A drug to treat hemophilia was polluted with hepatitis viruses and HIV

An excerpt from Doctor Guilt?

by Everett Winslow Lovrien, MD

This is the story of a boy who had hemophilia, a bleeding disorder that resulted in pain, disability and death before adulthood. A new medicine was developed which brought an end to suffering and increased longevity in persons with hemophilia.  The effect of the new medicine was like magic. It was a remarkable revolutionary advancement in the treatment of hemophilia, a medical disorder that had caused suffering for many previous centuries.

The medicine was manufactured from the plasma of paid blood donors.  Unexpectedly, a dark cloud descended when persons infusing the medicine became ill. It was discovered that the new medicine was polluted with hepatitis viruses and HIV.  By the time of discovery it was too late to prevent infection. The boy and 10,000 others in the USA became infected with HIV the virus that causes AIDS. He died from AIDS at age seventeen rather than have a prolonged life that was intended with the new medicine.  The medicine was sold to other countries resulting in thousands of deaths from AIDS all over the world.

In addition to the boy, others like him that received medical care at the same clinic he attended also became infected with HIV and hepatitis viruses. One hundred persons at the treatment center where he received his care died from AIDS or liver failure. A dozen other families who lost a son or father or husband were contacted or interviewed in their homes and asked if they blamed the doctors who prescribed the medicine that resulted in death. Doctors are supposed to provide treatment without causing harm to their patients. The doctors didn’t know that HIV, a new virus that causes AIDS, existed. But could they have known or should they have known?  Do the families view the doctors as guilty of causing harm and death?

The families believe the doctors were incorrect when they told the families to take the medicine and their loved one would live to become an old man and have a near normal life. But they do not believe the doctors are guilty.  They were using the best knowledge available at the time.

However, the families do believe the pharmaceutical manufacturers of the medicine are accountable for the deaths from AIDS in persons who infused their medicine to treat hemophilia. If there was suspicion that the medicine was polluted, why didn’t the producers of the medicine purify it by removing the viruses from the donor plasma?  The manufacturers replied that they didn’t know how to purify the medicine or that the methods of viral depletion were too expensive. But since then, reviews have revealed that although the drug companies didn’t know how to remove the hepatitis viruses and HIV, it was known but not by them. It has been known since World War II that heating plasma inactivates hepatitis viruses. If Hepatitis would have been destroyed in plasma by heating, HIV would have also been eliminated even though its existence was not known. AIDS could have been prevented in hemophilia.

In the USA the system of free marketing and capitalism leads to entrepreneurship resulting in the development of new beneficial medicines by pharmaceutical manufacturers. Remarkable and beneficial new medicines have been developed in the USA using genetic engineering methods with recombinant techniques as a result of capitalism.   The force that drives new development is profitability. But when safety is sacrificed for profitability, in a society without cost controls, greed prevails. The manufacture of medicine to treat hemophilia is a multi-billion dollar industry with intense competition.  Because of human nature regulations are necessary to prevent greed.  The families who lost a loved one from AIDS or liver failure from hepatitis regard the drug companies that made the new medicine for hemophilia as bringing great advancement but guilty of greed.

AIDS is not a mysterious disease. It is the result of HIV infection in humans when the natural occurring virus in simians in Africa, SIV, jumped a species to become HIV in humans.  This came about as the result of the production of the human hepatitis B vaccine. As the result of human behavior, the HIV virus infected intravenous drug users who sold their plasma to pharmaceutical manufacturers of the medicine to treat hemophilia.

The use of a medical treatment requires judgment by the prescribing doctor and the patient recipient.  The benefits of treatment must be compared with the hazards, a trade off. The impact of an activity, a medical treatment or a pharmaceutical innovation, may not be apparent at the time of an action. The risk of harm from a possible but unknown substance in the medicine was judged to be a less threat than the threat of death from bleeding into the brain if medicine was withheld. That turned out to be incorrect.

Sometimes good intentions result in bad things happening.  The intent to prevent hepatitis infection in Africa was a good intention. But the process led to the jumping of a species when SIV of monkeys and chimpanzees mutated to become HIV in humans.

