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Christine Maggiore and Eliza Jane Scovill: Living and dying with HIV/AIDS denialism

Christine Maggiore

On Science-Based Medicine, we strive to apply the light of science and reason on all manner of unscientific belief systems about medicine. For the most part, but by no means exclusively, we have concentrated on so-called “complementary and alternative medicine” (CAM) because there is an active movement to infiltrate faith-based, rather than science-based, modalities into “conventional” medicine. Indeed, such efforts are well-financed, both by public and private organizations, and are alarmingly successful at insinuating postmodernist and pseudoscientific beliefs into academia to form an unholy new monster that has been termed by some as “quackademic medicine.”

However, one pseudoscientific belief system about medicine that we at SBM have perhaps not dealt with as much as we should is the belief that, contrary to the overwhelming scientific consensus built up over 25 years, the Human Immunodeficiency Virus (HIV) does not cause Acquired Immune Deficiency Syndrome (AIDS). True, working with Tara Smith, our fearless leader Steve Novella has published an excellent primer on the phenomenon, but not on this blog. This belief system, which is commonly called HIV/AIDS denial or HIV/AIDS denialism, is championed by virologist Peter Duesberg, along with a panoply of groups, such as Alive & Well AIDS Alternatives and Rethinking AIDS; blogs, such as Science Guardian, HIV/AIDS Skepticism, and AIDS Is Over; podcasts, such as How Positive Are You?; books, such as What If Everything You Thought You Knew About AIDS Was Wrong? by Christine Maggiore; and movies, such as The Other Side of AIDS (which resembles in many ways the anti-evolution movie Expelled! and the pro-quackery movie The Beautiful Truth). The influence of HIV/AIDS denialism is horrific, too, particularly in Africa, where advocates of such nonsense, such as Matthias Rath, have advocated quackery over antiretroviral therapy and had the ear of South African President Thabo Mbeki, who lost power in late 2007.

Before I go on to do a case study of the tragic price of HIV/AIDS denialism, perhaps it is worthwhile to take a moment to discuss just what HIV/AIDS denialism is. It is not “skepticism” or “rethinking” any more than creationism is a “rethinking” or “skepticism” of evolution, although denialists like to try to claim the mantle of those labels. Seth Kalichman, author of the book Denying AIDS: Conspiracy Theories, Pseudoscience, and Human Tragedy has written a good primer of the phenomenon, and I’ll appropriate an excerpt:

AIDS denialism actively propagates myths, misconceptions, and misinformation to distort and refute reality. Denialism is the outright rejection of science and medicine. It involves actively contradicting and disregarding medical advice. It is steady state. Denialism is not open to criticism, and evades modification. Denialism is only open to additional evidence supporting its tenets and such evidence most often comes from the misuse of science and from pseudoscience. AIDS denialists, often for the sake of personal preservation or recognition, hold fast to old ideas in the face of new evidence.

One feature of denialism is the tendency to think of the denialist position as beleaguered, and under attack and in a minority that has to stave off the assaults of the vast wrong-thinking majority. As a consequence, those involved in denialism often, in the other justifications for their position, declare their strong allegiance to the principle of free speech. Interestingly, then, denialists often set themselves up as plucky underdogs, battling for their right to speak the truth against a tide of misinformation and, as often as not, conspiracies aimed at keeping them silent.

Indeed, denialism, specifically the denial of scientific medicine, tends to be at the heart of the quackademic medicine movement, just as the denial of evolution is at the heart of the anti-evolution movement known as “intelligent design” creationism. It is a more general phenomenon that involves a dogged clinging to pseudoscientific or pseudohistorical beliefs (creationists and antivaccine advocates are a good example of the former; 9/11 Truthers and Holocaust deniers are a good example of the latter) and the use of logical fallacies and conspiracy theories to bolster their world view.

Like vaccine denialists, HIV/AIDS denialists promulgate an ideology that kills. Indeed, last week, it very likely did just that to a prominent HIV/AIDS denialist named Christine Maggiore, whose activism led her to form the group Alive & Well AIDS Alternatives. Three years earlier, her HIV/AIDS denialism cost the life of her daughter, Eliza Jane (EJ) Scovill. Let us examine both cases. In the case of Eliza Jane, I will go into considerable detail, because much more is known; in the case of Christine Maggiore’s death, less so, because much less is (yet) known.

From Businesswoman to HIV/AIDS Denialist

Before she became an HIV/AIDS denialist, Christine Maggiore was a successful businesswoman. In 1986, she started what ultimately developed into a multimillion dollar inport/export clothing company, Alessi International, which is based in Italy. However, her life changed in 1992, when during a routine medical examination she was found to be HIV-positive. Initially, she became involved with AIDS charities, including the AIDS Project and Women At Risk, but then in 1994 she met Peter Duesberg, the biologist who, arguably more than anyone else, started the whole phenomenon of HIV/AIDS denialism. By that time she also had had other HIV tests that varied from negative to indeterminate to positive, which had made her start to question whether she really had HIV. After being “converted” by Duesberg, she became an HIV/AIDS denialist and activist, founding Alive & Well, an organization dedicated to providing “information that raises questions about the accuracy of HIV tests, the safety and effectiveness of AIDS drug treatment, and the validity of most common assumptions about HIV and AIDS.” She herself refused to take antiretroviral drugs and discouraged other at-risk mothers from doing so–or from even permitting themselves to be tested for HIV–under the guise of “telling both sides.”

Christine MaggioreNot surprisingly, when she became pregnant with her second child Eliza Jane, she similarly refused to take antiretroviral drugs in order to decrease the risk of maternal-fetal transmission of HIV. Indeed, she even appeared on the cover of Mothering Magazine sporting her pregnant belly with the word AZT in a circle with a slash through it and the headline HIV+ Moms Say NO to AIDS Drugs. The issue featured Maggiore in an article entitled Safe and Sound Underground: HIV-Positive Women Birthing Outside the System and included other articles about AIDS, such as Molecular Miscarriage: Is the HIV Theory a Tragic Mistake? and AZT in Babies- Terrible Risk, Zero Benefit. (Mothering Magazine’s promotion of HIV/AIDS denialism and antivaccine misinformation may well make a topic for a future post in and of itself. Suffice it to say that Christine Maggiore was very much into “alternative medicine” and refused to vaccinate her children, making Mothering, which is well-known for its promotion of antivaccine views, the perfect venue for her.) After EJ was born, Maggiore refused to allow her to be tested for HIV and insisted on breast-feeding her, even though breastfeeding results in an unacceptable risk of virus transmission to the baby. The stage was thus set for the tragedy that was to come.

The Preventable Death of a Child

In March 2005, Christine Maggiore was interviewed on the liberal talk network Air America. In the interview, she boldly proclaimed:

“Our children have excellent records of health,” Maggiore said on the Air America program when asked about 7-year-old Charlie and 3-year-old Eliza Jane Scovill. “They’ve never had respiratory problems, flus, intractable colds, ear infections, nothing. So, our choices, however radical they may seem, are extremely well-founded.”

As the article noted, seven weeks later, Eliza Jane was dead of Pneumocystis carinii pneumonia (PCP) and HIV encephalitis.

In early April, Eliza Jane developed a runny nose with yellow mucus. Here is what happened next:

On April 30, Maggiore took her daughter to a pediatrician covering for Fleiss. That doctor found the girl had clear lungs, no fever and adequate oxygen levels, the coroner’s report said.

Five days later, Maggiore sought a second opinion from Gordon. In an interview, Gordon said he suspected an ear infection but believed it could be resolved without antibiotics. In a follow-up call, he said, Eliza Jane’s parents told him she was getting better.

Maggiore then asked Denver physician Philip Incao, who was visiting Los Angeles for a lecture, to examine her, the mother told the coroner’s investigator. He found fluid in Eliza Jane’s right eardrum.

On May 14, Incao examined her again and prescribed amoxicillin, Maggiore told the coroner.

Incao is not licensed to practice medicine in California.

The next day, Eliza Jane vomited several times and her mother noticed she was pale. While Maggiore was on the phone with Incao, the little girl stopped breathing and “crumpled like a paper doll,” the mother told the coroner. She died early the next morning, at a Van Nuys hospital.

I consider it rather ironic that Dr. Jay Gordon, who has been castigated for his antivaccine apologia, was involved in the case. He was quoted thusly at the time:

Dr. Jay Gordon, a Santa Monica pediatrician who had treated Eliza Jane since she was a year old, said he should have demanded that she be tested for human immunodeficiency virus when, 11 days before she died, Maggiore brought her in with an apparent ear infection.

“It’s possible that the whole situation could have been changed if one of the doctors involved – one of the three doctors involved – had intervened,” said Gordon, who himself acknowledges that HIV causes AIDS. “It’s hindsight, Monday-morning quarterbacking, whatever you want to call it. Do I think I’m blameless in this? No, I’m not blameless.”

No, Dr. Gordon was not blameless. If he did not know that Christine Maggiore was HIV-positive, it’s not unreasonable to conclude that he probably should have, given that he had been caring for EJ since she was one, Maggiore’s notoriety in the Los Angeles area, and Dr. Gordon’s fame among the “alternative” medicine and antivaccine crowd. If he didn’t insist on having EJ tested for HIV, he should have. Of course, it’s very possible that Maggiore went from doctor to doctor in order to avoid having any of them find out about her HIV status or ask for an HIV test Indeed, Dr. Gordon states that his office called Maggiore a week later to see how EJ was doing. Be that as it may, he was closer to blameless than Christine Maggiore, who, along with her apologists in the HIV/AIDS denialism movement, immediately launched a public relations blitz to try to spin Eliza Jane’s death as not having been due to AIDS. The “real cause” of her death, according to the HIV/AIDS denialism spin, has to be heard to be believed. I will now examine in detail that blitz and why the spin used to try to convince the public that EJ did not die of AIDS complications was so scientifically ludicrous.

