Christine Maggiore
Encyclopedia
Christine Joy Maggiore was an HIV-positive activist who promoted the view that HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...

 is not the cause of AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...

. She was the founder of Alive & Well AIDS Alternatives
Alive & Well AIDS Alternatives
Alive & Well AIDS Alternatives is a 501 non-profit organization of AIDS denialists...

, an organization which questions the link between HIV and AIDS and encourages HIV-positive pregnant women to avoid anti-HIV medication. Maggiore authored and self-published the book What If Everything You Thought You Knew about AIDS Was Wrong?

Maggiore's promotion of AIDS denialism had long been controversial, particularly since her 3-year-old daughter, Eliza Jane Scovill
Eliza Jane Scovill
Eliza Jane Scovill was the daughter of AIDS denialist, the late Christine Maggiore, an HIV-positive activist who publicly questioned the link between HIV and AIDS, and supported HIV-positive pregnant women who want to avoid taking anti-HIV medication...

, died of Pneumocystis jiroveci pneumonia, considered to be an AIDS-defining illness. Consistent with her belief that HIV was harmless, Maggiore had not taken medication to reduce the risk of transmission of HIV to her daughter during pregnancy, and she did not have Eliza Jane tested for HIV during her daughter's lifetime. Maggiore hired a veterinary toxicologist (and AIDS denialist) to review the autopsy report. The toxicologist produced a report attributing Eliza Jane's death to an allergic reaction to amoxicillin
Amoxicillin
Amoxicillin , formerly amoxycillin , and abbreviated amox, is a moderate-spectrum, bacteriolytic, β-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. It is usually the drug of choice within the class because it is better absorbed, following oral...

, rather than AIDS. Maggiore herself died on December 27, 2008 after suffering from several AIDS-related conditions.

Early life and career

Born in Chicago, Illinois, Maggiore grew up in Southern California. After graduating with honors from Reseda
Reseda
Reseda may refer to:*Reseda , a plant genus also known as mignonette*1081 Reseda, a minor planet that orbits the Sun; named for the reseda plant genus*Reseda, Los Angeles, a suburb in the San Fernando Valley of Southern California...

 High, she worked in advertising and marketing in Los Angeles
Los Ángeles
Los Ángeles is the capital of the province of Biobío, in the commune of the same name, in Region VIII , in the center-south of Chile. It is located between the Laja and Biobío rivers. The population is 123,445 inhabitants...

 until 1984. She traveled through Europe
Europe
Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...

 and North Africa
North Africa
North Africa or Northern Africa is the northernmost region of the African continent, linked by the Sahara to Sub-Saharan Africa. Geopolitically, the United Nations definition of Northern Africa includes eight countries or territories; Algeria, Egypt, Libya, Morocco, South Sudan, Sudan, Tunisia, and...

 in 1984 before settling in Florence, Italy, where she lived from 1985 to 1987. In 1986, Maggiore started what became a multimillion dollar import/export clothing company, Alessi International, based in Tuscany
Tuscany
Tuscany is a region in Italy. It has an area of about 23,000 square kilometres and a population of about 3.75 million inhabitants. The regional capital is Florence ....

.

AIDS diagnosis and activism

In 1992, as part of a routine medical exam, Maggiore tested positive for HIV
HIV test
HIV tests are used to detect the presence of the human immunodeficiency virus , the virus that causes acquired immunodeficiency syndrome , in serum, saliva, or urine. Such tests may detect antibodies, antigens, or RNA.- Terminology :...

. A former boyfriend also tested positive. Subsequently, Maggiore became involved in volunteer work for a number of AIDS charities, including AIDS Project Los Angeles, L.A. Shanti, and Women at Risk. However, following an interaction with prominent AIDS denialist Peter Duesberg
Peter Duesberg
Peter H. Duesberg is a member of the United States National Academy of Sciences and a professor of molecular and cell biology at the University of California, Berkeley...

 in 1994, she began to question whether HIV causes AIDS. Maggiore came to believe that her positive test may have been due to flu shots, pregnancy
Pregnancy
Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...

, or a common viral infection.

In 1995, Maggiore left the clothing business to work as a freelance consultant for US government export programs. At the same time, she founded Alive & Well AIDS Alternatives
Alive & Well AIDS Alternatives
Alive & Well AIDS Alternatives is a 501 non-profit organization of AIDS denialists...

