by Claus Köhnlein
February 11, 2006
Remember our Patient with the lymphoma? Instead of getting his courses of
chemo (COPP-cyclophosphamide, oncovin, procarbacin, prednisone ) he got 1500 mg
AZT daily. The COOP is given in cycles of 3 days,
repeated every 4-6 weeks to give the bone marrow time to recover. The AZT was
given on a daily basis indefinitely. Under both therapy regimes the lymphoma
disappears. But under daily AZT the patient follows quickly. We, the orthodox
doctors, were not so much concerned about the early passing away of our patient
because we were told AIDS patients have a very poor prognosis- so the one under
AZT fulfilled the bleak prognosis he was given from the observations that AIDS
patients were passing away without AZT-treatment.
How could this iatrogenic AIDS tragedy have come about? It was because of Fischle et al. in 1987. Their "double-blind, placebo controlled trial", as it was announced in the NEJM, promoted 1500 mg AZT as the wonder drug against AIDS. Their conclusion was that "these data demonstrate that administration of 1500 mg AZT can decrease mortality and frequency of opportunistic infections in a selected group of subjects with AIDS or AIDS-related-complex, at least over the 8 to 24 week of observation."
What does that mean for an orthodox doctor? It means that you are more or less forced to give your patients this recommended treatment. If you don't, the patient can easily sue.
NEJM is the bible for an orthodox doctor. The end of any discussion is - No, it's true. I read it in the NEJM.
The placebo arm was stopped after four months because by then the advantage of the verum (AZT) seemed so obvious (1 death in a 145 patient verum against 19 deaths of 137 receiving placebo.)
But the question arises whether the advantage of a treatment after four months can be sustained when you give this treatment longer or even lifelong. AZT was developed to treat cancer and since it is a nucleoside analog it could be possibly useful there. It works like cytosinarabinoside or hydroxyurea, both well known in the treatment of leukemia. Gallo even proposed AZT in the treatment of "viral leukemia" . But it is not designed to treat people who are already suffering from a loss of T cells.
So how comes it that there was a survival benefit after 4 months of AZT? The patients included were AIDS and AIDS related complex patients. That means they were quite ill, and were suffering from serious opportunistic infections. AZT kills everything that depends on DNA replication -- that means opportunistic infections and also cancers will respond to the treatment -- but at a high price. At the same time you are killing the opportunists with AZT, you are killing all dividing cells quite effectively - that includes those in the bone marrow, the very source of our immune cells.
That's the dilemma: In treating AIDS patients with AZT, we bring about the very illness we seek to bring under control. And we all knew, orthodox AIDS doctors and borderline rebels both, was that the initial treatment with 1500 mg was an overkill . Everybody admits that now. Yes, it was too much. Maybe some people died, but that's history, that's the way medicine has always worked. Let's look forward. Today we have this wonderful triple therapy, and mortality rates are dropping. So what, I say.
We virtually killed a whole generation of AIDS patients without even noticing it because the symptoms of the AZT intoxication were almost indistinguishable from AIDS. And the placebo control, which could have warned us, was for "ethical reasons" cut off prematurely.
Indeed, AZT intoxication has given the HIV infection such a lethal outcome that the whole world still believes that HIV is a deadly virus.
I got angry. I wrote a letter to John Maddox, the editor of Nature.