Spinning EJ’s Death

After the death of EJ, the HIV/AIDS denialist propaganda machine went into high gear. The man who was hired, Mohammed Ali Al-Bayati, PhD, DABT, DABVT, was the perfect choice to go over the L.A. County Coroner’s report and try to find another explanation for EJ’s death, regardless of how much he had to twist the truth to do it. Dr. Al-Bayati represents himself as a toxicologist and “pathologist.” However, most pathologists who deal with HIV are MD’s. So what kind of pathologist is he? “DABVT” stands for Diplomate, American Board of Veterinary Toxicology; so basically he’s a veterinary pathologist and toxicologist. Whether that means he’s qualified to evaluate postmortem findings in AIDS, I don’t know. He has a few papers published in the peer-reviewed medical literature, but none of them have anything to do with HIV or AIDS; so his publication history doesn’t help me evaluate him. He does, however, have a very obvious and undeniable bias, as demonstrated by his listing on the infamous Virus Myth website or his book Get All the Facts: HIV Does Not Cause AIDS.

Dr. Al-Bayati also runs a company called Toxi-Health International, which, according to its website, provides expert witness services and “can evaluate the health effect resulting from acute and chronic exposure” to various agents,” including medication reactions, adverse reactions to vaccines, pesticides, and a variety of other compounds. He is also notorious for his role in another famous case, in which he produced a report similar to the one that he would ultimately produce about EJ. This report tried to spin the death of a baby due to shaken baby syndrome was a case of “vaccine-induced encephalitis.” The report was one of the most outrageous lies I have ever seen, and was used to try to win the freedom of a baby killer named Alan Yurko. Dr. Al-Bayati’s report on the death of Eliza Jane Scovill would approach, and possibly even surpass, his previous “achievement.” Soon HIV/AIDS denialist bloggers would be trumpeting the “Al-Bayati report” far and wide as “proof” that EJ did not die of AIDS.

But what, according to Dr. Al-Bayati, did EJ die of? If we’re to believe Dr. Al-Bayati’s report, she died of an allergic reaction to amoxicillin prescribed to her. I kid you not.

The first thing I noticed when I first read Dr. Al-Bayati’s report is that it appears not to be intended for a scientific audience. Instead, it was constructed more like a legal document designed to cast “reasonable” doubt on the coroner’s conclusion that AIDS-related pneumonia was the cause of Eliza Jane’s death, rather than actually putting together a coherent case for an alternate explanation. One particularly egregious example of his style was that he lambasted the coroner for not testing for a certain virus (more about this below), and then confidently concluded that Eliza Jane had that virus and not HIV, even though he couldn’t possibly have made such a conclusion without the results of the very test that he criticized the coroner for not having done in the first place! Let’s summarize the autopsy conclusions as Dr. Al-Bayati reports them:

  1. Pneumocystis carinii was found in Eliza Jane’s lungs by Gomori methenamine silver staining in association with pink foamy casts in the alveoli. The lungs were also edematous (water-logged).
  2. Eliza Jane was mildly neutropenic (low neutrophil–a type of white blood cell–count) and profoundly anemic (low red blood cell count)
  3. Eliza Jane’s brain contained throughout its white matter with relative sparing of cortex a number of variable-sized microglial nodules characterized by multinucleate giant cells associated with moderate pallor and myelination, occasional macrophages, and and angiocentric pattern. These lesions stained positive by immunohistochemistry (IHC) for the HIV core p24 protein, a finding consistent with HIV encephalitis.
  4. There was atrophy of the spleen and thymus
  5. There was enlargement of the liver with fatty infiltrate of the cells (steatosis) and ascites.

Dr. Al-Bayati then tried to “refute” each of these findings, using a variety of handwaving techniques and “might have beens” that truly astounded me at the time. One thing that puzzled me, though, was why he thought it so important to refute the finding that HIV was present at all. After all, if, as Dr. Al-Bayati clearly believes very strongly, HIV does not cause AIDS, then why didn’t he just come right out and argue that in his report? Why didn’t he just argue that AIDS couldn’t possibly have killed Eliza Jane and that the HIV protein detected in her brain was a red herring because HIV doesn’t cause AIDS? To argue otherwise was intellectually dishonest.

But I digress. I can’t help myself whenever I come across HIV/AIDS denialists trying to demonstrate that an HIV-positive person who died of what is considered an AIDS-defining illness did not, in fact, die of HIV.

Dr. Al-Bayati did concede that P. carinii, an AIDS-defining organism, was present in Eliza Jane’s lungs but tried to wave this finding away by pointing out that there was not a “pneumonia” because no inflammation was observed, citing a definition in a pathology textbook (a technique not unlike arguing about technical words using dictionary definitions). He also stated that P. carinii is ubiquitous, only causing disease in immunosuppressed patients. There are couple of problems with these arguments. First, immunosuppressed AIDS patients tend not to be able to mount a very effective inflammatory response to infection. Indeed, it has been noted that, in HIV infection, PCP pneumonia provokes fewer inflammatory cells and that PCP is worse in patients immunosuppressed by other causes as their immune system recovers and starts attacking the organism, causing inflammation, as real pathologist Dr. Trent McBride explained at the time. Dr. McBride also pointed out, for P. carinii to be detected in routine tissue samples at autopsy, there have to be a lot of organisms there. In immunocompetent individuals, there simply aren’t enough bugs to show up on silver stain.

The one argument Dr. Al-Bayati made in this context that wasn’t totally off the wall is that PCP can occur due to immunosuppression from other causes, and he cited several references that show that PCP can occur in people without HIV if they are immunosuppressed for other reasons. Of course, this line of argument totally begged the question of what the cause of this Eliza Jane’s profound immunosuppression was in the first place if it wasn’t HIV infection. Given that the HIV protein was also detected in the brain, there was an obvious cause for the immunosuppression that led to the presence of so much P. carinii in Eliza Jane’s lungs. By definition, Eliza Jane had AIDS-associated PCP. Dr. Al-Bayati clearly realized that he had to try to throw doubt on that finding.

And how did he try to do that? Disputing the findings of an experienced neuropathologist, Dr. Maurice A. Verity of UCLA, who examined the sections of Eliza Jane’s brain, Dr. Al-Bayati argued that the brain lesions seen are nonspecific and that the finding of the HIV p24 protein must have been a false-positive. He pointed out a paper from 1992 indicating a high level of false positivity of this test in the presence of inflammation. Tellingly, however, despite listing the numbers and types of tissues stained in the study (which included only 3 brains from HIV-positive patients and one brain without HIV), he did not cite the percentage of false positive results reported in the paper, only that it is “common.” The problem with this line of argument is that it’s not enough just to say that this “might” have been a false positive using references that, being 13 years old at the time, may not even be relevant to how IHC for HIV proteins was done 2005 or today. He has to show compelling reason that it was, rather than hand-waving and saying that some combination of a viral infection and/or an allergic reaction to amoxicillin caused this (see below). Even Dr. Al-Bayati appeared to realize this shortcoming.

And that’s where his strangest argument of all came in.

There’s a saying in medicine that, when you hear hoofbeats you don’t look for zebras. (A zebra is medical slang for a rare or highly unlikely diagnosis.) Yes, occasionally it you will find a zebra, but the vast majority of the time you will not. Consequently, when one hears hoofbeats from a tragic case of a dead child of an HIV-positive mother who was found to have profound anemia, PCP, and encephalitic lesions with HIV proteins detected in them, by far the most likely diagnosis is AIDS. Indeed, in the differential diagnosis, the first ten diagnoses in the differential would be AIDS, AIDS, AIDS, AIDS, AIDS, AIDS, AIDS, AIDS, AIDS, and then–very far down the line in probabilities–everything else. Given this, it’s not surprising that, in his rebuttal, Dr. Al-Bayati heard not one, but at least two zebras approaching.

Which zebras, though? The first one was erythrocytic aplastic crisis due to infection with parvovirus B19 (PVB19, the virus mentioned above), of course! Shouldn’t it have been obvious? He based this speculation on Eliza Jane’s anemia, encephalitis, upper respiratory infection, and atrophy of the spleen and thymus. I’ll give him props, though. This was a clever gambit, because this particular virus is common enough that a significant percentage of children have been exposed to it, meaning that there’s a reasonable probability that antibodies to it would be found if looked for, whether it was this virus that actually caused Eliza Jane’s death or not. Let’s look at this claim a little more closely.

PVB19 is a parvovirus that is fairly common and can cause upper respiratory infections, erythema infectiosum, arthritis and arthralgias, and transient aplastic crisis. Dr. Al-Bayati made much of the ability of this virus to cause anemia by transiently suppressing the progenitor cells that develop into red blood cells and blames infection with this virus for Eliza Jane’s profound anemia. He also attributed Eliza Jane’s encephalitis and bone marrow atrophy to infection with this virus. However, he neglected the observation that PVB19 is rarely much of a problem in healthy individuals. Severe anemia secondary to PVB19 usually only occurs in patients with a pre-existing anemia or pre-existing destruction of red blood cells and who therefore require a high level of reticulocyte production to keep their blood counts up. Conditions in which this can be a problem include chronic hemolytic anemias, sickle cell anemia, thalassemia, acute hemorrhage, and iron deficiency anemia, all of which cause red blood cell loss requiring replacement. Also, severe infections of the bone marrow with PVB19 causing aplastic anemia are rare aside from patients with pre-existing immunosuppression, such as transplant recipients, patients with malignancy, and, of course, patients with HIV. In such patients, PVB19 infection can result in severe, prolonged, recurrent, or even permanent anemia. Dr. Al-Bayati did point out a couple of case reports of a aplastic anemia due to PVB19 in immunocompetent individuals. However, PVB19 appears to be a fairly rare cause of aplastic anemia in healthy individuals. It is, of course, possible that PVB19 infection caused Eliza Jane’s serious anemia (that’s where “reasonable doubt” comes in). However, even if it had, given what is known about this strain of parvovirus, a far more likely explanation would be that the virus caused Eliza Jane’s anemia because of immunosuppression secondary to her HIV infection, if it did anything at all.

