Heimlich & UCLA Researchers Investigated: infecting Chinese AIDS Patients with Malaria

The Cincinnati Enquirer ^ | 16 Feb 03 | Robert Anglen

[xzins]

Sunday, February 16, 2003

Scientists linked to Heimlich investigated

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Experiment infects AIDS patients in China with malaria

By Robert Anglen
The Cincinnati Enquirer

Dr. Heimlich

Two prominent Los Angeles AIDS researchers are being investigated for taking part in a controversial medical experiment with Cincinnati physician Henry Heimlich to infect AIDS patients in China with malaria.

A medical oversight board at the University of California Los Angeles wants to know whether doctors John Fahey and Najib Aziz violated university policies that regulate tests on humans.

The investigation once again raises questions about Dr. Heimlich's work at Cincinnati's nonprofit Heimlich Institute, which is partnered with Deaconess Hospital. (This is the same Dr. Heimlich who developed the Heimlich maneuver, used to expel food from the throats of choking victims.)

His experiments - which seek to destroy HIV, the AIDS-causing virus, by inducing high malarial fevers- have been criticized by the Centers for Disease Control and the Food and Drug Administration and condemned by other health professionals and human rights advocates as a medical "atrocity.''

Both Dr. Fahey and Dr. Aziz deny involvement in Dr. Heimlich's malaria studies, and UCLA officials say they have asked Dr. Heimlich "to omit UCLA from all references relating to malaria studies or other Heimlich Institute research. Any claims of an affiliation with UCLA are inaccurate."

But documents obtained by the Enquirer show the doctors have been active in the malaria experiments since 1996.

Letters written by Dr. Fahey on UCLA stationary detail how doctors helped Dr. Heimlich set up the experiments, analyzed data, provided chemical reagents, made multiple trips to the test locations in China, reviewed test protocols and offered to obtain funding through grants at UCLA.

"I greatly appreciated all of the data you shared with us on this visit," Dr. Fahey wrote to Chen Xiao Ping, the doctor overseeing the experiments for Dr. Heimlich in China. "I want to assure you that we regard this as confidential information. My colleagues and I will gladly help with the analysis but not share it with others. You should report your result directly to Dr. Heimlich."

Dr. Fahey forwarded this e-mail, dated Nov. 10, 1998, to Dr. Aziz and UCLA School of Medicine researcher Barbara Hered.

MALARIOTHERAPY

Cincinnati's Dr. Henry Heimlich says malaria can be used to cure AIDS, cancer and Lyme disease through a process called malariotherapy. Dr. Heimlich has been sharply criticized by state, federal and international health organizations for these experiments.

This is how he explained the process at a conference in October:

His theory is based on tests performed in 1918 by Nobel Prize winner (medicine) Julius Wagner-Jauregg, who reported that malariotherapy cured neurosyphilis.

The idea is to inject AIDS patients with malaria to induce high fevers that will kill the HIV virus.

After 10-12 fevers and after approximately three weeks, the malaria is cured with drugs.

The fevers allegedly spark an immune reaction, which reverses AIDS' attack on patients' immune system.

In one study, malariotherapy was performed on eight HIV-positive men, ages 23-40, in China. After the malaria was cured, the patients were monitored for two years.

Heimlich contends that malariotherapy is affordable and available to patients who would not normally have access to expensive drugs.

In another letter to Dr. Heimlich, dated Aug. 8, 1996, Dr. Fahey described the malaria experiments - called malariotherapy - as "striking" and offered to help continue research through UCLA.

"I wondered if we could help you ... we could, perhaps, develop a means of helping your Chinese colleagues in carrying out their studies," Dr. Fahey wrote. "Assistance with reagents and quality control samples for (test) measurements as well as for other parameters of HIV infection."

Contacted at his California home, Dr. Fahey would not comment. He also did not respond to an e-mail detailing the contents of his letters to Dr. Heimlich and Dr. Chen. Dr. Aziz also would not comment.

Dr. Heimlich, who has credited Dr. Fahey for his support, says he has no idea why the doctors would say they are not involved. He says they provided technical assistance for years and used their labs to analyze data and suggest ways to proceed.

"Dr. Fahey is an outstanding professional. He was involved in the original work in China," Dr. Heimlich says. "He is a renowned scientist involved in AIDS research. He asked to contribute. He did an excellent job."

For years, Dr. Heimlich has been criticized by state, federal and international health organizations over malariotherapy. Despite this, Heimlich proudly continues his work in China and says he wants to expand malariotherapy to Africa.

