Christine Maggiore

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Christine Maggiore (born 1957) is an HIV-positive[1][2] activist who denies that HIV causes AIDS. She is the founder of Alive & Well AIDS Alternatives, an organization which questions "most common assumptions about HIV and AIDS".[3] She is the author and self-publisher of the book "What If Everything You Thought You Knew about AIDS Was Wrong?"

Maggiore has long been a controversial figure, particularly following the death of her 3-year-old daughter, Eliza Jane Scovill, on May 16, 2005. The Los Angeles County coroner concluded that Eliza Jane had died of Pneumocystis jiroveci pneumonia as a result of untreated AIDS. Maggiore had not taken medication to reduce the risk of transmission of HIV to her daughter during pregnancy, and Eliza Jane was never tested for HIV during her lifetime.[4][5] A veterinary toxicologist (and AIDS denialist) retained by Maggiore to review the autopsy report disagreed with the coroner's conclusion, stating that he believed Eliza Jane's death was due to an allergic reaction to amoxicillin.[4]

Contents

[edit] 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. A former boyfriend also tested positive.[1]

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 denialist 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.[4]

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.[3][4] Maggiore herself drew criticism for breast-feeding her children;[2] breast feeding has been shown to increase the risk of mother-to-child transmission of HIV.[6][7][8]

In a 2002 article entitled My Bout of So-Called AIDS, Maggiore wrote that she had been diagnosed with a cervical condition (a "Grade 3 Pap smear with cervical dysplasia") which she wrote would qualify her for an AIDS diagnosis (in fact, although invasive cervical cancer is an AIDS-defining illness, an abnormal Pap smear has never been an AIDS-defining condition). Maggiore's doctors recommended further evaluation with colposcopy; Maggiore instead followed a naturopathic program and had a third Pap test performed by another doctor under an assumed name, which she wrote was normal.[9]

In a 2005 article in the L.A. Times, Maggiore claimed to be in excellent health without taking anti-retroviral treatment.[4] Maggiore states that her husband and partner, filmmaker Robin Scovill, tests repeatedly negative despite what Maggiore describes as "a decade of normal, latex-free relations", as does their son Charlie, born in 1997.[2][4]

[edit] Death of Eliza Jane

Christine Maggiore chose to not take antiretroviral drugs or other measures that medical evidence suggests could have reduced the risk of mother-to-child transmission of HIV during her pregnancies.[5][10][11] However, given the known and unknown risks of antiretroviral use in pregnancy, the National Institutes of Health guidelines state that the final decision regarding their use "should be made by the woman after discussion with her health care provider about the known and unknown benefits and risks of therapy" in a "noncoercive" environment.[12] Maggiore also breast-fed her children, despite evidence that breast-feeding can also transmit HIV from mother to child. Her youngest daughter, Eliza Jane, was never tested for HIV, nor did she receive any of the recommended childhood vaccines.[4] 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."[4]

[edit] 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.[4] Reportedly, Gordon was aware of Maggiore's HIV status,[4] but did not have Eliza Jane tested for HIV and was not concerned about opportunistic infection. According to the hospital report, filed just after Eliza Jane's death and based upon an interview with Maggiore, Eliza Jane "had been diagnosed with pneumonia,"[13] in the weeks preceding her death.

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."[2] On May 14, 2005, Incao prescribed amoxicillin 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.[4] She was rushed by ambulance to Valley Presbyterian Hospital in Van Nuys, California. Physicians attempted to resuscitate Eliza Jane, but were unsuccessful. According to the hospital report, a "chest x-ray revealed pneumonia," and Eliza Jane was pronounced dead at 5:40 AM on May 16, 2005.[13]

[edit] Cause of death

An autopsy was performed. The Los Angeles County coroner found that Eliza Jane was markedly underweight and underheight, consistent with a chronic illness, and that she had had pronounced atrophy of her thymus and other lymphatic organs. Examination of her lungs showed infection with Pneumocystis jiroveci, a common opportunistic pathogen in people with AIDS and the leading cause of pediatric AIDS deaths.[14] The post-mortem examination of Eliza Jane's brain showed changes consistent with HIV encephalitis; protein components of HIV itself were identified in Eliza Jane's brain tissue via immunohistochemistry.[13]

Based on the clinical information, the immunohistochemical documentation of HIV in Eliza Jane's brain, the evidence of pronounced immunosuppression, and the isolation of the opportunistic pathogen Pneumocystis jiroveci from Eliza Jane's lungs, the coroner concluded that Eliza Jane had died of Pneumocystis pneumonia in the setting of advanced AIDS.[13] This conclusion was described by the coroner as "unequivocal".[2]

Maggiore rejected the coroner's conclusion, ascribing it to political bias and attacking the personal credibility of the senior coroner, James Ribe.[15] Maggiore retained a board member of Alive & Well AIDS Alternatives, toxicologist, Mohammed Al-Bayati, to review the autopsy report. Al-Bayati holds a Ph.D. in comparative pathology (the pathology of animal diseases). He is not a medical doctor, nor is he board-certified in human pathology.[16] He is the author of a book entitled Get All The Facts: HIV Does Not Cause AIDS.[17]

Al-Bayati released a report describing his conclusion that Eliza Jane had not died from AIDS or pneumocystis pneumonia, but from an allergic reaction to amoxicillin.[18] Maggiore embraced 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."[2]

Al-Bayati's report has been dismissed as both biased and medically unsound.[19][20] 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 resultant Pneumocystis pneumonia were the cause of death, and rejected Al-Bayati's report.[4][2]