The second zebra was a severe amoxicillin hypersensitivity. An amoxicillin allergic reaction in and of itself is not a zebra, but it was in the context of this particular case. Never mind that Eliza Jane had, as was emphasized in the report, never been exposed to antibiotics before and that her clinical course did not seem consistent with a hypersensitivity reaction. Never mind that there was no eosinophilia, no urticaria, or no other stigmata of an allergic reaction mentioned in Dr. Al-Bayati’s report (and you can bet that, had any of them been there, he would have mentioned them again and again). Amoxicillin hypersensitivity was also blamed for Eliza Jane’s steatosis (fatty liver infiltrate). It is true that amoxicillin-clavulanate has been associated with hepatocellular, cholestatic, granulomatous, or focal destructive cholangiopathy (all types of liver damage), and references are cited showing this. However, one would think that Dr. Al-Bayati would know that steatosis is not the same thing as any of these. Moreover, the pathology report did not state that Eliza Jane’s liver had any of the more common manifestations of amoxicillin-clavulanate-induced liver injury, casting further doubt on the antibiotic as the cause. (Drugs more classically associated with steatosis include valproic acid, tetracycline, amiodarone, and aspirin, not amoxicillin-clavulanate. I didn’t see any of Dr. Al-Bayati’s references supporting his implication that amoxicillin could cause steatosis within a day of exposure. Clearly, the steatosis must have been a pre-existing condition. As for the pulmonary edema and ascites reported, that could be due to allergic reaction, septic shock from an ear infection, cardiopulmonary collapse from whatever cause, or a number of other factors, but in the context of Eliza Jane’s HIV infection, rapid deterioriation, and cardiovascular collapse, it fits, especially given that steatosis is very common in pediatric AIDS patients.

The bottom line is that you can compare these two sets of conclusions about what caused Eliza Jane’s death and decide which seems more plausible. The first, the coroner’s report, looks at a child of an HIV-positive mother who refused to take AZT during pregnancy, breast-fed her child even though that is known to increase the rate of transmission of HIV, and refused to have her child tested for HIV, a child who collapsed after upper respiratory and ear infections, whose autopsy findings showed HIV encephalitis, P. carinii in the lungs, and severe anemia. Given such findings, it’s hard not to conclude that Eliza Jane died of AIDS complications. The second hypothesis, promulgated by an HIV “dissident” with a definite axe to grind, requires us to believe in not just one, but three, highly unlikely occurrences (plus one simply unlikely occurence), namely:

  1. A previously completely healthy girl developed PVB19 infection leading to both encephalitis and aplastic anemia (possible, but highly unlikely, and, even if PVB19 were found, it would be far more likely that it was able to cause anemia because of immunosuppression due to AIDS).
  2. This same girl also developed an acute allergic reaction to amoxicillin that led to cardiovascular collapse and–oh, by the way–also caused steatosis of the liver within a day after starting the drug, the steatosis being something even Dr. Al-Bayati’s own references do not seem to support as being likely.
  3. This same otherwise healthy girl had sufficient quantity of P. carinii in her lungs to show up on Gomori methenamine silver staining at her autopsy.
  4. The medical examiner and neuropathologist either botched the staining for the p24 protein (or that it was a false positive) and an experienced neuropathologist didn’t know the pitfalls of the diagnosis of HIV encephalitis using brain tissue sections.

A veritable herd of zebras indeed.

Sadly, none of this stopped Christine Maggiore from going on ABC’s PrimeTime Live to argue her case. In the intervening three years, efforts continued on and off to present Maggiore as lacking any culpability in EJ’s death, and, like a vampire, the Al-Bayati report kept rising from the dead whenever it was required. Denialist bloggers stated that Eliza Jane “died of an allergic reaction to an antibiotic, not of AIDS” as though it were a settled fact. In addition, Maggiore and her supporters continued a smear campaign against the L.A. County Coroner as incompetent or somehow in the pocket of big pharma. The preventable death of al little girl can’t be anything but tragic, but the desperate and scientifically dishonest methods used by HIV/AIDS denialists to try to deny that this little girl died of anything other than complications from AIDS added immeasurably to the tragedy.

History Repeats Itself

Three years later, it appears that Maggiore’s belief that HIV doesn’t cause AIDS might finally have caught up with her. I say “might have” because we do not know for sure right now and cannot know for sure without an autopsy. The one thing we do know is that about a week ago she died of pneumonia at the age of 52:

On Saturday, Maggiore died at her Van Nuys home, leaving a husband, a son and many unanswered questions. She was 52.

According to officials at the Los Angeles County coroner’s office, she had been treated for pneumonia in the last six months. Because she had recently been under a doctor’s care, no autopsy will be performed unless requested by the family, they said. Her husband, Robin Scovill, could not be reached for comment.

Maggiore was HIV-positive. When any HIV-positive person develops pneumonia, the galloping hooves usually signify horses, not zebras, the horse being an HIV-associated pneumonia. This is especially true in light of the coroner’s statement that she had been treated for pneumonia in the last six months. Two bouts of pneumonia in less than a year in an HIV-positive individual is, at the very least, very suspicious for AIDS-defining illness.

Of course, it is possible that Christine Maggiore, in fact, died of a community-acquired pneumonia or some other sudden cause. It happens sometimes. However, if Maggiore’s cause of death had been something other than a mystery illness, seemingly a pneumonia that sounds as though it might be HIV-related, chances are that Maggiore’s family would have stated plainly in a press release the cause of her death. Even though we’re unlikely ever to know for sure unless Maggiore’s family requests an autopsy, it’s still pretty unlikely that a 52 year old died of a simple community-acquired pneumonia or dropped dead of another illness, and if it wasn’t HIV-related why be so coy about it, anyway? Moreover, the fact that Maggiore had been treated for this “pneumonia” in the last six months sure sounds suspiciously as though she had developed a more chronic infection, consistent with Pneumocystis pneumonia. Assuming that’s the case, which is a pretty reasonable assumption, Maggiore has now joined the list of other HIV/AIDS denialists infected with HIV who have gone to their grave claiming that their HIV does not cause AIDS, that antiretrovirals do not improve survival of HIV-positive patients even though the evidence is overwhelming that they do, and that the illness that claimed them was not due to HIV, activists such as Michael Bellefountaine and David Pasquarelli.

Just as they did after EJ died, the HIV/AIDS denialists came out in force trying to deny that Maggiore died of HIV-related causes. Leading the charge to try to “prove” that it was not AIDS that killed Maggiore was Celia Farber, writing on on the blog of a prominent HIV/AIDS denialist blogger named Dean Esmay, who is most vociferous in his claim that AIDS did not kill Maggiore. Not unexpectedly, her claim was that Christina Maggiore did not die of AIDS. Surprisingly, according to Farber, it was rather a combination of stress and a “radical detoxification” regimen that led to Maggiore’s demise. However, even if Farber’s account is accurate, then, no matter what killed Maggiore, HIV or quackery, her case stands as a shining example that pseudoscience and antiscience kill. Indeed, HIV/AIDS denialists must be pretty desperate to blame quackery for Maggiore’s demise.

Farber begins with some drama, which, believe it or not, I can understand given that her friend just died but unfortunately her drama adds a lot of heat but no light on the case:

The news has been shattering to all who loved her around the world. Speaking for myself, I can say that Christine Maggiore was one of the strongest, most ethical, compassionate, intelligent, brave, funny, and decent human beings I have ever had the honor to know. I spoke to her in great depth about all aspects of life, death, love, and this battle we both found ourselves mired in, and I will be writing about her and about those conversations here, in the future. No matter what she was going through, and it was always, frankly, sheer hell-every day of her life, since 2005, she faced, acute grief, sadistic persecution, wild injustice, relentless battle, and deep betrayal-she was always there for her friends, and she never descended to human ugliness. She always tried to take the high road. She always tried to be stronger than any human being could ever be asked to be. I feared for her life, always. I feared the battle would kill her, as I have felt it could kill me, if I couldn’t find enough beauty to offset the malevolence. This is a deeply occult battle, and Christine got caught in its darkest shadows.

While I understand the pain the death of a loved one produces and even though one never likes to speak ill of the dead, I have to point out that Maggiore brought at least some of that “sheer hell” upon herself when her cultish belief in HIV/AIDS denial led her to fail to take simple steps that could have prevented the death of her daughter. I have no doubt that Maggiore suffered horribly from the grief that comes from losing a child, and I’m not unsympathetic to that. She suffered a loss that no parent should have to suffer, made all the more tragic because it was potentially preventable. Perhaps, somewhere deep within, she even felt guilty that her belief led her to fail to prevent it. However, the clear preventability of Eliza Jane Scovill’s death is why my sympathy for her mother only goes so far. While my sympathy for Eliza Jane for having had her young life snuffed out prematurely by AIDS is enormous, my sympathy for Eliza Jane’s mother ended at the point that she allowed an antivaccine and HIV/AIDS denialist hack to try to whitewash her daughter’s autopsy report and try to spin the cause of death as being from an antibiotic reaction, as described above. My sympathy also bumps up against Maggiore’s prominent role in spreading a denialist philosophy that has arguably led to the deaths of an estimated hundreds of thousands in Africa. As for this being a “deeply occult” battle, Farber is more correct than she knows, but not in the way she thinks. The battle is “occult” in the sense that HIV/AIDS denialism is very much like magic and the occult; it is based on faith, not science, and its adherents cling to it in the face of all evidence, science, and reason to the contrary like some dark religion.

