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Christine Maggiore

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Christine Maggiore is an HIV-positive activist and AIDS dissident (that is, a person who does not believe that HIV is the cause of AIDS). She is the founder of Alive & Well AIDS Alternatives, an organization which questions "most common assumptions about HIV and AIDS".

Maggiore became a controversial figure following the death of her 3-year-old daughter, Eliza Jane Scovill, on May 16 2005. Maggiore had not taken medication AZT to prevent transmission of HIV to her daughter, as she does not believe that HIV causes AIDS. AZT is a highly controversial medication as it is designed to interfere with DNA synthesis (it is a 'nucleoside analog') and its toxicity is well documented. Eliza Jane had never been tested for HIV. The Los Angeles County coroner concluded that Eliza Jane had died of Pneumocystis jiroveci pneumonia as a result of untreated AIDS. However, a toxicologist (and AIDS dissident) retained by Maggiore to review the autopsy report disagreed, stating that he believed Eliza Jane's death was due to an allergic reaction to amoxicillin.

History

Born in Chicago, Illinois, Maggiore grew up in Southern California. After graduating with honors from Reseda High, she worked in advertising and marketing in Los Angeles until 1984. After traveling through Europe and North Africa in 1984, she settled in Florence, Italy, where she lived from 1985 to 1987. In 1986, Maggiore started what became a multimillion dollar import/export clothing company, Alessi International, based in Tuscany. In 1992, as part of a routine medical exam, Maggiore tested HIV positive.

Following her diagnosis, Maggiore became involved in volunteer work for a number of AIDS charities, including AIDS Project Los Angeles, L.A. Shanti and Women at Risk. However, following some anomalous HIV test results (negative, positive and indeterminate) and subsequently an interaction with prominent AIDS dissident Peter Duesberg in 1994, she began to question whether HIV did in fact cause AIDS. Maggiore came to believe that her positive test may have been due to flu shots, pregnancy, or a common viral infection.

In 1995, Maggiore left the clothing business to work as a freelance consultant for US government export programs. At the same time, she founded Alive & Well AIDS Alternatives, an organization designed to foster an environment where HIV-positive people can feel free to openly discuss their health decisions, including decisions to avoid HIV medications for themselves or their children. Maggiore herself drew criticism from some people for breast-feeding her children; breast feeding has been proven to increase the risk of mother-to-child transmission of HIV, although this conclusion has not been accepted by many AIDS dissidents who have criticized this research as invalid, including in scientific journals.

In a 2005 article in the L.A. Times, Maggiore claimed to be in excellent health without taking anti-retroviral treatment. Some claimed that she was living in denail because she had been diagnosed with a cervical condition that would qualify her for an AIDS diagnosis. However, like many women she had simply experienced a false alarm. Later PAP smears were normal. Maggiore authored an article about this experience entitled My Bout of So-Called AIDS, expressing the fear and frustration of experiencing three conflicting Pap smear results.

Maggiore's husband and partner, filmmaker Robin Scovill, has tested repeatedly negative despite what Maggiore describes as "a decade of normal, latex-free relations". Their son Charlie, born in 1997, also tested negative several times in 2005.

Death of Eliza Jane

Christine Maggiore declined to take antiretroviral drugs or other measures to prevent mother-to-child transmission of HIV during her pregnancies. Antiretroviral drugs, along with other interventions, have been shown to reduce the risk of a child testing HIV-positive, although this conclusion is not accepted by AIDS dissidents who point out that there are no studies showing better health outcomes with drugs to prevent this condition, no proof that the antibodies are definite evidence for the presence of HIV and much evidence to show that the drugs are dangerous. Maggiore also breast-fed her children, despite the fact that breast-feeding can increase the risk of a child testing HIV-positive. Dissidents also point out that there is on evidence that there is live HIV in breast milk, no evidence that the antibodies are proof of the presence of HIV. The PCR ('viral load') tests that are often used in infants due to the unreliability of antibody tests have never been approved by the FDA for diagnostic purposes, and there is no proof that the genetic primers for these tests come from HIV, in the absence of purification of HIV.