, an organization denying the connection between HIV and AIDS and urging pregnant HIV-positive women to avoid HIV medications for themselves and their children. Maggiore herself drew criticism for breast-feeding her children, as breast feeding has been shown to increase the risk of mother-to-child transmission
Vertical transmission
Vertical transmission, also known as mother-to-child transmission, is the transmission of an infection or other disease from mother to child immediately before and after birth during the perinatal period. A pathogen's transmissibility refers to its capacity for vertical transmission...

 of HIV.

In a 2002 article entitled "My Bout of So-Called AIDS", Maggiore wrote that she had an abnormal Pap smear
Pap smear
The Papanicolaou test is a screening test used in to detect pre-cancerous and cancerous processes in the endocervical canal of the female reproductive system. Changes can be treated, thus preventing cervical cancer...

 (a "Grade 3 Pap smear with cervical dysplasia"), which she wrote would qualify her for an AIDS diagnosis. Maggiore's doctors recommended further evaluation with colposcopy
Colposcopy
Colposcopy is a medical diagnostic procedure to examine an illuminated, magnified view of the cervix and the tissues of the vagina and vulva. Many premalignant lesions and malignant lesions in these areas have discernible characteristics which can be detected through the examination...

; Maggiore writes that she instead followed a naturopathic
Naturopathic medicine
Naturopathy, or Naturopathic Medicine, is a form of alternative medicine based on a belief in vitalism, which posits that a special energy called vital energy or vital force guides bodily processes such as metabolism, reproduction, growth, and adaptation...

 program and had additional Pap tests performed under an assumed name by another doctor, ultimately obtaining what she described as a normal result.

In a 2005 article in the L.A. Times, Maggiore claimed to be in excellent health without taking anti-retroviral treatment. Maggiore's husband and partner, filmmaker Robin Scovill, has repeatedly tested negative despite what Maggiore describes as "a decade of normal, latex-free relations". Their son Charlie, born in 1997, has also tested negative for HIV.

Eliza Jane

Christine Maggiore chose not to take antiretroviral drugs or other measures which reduce the risk of mother-to-child transmission
Vertical transmission
Vertical transmission, also known as mother-to-child transmission, is the transmission of an infection or other disease from mother to child immediately before and after birth during the perinatal period. A pathogen's transmissibility refers to its capacity for vertical transmission...

 of HIV during her pregnancies. Maggiore also breast-fed her children, despite evidence that breast-feeding can also transmit HIV from mother to child. Her youngest daughter, Eliza Jane, was never tested for HIV, nor did she or her older brother Charlie receive any of the recommended childhood vaccines. Maggiore later reported Charlie to have tested HIV-negative three times, and asserted that both were in good health.

In April 2005, Eliza Jane became ill with a runny nose. She was seen by two physicians, one of whom reportedly knew of Maggiore's HIV status. Eliza Jane was not tested for HIV, and was diagnosed with pneumonia
Pneumonia
Pneumonia is an inflammatory condition of the lung—especially affecting the microscopic air sacs —associated with fever, chest symptoms, and a lack of air space on a chest X-ray. Pneumonia is typically caused by an infection but there are a number of other causes...

. When Eliza Jane failed to improve, Maggiore took her to see Philip Incao, a holistic practitioner and board member of Maggiore's AIDS-denialist organization Alive & Well AIDS Alternatives
Alive & Well AIDS Alternatives
Alive & Well AIDS Alternatives is a 501 non-profit organization of AIDS denialists...

, who claimed Eliza Jane appeared to be only mildly ill, and prescribed her amoxicillin
Amoxicillin
Amoxicillin , formerly amoxycillin , and abbreviated amox, is a moderate-spectrum, bacteriolytic, β-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. It is usually the drug of choice within the class because it is better absorbed, following oral...

 for a presumed ear infection
Otitis media
Otitis media is inflammation of the middle ear, or a middle ear infection.It occurs in the area between the tympanic membrane and the inner ear, including a duct known as the eustachian tube. It is one of the two categories of ear inflammation that can underlie what is commonly called an earache,...

. On May 16, 2005, Eliza Jane collapsed and stopped breathing. She was rushed to Valley Presbyterian Hospital in Van Nuys, California, where, after failed attempts to revive her, she was pronounced dead.