So what did actually kill Christine Maggiore? Well, if we’re to believe Celia Farber, the rankest of quackery killed her, plain and simple:

She had apparently been on a radical cleansing and detox regimen that had sickened her and left her very weak, dehydrated, and unable to breathe. She was shortly thereafter diagnosed with pneumonia and placed on IV antibiotics and rehydration. But she didn’t make it.

Later in the post, Farber tries to refute the reports that Maggiore had been ill for a while:

She had been HIV positive since 1992, and never had an AIDS defining illness. Her foes have predictably begun their attacks, and there is already a misleading statement from the LA County Coroner’s office, against whom Christine was scheduled to testify two days from when she died, stating that she had had pneumonia for six months. This is incorrect, but helps foster the impression that it was an AIDS related pneumonia (PCP) which is a longer term illness.

This is a twisting of what the news reports actually said, which was: “According to officials at the Los Angeles County coroner’s office, she had been treated for pneumonia in the last six months.” To me that means she had been treated for pneumonia sometime within the last six months. It does not mean that she had had pneumonia for six months prior to her death. Also, that Maggiore lived symptom-free with HIV for 16 years does not mean that HIV doesn’t kill. As Nick Bennett explains, a period of 16 years is not too far outside of the normal range for time to progression of untreated HIV infections.

More importantly, though, Farber’s account has a glaring inconsistency. Here Farber tries to argue that Maggiore was as healthy as the proverbial horse, aside from her understandable emotional distress over the death of her daughter due to AIDS, and yet she was undergoing some sort of “radical detoxification regimen.” (One wonders if she was undergoing the Gonzalez regimen, which is certainly a radical detoxification regimen–and about as dubious a “therapy” as there is.) If Christine Maggiore was in fact so healthy, why did she think she needed to undergo such a radical detoxification regimen? Healthier people, a.k.a. the “worried well” who are most drawn to “alternative” medicine, tend to opt for much less radical detoxification regimens. True, sometimes healthy people do undergo extreme regimens for vague symptoms or as a “preventative” measure, but in general usually only people who have a serious illness or who have persistent health problems that they can’t shake are drawn to the radical detoxification regimens. According to Farber, Christine Maggiore underwent a “detox cleansing” regimen so radical that she perceives it as being plausible that the regimen was what caused Maggiore to lose weight, become weaker, and finally become too weak to fight off the pneumonia that killed her. Quite frankly, that must have been one hell of a “detox regimen,” and I’d be very curious to know exactly what it involved.

In any case, in a followup post, Farber published a letter allegedly written by Maggiore on December 19, a mere week before her death. First, she launches an attack against anyone who has suggested that Maggiore may have died of AIDS:

I’m told that I stand accused in Internet hate swamp sites of claiming Christine Maggiore died “from a cleanse,” in the name of “denying” that she died of AIDS.

She died, while suffering from bilateral bronchial pneumonia, after taking on a de-tox cleanse, is what I reported. These people at these swampy sites apparently can’t read, can’t decipher basic English. Every time I report they accuse me of “denying,” but how can you be denying while you are reporting?

Apparently, Farber can’t read her own words (see above), because that’s exactly what she said: That a “cleanse” rendered Maggiore so weak that she could not fight off a case of pneumonia. She apparently can’t read the words of her friend, either. I quote an excerpt:

Regarding my health, I finally figured out what’s going on…but it got really scary. Here’s the scoop I just sent a friend:

I have been through the absolute worst health nightmare ever. The cleanse, while definitely bringing about some profound benefits, left me feeling weak and dehydrated. I lost my appetite almost completely about 10 days ago and for some weird reason could only tolerate hot tea and hot chicken broth. I had been in touch with the cleanse doc who said all was typical, uncomfortable but typical. Not one to quit, I kept going. Then I started to have trouble breathing, I was feeling winded after the most simple task like making the bed.

This last Sunday, I stopped being able to sleep at all. So finally, genius that I am, I made an appointment to see my MD who is really smart and very well versed in natural health care and not at all into the HIV paradigm.I could only get in to see her yesterday. She said I was totally dehydrated and having a reaction to the herbs in the cleanse which she thought were suspicious. I asked her to check my lungs and she said they sounded clear. I told her I thought I should have a chest Xray anyway, just to be sure, but she was skeptical because I hadn’t had a cold, flu, cough or fever. But I insisted so she wrote me up to go to a radiology place that would give an immediate reading. By then I felt so ill I had to ask my neighbor to drive me and thank god he was there with me because I never would have made it to the radiologist without his help. As it turned out, the Xray showed a very serious case of bi-lateral bronchial pneumonia. The doctor immediately gave me IV rehydration, IV natural cortisone, and IV antibiotic.

It sure sounds to me as though Maggiore had been seriously ill at least since early December. Indeed, Farber’s reposting of Maggiore’s e-mail reinforces my opinion that she was either very ill beforehand, became ill (or more ill) after a “cleanse,” or both. Perhaps the most bizarre claim I’ve seen as to the cause of Maggiore’s death came from a commenter called Baby Pong on the Science Guardian blog, who claimed that EJ died as a result of a covert operation and that Maggiore’s death was similarly “extremely suspicious,” even going so far as to speculate that “the ‘holistic cleanse’ would have been an excellent opportunity for someone to have covertly introduced some extremely toxic substance into Christine’s body.” I don’t claim that this is what HIV/AIDS denialists are arguing in general; I only present it to show the depths of conspiracy mongering to which some of them routinely descend.

Of course, I can’t help but think of an alternate explanation to the one provided by Celia Farber, one that, to me at least, fits better the facts as we know them so far. I admit I’m speculating, but, without hard evidence from an autopsy to tell us what killed Christine Maggiore, I submit to you that my speculation fits the known facts better than Farber’s explanation. My explanation would be that Maggiore had been ill for a while. Because she had become ill, she started a “radical detoxification” regimen. Perhaps she even had a little dry cough that got a bit worse, which she would never allow herself to recognize as an early symptom of PCP. She became weaker and sicker not primarily because of whatever quack regimen she was undergoing but because of HIV. Most radical detoxification regimens, even the worst, usually do not sicken people to the point of being so weak they are susceptible to fatal pneumonia–unless, of course, they are already seriously ill. This is especially true after only one such “cleanse,” rather than the multiple sessions that quacks generally recommend.

Conclusion

Progress against the scourge of AIDS is one of the most dramatic success stories of science-based medicine. Think about it. In 1981 the CDC reported a newly identified immunodeficiency syndrome affecting homosexual men in New York and San Francisco and hemophiliacs. This syndrome was associated with lymphadenopathy, Kaposi’s sarcoma (a tumor previously very rare in populations other than old men of Mediterranean descent), and opportunistic infections such as PCP. Within four years, the virus causing the disease was isolated. Within a few short years after that, AZT was shown to be effective against HIV. By the mid-1990s, combinations of antiretroviral therapy including protease inhibitors were shown to significantly delay the onset of AIDS. Within a decade after that, these cocktails of three or four antiretroviral drugs, known as highly active antiretroviral therapy (HAART) had dramatically reduced mortality from HIV. In the meantime we learned about the clinical course of HIV infection, discovered genetic mutations that made some people very resistant to progression to AIDS, and characterized the molecular mechanism by which HIV gradually destroys the immune system. Within 25 years of its description as a distinct clinical entity, HIV had been transformed from a probable death sentence to a chronically manageable disease. True, many challenges remain. HAART has many side effects, some of them serious, and resistance to the drugs can develop. Nonetheless, by any reasonable measure, science-based medicine has done more faster to improve the outlook of HIV-infected patients than it has for virtually any other disease.

It is also very clear that HIV/AIDS denialism is a delusion that kills. It kills by encouraging HIV+ individuals not to take antiretroviral drugs, which have been shown unequivocably to prolong life and forestall progression of HIV infection to AIDS. It kills by encouraging quackery over effective antiretroviral therapy, as has happened in Africa, particularly under Thabo Mbeki’s regime in South Africa. Indeed, it has been estimated that the delay in introducing HAART therapy into Africa, which was in part due to denialist policies, resulted in the potentially preventable deaths of over 300,000. In the case of Christine Maggiore and her family, it has claimed at least one life and likely two lives, devastating a family. Unfortunately, HIV/AIDS denialists will continue to use logical fallacies, pseudoscience, and cherry picking of data and studies to argue otherwise.

There is, of course, one way for HIV/AIDS denialists to prove my discussion of Maggiore’s death wrong, and it’s one area where I actually agree with Celia Farber:

We all agree that it is imperative that an impartial and thorough autopsy bring to light all facts about Christine’s cause of death, and the state of her immune system, and how these facts might bring us all closer to the ultimate truth we all seek.

I agree with the expressed sentiment, and, if an autopsy is done and it turns out that Maggiore did not die of an AIDS-related pneumonia, I will forthrightly admit my speculation was incorrect. However, even if Maggiore did not die of AIDS, it would not in any way validate her HIV/AIDS denialist beliefs, although no doubt that’s exactly what denialists like Farber and Esmay would try to do. I will also point out that, if Farber’s account is confirmed, then Maggiore’s death would be prima facie evidence that unscientific quackery can kill.