From his Cincinnati institute on Straight Street, the 83-year-old Dr. Heimlich solicits private donations for malariotherapy research and distributes a quarterly newsletter about his work to "promote peaceful solutions to international problems." He is the father of Hamilton County Commissioner Phil Heimlich.

He often is at odds with medical professionals. One of his most public fights has been with the American Red Cross over the agency's refusal to adopt the Heimlich maneuver as the first response in drowning rescues instead of traditional CPR.

Dr. Heimlich says his critics are motivated by politics rather than legitimate medical concern.

Malariotherapy research was the topic of Heimlich's presentation to the respected Pan Africa AIDS Conference in Nashville, Tenn., last October.

"They don't question my work," he says, adding that his tests offer a chance to end the scourge of AIDS.

Officials with the Pan Africa Conference could not be reached. However, Peter Lurie, a former AIDS researcher and now a physician with Public Citizen's Health Research Group in Washington, D.C., calls the malariotherapy studies dangerous and unnecessary.

Public Citizen is a 32-year-old, nonprofit group founded by consumer advocate Ralph Nader. The Health Research Group provides oversight concerning drugs, medical devices, doctors and hospitals and occupational health. It works to identify and ban unsafe or ineffective drugs, medical devices and procedures.

"It is charlatanism of the highest order," Dr. Lurie says of malariotherapy. "It is exploiting the lack of decent medical care in China."

Dr. Heimlich began soliciting funds for malaria treatment of cancer, AIDS and Lyme disease in the late 1980s.

"Ever since then he's been coming up with new maneuvers," Dr. Lurie says. "Many or most of them have not worked. Some are incredibly grandiose."

Dr. Lurie included Dr. Heimlich's malariotherapy studies in a September 1997 New England Journal of Medicine article about "exploitive" medical procedures in developing countries.

Dr. Heimlich insists that he has approval to conduct his studies through a review board of doctors that is supposed to ensure federal regulations for ethical research are met. But that review board was disbanded several years ago after the Food and Drug Administration sharply criticized the China malaria experiment.

The review board overseeing Dr. Heimlich's China experiment was formed by an "alternative medicine" group called the Great Lakes College of Clinical Medicine.

In 2000, an FDA compliance director described Dr. Heimlich's procedures as inadequate. He said the experiments would not be permitted in the United States, that researchers failed to consider community attitudes in China and that there was no description of lifelong risks facing patients injected with malaria.

Dr. Heimlich called the report biased.

"We ask you," Dr. Heimlich wrote to FDA Commissioner Jane Henney, "to take immediate action vis-ý-vis your employee and the unwarranted harm to our research that his bias and false accusations are causing."

In 1993, the U.S. Centers for Disease Control and Prevention questioned Dr. Heimlich's research. Carlos Campbell, CDC's chief of malaria studies at the time, said there was no evidence to support Heimlich's conclusions.

"No evidence currently exists to indicate that malaria infection would beneficially affect the course of HIV infection," Campbell wrote. "In fact, substantive concerns have been raised regarding the possibility that malaria therapy could (worsen) the course of HIV infection."

Los Angeles physician Paul Bronston, who serves as the national chair of the Ethics and Professional Policy Committee for the American College of Medical Quality, says there is still no evidence that the experiments have any merit.

"Indeed, there is evidence that it is very dangerous," he says.

Dr. Bronston organized a petition against Dr. Heimlich in 1994 over malaria experiments to treat Lyme disease, which were being conducted in Mexico. The experiments resulted in a groundswell of protest from the medical community.

Dr. Heimlich contends the China experiments have proved that malaria works to combat AIDS. He says that malaria strengthens the immune system and increases T-cells in AIDS patients.

T-cells are a common way to measure the severity of HIV. In a healthy person, T-cell counts are usually above 1,000. When counts fall below 200, patients are considered to have full-blown AIDS.

Dr. Heimlich says before being treated with malaria, eight male AIDS patients in China had T-cell counts that ranged from 269 to 1,868. Two years after malariotherapy, the T-cell counts in those patients were 570 to 2,063.

"These results ... confirm malariotherapy is safe and can be effective for HIV infected patients," Heimlich said in his Pan Africa presentation.

Both Dr. Lurie and Dr. Bronston say they are surprised that AIDS researchers would continue to be involved in malaria experiments after all of the continued negative publicity and criticism that Dr. Heimlich receives.

UCLA officials acknowledge that Dr. Fahey and Dr. Aziz helped train Dr. Chen along with other international scholars. But officials say the doctors were limited to teaching methods for conducting and evaluating AIDS research studies. Officials say the doctors never were involved in Dr. Heimlich's studies.

