NEW YORK TIMES, March 4, 2003
Malarial Treatment for Chinese AIDS Patients Prompts Inquiry in U.S.
By Donald G. McNeil, Jr.
The University of California at Los Angeles is investigating whether
two of its researchers aided experiments in China in which H.I.V.
patients were deliberately injected with malaria in an effort to kill
the AIDS virus.
The China research was done from 1993 to 1996 at the request of Dr.
Henry J. Heimlich, now 83, the inventor of the Heimlich maneuver,
which can save people who are choking.
Dr. Heimlich, who has courted controversy in several fields of
medicine, argues that inducing high malarial fevers can stimulate the
immune system to fight AIDS, Lyme disease and cancer. In the early
1990's, he held fund-raising parties in Hollywood, raising tens of
thousands of dollars from movie stars and agents to pursue a malaria
AIDS cure.
The Centers for Disease Control and Prevention opposes malarial
therapy, and some medical experts have harshly criticized him for
experimenting on humans in China when it was unthinkable that such a
trial would have been approved in the United States.
U.C.L.A.'s medical board overseeing human tests is investigating two
researchers, Dr. John Fahey and Dr. Najib Aziz, based on information
that a university spokesman declined to describe.
On Feb 16, The Cincinnati Enquirer published an article in which Dr.
Heimlich described his work in China and said Dr. Fahey was involved.
The Web site for Dr. Heimlich's Institute at the Deaconess Hospital in
Cincinnati still says U.C.L.A. helped with the research.
The article quoted letters and e-mail messages supposedly written by
Dr. Fahey that, The Enquirer said, detailed how the two doctors set up
the experiments, analyzed data, provided test chemicals, visited the
test site in China and offered to find research grants. In another
document The Enquirer quotes, Dr. Fahey asks his Chinese colleagues to
refrain from naming him or Dr. Aziz as an author of a research paper.
The paper, presented at two international AIDS conferences in 1996,
published in the Chinese Medical Science Journal in 1999 and still
available on the Heimlich Institute Web site at
www.heimlichinstitute.org, lists Dr. Heimlich and three Chinese
doctors as authors.
A later paper describing 12 H.I.V.-positive Chinese men and women who
were injected with malaria and then had their immune responses
measured, released in 2000 by the Center for AIDS Control and Research
in Guangzhou, China, thanked Dr. Heimlich, Dr. Fahey and Dr. Aziz for
their help with the "pilot study."
Dr. Fahey's office assistant said he would not speak to the press. Dr.
Aziz, reached at his laboratory, refused to comment.
Barbara Lohr, a spokeswoman for the Heimlich Institute, said Dr.
Heimlich was on vacation and would not comment. However, he did
forward answers to some e-mailed questions and sent documents
defending malarial therapy.
On April 29, 1993, noting that Dr. Heimlich was encouraging the use of
malaria to treat Lyme disease and AIDS, C.D.C. officials issued a
memorandum saying the practice "cannot be justified." It cited studies
showing that malaria victims in Zaire received no protection from
H.I.V. infection and may have gotten sicker more quickly having both.
Deliberately giving patients malaria risked killing them, the C.D.C.
said.
Dr. Heimlich went ahead nonetheless, in conjunction with Chinese
scientists led by Dr. Chen Xiao Ping. Eight men with H.I.V. were
injected with vivax-strain malaria, two in 1993 and six in 1995. After
three weeks of fever cycles, the malaria was killed with the drug
chloroquine.
The study, which ended in 1996, reported then that all eight were
alive and had normal CD4 counts; the H.I.V. virus cripples the immune
system by destroying CD4 cells. Dr. Heimlich said on Feb. 21 that, as
of his last contact with his Chinese colleagues in 2001, one man was
dead of non-AIDS-related causes and the rest were alive.
It is difficult, however, to draw conclusions from such short-term
data. It typically takes at least eight years from infection with
H.I.V. for a healthy adult to develop symptoms; it was unknown whether
the men later received antiretroviral therapy.
Dr. Peter Lurie, a former AIDS researcher now with Ralph Nader's
Public Citizen Health Research Group, called the follow-up period "not
enough to say anything" and said that Dr. Heimlich's use of human
subjects to test his theory was "outrageous."
Dr. Mark Siegler, director of the Center for Clinical Medical Ethics
at the University of Chicago Hospital, said that injecting patients
with a dangerous disease to fight another was done 50 years ago in
this country but would not be tolerated now.
Dr. Heimlich has long argued that malarial fevers can be used against
syphilis, Lyme disease, AIDS and cancer.
Before the invention of penicillin, blood from people with vivax
malaria, sometimes provided by the United States Public Health
Service, was injected as a treatment for late-stage syphilis that had
reached the brain. In the late 1970's some Americans with Lyme disease
went to Mexico for "malaria treatment."
In its 1993 paper, the C.D.C. said no clinical trials had ever proved
malaria treatment worked and anecdotal reports on syphilis patients
called it unpredictable.
Dr. Lurie said malarial cures had been "relegated to the status of
leeches."
Prominent AIDS researchers say Dr. Heimlich's theory doesn't make
scientific sense. Syphilis and Lyme disease, which are caused by
spirochetes, are now treated with antibiotics. AIDS, in contrast, is
caused by a retrovirus, which does not live outside cells as a
spirochete does; it incorporates itself into a cell's DNA. Cancers -
pockets of abnormally rapid cell growth - have many causes, but are
thought to stem from damage to a cell's DNA. Also, many Africans have
AIDS and malaria simultaneously.
"A lot of micro-organisms don't do well in a high fever," said Dr.
Merle A. Sande, a University of Utah AIDS researcher who has a
treatment program in Uganda. "But I don't have any reason to think
malaria would suppress the AIDS virus."
Dr. Heimlich's Web site responds to some of these criticisms, arguing
that Africans are often infected with the falciparum strain of
malaria, which can be so rapidly fatal that it must be treated
immediately. Chronic malaria weakens the immune system and should not
be compared with a short, deliberate vivax-strain infection, it said.
Dr. Heimlich, whose maneuver, introduced in 1974, is credited with
saving the lives of many choking victims, has often provoked
controversy. He argues that it should be used in drowning cases to
clear water and on victims of asthma and cystic fibrosis to clear
mucus. His institute is devoted to simple lifesaving solutions, and it
credits him with inventing a chest drain valve, an
esophagus-replacement operation, tracheal oxygen tubes and a method to
restore swallowing to stroke victims.
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2003, The NY Times Company
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