If, on the other hand, however, an autopsy is performed and it does show PCP and other evidence of AIDS, will Celia Farber and Dean Esmay concede that AIDS killed Christine Maggiore? I sincerely doubt that they would. Indeed, if there is an autopsy and it shows that Christine Maggiore died of AIDS-related pneumonia, expect a replay of the Eliza Jane Scovill story. Expect more dubious attempts to spin the results as being something else. Expect HIV/AIDS denialists to trot out Dr. Al-Bayati again, who will dutifully examine the autopsy report and come up with an equally inane “explanation” for Maggiore’s death as he did for Eliza Jane’s

There are at least three tragedies in this sad tale. The first was the death of EJ at such a young age. She was sacrificed on the altar of her mother’s cultish refusal to accept the overwhelming scientific consensus that HIV causes AIDS and that antiretroviral therapy can not only prolong life but decrease the risk of maternal-fetal transmission of the virus. The second is that since the mid-1990s Maggiore has done a lot to spread the pseudoscience and misinformation that claims that HIV does not cause AIDS. Perhaps the worst of her offenses was that she discouraged at-risk women from being tested for HIV and HIV-positive women to take antiretroviral drugs during pregnancy to reduce the risk of maternal-fetal transmission of HIV. Moreover, she was undoubtedly a leader and spokesperson of the HIV/AIDS denialist movement, which is why denialists are now trying to hard to deny that her death might have been due to HIV, as Seth Kalichman documents. The third tragedy is that Maggiore had another child, a son. Fortunately, he appears to have escaped having HIV transmitted to him by his mother. Unfortunately, he and his father are left mourning the deaths of his sister and mother, whose deaths occurred a mere three years apart.

I have almost no hope that this tragedy, whatever the cause of Christine Maggiore’s death is determined to be or not to be, will silence HIV/AIDS denialists or even make them truly “rethink” their position, I do hope that Maggiore’s survivors, her husband Robin and her son Charlie, can somehow find some peace and manage to get on with their lives after their mourning is finished. A cultish ideology claimed at least one, and probably both, of them.

Posted in: Health Fraud, Public Health, Science and Medicine, Science and the Media

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40 thoughts on “Christine Maggiore and Eliza Jane Scovill: Living and dying with HIV/AIDS denialism

  1. overshoot says:

    PCP can occur due to immunosuppression from other causes, and he cited several references that show that PCP can occur in people without HIV if they are immunosuppressed for other reasons. Of course, this line of argument totally begged the question of what the cause of this Eliza Jane’s profound immunosuppression was in the first place if it wasn’t HIV infection.

    Well, the main non-HIV incidence of PCP is, after all, a perfectly natural loss of immune function. I do suspect, though, that a gerontologist wouldn’t have been appropriate for EJ.

  2. Another aspect to the tragedy is that Maggiore really did seem to be “healthy as a horse” for much of her life, and as such, she probably would have had a great prognosis for a normal lifespan had she taken antiretrovirals.

  3. BD says:

    “Dr. McBride also pointed out, for P. carinii to be detected in routine tissue samples at autopsy, there have to be a lot of organisms there. In immunocompetent individuals, there simply aren’t enough bugs to show up on silver stain.”

    - This is something that has not been emphasized enough, I think. In an attempt to deflect from their culpability in EJ’s death. Duesberg & Bialy wrote an unpublished letter to the LA Times in which they claimed “A post mortem finding of PCP in the lungs means nothing since it is 100% ubiquitous in human beings.”

    http://deanesmay.powerblogs.com/posts/1150349954.shtml

    As you point out, this is false. The largest autopsy series I know of is cited here: http://hivinsite.ucsf.edu/InSite?page=kb-05-02-01

    “At the National Cancer Institute, only 7 of 2,887 consecutive autopsies revealed PCP, a prevalence rate of only 0.2% in a high-risk population.” (Vogel CL, Cohen MH, Powell RD, DeVita VT.
    Pneumocystis carinii pneumonia. Ann Intern Med. 1968 Jan;68(1):97-108).

    The population is described as “high risk” because it was people who had cancer. So once Bayati or any other denier acknowledges that the GMS stains documented PCP in EJs lungs, they’ve acknowledged the cause of death. Acute respiratory distress from PCP has always been the most common reason for ER admission among HIV-infected children.

  4. hatch_xanadu says:

    Amazing. Amazing that people will deliberately engage in deception, to the point that it endangers the lives of their own children, just to be “right”. I can only imagine the awful stew of guilt and defensiveness and mendacity that must have been brewing in Maggiore’s brain when that little girl died.

    Thanks for this post. I do have one qualm, and I believe it’s only grammatical, re: Jay Gordon: “Be that as it may, he was far less blameless than Christine Maggiore, who, along with her apologists in the HIV/AIDS denialism movement, immediately launched a public relations blitz to try to spin Eliza Jane’s death as not having been due to AIDS.”

    I think you may have meant “far less to blame”. As much as I’d like to kick Jay Gordon in the crotch, it seems he conducted himself reasonably, albeit perhaps too passively, in this case. And I’m quite willing to bet that Maggiore was evasive with all of her physicians, and rather hellish to challenge.

    As for Al-Bayati, good God. Just . . . good God. And you’re right on with this: “One thing that puzzled me, though, was why he thought it so important to refute the finding that HIV was present at all. After all, if, as Dr. Al-Bayati clearly believes very strongly, HIV does not cause AIDS, then why didn’t he just come right out and argue that in his report?”

    And somehow in its sensationalism, and by mere virtue of it being infinitely murkier than a straightforward report of AIDS-related death, his is a very effective Chewbacca defense: http://www.southparkstudios.com/clips/103454/

  5. weing says:

    I give her the Darwin award.

  6. Danio says:

    Wow, David. What an incredibly thorough and well presented history on this tragic story. The dangers of pseudoskepticism have rarely been laid out more clearly.

    The sorrowful story of the breast cancer patient who chose alternative medicine and a horrible death over early surgical treatment has always stood out to me as the worst, most startling example of the harm CAM can do. The Maggiore saga is a brutal example of how much worse it can get when it involves a communicable disease. That cover photo of ‘Mothering’ makes my blood run cold.

    I appreciate your thorough and sensitive treatment of this case. Thanks for all that you do.

  7. TsuDhoNimh says:

    I can understand the HIV denialism. Mothering magazine’s forums are loaded with denialism:

    Vaccine denialism and alarmism over the ingredients,

    Germ theory denialism … to the extent that people headed for a mission in the rice paddies of Asia are wondering if it’s really necessary to get the tetanus booster that the mission organizers require.

    The joys of home and/or unattended birth denialism … the birth process was perfect (by their standards), but the baby is dead/brain damaged doesn’t bother them nearly as much as having a C-section, pitocin or forceps to have a better outcome for the baby.

    Anthropology denialism … unable to understand why a toddler isn’t responding to their discipline woo of the year, why siblings quarrel, why teenagers have sex.

  8. Chris says:

    I would hope that Mr. Scovill will finally see through his grief the effects Duesberg and others had on his family. Though, he will probably still be promoting Ms. Maggiore’s dangerous ideas.

    Their son will probably never fully recover (I lost my mother when I was young, and there is still a void).

    I must confess when I got to the end of the first LA Times article, any sympathy I had for Ms. Maggiore evaporated:
    http://www.latimes.com/news/local/la-me-christine-maggiore24-2005sep24,0,7927684.story?page=5

    “Why our child — so appreciated, so held, so carefully nurtured — and not one ignored, abused or abandoned?” she wrote. “How come what we offered was not enough to keep her here when children with far less — impatient distracted parents, a small apartment on a busy street, extended day care, Oscar Mayer Lunchables — will happily stay?”

    Well, my dear, it is because you failed to prevent transference of a virus you carried to your daughter. You deluded yourself that all you need is live the perfect life and all will be well. Some of us have grown up near busy streets in small apartments with working mothers and turned out okay. But, then again, we were also given proper medical care. I was rushed to the hospital when I was gravely ill and lived.

    My children did get fast food meals when we were building our house, and they are still alive and very loved (even though they are teenagers). But they are also fully vaccinated, have had regular check-ups (which is where a very genetic disorder was found in one child), and taken to the hospital when one was very sick (and lived).

  9. Danio says:

    Wow, Chris, that outrageous quote pretty much sums up the altie philosophy, doesn’t it? Purge your life of all of science’s evil synthetic spawn and you’ll live forever, just like your ancestors…oh, wait.

    I was also sickened by Maggiore’s sentiments at the end of the penultimate paragraph of the LA Times piece:

    Maggiore wrote lovingly of her daughter, wavering between despair at her loss and acceptance that Eliza Jane had simply chosen, as Maggiore put it, to “go home.”

    As if that child had anything like a choice.

  10. overshoot says:

    How come what we offered was not enough to keep her here when children with far less — impatient distracted parents, a small apartment on a busy street, extended day care, Oscar Mayer Lunchables — will happily stay?

    This can’t happen to me! I’m rich!

    Sounds like an idea for a song.

  11. weing says:

    One reason for maintaining her denialism was the comfort it provided. It’s very uncomfortable for someone to admit that they are responsible for their child’s death.

  12. Fifi says:

    People don’t “go home” when they die, they simply cease to physically exist – though I guess it’s more comforting to pretend that one’s child is alive in a better place than dead because of one’s own denial! It makes it sound like like infanticide.

  13. apteryx says:

    “The third tragedy is that Maggiore had another child, a son.”

    Yikes! I hope you do not mean to be so malevolent as to begrudge this boy his existence and good health simply because the publicity of those facts might possibly encourage other HIV+ women to let themselves get pregnant.