"Dr. Chen acknowledged the immunology training by Dr. Fahey in his research paper. However, Dr. Fahey was not a coauthor and did not collaborate on the malaria studies," UCLA officials said in a Nov. 27 statement.

But in his 1998 e-mail to Dr. Chen, Dr. Fahey attempted to discourage the Chinese doctor from naming UCLA doctors as authors on a research paper.

"It is more appropriate if you simply acknowledge assistance of Dr. Najib Aziz and myself in some aspects of the study in an acknowledgement paragraph or at the end of your manuscript," Dr. Fahey wrote. "You must understand that we want very much to see this study succeed but we think that we should not be among manuscript authors at this time."

In 1999, Dr. Chen and Dr. Heimlich coauthored a report on the malaria experiments for the Chinese Medical Sciences Journal. The paper notes that UCLA helped measure serums.

And in letters to Dr. Chen, Dr. Fahey arranged ways to ship reagents for studies to and from Los Angeles and Guangzhou, China.

The Office for the Protection of Research Subjects at UCLA, which is responsible for reviewing research protocols and ensuring that medical studies are ethical and do not involve abuse, began investigating Dr. Fahey and Dr. Aziz in October and initially cleared them of wrongdoing.

But this month, the office reopened its investigation. Associate Director Steven Peckman says his office received additional information, but will not comment about it.

After being advised of the memos between Dr. Heimlich and Dr. Fahey, UCLA spokesman Max Benavidez issued a new statement Friday. It acknowledges the ongoing investigation and says: "UCLA reiterates that the university has never approved any research studies pertaining to malariotherapy for HIV."

[expatpat]

You might get some initial indications that way (and perhaps that has already been done, and gave some encouragement to the idea), but to get reliable results you'd have to do controlled experiments, as you must do for any cure.

[wonders]

Interesting article, xzins, thanks for posting it.

Did I miss something - as in no stats given on deaths resulting from this 'treatment' method. I find it hard to believe there was 100% survival rate among those under the experiment.

I missed them, too. But not all forms of malaria are necessarily deadly. My guess is they're using the P. vivax form (which is rarely fatal) and eventually curing the patient with cholorquine after x number of febrile episodes.

Wish I'd had vivax instead drug-resistant falciparum. And wish I'd had artesunate at the time -- that stuff rocks!

[Verginius Rufus]

Recently Jay Leno asked three "Jaywalking" contestants to name the doctor who developed the Heimlich maneuver. None of them had the slightest idea.

[wonders]

Wow -- look what I found: Impact of vivax malaria on the immune system of HIV-positive subjectsCenter for AIDS Control and Research, Municipal Health and Anti-Epidemic Station of Guangzhou, Guangzhou, P. R. China (XP Chen MD, PhD, BQ Xiao PhD, WJ Shi PhD, HF Xu MD, K Gao BS, JL Rao MD, ZB Zhang MD)

A beneficial interaction of malaria and HIV co-infection has been reported in a hospital-based study and in a well-controlled cohort study in Africa. In our previous studies there was an increase in total trend of CD4 cell counts in HIV-positive subjects during two years follow up to malariotherapy (therapeutic vivax malaria).

[Cicero]

I don't think we know enough about this to judge. I thought malaria was basically incurable. That is, it can be treated but it then recurs. I may be wrong about that, because what I know about malaria is way out of date.

As for experimenting on humans, it is legitimate if they are properly informed, if they are seriously ill, and if there is at least a reasonable chance that it may benefit them directly as well as others in the future. It could be that he is doing it in China because the U.S. authorities have blocked the research here; or it could be that the Chinese are using political prisoners or others without their consent, which they have been known to do.

On balance, I'm inclined to believe there may be something in this. The AIDS establishment is extremely untrustworthy and politicized and might easily oppose legitimate research for some bizarre reason of their own. Not to speak of drug company profits for AIDS drugs.

[Kenny Bunk]

Dr. Lurie says. "Many or most of them have not worked. Some are incredibly grandiose."

Which is to say that some of them have worked. This is a replay of a 19th Century idea which sought to cure syphilis patients by infecting them with malaria. It is simply too weird for Dr. Lurie-type scientists to handle.

Apparently, it apparently occasionally worked. The AIDS virus is very small, requiring careful electron microscopy of the highest order to observe. Malaria, Syphilis, and Lyme Disease are all three caused by very large (In microscopic terms) unicellular protozoa, rather than bacteria or viruses. Malaria causes extremely high fevers which kill or weaken the other protozoa. It somehow might do the same with AIDS. In the old days, the subsequent Malaria could be controlled with quinine> Today much more advanced drugs are available.