An autopsy revealed that Eliza Jane was markedly underweight and underheight
Failure to thrive
Failure to thrive is a medical term which is used in both pediatric and adult human medicine, as well as veterinary medicine ....

, consistent with a chronic illness, exhibited a pronounced atrophy
Atrophy
Atrophy is the partial or complete wasting away of a part of the body. Causes of atrophy include mutations , poor nourishment, poor circulation, loss of hormonal support, loss of nerve supply to the target organ, disuse or lack of exercise or disease intrinsic to the tissue itself...

 of her thymus
Thymus
The thymus is a specialized organ of the immune system. The thymus produces and "educates" T-lymphocytes , which are critical cells of the adaptive immune system....

 and other lymphatic organs, and that her lungs were infected with Pneumocystis jirovecii
Pneumocystis jirovecii
Pneumocystis jirovecii is a yeast-like fungus of the genus Pneumocystis. The causative organism of Pneumocystis pneumonia, it is an important human pathogen, particularly among immunocompromised hosts. Prior to its discovery as a human-specific pathogen, P. jirovecii was known as P...

, a common opportunistic pathogen
Opportunistic infection
An opportunistic infection is an infection caused by pathogens, particularly opportunistic pathogens—those that take advantage of certain situations—such as bacterial, viral, fungal or protozoan infections that usually do not cause disease in a healthy host, one with a healthy immune system...

 in people with AIDS and the leading cause of pediatric AIDS deaths. The post-mortem examination of Eliza Jane's brain
Brain
The brain is the center of the nervous system in all vertebrate and most invertebrate animals—only a few primitive invertebrates such as sponges, jellyfish, sea squirts and starfishes do not have one. It is located in the head, usually close to primary sensory apparatus such as vision, hearing,...

 showed changes consistent with HIV encephalitis
Encephalitis
Encephalitis is an acute inflammation of the brain. Encephalitis with meningitis is known as meningoencephalitis. Symptoms include headache, fever, confusion, drowsiness, and fatigue...

; protein components of HIV itself
P24 capsid protein
p24 is a component of the HIV particle capsid. There are approximately 2000 molecules per virus particle, or at a molecule weight of 24 kDa, about 10^4 virus particles per picogram of p24.-References:...

 were identified in Eliza Jane's brain tissue via immunohistochemistry
Immunohistochemistry
Immunohistochemistry or IHC refers to the process of detecting antigens in cells of a tissue section by exploiting the principle of antibodies binding specifically to antigens in biological tissues. IHC takes its name from the roots "immuno," in reference to antibodies used in the procedure, and...

. The coroner concluded unequivocally that Eliza Jane had died of Pneumocystis pneumonia
Pneumocystis pneumonia
Pneumocystis pneumonia or pneumocystosis is a form of pneumonia, caused by the yeast-like fungus Pneumocystis jirovecii...

 in the setting of advanced AIDS.

Maggiore rejected the coroner's conclusion, ascribing it to political bias and attacking the personal credibility of the senior coroner, James Ribe. Maggiore had the autopsy reviewed by AIDS denialist Mohammed Al-Bayati, who holds a Ph.D.
Ph.D.
A Ph.D. is a Doctor of Philosophy, an academic degree.Ph.D. may also refer to:* Ph.D. , a 1980s British group*Piled Higher and Deeper, a web comic strip*PhD: Phantasy Degree, a Korean comic series* PhD Docbook renderer, an XML renderer...

 in animal disease pathology, but is not a medical doctor, nor board-certified in human pathology. Al-Bayati concluded Eliza Jane died from an allergic reaction to amoxicillin
Amoxicillin
Amoxicillin , formerly amoxycillin , and abbreviated amox, is a moderate-spectrum, bacteriolytic, β-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. It is usually the drug of choice within the class because it is better absorbed, following oral...

, a conclusion Maggiore embraced.

Al-Bayati's report has been dismissed as both biased and medically unsound by independent pathology experts who agreed with the coroner's conclusion.

Criticism and controversy

Despite the controversy that followed Eliza Jane's death, Maggiore had held fast to her denialist beliefs, and to Al-Bayati conclusion. She submitted a letter to the LA Times alleging factual errors and omissions in their articles on Eliza Jane; the Times did not print the letter, stating that "If facts in an article are wrong, a correction would be published. However, no correction is warranted in this case."