    Even without treatment, such women would run at worst a 25% risk of transmission. Even if you assume a 100% death rate for infected children, which is not true even without treatment, this is no worse than the odds for many genetic diseases that arouse less anger in Americans. Any number of recessive genes, if carried by both parents, offer 25% risks of disaster with each pregnancy. I knew a guy once who worked in a facility for severely retarded and handicapped children. There were once two or three sweet little sisters there simultaneously, completely disabled and waiting for slow miserable deaths; the mother, constantly pregnant, thought that she was doing Jesus’ will by continuing to crank ‘em out. The flip side of that is that some carriers gamble and produce two or three perfectly normal kids, to everyone’s benefit. I find the serial losers repulsive and probably you do as well, but we usually do not suggest that people who carry severe genetic diseases are child abusers just because they wish to get pregnant.

    Incidentally, since you condemn the Mothering magazine article to which you link in such broad terms, you might wish to make it clear whether you agree or disagree with one of the author’s main contentions, that doctors should not have the state threaten or outright seize the children of HIV+ mothers who consider breastfeeding. Studies have shown that if a child has not been infected before or during delivery, the chance of infection from breastfeeding is very small. The excessive fear of breast milk has led to many deaths in Africa; women were pressured to use formula for years, but when the issue was finally studied, it was found that breast-fed babies of HIV+ women do much better. The negatives of formula feeding that are usually survivable in our cushy and sanitary environment hit Third World babies much harder.

  14. wertys says:

    Thanks for ruining my day by making me feel physically sick at the thought that an innocent child can die with undiagnosed HIV at the deliberate behest of her mother. In a situation like this you just don’t know where to look or what to feel apart form trying harder to make sure that it can’t happen again…

    Alt.med is woo with a body count…

  15. James Fox says:

    In a case like this my favorite form of denialism is when the state denies these parents of their children.

    It’s a shame that someone didn’t call CPS and report the clear and obvious case of neglect and I don’t think this would have qualified for any kind of religious exclusion aside from the church of dumb which has still failed to properly register.

  16. Fifi says:

    Correction:

    It makes it sound less like infanticide.

  17. Deetee says:

    @Apteryx, who said:

    “Incidentally, since you condemn the Mothering magazine article to which you link in such broad terms, you might wish to make it clear whether you agree or disagree with one of the author’s main contentions, that doctors should not have the state threaten or outright seize the children of HIV+ mothers who consider breastfeeding. Studies have shown that if a child has not been infected before or during delivery, the chance of infection from breastfeeding is very small. The excessive fear of breast milk has led to many deaths in Africa; women were pressured to use formula for years, but when the issue was finally studied, it was found that breast-fed babies of HIV+ women do much better. The negatives of formula feeding that are usually survivable in our cushy and sanitary environment hit Third World babies much harder.”

    Well I disagree, and think that the State has every right to intervene to protect the health of a child put at risk of harm by its mother.

    In fact the risk of HIV infection through breastfeeding, though smaller than the risk of infection during the delivery, is not “very small”, but is significant enough to justify advising complete avoidance.

    You are using the African situation without understanding the science. Yes, bottle feeding has its own risks, but should the hygiene circumstances permit, then it is still safer than breast feeding. Most dangerous of all is mixed feeding, where Moms both bottle feed and breastfeed. Using the risks of bottle feeding in Africa to justify your idea that mothers in this country should not bother with it is a misuse of scientific evidence, and a logical fallacy to boot.

  18. Danio says:

    Yikes! I hope you do not mean to be so malevolent as to begrudge this boy his existence and good health simply because the publicity of those facts might possibly encourage other HIV+ women to let themselves get pregnant.

    Apteryx, The ‘third tragedy’ has nothing to do with the physical health of the child, per se–at least not with any symptoms that couldn’t be attributed to grief or post-traumatic stress. I think it’s pretty clear from the context that the tragedy here is that this boy has suffered so much, and that he need not have endured such emotional pain and loss at such a young age had his mother not eschewed evidence-based treatment for herself, or at the very least her daughter.

    As to the rest of your post: citations, please.

  19. Seth Kalichman says:

    Christine Maggiore was misled by Peter Duesberg into thinking that HIV is harmless and HIV treatments are toxic poison. Ultimately she promoted this same pseudoscience-based denialism at her own peril. Many others were harmed by her relentless spreading of false information that confused people about HIV testing and treatment.

    The misinformation and disinformation of denialism is dangerous because the Internet easily allows fakes and frauds to masquerade as genuine doctors and scientists. Denialism tells people with HIV what they want to hear – that HIV does not exist, that AIDS is caused by stress, and that taking vitamins and eating healthy will make everything ok. But it does not. It did not for Christine Maggiore and will not for anyone else with HIV/AIDS.

    Thanks for posting this story. It does not take long to figure out that AIDS denialism is the same phenomenon as holocaust denial and 9/11 truth seeking. He sad story of AIDS denialism that enmeshed Christine Maggiore is told in a new book coming out Denying AIDS: Conspiracy Theories, Pseudoscience, and Human Tragedy (all Royalties donated to buy HIV medications in Africa) published by Springer/Copernicus Books. You can read more at http://denyingaids.blogspot.com/

  20. Deetee says:

    I wonder what Charlie Scovill, Maggiore’s son, will think about this appalling episode in the years to come. He has he lost both his sister and his mother to a disease that she and his father could easily have prevented or controlled.

    One of the fears of aduts with this disease was that they would never be able to have children, or would leave their kids orphaned at a young age. But in the clinic today, one hardly ever sees this happen. Many Moms have gone on to raise their kids into adulthood and independence, purely thanks to the life-saving properties of the ARVs they took.

  21. Mark Crislip says:

    I find this entry particularly depressing.
    I started my infectious disease fellowship in L.A in 1986 at the beginning of the AIDS flood, before we had a good handle on treatments or even the etiology

    The end of the century was an endless line of young men (mostly) dying particularly slow, horrible deaths. The progress seemed so slow as the body count mounted, although I know that the progress we made was amazing in a short period of time.

    This century I have had one AIDS death. One. And he presented at the end of the line with his disease.

    The application of science on HIV and the resultant effects of HAART have been the medical miracle of my medical career.

    People do not die of AIDS in the US. For those of us who have been there since the beginning the change has been astounding, and for years seemed unobtainable.

    I have seen lots of death in my day, but pointless, useless, un needed death is dispiriting

    whats the harm in believing in nonsense: two deaths too many

  22. Rune from Oslo Norway says:

    I want to ask on the subject of HIV/AIDS if anyone here can recommend some books for a layperson such as myself?

    I have done some searches on Amazon, but the ranking system doesn’t discern between crapbased and sciencebased books.
    I done a couple of searches, and because of that Maggiore’s book and others I figure as nonsense right away are turning up as recommended.
    I am not primarily interested in books about denial either, I would like to know what’s true and why rather than a catalogue of wrongs which debunking tends to be.

    Any advice would be appreciated.

  23. David Gorski says:

    A couple of people last night pointed out to me that the link to Celia Farber’s second post, the one in which she republishes Christine Maggiore’s e-mail of December 19, no longer works. There is now an explanation on Dean Esmay’s blog: Farber admits that she took it down. I can’t help but think that she knows she did harm to the cause of HIV/AIDS denialism by republishing that e-mail which, quite frankly, only served to confirm in my mind that Maggiore very likely did die of an AIDS-defining pneumonia, probably PCP. After all, she was short of breath, her lungs were clear, but she asked for an X-ray. Why on earth would she do that if she weren’t worried about pneumonia? Also, the clinical course was about right, two to three weeks.

    In any case, predictably, Farber lays on the inflammatory rhetoric:

    I took down the post I wrote the other day in which I re-published an email from Christine Maggiore, in her own words, about a week before she died suddenly and unexpectedly at home, on December 27.

    I want to contribute toward a much needed silence. Things will work themselves out, truths will emerge, whatever is, is.

    I don’t want to bring anything loud or contentious to Christine’s memory, or provide a feeding ground for those few vultures whose egos remain tied up in their insatiable death wishes, not only those they projected onto Christine, but onto all HIV positive people they wish to enslave with their cult of fear, and deprive of the fundamental human right to make their own choices.

    I guess Farber counts me as one of those “vultures,” if she’s seen my post. Of course, I had no desire to see Maggiore die. Her death saddens me. Not as much as the death of her daughter did, but I am still saddened.

    Note the typical “health freedom” rhetoric, though, beloved of believers in pseudoscientific health claims like HIV/AIDS denialism. Apparently infectious disease doctors like Dr. Crislip aren’t out to save HIV+ patients; they want to “enslave” them with a “cult of fear” and deprive them of the right to make their own choices. Now, Dr. Crislip may be a sarcastic and acid-tonged podcaster and blogger, but he utilizes those tools in the service of science-based medicine and saving as many patients as he can.

    What a load of hooey. Maggiore was free to refuse HAART. She was an adult, and, as far as I’m concerned, competent adults can refuse therapy for any reason or no reason at all, as long as that decision does not endanger others. She was in a monogamous relationship; so it’s not as though she was risking spreading the virus to people who did not know of her status through her continued refusal to take HAART or, presumably, condoms. What I do not like is when adults deny their children effective therapy in the name of irrational and pseudoscientific beliefs. Adults can do close to whatever they want with their own bodies, but they do not have the right to endanger their children with pseudoscience, which is why I was so harsh on her for not having taken HAART when she was pregnant with EJ and for blithely breastfeeding when not doing so would have significantly decreased the risk of transmission of the virus to her child. Worse, Maggiore aggressively spread her gospel of happy happy joy joy, “don’t take that HAART; it’s a product of evil big pharma seeking to enslave you” to HIV+ people. “Really,” she said, “you’ll be fine.” Well, a lot of people, including EJ and her, weren’t fine. Maggiore was lucky in that she was clearly an outlier, having gone at least 16 years without an AIDS-defining illness, but, if she did die of AIDS, she was not that far out of the range of normal variability for the virus’ progression from infection to AIDS. In any case, it is quite possible to be saddened by Maggiore’s death and at the same time point out that she had dedicated her life to a dangerous pseudoscience that kills. Indeed, that dangerous pseudoscience appears very likely to have ended up killing her.