For a balanced society, critical thinking is necessary.  Doctors are closest to their patients and should make treatment decisions, with input from their patients, without influence from pharmaceutical manufacturers and commercial and publicity organizations.

We should not forget the great tragedy that happened in hemophilia when thousands of persons all over the world died from AIDS and liver failure.  AIDS is a man-made disease and could have been avoided. Their families want their story to be told. They should be remembered so that this tragedy does not recur.   They are part of our society and all of us should care what happened to them.

Everett Winslow Lovrien is former medical director of Hemophilia Center at the Oregon Health Sciences University and the author of Doctor Guilt?

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  • http://www.medicallessons.net Elaine Schattner, M.D.

    This is a tragic story, but I’m concerned it’s misleading to countless patients with hemophilia. There’s no date mentioned in the post title or text, but presumably the boy’s infection happened sometime around 1979 – 1982, when AIDS was emerging in the blood supply and before doctors recognized the disease as a blood-borne condition and could screen for the virus. That was 20 years ago.

    • http://www.aneurysmsupport.com/ Mike

      Dr. Schattner, I assume that the author was talking about Ryan White, who was a hemophilliac who became infected with the HIV virus. He passed away in 1990, as you said, 20 years ago. I found the following link on the net, it is Wikipedia so I have no idea how accurate it is.

      http://en.wikipedia.org/wiki/Ryan_White

      • http://doctorguilt E W Lovrien

        This book ‘Doctor Guilt?’ is not about Ryan White. This is the tale of a different boy,a boy from Oregon, who was infused many times with AHF concentrate and died at age 17 years of AIDS.

    • http://doctorguilt E W Lovrien

      The boy was infused for the first time in 1976. He continued to receive AHF concentrates, to treat recurrent bleeding episodes, that were polluted with HIV and hepatitis viruses until 1985. In 1985, at 10 years of age, he received HT AHF concentrates ( Heat Treated) when HT became available in the US until he died at 17 years of age from pneumocystis pneumonia as part of AIDS in 1993. Yes, it was twenty years go. That is what this book is about – re-telling the story so these boys who died unncessarily from AIDS will not be forgotten.

  • Greg

    Do you have references to support the assertion that the jump of SIV to a human was somehow related to efforts to produce a Hep B vaccine? Last I’d heard, best estimates put the origin of HIV in the early 1900s, which I am pretty sure is well before we had even identified hepatitis B.

    • http://doctorguilt E W Lovrien

      The origin of HIV in humans from SIV in Simians (a zoonosis) is discussed in the Chapter ‘Infectiouis Diseases in Humans Originated in Animals’ page 297. Although originally proposed by Tom Curtis in 1992 (in Rolling Stones), and subsequently researched and supported by Edward Hooper ( Hooper, E. ‘The River; a Journey to the Source of HIV and AIDS’ Boston: LIttle Brown and Company, 1999) that SIV jumped a species to become HIV as a result of OPV (Oral Polio Vaccine) more recent research dismissed the OPV theory. A British AIDS Conference was convened by the Royal Society of London in 2001 to discuss the OPV theory for the origin of AIDS. Based primarily on results of genetic research by the Los Alamos group headed by Gerald Meyers ( Burr,T., M. Hyman, and G. Meyers, “The origin of acquired immune deficiency syndrome: Darwinian or Lamarckian?” Philosophical Transactions of the Royal Society of Londom B 356(2001):877-887, the conference concluded that the origin of HIV from SIV was from another human event. That event was the production of hepatitis B vaccine and its use in Africa in 1970 and 1975 ( see Figure 5. ‘Path of SIV to HIV’ in Doctor Guilt? There has been no evidence that HIV existed in the early 1900s as you suggested. SIV has existed for many years but not HIV.

  • http://doctorguilt E W Lovrien

    Kevin Pho referred to me as the Director of the Hemophilia Treatment Center at The Oregon Health Sciences University. That is incorrect. I am retired. I was the director for 28 years from 1968 to 1996.

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