Others point to the evidence which indicates that Eliza Jane acquired AIDS from Maggiore perinatally or via breast feeding, that Eliza's HIV infection might have been prevented had Maggiore taken antiretroviral drugs or avoided breast feeding, that Eliza Jane's death was due to complications of AIDS, and that her death may have been preventable with proper medical care.

John Moore, a prominent HIV/AIDS researcher speaking at the 16th International AIDS Conference
International AIDS Conference
The International AIDS Society is the custodian of the International AIDS Conference, the largest regular conference on any health or development issue. These conferences provide a forum for the interaction of science, community and leadership, and are claimed to strengthen an evidence-based...

, described Eliza Jane's death as a concrete example of the human harm that can result from pseudoscientific
Pseudoscience
Pseudoscience is a claim, belief, or practice which is presented as scientific, but which does not adhere to a valid scientific method, lacks supporting evidence or plausibility, cannot be reliably tested, or otherwise lacks scientific status...

 beliefs such as AIDS denialism:
Maggiore's inclusion as an exhibitor at the 13th International AIDS Conference
International AIDS Conference
The International AIDS Society is the custodian of the International AIDS Conference, the largest regular conference on any health or development issue. These conferences provide a forum for the interaction of science, community and leadership, and are claimed to strengthen an evidence-based...

 in Durban
Durban
Durban is the largest city in the South African province of KwaZulu-Natal and the third largest city in South Africa. It forms part of the eThekwini metropolitan municipality. Durban is famous for being the busiest port in South Africa. It is also seen as one of the major centres of tourism...

, South Africa
South Africa
The Republic of South Africa is a country in southern Africa. Located at the southern tip of Africa, it is divided into nine provinces, with of coastline on the Atlantic and Indian oceans...

 has been criticized by AIDS activists.

Maggiore's influence on Thabo Mbeki's
Thabo Mbeki
Thabo Mvuyelwa Mbeki is a South African politician who served two terms as the second post-apartheid President of South Africa from 14 June 1999 to 24 September 2008. He is also the brother of Moeletsi Mbeki...

 decision to block funding of medical treatment of HIV-positive pregnant woman was criticized following her death, with medical researchers noting a Harvard study which estimated "330,000 lives were lost to new AIDS infections during the time Mbeki blocked government funding of AZT treatment to mothers."

The journalist and AIDS denialist Celia Farber
Celia Farber
Celia Ingrid Farber is an American print journalist and author, best known for her part in the campaign which denies that AIDS is an infectious disease...

 wrote an article in June 2006 in the independent paper Los Angeles CityBeat
Los Angeles CityBeat
Los Angeles CityBeat was an alternative weekly newspaper in Los Angeles, California, debuting June 12, 2003. The publication ceased production with the March 26, 2009 issue. LA CityBeat was available every Thursday at more than 1,500 distribution locations throughout the Los Angeles area, with an...

, arguing Maggiore's case and alleging incompetence, conspiracy
Conspiracy theory
A conspiracy theory explains an event as being the result of an alleged plot by a covert group or organization or, more broadly, the idea that important political, social or economic events are the products of secret plots that are largely unknown to the general public.-Usage:The term "conspiracy...

, and coverups on the part of the coroner, the mainstream AIDS community, the mainstream media, and the medical community. In particular, Farber's article claimed that the coroner's office had not disclosed the records of Eliza Jane's HIV serology test, and quoted another denialist who claimed Eliza Jane's total lymphocyte count
Lymphocyte
A lymphocyte is a type of white blood cell in the vertebrate immune system.Under the microscope, lymphocytes can be divided into large lymphocytes and small lymphocytes. Large granular lymphocytes include natural killer cells...

 was elevated at the time of her death.

Legal ramifications

Eliza Jane's death was investigated by the Los Angeles Police Department
Los Angeles Police Department
The Los Angeles Police Department is the police department of the city of Los Angeles, California. With just under 10,000 officers and more than 3,000 civilian staff, covering an area of with a population of more than 4.1 million people, it is the third largest local law enforcement agency in...

 and the Los Angeles Department of Child Protective Services
Child Protective Services
Child Protective Services is the name of a governmental agency in many states of the United States that responds to reports of child abuse or neglect. Some states use other names, often attempting to reflect more family-centered practices, such as "Department of Children & Family Services"...

 as a possible case of medical neglect or child endangerment. On September 15, 2006 the LA County District Attorney's office announced that it would not file charges against Christine Maggiore, noting that Maggiore did take her sick child to several physicians.

