From the archives of The Memory Hole

HIV=AIDS Controversy: AZT

The following is the last section of Chapter Nine--With Therapies Like This, Who Needs Disease?--of the book Inventing the AIDS Virus by Peter Duesberg. Copyright © 1996 by Peter Duesberg. All rights reserved. Reprinted by special permission of the Regnery Publishing, Inc., Washington, D.C.


The Stories of Those Who Believed in AZT

by Peter Duesberg

Not all AIDS victims are fortunate enough to question medical authority. The resulting tragedies can sometimes turn into a media circus promoting the HIV hypothesis. Of all the cases hyped up for their AIDS scare value, the Florida woman who supposedly caught AIDS from her dentist has become the most notorious.
Kimberly Bergalis: The story began in late 1986, in the small town of Stuart on Florida's Atlantic coast. David Acer, a dentist who had begun his private practice five years earlier, felt a bit under the weather and saw a physician. Acer was also an active homosexual, a fact that led him to seek an HIV test. The result came back positive. Although disturbed by the news, he still felt reasonably healthy and saw no reason to stop his dental practice, nor apparently his fast-track lifestyle.
One year later he experienced worsening symptoms and a visit to his doctor confirmed the diagnosis: full-blown AIDS. A Kaposi's sarcoma covered the inside of his throat and his T-cell count had fallen dangerously low. Both symptoms suggested the extensive use of poppers and other drugs so common in the homosexual bathhouse scene. Acer could see his life slowly wasting away. He continued practicing dentistry while remaining discreet about his sexual life and failing health, making sure to follow the standard guidelines for protecting his patients from infection.
That December, in 1987, he pulled two molars from a nineteen-year-old college student, Kimberly Bergalis. At the time he had no idea the business major would one day be touted as his hapless victim.
The story picks up again in May 1989, when Bergalis developed a transient oral yeast infection. Later that year, during the emotional stress of preparing for an actuarial exam for the state of Florida, she felt some ongoing nausea, and she became dizzy during the test itself. Afterward, the symptoms disappeared. But a brief pneumonia that December sent her to the hospital, where the doctor decided out of the blue to test her for HIV. As chance would have it, she had antibodies against the virus.
Up to this point, none of her occasional diseases differed from the common health problems many HIV-negative people encounter. But the positive HIV test changed her whole attitude, as well as her medical treatment. Within three months the CDC had heard of her case, possibly aided by the presence of several EIS members in the Florida health department, and sent investigators to probe further. The CDC team included such EIS members as Harold Jaffe, Ruth Berkelman, and Carol Ciesielski. Bergalis denied any intravenous drug use or blood transfusions and insisted she was a virgin. During the prolonged examination, the CDC officers stumbled across David Acer's positive HIV status and made the connection to Bergalis. Before the HIV hypothesis of AIDS, no medical expert in his right mind would ever have entertained the slightest thought that a dentist with a Kaposi's tumor and a patient with a yeast infection had anything in common. But in the era of AIDS, doctors tended to discard common sense. That the dentist and patient both carried a dormant virus was enough.
Excited by its discovery, the CDC boldly advertised its results in its weekly newsletter, the same one that nine years earlier had broadcast the first five AIDS cases. The July 27, 1990, issue prominently featured their amazing leap of logic--that the dentist must somehow have infected Bergalis. Naturally, the CDC's speculation leapt straight to the front pages and prime-time television news broadcasts.
Acer died in early September 1990. Bergalis meanwhile sought medical care at the University of Miami, where she was treated with an unidentified "experimental" method. Certainly this was the appropriate place for such therapies. Margaret Fischl, the head of the Phase II AZT trial, worked at that medical center, which had serves as one of the twelve facilities sponsored by Burroughs Wellcome for the study. So Bergalis was prescribed AZT.110
Suddenly she started a precipitous decline in health. In an angry letter, she partly acknowledged her symptoms resulted from the toxic drug:

I have lived through the torturous ache that infested my face and neck, brought on by AZT. I have endured trips twice a week to Miami for three months only to receive painful IV injections. I've had blood transfusions. I've had a bone marrow biopsy. I cried my heart out from the pain.111

