The cure that failed - effects of AIDS drug AZT

National Review, May 10, 1993 by Tom Bethell

Did the AIDS lobby know what it was doing when it pressed the government to approve AZT?

Lindsey Nagel was born in Petrosani, Rumania, in October 1990. She was adopted by a Minneapolis couple, Cheryl and Steve Nagel, who brought her back to the States later that year. Within a few weeks, they were dismayed to find that she had tested positive for HIV. Although she showed no symptoms of disease, the Nagels' doctor put her on Retrovir syrup, otherwise known as AZT. In response to protests by homosexual activists this drug had been hurriedly approved by the FDA in 1987. "The government bends to AIDS victims' pleas," was the way U.S. News & World Report headlined a critical story at the time.

Over the next 18 months Lindsey's general health declined. She became "hyperactive," as though "she did not feel comfortable in her body," according to her father. She did not eat properly, avoided milk, and suffered from nausea and diarrhea. Then, in October 1992, things took a turn for the worse. Night after night she woke up screaming. Her parents would find her half sitting up in bed, clutching at her knees and thighs. Sometimes this would happen twice a night.

A month or so before this turn of events, the Nagels had read a couple of magazine articles about Peter Duesberg, a virologist at UC Berkeley. Duesberg says that HIV does not cause AIDS, and that AZT is toxic and not a rational treatment for AIDS. The Nagels wanted to know more, so they wrote and told him about the treatment their daughter was receiving.

"Take her off AZT immediately if you want to see her live," Duesberg wrote back. "Your daughter will die from it, like Kimberly Bergalis was believed to have been infected with HIV by her dentist in Florida. She had a yeast infection, which is common among women, but it is also one of the "indicator diseases" within the Centers for Disease Control's ever-expanding definition of AIDS. (First defined in 1982, AIDS was redefined more and more inclusively in 1984, 1985, 1987, and 1993.) With a yeast infection plus HIV, Miss Bergalis became an AIDS patient by definition, and was duly prescribed AZT. Within a year she was in a wheelchair (as was Rudolf Nureyev toward the end of his life, and he, too, took AZT). Among its other side-effects, AZT causes myopathy, or muscle atrophy. Miss Bergalis died in 1991.

Arthur Ashe also took AZT. After his death, New York Daily News columnist Earl Caldwell reported that Ashe had "wanted to" break away from his treatment, but was worried about giving offense. "What will I tell my doctors?" he said to a friend. Michael Callen, the author of Surviving AIDS, claims that the only long-term AIDS survivors are those who have not taken AZT. Larry Kramer, HIV-positive gay playwright, and unremitting scourge of the government when it doesn't seem to be doing enough, says that AZT is not for him.

AZT was designed in 1964 as chemotherapy for cancer. But it was never approved, because of its side-effects. With an AIDS cure much in demand, it was retrieved fromt he storage room. After toxicity and efficacy trials seemed to show that it did some good, at least in the short run, the FDA gave the drug its seal of approval. "From a failed cancer medication to the only fully approved AIDS treatment, AZT has made an astonishing comeback," Discover reported in 1990.

Chemotherapy prevents cells from dividing by fooling cellular DNA into accepting a chain-terminator into the DNA chain. It's like putting a caboose (with no rear coupling) into the middle of a freight train that was supposed to incorporate many more cars. Now the train cannot expand beyond the caboose because there's nothing to hook onto.

The problem with chemotherapy is that it stops all cells from dividing, not just cancer cells. Science hasn't been able to figure out a way for it to zero in on the cancer exclusively. Cancer cells divide rapidly, but so do stomach cells and bone-marrow cells and lots of other cells. The formation of new DNA chains is stopped within all of them. That's why long-term chemotherapy is very destructive.

The same problem arises with AZT. The drug doesn't know how to find just the HIV-infected cells (assuming, arguendo, that HIV really does cause AIDS). And that's why Duesberg wrote in a recent article that AZT "must be the most toxic drug ever approved for indefinite therapy in America." Nonetheless, about 100,000 people are now taking it. One is Jeffrey Schmalz, the New York Times reporter who has AIDS. Many people report early beneficial effects from AZT. And Schmalz told me that the drug had saved his life. "The problem is long range," he said, "because it begins to eat away at your system."

What about the efficacy and toxicity studies? Here I warn NR readers that I shall make a "left wing" point, but I wouldn't bother to do so if the news media had shown any interest in it. Surprisingly, they have not. Many of the AZT studies have been funded by the company that makes AZT, Burroughs Wellcome. This was true of the "double-blind, placebo-controlled trials" in 1986 that led to FDA approval of the drug. The results of these trials were published in The New England Journal of Medicine in 1987.