Her youngest daughter, Eliza Jane, was never tested for HIV, nor did she receive any of the recommended childhood vaccines. Maggiore discussed her beliefs as an AIDS dissident on Air America in March 2005, stating that "...our children have excellent records of health. They've never had respiratory problems, flus, intractable colds, ear infections, nothing. So, our choices, however radical they may seem, are extremely well-founded."

Illness and death

Several weeks after this interview, in April 2005, Eliza Jane became ill with a runny nose. She was seen by a physician from the family's pediatric practice, who documented a normal physical exam. Several days later, Maggiore took Eliza Jane to see another pediatrician, Dr. Jay Gordon, who felt she had a mild ear infection. Reportedly, Gordon was aware of Maggiore's HIV status, but did not have Eliza Jane tested for HIV and was not concerned about opportunistic infection.

When Eliza Jane failed to improve, Maggiore took her to see Dr. Philip Incao, a holistic practitioner and board member of Maggiore's dissident organization Alive & Well AIDS Alternatives. Incao stated that Eliza Jane appeared "mildly ill... no way I considered her in danger... she did not act as a patient acts if she's severely ill or in danger." On May 14 2005, Incao prescribed amoxicillin (a penicillin derivative) for a presumed ear infection.

The following day, Eliza Jane became lethargic and vomited several times. While Maggiore was on the phone to Dr. Incao, Eliza Jane collapsed and stopped breathing. She was rushed by ambulance to Valley Presbyterian Hospital in Van Nuys, California. Physicians attempted to rescusitate Eliza Jane, but were unsuccessful; she was pronounced dead at 5:40 AM on May 16 2005.

Cause of death

An autopsy was performed. The Los Angeles County coroner found that Eliza Jane was severely underweight and underheight, consistent with a chronic illness, and that she had had pronounced atrophy of her spleen, thymus, and other lymphatic organs. Examination of her lungs showed infection with Pneumocystis jiroveci, a common opportunistic pathogen in people with AIDS. The post-mortem examination of Eliza Jane's brain showed changes consistent with HIV encephalitis; protein components of the HIV virus itself were identified in Eliza Jane's brain tissue via immunohistochemistry.

This case has become increasingly polarized. The previous paragraph is left intact to illustrate the serious distortions that are introduced by people who want to go far beyond the evidence to use Eliza Jane's death to get at Christine Maggiore for once and for all. The coroner's report actually says "The spleen 40 grams (expected average weight for age 47 grams) and is of average size." There is no question that Eliza Jane was smaller than average, but so is her mother. Three pediatricians had seen nothing wrong with her growth and her normally vibrant disposition belied concerns about chronic health problems.

Based on their interpretation of the clinical information, the presence of documented HIV in Eliza Jane's brain (but without any normal HIV tests being performed), the evidence of pronounced immunosuppression (a conclusion that is hard to understand in the presence of an above-normal number of lymphocytes), and the isolation of the opportunistic pathogen Pneumocystis jiroveci from Eliza Jane's lungs (a pathogen that is found commonly, but only causes problems in the highly immune suppressed), the coroner concluded that Eliza Jane had died of Pneumocystis pneumonia in the setting of advanced AIDS. This conclusion was described by the coroner as "unequivocal".

Supporters of Maggiore rejected the coroner's conclusion, ascribing it to political bias and publishing a statement from a lawyer pointing out several previous times when the actions of the coroner, Dr. James Ribe, appear to have been biased against the parents of a dead child. Maggiore retained a board-certified toxicologist, Dr. Mohammed Al-Bayati, to review the autopsy report. Dr. Al-Bayati holds a Ph.D. in comparative pathology; he is not a medical doctor, nor is he board-certified in human pathology; he does not believe that HIV causes AIDS.