This represented only the beginning. Her yeast infection worsened and became uncontrollable, she lost more than thirty pounds, her hair gradually fell out, her blood cells died and had to be replaced with transfusions, and her muscles wasted away. Her fevers hit highs of 103 degrees, and by late 1990 her T-cell count had dropped from the average of 1,000 to a mere 43. She looked just like a chemotherapy patient--which she now was.
The CDC saw its golden opportunity in the Bergalis case. It publicized a second report on the Bergalis case, announcing its belief that four of Dr. Acer's other patients had also been infected by him, and even surveyed the patients of other HIV-positive doctors and dentists--suggesting that all HIV-positive patients had also been infected by their doctors. Such CDC-funded organizations as Americans for a Sound AIDS Policy (see Chapter 10) aggressively promoted public fear with these speculations. A media feeding frenzy resulted, with every major television talk show, and every national magazine, running scare stories.112 The CDC's relentless publicity had its expected effect: By mid-1991, more than 90 percent of the public believed HIV-positive doctors should be forced to inform their patients of their status, and a clear majority favored banning such doctors from medical practice.113 Many doctors, angered by the publicity campaign, "accused the federal Centers of Disease Control of unduly alarming the public."114
The CDC certainly had an agenda behind its campaign. In July of 1991, the agency issued a set of proposed rules that would require doctors to follow extraordinarily burdensome measures, supposedly to protect their patients from HIV infection. By hyping up the Bergalis case, the CDC had created enough public panic and backlash to favor its proposed regulations. To dramatize the point, Bergalis was brought in to testify before a stunned Senate in October of 1991. Her muscles largely destroyed by AZT, she had to be brought in a wheelchair. Her furious testimony, whispered into the microphone, made a powerful emotional impact on the attentive congressmen and the television audience.
Congress soon passed a new law requiring the states to adopt the CDC guidelines--or else begin losing federal funds. When the medical profession resisted the new rules, the Occupational Safety and Health Administration (OSHA), which works closely with the CDC, stepped in with parallel rules of its own. On threat of criminal prosecution, laboratory and medical workers must now follow incredibly restrictive regulations on their practices and equipment, and must deal with extra bureaucratic red tape.
Blaming her deteriorating condition on the latent virus supposedly passed on by her dentist, Bergalis sued the Acer estate. She received a $1 million award, plus unannounced compensation from the dentist's insurance company. She parceled out the money to a variety of friends, family members, and AIDS organizations, and told her father to purchase "a new, red Porsche and deliver it to my aunt with a large bow on top."115 Had she known better, she could have instead sued Burroughs Wellcome.
Bergalis died in December 1991 at twenty-three years of age, having taken AZT for up to two years. Her death became the ultimate symbol of the deadly powers of HIV. No one pointed out that, according to the HIV hypothesis, the virus should take ten years to kill its victims, particularly someone like Bergalis with no other risk factors. She had died within four years of her initial visit to Dr. Acer. As her symptoms would indicate, AZT must have killed her instead.
In December 1992, another former patient of Dr. Acer tested positive for HIV, but had no symptoms. Two months later, eighteen-year-old Sherry Johnson began taking AZT. She has since begun wasting away, admitting she periodically feels sick.
The CDC continued to exploit the Bergalis story as proof of the risk of doctor-to-patient HIV transmission. Some eleven hundred of Acer's two thousand former clients volunteered for HIV tests. Seven of these were positive, including Bergalis, two of them having standard risk factors for AIDS. That left five people who supposedly caught the virus from Acer. Expanding its search, the CDC tested almost sixteen thousand total patients of some thirty-two HIV-positive doctors around the country, finding eighty-four infected patients. Though admittedly baffled by how HIV could pass from doctors and dentists to the patients, the CDC nonetheless advertised the alleged threat. Curiously, when confronted with an unexpected outcome for an unproved test, the CDC did not proceed with caution. It published its findings in July 1990 without further verification.
Apart from HIV being a harmless virus, the evidence that this virus has ever been medically transmitted remains dubious. Based on their own research, insurance companies concluded that the HIV strains in the five patients were different from that in Acer, meaning each caught it from a different source.116 A study out of Florida State University has backed this conclusion.117 Even the CDC acknowledged this evidence, though it still preferred to believe the dentist had infected Bergalis. But the CDC's own numbers give away the reality. An estimated 1 million Americans have HIV, in a total population of 250 million. Thus, 1 in 250 Americans have the virus. Five HIV-infected patients of Dr. Acer, out of 1100 tested, comes to 1 in 220, virtually identical to the national average. So does the proportion of HIV-positives from the patients of the 32 doctors, which works to 1 in 188. These HIV-positive patients merely represent random samples from the general population.
And where did these people get the virus? As suggested in chapter 6, HIV is probably transmitted much as other retroviruses, from mother to child during pregnancy. There is no evidence that Kimberly Bergalis' mother has never been tested for HIV antibodies, nor that the mothers of Dr. Acer's other patients were tested. Perhaps Kimberly carried the harmless virus for twenty-three years.
The CDC's theory that AIDS was transmitted from Dr. Acer to his patient began to crumble in the mainstream press in 1994 when an investigative reporter researched the alleged victims of Dr. Acer. "He found weak evidence shoddy science, and the work of a very accomplished malpractice attorney."118
The report first casts doubt on the time course of AIDS transmission from Dr. Acer to his patients. "She developed AIDS just two years after the surgery, and only 1 percent of HIV positive patients develop the full-blown disease that quickly."119 The investigation disclosed that one of the six other patients that Acer presumably infected had visited the dentist's office only once for a cleaning by a hygienist, not by Acer himself.120 The report further calls into question the exclusive reliance of the CDC and the malpractice attorney of the "Acer six" on the DNA fingerprinting technique to match Acer's virus with those of his patients. This same technique had also been used to determine that the NIH researcher Gallo had claimed HIV obtained from his French rival Montagnier as his own. Several experts have directly challenged the DNA fingerprinting that linked Acer to his patients, claiming that instead Bergalis's virus matched other HIV strains much more closely.121 In view of this, a writer in the New York Times commented, "The CDC owes it to the public to reopen [Acer's] case."122
The re-investigation of the "Acer six" provides unknowingly yet another reason why the "CDC owes it to the public to reopen [this] case": It supports the hypothesis that AIDS is caused by recreational drugs and AZT. Only three of the "Acer six" have developed AIDS, and every one of them was on drugs: Bergalis was on AZT; a thirty-year-old male was involved with "drug dealers, and a homosexual relationship"; and another male was a "notorious crack head."123
While on AZT, Bergalis once told a reporter she hoped to also get dideoxyinosine (ddI), another experimental AIDS drug. This drug and ddC, two products of cancer chemotherapy research, work in precisely the same way as AZT. Chemically altered building blocks of DNA, they enter the growing chain of DNA while a cell is preparing to divide and abort the process by preventing new DNA building blocks from adding on (see Figure 1). So, like AZT, ddI and ddC kill dividing cells and have similar toxic effects. They destroy white blood cells and therefore can cause AIDS. The only difference between ddI, ddC, and AZT lies in how easily each is absorbed into the body; people who absorb one evidently may not be equally affected by the other.
Alison Gertz: Both ddI and ddC have begun to claim their victims. In 1988, twenty-two-year-old New York socialite and aspiring graphic artist Alison Gertz entered the hospital for a fever and diarrhea. At some point the doctor decided to test for HIV and found antibodies against HIV. Gertz's transient illness was rediagnosed as AIDS. She had not injected drugs, although her wilder days at Studio 54 bespoke the cocaine and other free drugs available to patrons. A process of elimination traced her infection to a one-night stand with a bisexual male--six years earlier. The announcement left her feeling depressed, but she began a lecture circuit at high schools and colleges, admonishing students that AIDS could come from a single sexual encounter. Television talk shows followed, as did the cover of People magazine and Woman of the Year for Esquire. Even the World Health Organization circulated a documentary featuring her story.
Gertz started AZT treatment in 1989. The 1990 People magazine profile recounted the consequent disaster:
Last October she was hospitalized with a severe allergic reactions to AZT. When doctors called for a lung biopsy, Ali balked. "I told them if they put me to sleep, I'd never wake up," she says. "My strength was gone." Released after 17 days, she recuperated at home, where her mother and girlfriends took turns nursing her around the clock. "They'd help me to the bathroom, feed me, see that I didn't fall in the shower," says Ali. "My knees were so bony, I had to sleep with a pillow between them."124

