurodegenerative condition that kills its victims in infancy. The condition highlighted by Blanche is thought to be caused by abnormalities in mitochondria, the energy 'factories' within our cells. The babies' mothers had all taken a combination of the drugs AZT and 3TC from week 32 of their pregnancy. This condition is an extraordinarily rare mitochondrial disorder that you might expect to see in only 1 in 10,000 or 1 in 100,000 births." Michael Day, New Scientist, June 26, 1999 "At present, data regarding the effects of ZDV use on vertical [mother to child] transmission rates are inconclusive and incomplete. In addition, the long-term effects of ZDV use during pregnancy and after birth on the woman and any resulting child are yet to be discovered. The possibility has not yet been ruled out that this 'risk-reducing' measure may not be effective and may prove detrimental to the health of both mother and child." Bennett, Mandatory Testing of Pregnant Women and Newborns: "A total of 172 participants died [169 while taking AZT, 3 while on placebo]...The results of Concorde do not encourage the early use of zidovudine in symptom-free HIV-infected adults...Representatives of the Wellcome Foundation who were also members of the Coordinating Committee have declined to endorse this report." Concorde Coordinating Committee, Concorde: MRC/ANRS Randomised Double-blind "Following combination antiretroviral therapy administered during pregnancy, most HIV positive mothers and their children developed one or more adverse events, according to the results of an observational study. "Dr. Lorenzi's group evaluated 37 pregnant women with HIV infection and the 30 infants who had been born at the time of the study. All of the women received two reverse transcriptase inhibitors, and 16 women were also given a protease inhibitor. Among the infants, the most common adverse event was prematurity (10 infants), followed by profound anemia (8 infants). The investigators also noted two cases of cutaneous angioma, two cases of cryptorchidism, and one case of transient hepatitis. Two infants whose mothers were on triple therapy with a protease inhibitor developed non-life-threatening intracerebral hemorrhage. One infant, also exposed to triple therapy, developed extrahepatic biliary atresia." Reuters, January 1, 1999 "New York researchers report a case of severe anemia in a newborn infant that was probably caused by treatment of the HIV positive mother with the antiretroviral combination of zidovudine, lamivudine and zalcitabine. The male infant, who was pale and developed respiratory distress soon after birth, '...was diagnosed with high output congestive heart failure secondary to profound anemia.' "Dr. Wendy J. Watson of the University of Rochester Medical Center and colleagues ruled out infection, nutritional deficiencies, congenital leukemia and congenital red blood cell aplasia in the child. 'The cause of the life-threatening anemia in our infant is presumed to be utero bone marrow suppression by one or more of the antiretroviral agents administered to the mother,' they report in the May issue of The Pediatric Infectious Disease Journal." Reuters, June 8, 1998 "...the estimated probability of developing [Non-Hodgkin's] lymphoma [in patients taking AZT alone, or in combination] by 30 months of therapy was 28.6%...and by 36 months, 46.4%." Pluda et al, Development of Non-Hodgkin's Lymphoma in a Cohort of "The long-term consequences of in-utero and infant exposure to zidovudine are unknown. The long-term effects of early or short-term use of zidovudine in pregnant women are also unknown." Retrovir, Canadian Pharmaceutical Association Compendium "A long-term federal government study of AZT begun in August 1991 involving 839 children at 62 hospitals was halted. An independent committee monitoring the trial recommended it be halted because 'the children receiving AZT had more rapid rates of disease progression, AIDS-related infections, impaired neurological development and death.'" The New York Times, February 14, 1995 "Proven Power For HIV: Because of her baby, because she vows to be there for her family, because her kids remind her to take her combination of anti-HIV medicines everyday...There are no adequate and well-controlled studies of Combivir [lamivudine/zidovudine tablets] in pregnant women. Combivir should be used in pregnancy only if the potential benefits outweigh the risks." Glaxo-Wellcome ad for Combivir, April 1999 |
AZT's manufacturer Glaxo-Wellcome reported $2.35 billion in annual |
Defined Terms
Carcinogen: Any agent capable of causing cancer such as asbestos fibers and high-energy radiation. Chemicals form the largest group of carcinogens.
Mutagen: Any physical or chemical agent that, when applied to a group of living cells, increases the rate of mutation in those cells. Mutation is a change in the genetic material within a cell which can give rise to cancer or a hereditary disease.
Teratogen: An agent that causes physical abnormalities in a developing embryo or fetus. The drug thalidomide is an example of a teratogen. Drug regulating agencies usually refuse to license drugs for use during pregnancy if they have been found to be teratogenic for any species.
Contraindicated: A line of medical treatment, such as drug therapy or surgery, that is inadvisable or unwise due to any factor in a patient's condition.