In September 2006, the Medical Board of California filed charges of gross negligence
Gross negligence
Gross negligence is a legal concept which means serious carelessness. Negligence is the opposite of diligence, or being careful. The standard of ordinary negligence is what conduct one expects from the proverbial "reasonable person"...

 against Eliza Jane's pediatrician Paul Fleiss
Paul M. Fleiss
Paul Murray Fleiss M.D. is an American pediatrician, breastfeeding advocate, and anti-circumcision activist based in Los Feliz, California....

. The board stated Fleiss had failed to test Eliza Jane for HIV (or to document her parents' refusal of testing), a failure to counsel Maggiore to avoid breast-feeding at any time during the three years Maggiore breast-fed her daughter, given the risk of transmitting HIV, and similar violations of standard medical practice in Fleiss' care of a second HIV-positive child.

In September 2007, the Medical Board of California issued its decision in the Fleiss case, The Board revoked Fleiss' medical license as October 8, but stayed this action in favor of a 35-month probation period during which Fleiss must submit to regular monitoring, pay costs, notify insurance and hospitals of the decision against him, and take continuing medical education (CME) classes and record-keeping courses. He is not permitted to supervise Physician Assistants and has affirmed the practice of referring HIV-positive patients to a specialist.

In an admonition letter dated September 13, 2007, an Inquiry Panel of the Colorado State Board of Medical Examiners issued its finding that Philip Incao's "care and treatment and lack of timely documentation" in the case of Eliza Jane Scovill "falls below the generally accepted standards of medical practice". The Panel warned Incao that any further instances of such behavior could result in "formal disciplinary proceedings against your license to practice medicine".

Maggiore and her husband, Robin Scovill, sued Los Angeles county in 2007 for allegedly violating their daughter's civil rights and privacy by releasing her autopsy report, which indicated that she was HIV-positive. A settlement was reached in 2009.

Death

On December 27, 2008, Maggiore died at the age of 52. She was under a doctor's care and was being treated for what was originally reported as pneumonia. The Los Angeles County coroner's office stated Maggiore had been treated for pneumonia in the six months prior to her death as well. A doctor familiar with the family noted that anti-HIV drugs could have prevented her death, but Maggiore's fellow AIDS denialists argued that her pneumonia was not related to AIDS and suggested instead that she died as a result of a toxic alternative medicine
Alternative medicine
Alternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....

 "holistic cleanse", or stress, or the cold and flu.

Maggiore's death certificate states that the cause of death was disseminated herpes virus infection and bilateral pneumonia
Pneumonia
Pneumonia is an inflammatory condition of the lung—especially affecting the microscopic air sacs —associated with fever, chest symptoms, and a lack of air space on a chest X-ray. Pneumonia is typically caused by an infection but there are a number of other causes...

, with oral candidiasis
Candidiasis
Thrush redirects here. For the hoof infection see Thrush .Candidiasis or thrush is a fungal infection of any of the Candida species , of which Candida albicans is the most common...

 as a contributing cause, all of which can be related to HIV infection. The death certificate also states there was no autopsy or biopsy performed.

External links

  • A Mother's Denial, A Daughter's Death: from the Los Angeles Times
    Los Angeles Times
    The Los Angeles Times is a daily newspaper published in Los Angeles, California, since 1881. It was the second-largest metropolitan newspaper in circulation in the United States in 2008 and the fourth most widely distributed newspaper in the country....

    .
  • Did HIV-Positive Mom's Beliefs Put Her Children at Risk? An ABC News Primetime special.
  • AIDS denial: A lethal delusion Jonny Steinberg, New Scientist
    New Scientist
    New Scientist is a weekly non-peer-reviewed English-language international science magazine, which since 1996 has also run a website, covering recent developments in science and technology for a general audience. Founded in 1956, it is published by Reed Business Information Ltd, a subsidiary of...

    , 17 June 2009.
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