The doctors switched her to the still-experimental ddI, which Gertz apparently did not absorb as well and thus allowed her partly to recover. She mixed the powder in her drink twice every day. Her immune system and general health declined, though more slowly. "Gertz remains susceptible to infections like thrush, a fungus that frequently affects the mouth," stated the People article. "She has lost 30 lbs. since last summer, naps each afternoon and continues to visit her doctor every 10 days."125 Ultimately, the ravages of the chemotherapy took her life in August 1992, the news media advertising her death as AIDS-related. She was only twenty-six.
A backlash is now rising against the toxic and irrational treatment approaches to AIDS. In 1993, during the Ninth International AIDS Conference in Berlin, Germany, medical reporter Laurie Garret was interviewed on the MacNeil-Lehrer News Hour. She described the growing discontent among scientists and patients alike:
Most drug trials were terminated early. The AZT trial was terminated early, ddI, ddC, and so on, and people were allowed as soon as there was any sign that something showed promise to jump out of the placebo arm and get into the treatment arm...
Dr. Anthony Pinching, who was really the leader of most of the clinical research related to AIDS in the United Kingdom, gave a very important speech this morning. I think if he had given this precise same speech a year ago, he would have been booed off the stage, and this morning, he was applauded heavily. And what he basically was saying was we have no idea what drugs work. We have no idea what we're doing in treatment, and it's time to return to the use of placebo trials. He went a step further and said that at least in Europe a lot of AIDS activists and patients now agree, because they're shocked to find out that the drugs they've been taking, thinking they would be helpful, might even be hurtful.126