Why this avenue of research should be forbidden is a mystery to me, given that the therapy has shown some promise in the past. No one knows exactly why, which is exactly why it should be of scientific interest.

[expatpat]

That's the feeling I had, tho' you clearly know a lot more about it than I do.

[George W. Bush]

Interesting reading. First you think, "Just a quack scheme." Then you think and wonder about the results. Still, the notion of curing a major disease by inflicting another more treatable disease is kind of weird until you reflect that innoculation works by giving you a weaker form of the illness so you can build the necessary antibodies.

Of course, the big money in the current AIDS industry insures they'll guard their revenues closely.

[xzins]

Part of what fascinates me in this is the denial by UCLA that they're involved.

Both Dr. Fahey and Dr. Aziz deny involvement in Dr. Heimlich's malaria studies, and UCLA officials say they have asked Dr. Heimlich "to omit UCLA from all references relating to malaria studies or other Heimlich Institute research. Any claims of an affiliation with UCLA are inaccurate." But documents obtained by the Enquirer show the doctors have been active in the malaria experiments since 1996.

The denial is important to them. Is it reputation they're afraid of....simply that?

[NetValue]

"Controversial it does seem to be. But does it work? If it does, the establishment is being obstructive."

The pharmaceutical companies are the biggest obstacle to this research. My pharmacist cousin says he believes it is the best chance for a technique to cure AIDS. We have no cure at this time.

[LadyDoc]

high fever from malaria is an old cure for syphyllis, especially syphyllis of the brain.

Sounds like a dumb experiment, since HIV is common in countries with malaria, and population studies would show if it controlled it.

[wonders]

Oh no, malaria is quite curable. I'm cured! It can recur periodically (especially the vivax type) if untreated or incorrectly treated, or is a drug-resistant strain.

I found the actual study (link is in my #24) and under "methodology" the researchers state the participants signed informed consent.

I don't think Heimlich or any of the researchers claim "malariatherapy" cures HIV/AIDS, but it has an interesting effect on the immune system of HIV+ patients. Apparently, it is most effective for AIDS patients whose CD4 levels are within a certain range. From the study:

We here propose a hypothesis that malaria parasite is a special and strong natural immune regulator which has dual effects: when the host has a relatively normal level of immune status, it down regulates immune function, when host is at relatively lower immune status, it up regulates immune functions; but when host is at a very low level of immune status, it just gives rise to a transient and weak immune response. Therefore, based on our studies, malariotherapy seems more suitable for treatment of HIV-positive patients with CD4 cell level at 499~200/µL.

Well, yes, it sounds like such research has been blocked here, doesn't it? I wonder how many people (especially children) died because of the prejudice against artesunate. It's derived from a Chinese herb. Back in '92 when I had a super-drug-resistant strain of P. falciparum (the deadly type of malaria) in Cambodia, the treatment was worse than the disease. One of the German doctors who treated me felt sorry for me, and knowing I was going back to my remote island (it took me a week's travel to get to a clinic for treatment from my island) and slipped me some artesunate, explaining to me that it was "illegal" but very effective.

Soon after I arrived back to my island, the villagers summoned me to help "the dying man." He was having convulsions and the monks were already preparing his funeral. I suspected P. falciparum gone cerebral, but tested his reflexes to make sure it wasn't Tetanus (that's how bad he was). With nothing to lose (he was at death's door), I mixed the artesunate in with some Pepto Bismol and poured it down the guy's throat. In only two hours, he was sitting up and feeling fine. He never suffered any side effects, either. I was astounded. Everyone was. I became known by the people as "The White Witch of Kiri Sakor" because they considered this guy's amazing recovery as a sort of magical miracle. But it was just some little Chinese pills in Pepto.

Some months later, I was med-evaced to Bangkok with rat bite fever (not very glamorous, I know) and what should come on the TV in my hotel room as I was recuperating but a BBC documentary on Brit doctors in Africa up in arms because the use of artesunate was not sanctioned, yet was very effective in saving lives (especially in children and cases of drug-resistant strains) where all other drugs failed and did not have the nasty and even dangerous side effects of some of other drugs used against strains resistant to standard antimaliarals.

Thanks to the pressure exerted by these Good Samaritan doctors, aresunate is now sanctioned and saving many lives.

