Alberta Reappraising AIDS Society

David Crowe, President
Phone: +1-403-289-6609
Fax: +1-403-289-6658

Kathleen Newell, Treasurer
Box 61037, Kensington Postal Outlet
Calgary, Alberta T2N 4S6
Phone: +1-403-220-0129

Mothers Avoiding AZT

Lisa Priest article

First letter by David Crowe

Rebuttal by Tony Nickonchuk (BSc Pharmacy)

Second letter by David Crowe

Lisa Priest
Globe and Mail
August 7, 2006

Mother convicted of hiding HIV status for son's birth

[link to newspaper version]

An Ontario mother has been convicted for hiding her HIV status, which denied doctors the chance to treat her baby and possibly prevent her newborn son from being infected — a case considered the first of its kind in Canada.

The mother of two pleaded guilty to failing to provide the necessaries of life. On April 6, Mr. Justice Anton Zuraw sentenced her to a six-month conditional sentence, followed by three years of probation, Hamilton-based assistant Crown attorney Karen Shea has confirmed.

Until today, news of her conviction had escaped public view.

“The moment that child was born, the child did not have an opportunity to have the medication,” Detective Brien Smyth of Hamilton Police Service said in a telephone interview. “We had our fingers crossed, hoping the baby did not ever get HIV.”

As it turned out, the baby did test positive for the human immunodeficiency virus when he was 2 months old. He turns 2 next month.

The woman's lawyer, Larissa Fedak, refused comment. Her client, who lives in Hamilton, could not be reached for comment. She is not being named to protect the identity of her son.

The charge the woman was convicted of is typically reserved for cases of child neglect. In this case, her conviction stems not from what she did or didn't do during her pregnancy, but her behaviour after the baby was born.

“I think it's such a unique case, I hope we never see another one like it,” Det. Smyth said. “It's unfathomable.”

Unfathomable, he said, because the mother was counselled about the risks of transmitting HIV to her baby during her first pregnancy. When she came to Canada in April of 2003, she was HIV-positive and far along in her pregnancy. Hamilton doctors advised her about ways to reduce the chances of passing the virus onto her baby.

Steps included receiving antiretroviral therapy two hours prior to delivery, having a cesarean section, ensuring the newborn received antiretroviral therapy and refraining from breastfeeding, according to the synopsis of offence that was filed in Provincial Court.

Today, if a woman with HIV takes antiretroviral therapy during pregnancy, she can deliver her baby vaginally, so long as her viral load is below 1,000 copies per millilitre, which is the amount of HIV normally present in blood. If she takes the drugs and does not breastfeed, and the baby receives antiretroviral therapy within the first 72 hours of life, the chances of the infant getting the virus are just 1 per cent, said Stanley Read, director of the HIV/AIDS program at the Hospital for Sick Children in Toronto.

If a woman follows none of the precautions, her chances of passing the virus on to her newborn are 25 to 30 per cent.

“We haven't had an infected baby of a mom who took medication, however badly, for three years, maybe four now — and that's across Canada,” Dr. Read said in an interview in Toronto. “The only transmission to babies has been when mom didn't get diagnosed, didn't get treated or didn't take her treatment.”

The convicted woman followed the advice of Hamilton doctors during her first pregnancy. On June 30, 2003, she gave birth to a healthy girl who never acquired the virus, according to the synopsis of offence.

But things went differently the second time.

She discontinued her antiretroviral therapy in August, 2004, even though it had reduced her viral load to undetectable levels. When her viral load climbed, it necessitated a scheduled cesarean section on Aug. 27, 2004, which she did not show up for, according to the synopsis of offence.

It is not clear why she treated the second pregnancy so differently. The only clue is that when speaking to a McMaster University Medical Centre social worker about the possible transmission of HIV to her baby, she described it as being “in God's hands,” the synopsis says.

She did assure that same social worker that although she was going to have a vaginal birth, she would allow the newborn to receive antiretroviral therapy, according to the synopsis of offence.

But when she experienced abdominal pains, she did not go to McMaster University Medical Centre — the hospital where she had received prenatal care. Instead, she went to a different hospital.

On Aug. 30 at St. Joseph's Hospital in Hamilton, she told health-care workers that she had not received prenatal care but was healthy and had experienced no complications during her pregnancy. She denied being HIV-positive. Blood tests were ordered.

Days later, on Sept. 4, 2004, she went back to St. Joseph's, where she gave birth to her son. Staff was still not aware of her HIV status because results from her blood tests were not yet available.

A social worker became concerned by the lack of prenatal care and what was described as the woman's poor attitude, according to the synopsis of offence.

The social worker then contacted the Children's Aid Society, which is the point where the hospital learned the woman was HIV-positive. By that time, the baby was three days old; he was immediately given antiretroviral drugs, according to the synopsis of offence.

In connection with the same offence, the woman was also charged with criminal negligence causing bodily harm and aggravated assault. However, those charges were withdrawn, Ms. Shea, the assistant Crown attorney, confirmed.