    I particularly like this bit of relativism:

    I defy anybody to find a single communique from Christine Maggiore in which she reveled in the deaths of her attackers or their friends, who have died in the hundreds of thousands, following orders, taking the drugs. There are deaths on all sides; The answers light up like fireflies, then vanish. Who among us can claim to know what is really happening? All we can know, all we can control, is who we are as human beings, how we treat others, and especially how we treat those who think or believe different things than we ourselves do.

    I defy Farber to find a single communique from skeptical bloggers like myself reveling in Maggiore’s death. Certainly, I do not, even though I do blame her for the entirely preventable death of her daughter.

  24. Fifi says:

    Well Farber lacks credibility on a number of levels, particularly as a journalist since she received undue favor for sleeping with her boss. Farber is self styled “anti-PC” crusader who sucks up to men while pretending to be an independent woman. She’s a faux “radical” (meaning she’s trying to dress up arch conservatism in a leather jacket to present it as being “radical”, it’s the “dissident” label she’s interested in, not actually being a true dissident – let’s not forget that the whole http://www.healthfreedomUSA.com meme was thought and is vigorously promoted by General Stubblebine who spent lots of taxpayer money on new agey experiments!). It was pretty common in rock and roll and the music biz when she started out for some women to pander this way since, if you’re actually into being part of the music biz power structure rather than actually creating independent music, this was the way to get ahead at the time. There are tons of brilliant and truly independent women in music and journalism – Farber isn’t one! (It probably doesn’t help that the Foo Fighters also jumped on this bandwagon! One more reason why they’re not nearly as good as Nirvana once was!)

  25. BD says:

    I think it may be potentially misleading to say that Christine Maggiore was “not too far outside of the normal range for time to progression of untreated HIV infections.” There are published average times of progression, but the phrase “normal range” doesn’t really have any meaning. While slightly less than 50% of untreated people are asymptomatic at the ten year mark, most of those individuals will progress over the next ten years. In cohorts like the San Francisco Gay Men’s Health study, the small proportion of individuals asymptomatic after 15 years continues to dwindle over continued follow-up, so Christine Maggiore’s case is within the range of progression that has been described, not outside of it.

    http://hivinsite.ucsf.edu/InSite?page=kb-03-01-04

    “In data from the era prior to the advent of therapy with protease inhibitors in combination with other antiretroviral drugs, retrospective testing of serum samples stored from the hepatitis B vaccine trial in 1978 and subsequent follow-up identified a cohort of 621 men with well-characterized seroconversion. By 17 years after infection, 87% had developed AIDS. Defining nonprogression as a CD4 lymphocyte count greater than 500/µl, 12% were nonprogressors at 10 years of follow-up, but only 3% were nonprogressors at 16 years of follow-up.(6)”

  26. Deetee says:

    Fintan Dunne’s and Celia Farber’s spectacular own goals.

    Since her death, there has been much speculation as to why Christine Maggiore died. The only information available at the time from the Los Angeles Coroner’s Office and in a statement from her family was that she had suffered from pneumonia sometime in the last 6 months, had apparently undergone a “holistic detox” in December which had left her dehydrated and weak, and she then developed pneumonia, dying at home on 27th December 2008.

    This information raised more questions than it answered. Had Maggiore been unwell recently, and was that why she thought she needed detox? How does someone come to die at home from pneumonia, rather than being admitted to hospital? What type of pneumonia did she have, and was it AIDS-related?

    Of course, there were many who have added 2 plus 2 and came up with the conclusion she had “AIDS”, saying, in effect “We told you so”. But clear evidence Magiore had AIDS was rather lacking. The main reason for thinking she may have was that she had apparently had 2 attacks of pneumonia in a 6 month period. Now simple bacterial pneumonias are not uncommon, and they do affect otherwise healthy adults. But Maggiore had 2 bouts of pneumonia, which is very unusual, and often points to some underlying immune deficiency. Indeed, it is so unusual that 2 episodes of bacterial pneumonia within 1 year qualifies someone with HIV for an AIDS diagnosis. But that aside, there was only speculation to go on, and no clear information about Maggiore’s final illness.

    Of course, the AIDS denial movement went into immediate overdrive with speculation of their own. Desperate to “disprove” that Maggiore could have died from AIDS, they theorised that she had died of a type of “voodoo hex”, the result of being physically and emotionally worn down from the struggle to cope with and refute accusations that she bore the blame for the death of her daughter Eliza Jane 3 years previously. Her husband, Robert Scovill, had this to say:

    “Christine never fully recovered from the unjust treatment that she received around the loss of Eliza Jane and that treatment ultimately exhausted her [and led to pneumonia].”

    Of course, other suggestions also surfaced, without a shred of evidence, including theories that she had not had pneumonia at all, or had suffered a reaction to the herbs used in her detox, or a reaction to the antibiotics she may have got to treat her pneumonia.

    In their desperation to show how Christine could not have had AIDS, denialists started to release information of their own, in the misguided and medically-ignorant view that this would somehow prove she did not have AIDS.

    First, Fintan Dunne, web journalist who hosts a podcast called “AIDS is over”, tried to show Christine could not have had a long standing pneumonia.
    http://aidsisover.com/audio/aidsisover090102.mp3
    He did this in the mistaken impression that the accusation was that Maggiore, said to have had pneumonia previously within the last 6 months, had experience a pneumonia that had lasted for 6 months. To disprove this non-accusation, Dunne produced evidence that Christine had been extremely healthy during the last 6 months of her life, full of plans for the future and co-producing podcasts of her own. Christine could not have had pneumonia, said Dunne, because she was so healthy as late as November. As proof, he published a clip of her talking for her podcast, with a strong clear voice. As evidence this meant she did not have pneumonia, he produced clips of several people with pneumonia, coughing, wheezing and breathlessly trying to talk. QED, Christine did not have a chronic pneumonia over the last 6 months. But this was a total misunderstanding on Dunne’s part. No-one had accused Christine of having a chronic, long standing pneumonia, merely that she had experienced a prior attack sometime in the last 6 months. So all that Dunne had actually achieved (apart from revealing his own medical ignorance) was to show that as late as November, a month before she died, Christine was indeed “alive and well”, and seemingly in good health. All Dunne’s evidence demonstrates is that there is no valid evidence whatsoever for a “voodoo hex” deterioration in Christine because of the stress of the last few years. Scratch denialist theory number one then.

    Next, journalist Christine Farber, another prominent denialist, tried to get in on the act. First she suggested in an article on Dean Esmay’s blog on December 30th.
    http://www.deanesmay.com/2008/12/30/what-killed-christine-maggiore/ that Christine had been weakened by her detox, and this caused her death rather than it being anything to do with AIDS.

    “She had apparently been on a radical cleansing and detox regimen that had sickened her and left her very weak, dehydrated, and unable to breathe. She was shortly thereafter diagnosed with pneumonia and placed on IV antibiotics and rehydration. But she didn’t make it.”

    In order to provide the evidence to back up this claim, Farber then released an e-mail Christine had sent to a friend dated the 19th December, 8 days before she died. Unfortunately for Farber, this e-mail revealed a number of new facts that actually pointed very strongly towards Christine having died from AIDS-related Pneumocystis pneumonia (the same infection which killed her daughter).
    http://www.deanesmay.com/2009/01/02/in-her-own-words-a-dec-19-email-from-christine-maggiore/

    As others have pointed out, this article no longer exists, having been rapidly pulled from view when the denialists realised it merely provided additional, strong evidence for Maggiore having AIDS. Fortunately there is the facility of Google cache, so the original article is still available.
    http://74.125.45.132/search?q=cache:8sjDs_vchccJ:www.deanesmay.com/2009/01/02/in-her-own-words-a-dec-19-email-from-christine-maggiore/

    Farber has since tried to lamely explain why she pulled the article, stating

    “I want to contribute toward a much needed silence.”

    I’ve a suggestion then, Celia. Shut the f* up.
    http://www.deanesmay.com/2009/01/06/the-clearing/

    Maggiore’s e-mail reads thus:

    “Regarding my health, I finally figured out what’s going on…but it got really scary. Here’s the scoop I just sent a friend: I have been through the absolute worst health nightmare ever. The cleanse, while definitely bringing about some profound benefits, left me feeling weak and dehydrated. I lost my appetite almost completely about 10 days ago and for some weird reason could only tolerate hot tea and hot chicken broth. I had been in touch with the cleanse doc who said all was typical, uncomfortable but typical. Not one to quit, I kept going. Then I started to have trouble breathing, I was feeling winded after the most simple task like making the bed. This last Sunday, I stopped being able to sleep at all. So finally, genius that I am, I made an appointment to see my MD who is really smart and very well versed in natural health care and not at all into the HIV paradigm.I could only get in to see her yesterday. She said I was totally dehydrated and having a reaction to the herbs in the cleanse which she thought were suspicious. I asked her to check my lungs and she said they sounded clear. I told her I thought I should have a chest Xray anyway, just to be sure, but she was skeptical because I hadn’t had a cold, flu, cough or fever. But I insisted so she wrote me up to go to a radiology place that would give an immediate reading. By then I felt so ill I had to ask my neighbor to drive me and thank god he was there with me because I never would have made it to the radiologist without his help. As it turned out, the Xray showed a very serious case of bi-lateral bronchial pneumonia. The doctor immediately gave me IV rehydration, IV natural cortisone, and IV antibiotic. She said if I did not improve by the next day, I would have to go to the hospital which I argued would give me worse treatment, lousy food and maybe a MRS infection as a parting gift. I went back again today, had more IV treatments and she said if I can make it through the weekend without having to go to the hospital, she will be very happy. She also said I’m pretty tough to have had such severe pneumonia and keep going. I have three natural cortisone treatments I am to take everyday, and today I started with another antibiotic called Z pack which is different from the one used in the IV. It’s a little scary because she asked me if I am allergic to the antibiotics she’s giving me but I’ve never taken them, so I don’t know. She stayed next to me during the IV antibiotic to make sure I was not going into reaction which sort of made me feel like I might be having a reaction! But I didn’t and I slept for the first time since Sunday last night.My appetite is getting back to normal and I am on total bed rest for two weeks. I can’t imagine doing otherwise.
    Christine.”