Arthur Ashe: This lesson almost saved the life of the late Arthur Ashe, the tennis star and one-time Wimbledon champion who died in 1993, supposedly of AIDS. Ashe's medical problems surfaced in 1979 with a heart attack, despite his young age of 36. In December he underwent quadruple-bypass surgery. His chronic heart condition continued plaguing him, and by 1983 he had double-bypass surgery. A blood transfusion during either one of the operations may have carried HIV.
His heart condition and its complications nagged him for several years. Then in 1988 he entered the hospital for toxoplasmosis, a protozoal disease relatively uncommon in humans. The germ resides in cattle and household pets, and in 17 percent to 50 percent of the U.S. population, but most people never succumb to the disease because of healthy immune systems. This also happens to be one of the many diseases on the AIDS list, so the doctor tested and found Ashe to be HIV-positive. Although his toxoplasmosis soon disappeared, Ashe was pronounced an AIDS victim. His disease was retroactively blamed on HIV, not on his heart condition.
Yet his condition hardly seemed contagious. Neither his wife nor his daughter, born three years after his second transfusion, ever developed any AIDS conditions. Indeed, his immune system must have neutralized HIV quite effectively, as Ashe never transmitted the virus to his family.
His daily medicine intake expanded to a virtual pharmacy. He continued to take several drugs for his heart problems, one to lower cholesterol by interfering with liver function, another to slow down the heartbeat, and three others, including nitroglycerin, to lower blood pressure. To these his doctors added a spectrum of antibiotics, all with mild to serious side effects, to prevent the possibility of opportunistic infections. Ashe took Cleocin to fight further toxoplasmosis, nystatin to slow down yeast infections, and toxic pentamidine to stave off Pneumocystis pneumonia. Two other drugs were prescribed against possible brain seizures. Eventually his daily regimen included some thirty pills, only a few of them vitamins.
But just as soon as Ashe received his AIDS diagnosis in 1988, his doctor pushed him into taking AZT. he started on an unbelievably high dose, nearly double the seriously toxic levels used in the Phase II trial. His doctor only gradually lowered the dose over the next four years. "I refuse to dwell on how much damage I may have done to myself taking the higher dosage," Ashe later admitted.127
In early 1992 he established an acquaintance that came close to rescuing him. A close friend arranged a series of meetings with Gary Null, a New York-based radio talk show host and nutritionist. Null introduced Ashe to the evidence of AZT's toxicity and against the HIV-AIDS hypothesis, desperately trying to convince him to halt the therapy. For the next ten months, Ashe "wrestled with the possibility of breaking away from the medical establishment to seek alternative treatment for AIDS," according to one columnist. Ashe never met Peter Duesberg, but became familiar with his arguments. "He read everything; he studied what we gave him and asked lots of questions," recalled Null.128 In October, Ashe announced the lessons he was learning in a column he wrote for the Washington Post: "The confusion for AIDS patients like me is that there is a growing school of thought that HIV may not be the sole cause of AIDS, and that standard treatments such as AZT actually make matters worse. That there may very well be unknown cofactors but that the medical establishment is too rigid to change the direction of basic research and/or clinical trials."129 But psychological pressure stopped Ashe short from rejecting AZT. AS Null stated, "He wanted to do it, but he would say, 'What will I tell my doctors?'"130
In his 1993 book, Days of Grace: A Memoir, Ashe openly acknowledged his interest in alternative AIDS hypotheses:
But AZT was controversial in other ways. A gift from heaven to many desperate people, it was poison to others. Developed for use in cancer chemotherapy to destroy cells then in the process of actively dividing, AZT was only later applied to AIDS. Some scientists believe that AZT, which relentlessly kills cells but cannot distinguish between infected and uninfected cells, is as harmful as AIDS itself. After all, HIV is present in only 1 of every 10,000 T-cells, which are vital to the immune system; but AZT kills them all. Dr. Peter Duesberg, the once eminent and now controversial professor of molecular and cell biology at the University of California, who bitterly disputes the notion that HIV causes AIDS, has called AZT "AIDS by prescription."
Dr. Duesberg argues that the use of recreational drugs, not sex led to AIDS. It is well known that many gay men used--and many of them continue to use--drug stimulus in sexual activity or to facilitate intercourse. "Natural and synthetic psychoactive drugs," he has argued (drugs such as cocaine, amphetamine, heroin, Quaaludes, and amylnitrates and butylnitrites, or "poppers"), "are the only new pathogens around since the 1970s and the only new disease syndrome around is AIDS, and both are found in exactly the same populations."131