Perhaps this "malariatherapy" may not produce a cure for HIV/AIDS in and of itself, but may produce a better understanding of the disease and lead to a cure. Who knows? If I were HIV+, after reading this study, I'd volunteer to be one of these guys' guinea pigs.

[xzins]

Hey, doc, can you comment on #15?

[wonders]

...since HIV is common in countries with malaria, and population studies would show if it controlled it

Well, apparently the interaction between malaria and AIDS was duly noted in Africa, as you can see from the study's references:

References 1. Lockwood DNJ and Weber JN. Parasite infection in AIDS. Parastol Today 1989; 5:310-15.
2. Riley EM, Anderson G, Otoo LN, et al. Cellular immune responses to Plasmodium falciparum antigens in Gambian children during and after an acute attack of falciparum malaria. Clin Exp Immunol 1988; 73: 17-22.
3. Chandramohan D, Greenwood BM. Is there an interaction between human immunodeficiency virus and Plasmodium falciparum? Int J Epidemiol 1998; 27:296-301.
4. Davachi F, Kabongo L and Nagule K. Decreased mortality from malaria in children with symptomatic HIV infection (abstract W. A. 1291). Proceedings of the VI International Conference on AIDS. Florence, 1990.
5. Kalyesubula I, Musoke-Mudido P, Marum L, et al. Effects of malaria infection in human immunodeficiency virus type 1-infected Ugandan children. Pediatr Infect Dis J 1997; 16: 876-81.
6. Greenberg AE, Nsa W, Ryder RW, et al. Plasmodium falciparum malaria and perinatally acquired human immunodeficiency virus type 1 infection in Kinshasa, Zaire. N Engl J Med 1991; 325: 105-09.
7. Marussig M, Rénia L, Mazier D. Interactions between AIDS viruses and malaria parasites: a role for macrophages? Res Virol 1996; 147:139-45.
8. Heimlich HJ, Chen XP, Xiao BQ, et al. Malariotherapy for HIV patients. Mech Ageing Dev 1997; 93:79-85.
9. Chen XP, Heimlich HJ, Xiao BQ, et al. Phase-1 studies of malariotherapy for HIV infection. Chin Med Sci J 1999; 14:224-28.
10. Worku S, Björkman A, Troye-Blomberg M, et al. Lymphocyte activation and subset redistribution in peripheral blood in acute malaria illness: distinct γδ+ T cell patterns in Plasmodium falciparum and P. vivax infections. Clin Exp Immunol
1997; 108: 34-41. 11. Kimpen JL and Ogra PL. T cell redistribution kinetics after secondary infection of BALB/c mice with respiratory syncytial virus. Clin Exp Immunol 1993; 91:78-82.
12. Fahey JL. Minireview: Cytokines, plasma immune activation markers, and clinically relevant surrogate markers in human immunodeficiency virus infection. Clin Diagn Lab Immunol 1998; 5: 597-603.
13. Fan J, Bass HZ and Fahey JL. Elevated IFNγ and decreased IL-2 expression are associated with HIV infection. J Immunol 1993; 151: 5031-37.
14. Migot F, Ouedraogo JB, Diallo J, et al. Selected P. falciparum specific immune responses are maintained in AIDS adults in Burkino Faso. Parasite Immunology 1996; 18: 333-39.

Well, it goes on and on and on. You can click the link in #24 to see it all.

[boris]

You lead an interesting--and dangerous--life.

Good luck; you appear to need all you can get.

--Boris

[wonders]

Those days are over. The most dangerous thing I do is drive in Atlanta traffic these days. But thanks!

[drlevy88]

There are drugs that elevate body temperature. Why use a parasite, which will weaken the body in other ways?

[Jemian]

Might there be a black market for malaria mosquitos around the corner?

If there is, let me know. I have several million of them critters incubating in my backyard.

I reckon there might be something in this. I currently have malaria. And I DON'T have AIDS.

Freepmail me with where you want them anaphales, or however you spell it, sent.

[equus]

There is increasing interest in hyperthermia--whether through infection, chemicals, or contraptions where they put you in a semi coma and heat up your entire body, or take your blood out and heat it--various methods to heat the body to treat infection and cancer.

Many organisms are heat sensitive--thats why our own body makes a fever. Fever boosts the immune system as well. And many drugs are more effective in the presence of heat, such as cancer drugs and antibiotics. So...

Malaria can be cured, but sometimes it becomes chronic. I'd rather see them study HOW this works and then try to find safer ways to do it as it has wide application.

[equus]

Syphilis and lyme are caused by bacteria called spirochetes.

They are heat sensitive. Syphilis more so than lyme.