Dr. Al-Bayati released a report describing his conclusion that Eliza Jane had not died from AIDS or PCP, but from an allergic reaction to amoxicillin. Maggiore embraced Dr. Al-Bayati's conclusion that a reaction to amoxicillin was responsible, stating, "I believe the unfortunate irony in this situation is that the one time that we were asked to and that we complied with mainstream medicine, we inadvertently gave our daughter something that took her life."

Some critics have dismissed Al-Bayati's report as both biased and medically unsound. Both the L.A. Times and ABC PrimeTime Live consulted independent experts in pathology about Eliza Jane's case; these experts agreed unequivocally with the coroner's conclusion that AIDS and PCP were the cause of death, and rejected Dr. Al-Bayati's report.

Other medical experts have agree with Al-Bayati's conclusions including Dr. Harold E. Buttram, MD, FAAEM (Fellow of the American Academy of Emergency Medicine) and Dr. Andrew Maniotis, PhD, a pathologist and professor at medical school of the University of Illinois in Chicago.

Al-Bayati has recently published a second report comparing the LA Country Coroner's reports into the death of Eliza Jane and Destiny Jacobo. These cases are an interesting comparison because Al-Bayati claims that Destiny Jacobo did die of pneumonia while the coroner claimed that the little girl died of physical and sexual abuse. By comparison, Al-Bayati claims that Eliza Jane died of an allergic reaction, while the coroner in this cases claims the death was due to pneumonia. These opposite conclusions have one thing in common, they both make the parents responsible for the death of the two children, in the opinion of the coroner.

Nicholas Bennett has refused to comment on the new Al-Bayati report.

Criticism and controversy

Following Eliza Jane Scovill's death, Maggiore's beliefs, as well as her refusal to take medication to prevent transmission of HIV to her children and her refusal to have her child tested for HIV, have become points of controversy. Maggiore holds fast to her belief that HIV does not cause AIDS, and that Eliza Jane died of an adverse reaction to amoxicillin. Adverse reactions to amoxicillin are one of the three commonest causes for admission to hospital emergency departments in the United States according to a CDC survey that collected data through 2004 and 2005. Maggiore has also described much of the major journalistic coverage of her story as biased or inaccurate. She submitted a letter to the L.A. Times alleging factual errors and omissions in their articles on Eliza Jane; the Times did not print the letter, stating that "If facts in an article are wrong, a correction would be published. However, no correction is warranted in this case."

Maggiore has also submitted a detailed list of errors in an article in ELLE magazine which the magazine has agreed to print to correct the record.

Others point to the weight of evidence, which suggests that Eliza Jane acquired AIDS from Maggiore perinatally or via breast feeding, that Eliza's HIV infection might have been prevented had Maggiore taken antiretroviral drugs or avoided breast feeding, that Eliza Jane's death was due to complications of AIDS, and that her death may have been preventable with proper medical care. Eliza Jane's death has been described as a concrete example of the human harm that can result from pseudoscientific beliefs such as AIDS denialism.

Speaking at the 16th International AIDS Conference, Dr. John Moore argued:

... infants whose HIV infected mothers listen to AIDS denialists never got the chance to make their own decisions. The Maggiore case received wide publicity. Christine Maggiore is a person who’s proselytized against the use of antiretrovirals to prevent HIV/AIDS. She’s a classic AIDS denialist, and she gave birth to a child who died at age three late last year of an AIDS-related infection. The coroner’s report clearly reports that the child died of AIDS. That was another unnecessary death.

These comments were made despite the lack of a positive HIV test for Eliza Jane and ignore the serious toxicity of antiretroviral drugs (mainly AZT and Nevirapine) for prevention of mother-to-child transmission. Several researchers have found more health problems in children of mothers who took these drugs

The journalist and AIDS dissident Celia Farber wrote an article in June 2006 in the independent paper Los Angeles City Beat, arguing Maggiore's case and alleging incompetence, conspiracy, and coverups on the part of the coroner, the mainstream AIDS community, the mainstream media, and the medical community.