[edit] Criticism and controversy

Following Eliza Jane Scovill's death, Maggiore's beliefs have become points of controversy. Maggiore has held fast to her belief that HIV does not cause AIDS, and that Eliza Jane died of a reaction to amoxicillin.[15] Maggiore has also described much of the major journalistic coverage of her story as biased or inaccurate.[15] 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."[21]

Others point to the evidence which indicates 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.[4][2][20]

Dr. John Moore, speaking at the 16th International AIDS Conference, described Eliza Jane's death as a concrete example of the human harm that can result from pseudoscientific beliefs such as AIDS denialism:

... 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.[22]

Maggiore's inclusion as an exhibitor at the 13th International AIDS Conference in Durban, South Africa has been criticized by AIDS activists.[23]

The journalist and AIDS denialist Celia Farber wrote an article in June 2006 in the independent paper Los Angeles CityBeat, 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. In particular, Farber's article raised the issues that the coroner's office had not disclosed the results of Eliza Jane's HIV serology test, and that her total lymphocyte count was elevated at the time of her death.[24]

[edit] 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.[4] On September 15, 2006 the LA County District Attorney's office announced that it would not file charges against Christine Maggiore, noting that Ms. Maggiore did take her sick child to several physicians.[25]

In September 2006, the Medical Board of California filed charges of gross negligence against one of these physicians, Dr. Paul Fleiss, a convicted felon[26] who was Eliza Jane's pediatrician, alleging a failure to test Eliza Jane for HIV (or to document her parents' refusal of testing), a failure to counsel Maggiore to avoid breast-feeding at any time during the three years Maggiore breast-fed her daughter, given the risk of transmitting HIV, and similar violations of standard medical practice in Fleiss' care of a second HIV-positive child.[25]

In September of 2007, the Medical Board of California issued its decision in the Fleiss case, effective October 8, 2007.[27] The Board revoked Fleiss' medical license, but stayed this action in favor of a 35-month probation period during which Fleiss must submit to regular monitoring, pay costs, notify insurance and hospitals of the decision against him, and take continuing medical education (CME) classes and record-keeping courses. He is not permitted to supervise Physician's Assistants and has affirmed the practice of referring HIV-positive patients to a specialist.

In an admonition letter dated September 13, 2007, an Inquiry Panel of the Colorado State Board of Medical Examiners issued its finding that Dr. Philip Incao's "care and treatment and lack of timely documentation" in the case of Eliza Jane Scovill "falls below the generally accepted standards of medical practice". The Panel warned Dr. Incao that any further instances of such behavior could result in "formal disciplinary proceedings against your license to practice medicine".[28]

[edit] References

  1. ^ a b "The HIV Disbeliever", by David France. Published in Newsweek, 28 August 2000.
  2. ^ a b c d e f g h ABC News Primetime Live special report
  3. ^ a b Alive & Well: AIDS Alternatives official organization page.
  4. ^ a b c d e f g h i j k l m n A Mother's Denial, a Daughter's Death: Article from L.A. Times, Sep 24, 2005
  5. ^ a b "Mother who denied Aids link faces police investigation after death of daughter", by Julian Borger. Published in The Guardian on September 26, 2005. Accessed March 28, 2007.
  6. ^ 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. doi:10.1001/jama.283.9.1167. PMID 10703779. 
  7. ^ 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. 
  8. ^ Watts D (2002). "Management of human immunodeficiency virus infection in pregnancy.". N Engl J Med 346 (24): 1879–91. doi:10.1056/NEJMra013338. PMID 12063373. 
  9. ^ "My Bout of So-Called AIDS". Article by Christine Maggiore. Accessed 5 Dec 2006.
  10. ^ Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection: A review of the medical literature from the Cochrane Library. Accessed March 16, 2007.
  11. ^ Mofenson, LM, and the Committee on Pediatric AIDS. Technical report: perinatal human immunodeficiency virus testing and prevention of transmission. Pediatrics 2000; 106(6).
  12. ^ National Institutes of Health recommendations on HIV therapy during pregnancy. Accessed 4 Dec 2006.
  13. ^ a b c d Autopsy Report on Eliza Jane ScovillPDF (2.29 MiB)
  14. ^ [1] Accessed 20 July 2007.
  15. ^ a b c Justice For E.J., website maintained by David Crowe of the Alberta Reappraising AIDS Society, accessed 5 September 2006.
  16. ^ Mohammed Al-Bayati's C.V., accessed 5 September 2006.
  17. ^ Virusmyth (dissident) website advertising Mohammed Al-Bayati's book. Accessed 1 Dec 2006.
  18. ^ Mohammed Al-Bayati's review of Eliza Jane Scovill's autopsy, accessed 5 September 2006.
  19. ^ Christine Maggiore: AIDS naysayer, accessed 5 September 2006.
  20. ^ a b Rebuttal to Dr. Mohammed Al-Bayati's report, by Nicholas Bennett, accessed 5 September 2006.
  21. ^ Maggiore's view of the L.A. Times article, accessed 5 September 2006.
  22. ^ HIV and Responsible Journalism, presented at the 16th annual International AIDS Conference, accessed 5 September 2006.
  23. ^ Criticism of Maggiore's inclusion in the 13th International AIDS Conference
  24. ^ Celia Farber, A Daughter's Death, A Mother's Survival, Los Angeles City Beat.
  25. ^ a b "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.
  26. ^ "Fleiss (the father) is placed on probation, article in the L.A. Times, published 9 October 2007. Accessed 10 October 2007.
  27. ^ Attorney General (2007-09-10). Decision in the Matter of the Accusation Against: Paul Fleiss, M.D. - MBC Case #17-2005-169843 (PDF) (English) 14. Medical Board of California. Retrieved on 2007-10-21.
  28. ^ State of Colorado State Board of Medical Examiners letter to Dr. Philip F. Incao, M.D. Accessed 04 May 2008.

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