Hemophilia is a serious disease -- blood won't clot, huge risk of internal bleeding, big need for blood transfusions. And these transfusions placed those with this rare, single gene disorder in the original AIDS 4-H club (Haitians, Homosexuals, Heroin users and Hemophiliacs).
A well-cited paper by Goedert et al., Risks of immuodeficiency, AIDS and death related to purity of factor viii concentrate, published in the Lancet in 1994, describes a large multi-center trial to compare the benefits of highly purified clotting factor versus a less purified product for those unfortunate enough to suffer both hemophilia and the AIDS stigmata. The abstract reads:
In HIV-infected subjects with haemophilia, CD4 counts seem to fall more slowly in those on high-purity factor VIII (FVIII) than on intermediate-purity product. We evaluated whether risks for AIDS or death were associated with either product among 411 HIV-infected individuals. The relative hazard of AIDS was slightly elevated for both current (1.34) [corrected] and cumulative (1.01 per month) use of high-purity products (neither significant). The corresponding hazards for death were 1.49 and 1.03 (neither significant). Thus we found no evidence that high-purity FVIII concentrates retard the development of AIDS.
All well and good. But take a close look at the key table from this paper. It seems that some of these hemophiliacs were also being "medicated" with the chain-terminating nucleoside analog and failed cancer drug, AZT. And wouldn't you know, the risk of hemophiliacs on AZT developing AIDS was 4.5-fold elevated, and they were more than twice as likely to die. How ya like them poisoned apples!
This is, by far, the most important variable in the multi-authored "parametric model".
How did the many, senior scientist authors let this damning line into an otherwise bland table? The "quick and dirty" answer is that the junior level preparation of the graphics to go with the manuscript was not too swift, and the senior scientist crew was inattentive and no one noticed that the computer-generated, "total" data-package required editing. More to the point, and more significantly, why did the referees not question this? (They did not since it is never discussed, or even mentioned anywhere in the text.)
But science is self-correcting, even if the wheels of the mill of truth grind exceedingly slow but fine (or something like that).
Shortly after the discordant entry was called to my attention by our good friend doc Bialy (whose slide is linked above), we alerted the highly esteemed, very British editors of the Lancet to this minor anomaly, and the clear demonstration of the extreme toxicity of AZT. Perhaps in line with a trend started by the honest publication in August of some very provocative (to put it mildly) results of newer "antiretroviral therapy", they agreed to print an erratum in the very first issue with the beautiful, redesigned cover we sent them (and which is reproduced below), and to elevate the important, but previously overlooked, major conclusion of the Godert study to its proper place in a suitably retitled article: Risks of Immunodeficiency, AIDS and Death Related to AZT Intoxication.
Although this may come a little late for the thousands of hemophiliacs who had their lives shortened by AZT, we think the editors still deserve a "Bravo" on the strength of what all our grandmother's told us about better late than never being almost, always true.
So, Bravo, guys and gals, but in the future try and get it right the first time OK?
"In 1989 or 1990 the New England Journal of Medicine published findings that compared AIDS patients given 1200mg of AZT compared with those given 600mg AZT. Their findings? People with the higher dose had twice the mortality."
2. Library trip aborted! One kind fellow (thank you very much, Sir) sent me the pdf. Pharma Ditz and George, y'all have the quote right:
"Subjects who had started [AZT] had an increased risk of AIDS, probably because [AZT] was administered first to those whom clinicians considered to be at highest risk. "
My bad for missing this, but so what? It's pure speculation. Whenever medicine kills, the underlying disease is blamed. (See Pluda paper, where excess lymphoma rates were attributed to the virus, not the AZT)
p.s. AZT is dangerous stuff. It screws with your DNA. Best to be avoided. Should not have been given to hemophiliacs.