    This enables a time line of events to be built up:

    Early December: Maggiore [feeling unwell?]undergoes a cleanse detox, which “profoundly benefits” her but leaves her feeling weak and dehydrated.

    9th December: Loses appetite, reassured by cleanse doc that this is “typical”

    Sometime between 9th and 13th December: Becomes breathless with minimal exertion.

    14th December: Unable to sleep.

    18th December: Sees own MD (who is “really smart and well versed in natural health care” and who does not believe in the “HIV paradigm”). Told she is dehydrated from reaction to the cleansing herbs. MD finds chest is clear, but Maggiore insists on an X-Ray [presumably concerned about her persisting breathlessness], which reveals “a serious case of bilateral bronchial pneumonia”. Begins treatment with IV antibiotics and natural steroids. Specifically says she had no allergic reaction to the IV antibiotics.

    19th December: Has further IV antibiotics and steroids, and also given another antibiotic, oral azithromycin. Is able to sleep for the first time in 5 days.

    27th December: Dies at home of pneumonia.

    The significant aspects of this story can be summarised thus: Maggiore died following a four week illness, characterised by increasing breathlessness on minimal exertion over three weeks. Her chest sounded clear to examination, but X-Rays revealed pneumonia present in both lungs. An antibiotic regime was commenced which would cover bacterial pneumonia (and which would also cover atypical pneumonia organisms such as Chlamydia, Mycoplasma and Legionella since a macrolide had been prescribed). Her pneumonia ultimately fails to improve, and Maggiore died 8 days later.

    If Maggiore had been suffering from a bacterial pneumonia, then IV antibiotics would have been expected to lead to clinical improvement. Similarly, one of the “atypical” pneumonia such as Mycoplasma or Clamydia pneumonia, which are seldom so severe as to cause death, would have been expected to respond to the azithromycin she received. It is possible Maggiore had Legionella pneumonia (Legionnaires disease) which can be very serious and spread to involve both lungs, and although azithromycin is an effective treatment for Legionella, a severe case usually requires additional antibiotics. Alternatively, she could have had a viral pneumonia, which can in some instances be fatal (e.g. severe influenza A infection).

    However, with all these types of pneumonia, the chest does not sound clear, since there will be crackles evident (from fluid build up within the lung) and with bacterial pneumonias there may also be an additional, diagnostically characteristic noise heard over the affected lobe of the lung (bronchial breathing). Should Maggiore have had a pneumonia severe enough to affect both lungs radiologically, I would have expected there to have been plenty of evidence of abnormalities on examination (auscultation) of the chest. Radiologically, these pneumonias are confined to one lung, (often only one lobe of one lung, although Legionella and viral pneumonias can involve several lobes). Pneumonias such as bacterial pneumonias and the atypical/viral pneumonias are characteristically short and sharp in their effects. Bacterial pneumonia is typified by a short duration (i.e a few days) of symptoms with productive cough and high fever. Likewise Mycoplasma, Chlamydia, Legionella and viral infections, although the cough may be dry and non-productive.

    However, there is another type of pneumonia, the features of which appear to fit almost exactly with the clinical story in the case of Christine Maggiore. It is a more insidious pneumonia, typically taking 2 to 3 weeks to gradually increase in severity. The cardinal symptom is one of breathlessness with minimal exertion, so everyday tasks (like making a bed) are exhausting. It typically causes very little by way of cough, although it can cause a fever. The lungs are characteristically clear on examination, even when radiological changes are quite marked. By the time X-Ray changes are evident, the pneumonia is usually moderately severe. On X-Ray, there is a bilateral infiltration of several lobes of the lung. This pneumonia will not respond to standard antibiotics. It may, with the help of steroids, temporarily improve, but without specific specialised antibiotics it is always fatal. The name of this pneumonia? Pneumocystis jiroveci (PCP)

    It is no wonder that the denialists are now attempting to airbrush their articles from history. With every medically-incompetent attempt of theirs to show Christine Maggiore did not die from an AIDS-related pneumonia, they merely ended up showing how likely it is that she did die from AIDS.

    I must point out that there are many things we don’t know about the last few days of Maggiore’s life, such as what symptoms occurred, what tests she had if any, what treatments she received, and why she resisted hospital admission. But the clinical picture of the weeks preceding her death fit very well with a diagnosis of PCP, and any decent clinician, knowing that Maggiore had underlying HIV infection, would have recognised these typical symptoms for what they appear to have been, a sign of an opportunistic pneumonia such as PCP. In the real world, 2 plus 2 usually equals 4.

  27. Fifi says:

    One thing we don’t know is how much the “detox” actually contributed to Christine getting ill. It may have been what pushed her immune system over the edge since even healthy people have gotten severely ill from poorly designed (and just plain biologically ignorant) “cleanses”. Since naturopaths and CAM practitioners tend to designate any discomfort to “detox” – including that from “cleansing” those pesky electrolytes that keep us alive – who knows what additional harm Christine did to herself with the detox. Clearly enough to need IV re-hydration which would potentially point to a potential lack of electrolytes or a muscle meltdown of some kind (particularly if she had a fever already and she was the kind of person to just push herself harder when faced with illness or discomfort).

  28. Holy cow, Deetee, nice work!!! Do you have a blog?

  29. Deetee says:

    The detox may have not helped Christine in the way she assumed. She says she felt dehydrated (what did she get, colonic irrigations?) but part of many detox regimes is pushing plenty of fluids to flush out the “toxins”. I suspect she was exhibiting the early signs of her infection at this time and this is why she still felt poorly. Anyhow, nearly 2 weeks passed between the detox cleanse and Christine’s seeing her MD who put her on an IV to rehydrate her, so I doubt the effects of the detox would still be making her dehydrated at that point.

    I think the most significant symptom is the insidious onset of breathlesness with even trivial exertion – as a clinician who deals with PCP and other chest infections I will tell you this is so typical as to be almost pathognomonic of PCP. Combined with all the other clinical and radiological info, I think it’s a safe bet this is what Christine had.

    I doubt there will be an autopsy. Her family would not dare risk it. Rather keep the diagnosis “unknown”, then it can continue to be denied. I doubt we will ever catch sight of the formal X-Ray report either. Christine’s “I don’t believe in the HIV paradigm” MD said it showed bilateral pneumonia. I am sure a radiologist would mention the possibility that it could be PCP considering this is the commonest cause of bilateral pneumonia in a middle aged adult (even if the radiologist did not know the HIV status of the patient).

    Perky, no, I don’t have a blog. I don’t have the time, energy, literary skills and sheer brilliance that people like David Gorski and Steve Novella have. I stand in awe of them and others who continue to battle against pseudoscience on these and other blogs.

  30. Heraclides says:

    Rune,

    I can’t help you with a recommendation, but one tip that I find helps to assess books on Amazon is to look at the lowest-scoring reviews for clues as to the nature of the book. Many of the highest-scoring reviews are “empty praise”, which isn’t very helpful, but in my experience the lower scoring ones often reveal what the book not and or what it is if it’s negative in the eyes of the reviewer.

    In the case of HIV books, the rock bottom scores will be from either HIV denialists “dismissing” a book for being based on science and they’ll say words to that effect or vice versa in the case of denialist’s book.

    Maybe this might help?

  31. Fifi says:

    This is a great article about the US religious and governmental involvement in Christian religious evanglicism and AIDS denialism in Africa that also raises questions Obama’s real commitment to science based medicine and how far he’s willing to bend over for the evangelical de jour.

    http://www.thedailybeast.com/blogs-and-stories/2009-01-07/the-truth-about-rick-warren-in-africa/full/

    I’d say that the distance between Canadian Stephen Lewis and American Rev. Warren Buffet says a lot about the Canadian and American government’s approach not only to AIDS but to science in general. Though, Stephen Lewis has changed his focus onto women’s rights in Africa (as a foundation for helping deal AIDS).

    http://www.stephenlewisfoundation.org/news_item.cfm?news=946&year=2006

  32. psb says:

    Great, incredibly thorough article. However it glosses over the enormous difference between current HAART therapies and AZT.

    AZT is a nasty, extremely toxic drug which when taken alone can suppress HIV only in the short run. HIV is able to mutate quickly to the point where AZT therapy is completely ineffective.

    When Maggiore was first diagnosed HIV-positive, AZT was the only AIDS drug available, and doctors (and the pharmaceutical industry) were pushing it on patients despite a lack of evidence that it prolonged lives. In fact its side-effects may have been more damaging than beneficial to a patient’s health.

    So while I completely agree with your assessment of AIDS denialism, it’s important to point out that Christine Maggiore’s initial decision to refuse AZT was not at all unreasonable. Also, the phenomenon of AIDS denialism can be better understood when you consider that it was born at a time when Science Based Medicine had very little to offer, and the possibility that “everything you thought you knew about AIDS is wrong” was a source of hope.

  33. psb says:

    Also, the point about denialism’s effect on AIDS treatment in South Africa is well taken, but when you pull out the “it has been estimated” figure of 300,000 “potentially preventable” deaths you are using the same kind of unverifiable “facts” as the denialists. Let’s keep it science-based, please!

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