Legal ramifications

The death of Eliza Jane was investigated by the Los Angeles Police Department and the Los Angeles Department of Child Protective Services as a possible case of medical neglect or child endangerment. On September 15 2006 the LA County district attorney's office announced that it would not be filing charges against Christine Maggiore.

In September 2006, the Medical Board of California has filed charges of gross negligence against Dr. Paul Fleiss, Eliza Jane's pediatrician, due to his failure to test Eliza Jane for HIV (or document her parents' refusal of testing), his failure to counsel Maggiore to avoid breast-feeding given the risk of transmitting HIV, and similar violations of standard medical practice in Fleiss' care of a second HIV-positive child.

No action has been initiated against the other two pediatricians who saw Eliza Jane in the weeks before her death, Jay Gordon and Philip Incao.

References

  1. ^ Alive & Well: AIDS Alternatives official organization page.
  2. AZT and Pregnant Women and Children
  3. ^ A Mother's Denial, a Daughter's Death: Article from L.A. Times
  4. ^ ABC News Primetime Live special report
  5. Nduati R, John G, Mbori-Ngacha D, Richardson B, Overbaugh J, Mwatha A, Ndinya-Achola J, Bwayo J, Onyango F, Hughes J, Kreiss J (2000). "Effect of breastfeeding and formula feeding on transmission of HIV-1: a randomized clinical trial". JAMA. 283 (9): 1167–74. PMID 10703779.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  6. Tess B, Rodrigues L, Newell M, Dunn D, Lago T (1998). "Infant feeding and risk of mother-to-child transmission of HIV-1 in São Paulo State, Brazil. São Paulo Collaborative Study for Vertical Transmission of HIV-1". J Acquir Immune Defic Syndr Hum Retrovirol. 19 (2): 189–94. PMID 9768630.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  7. Watts D (2002). "Management of human immunodeficiency virus infection in pregnancy". N Engl J Med. 346 (24): 1879–91. PMID 12063373.
  8. Eastman A (2002). "Breastfeeding vs formula-feeding among HIV-infected women in resource-poor areas". 287 (9): 1111. {{cite journal}}: Cite journal requires |journal= (help); Unknown parameter |Journal= ignored (|journal= suggested) (help)
  9. Mofenson, LM, and the Committee on Pediatric AIDS. Technical report: perinatal human immunodeficiency virus testing and prevention of transmission. Pediatrics 2000; 106(6).
  10. ^ Autopsy Report on Eliza Jane Scovill
  11. ^ Justice For E.J., website maintained by David Crowe of the Alberta Reappraising AIDS Society, accessed 5 September 2006.
  12. Dr. Mohammed Al-Bayati's C.V., accessed 5 September 2006.
  13. Dr. Mohammed Al-Bayati's home page at http://www.toxi-health.com. Accessed 5 September 2006.
  14. Mohammed Al-Bayati's review of Eliza Jane Scovill's autopsy, accessed 5 September 2006.
  15. Christine Maggiore: AIDS naysayer, accessed 5 September 2006.
  16. ^ Rebuttal to Dr. Mohammed Al-Bayati's report, by Nicholas Bennett, accessed 5 September 2006.
  17. Destiny Jacobo/Eliza Jane Comparison
  18. Budnitz DS; et al. (2006). "National Surveillance of Emergency Department Visits for Outpatient Adverse Drugs Events". 296 (15): 1858–1866. PMID 17047216. {{cite journal}}: Cite journal requires |journal= (help); Explicit use of et al. in: |author= (help); Unknown parameter |Journal= ignored (|journal= suggested) (help)
  19. Maggiore's view of the L.A. Times article, accessed 5 September 2006.
  20. HIV and Responsible Journalism, presented at the 16th annual International AIDS Conference, accessed 5 September 2006.
  21. AZT, Pregant Women and Infants
  22. Celia Farber's article on Eliza Jane, accessed 5 September 2006.
  23. ^ "L.A. County D.A. Won't Act in Girl's AIDS-Related Death", article in the L.A. Times, published 16 September 2006. Accessed 5 October 2006.

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