Ashe faithfully summarized the main points against the HIV hypothesis and for the drug-AIDS hypothesis and explained the deadly effects of AZT and the flaws of its Phase II trial. "Some tolerate [AZT] for a while, then must give it up. Still others cannot tolerate it at all," wrote Ashe. "To my relief, I tolerate AZT fairly easily."132 With that rationalization, he sealed his fate.
During 1992, his doctors placed him on ddI. Each morning he sprinkled the powder on his cereal, in addition to the AZT pills he swallowed throughout the day. By this time he was wasting away rapidly, his underweight frame hidden by loose clothes. He began rotating in and out of the hospital. January of the following year brought more bad news: Now he had a serious case of Pneumocystis pneumonia that his poisoned immune system could no longer fight off. He never recovered. On February 6, 1993, he breathed his last.
The list of celebrity AIDS patients who died on AZT for their belief in medical authority includes ballet star Rudolf Nureyev, who died in 1993, Randy Shilts, the author of the bestseller And the Band Played On, who died in 1994, and many more.
As a thoroughly politicized epidemic, AIDS began with a falsehood and ended in tragedy. Virus hunters in the CDC-directed public health movement first made the new syndrome appear contagious. Virus hunters in the NIH-funded research establishment then blamed AIDS on a retrovirus. And virus hunters in the NIH, CDC, FDA, and pharmaceutical industry exploited the situation by resurrecting failed cancer chemotherapeutic drugs for AIDS treatment. In the crisis atmosphere created by the CDC, which allowed no time to think before acting, such toxic drugs as AZT, ddI, and ddC could bypass the normal review procedures and achieve a sanctified monopoly status. The final results have been an unnecessary death toll and an artificially expanding AIDS epidemic.
To make all this possible, the virus hunters from all fields first had to join forces. They have used their combined influence, often behind the scenes, to mobilize the government, media, and other institutions behind a global war on AIDS. Few outsiders have realized just how coordinated the whole strategy has been. The story behind this war, and how its leaders are actively suppressing dissent, is told in the next chapter.

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