Shortly after the woman's arrest in late May of 2005, both of her children were apprehended by the Catholic Children's Aid Society of Hamilton. For privacy, the society cannot divulge whether the children are in their care, said Karen Dolyniuk, manager of development and communications.

The case is highly unusual. Experts say most pregnant women who test positive for HIV do everything possible to reduce the chances of transmitting the virus to their babies, and statistics concur.

From 1984 to 2005, there were 2,206 Canadian babies exposed to the virus in the womb. Of those, 496 babies were infected, 1,612 were not infected and the remainder could not be confirmed, most because they were lost to follow up, said Jennifer Pennock, an epidemiologist with the Public Health Agency of Canada in Ottawa.

“What we've seen over time is that when we look at the proportion of babies confirmed to be infected, it has decreased over time,” she said in a telephone interview.

For example, in 1994, 40 per cent of infants exposed to HIV in the womb contracted the disease. But by 2005, the rate of infected babies had fallen to 4 per cent.

Although testing rates have climbed across the country over the past few years, there are still tens of thousands of pregnant women each year who are never tested for HIV. Consequently, an estimated 15 to 20 babies are born with the virus each year, according to Robert Remis, a public-health-sciences professor at the University of Toronto, who has studied HIV/AIDS extensively. Many of these infections could be prevented if the women were diagnosed and treated.

“I believe women are more concerned about not getting tested than getting tested,” Dr. Remis said in a telephone interview.

One who feels that way is Denise Becker, 47, of Kelowna, B.C. It was only when her daughter Katie died at six months of age in 1994 that Ms. Becker discovered she had HIV and had passed it on to her daughter.

“When I found out I hadn't been offered the test, I was just floored,” Ms. Becker said by telephone. “It was never brought up to me by any of my general practitioners.”

In Ontario, the rate of HIV testing in pregnant women is 89 per cent, according to Frank McGee, AIDS co-ordinator for the Ontario Health Ministry. Since the testing program began in 1999, an estimated 50 HIV transmissions have been prevented.

“It's very important that pregnant women be tested,” Mr. McGee said in a telephone interview.

David Crowe’s First Letter

David Crowe
Globe and Mail
August 8, 2006

To the Editors,
Globe & Mail:

It might seem inconceivable that a woman would deliberately evade AIDS drugs for her infant, but that is only because the toxicity of 'life saving' AIDS drugs is rarely discussed. AZT, the drug given to the vast majority of pregnant, HIV-positive mothers, most of their infants and, in combination with other drugs, to many other HIV-positive people, is one of the most toxic substances known to man.

AZT is a nucleoside analog, which means that it replaces one of the four DNA bases and thus interferes with DNA synthesis. Giving a drug that interferes with cell division to a pregnant woman or to an infant child is incredibly dangerous. It is not surprising that, among the long list of side effects that can be fatal, various forms of white and red blood cells deficiencies are listed. These are so serious that blood transfusions are often needed, and a compound (erythropoietin) to stimulate the formation of blood is specifically advertised for use with AZT treated patients in major AIDS journals.

David Crowe
Alberta Reappraising AIDS Society

Rebuttal Letter

Tony Nickonchuk
BSc Pharmacy
Globe and Mail
August 10, 2006

To the Editors,
Globe & Mail:

[link to newspaper version]

Timmins, Ont. – David Crowe (AIDS And AZT -- letter, Aug. 8) is the president of the Alberta Reappraising AIDS Society, a group dedicated to disproving the widely accepted scientific notions of HIV-AIDS. In this capacity, he presents unconventional and highly controversial information about AZT as a drug used in the fight against this disease.

First of all, AZT hardly qualifies as “one of the most toxic substances known to man.” Second, it is a nucleoside reverse transcriptase inhibitor, inhibiting the enzyme that HIV uses to make DNA copies of itself. This affords it a degree of selectivity for HIV-RNA versus human genetic material. It does not inhibit human cell division akin to chemotherapeutics used for cancer. It instead prevents replication and division of the human-immunodeficiency virus.

Finally, Mr. Crowe trumpets the sensationalistic fatal-side-effects mantra so dear to pharmaceutical naysayers everywhere. The fact of the matter is that all drugs have risks and benefits. The only right decision is that made by the patient, a decision best made with sound advice and deep reflection.

David Crowe’s Second Letter

David Crowe
Globe and Mail
Refused publication

To the Editors,
Globe & Mail:

If AZT was selective for the virus HIV’s attempt to transcribe its RNA into DNA as opposed to human DNA, as Tony Nickonchuk suggests, the drug would not kill white and red blood cells, causing severe anemia. Yet severe anemia is the most prominent side effect of AZT (although far from the only potentially fatal side effect).

Worse yet, the manufacturer’s own description of the drug states “It was often difficult to distinguish adverse events possibly associated with administration of RETROVIR® (AZT™) from underlying signs of HIV disease or intercurrent illnesses.” (Retrovir product monograph. GlaxoSmithKline. 2005 Sep 21.). This is very close to saying that AZT can cause AIDS.

David Crowe
Alberta Reappraising AIDS Society