Lin-Z wrote:

"When you have genital herpes, you give birth through a C-section or have a blinded, sore-covered baby: that is just the way that it is and always has been."

Uhhh, No. The standard is to do viral testing of the cervix leading up to the time of the birth. If there is no outbreak and no asymptomatic shedding of the virus at the time of the birth, then a normal vaginal birth can be undertaken.

You do realize that an estimated 20-25% of the adult population in the U.S. has genital herpes, right? This is something that is dealt with often in OB. And while there *are* still questions of safety with Valtrex during pregnancy, there is a proven higher mortality rate with elective C-sections than vaginal births, and that has to be weighed against the risks of the drug.

"Their consent to receive a placebo is not the issue; the issue is that they should have been given either the standard treatment or the experimental one - not a placebo at all."

Well, that's exactly what I was talking about when I posted my "AZT Nonsense" letter. AZT is the "standard of care" in AIDS patients, so all subsequent drugs are compared with it. I usually refer to this as comparing the new, improved taking of lighter fluid to the old, standard dose of Drano. AZT is incompletely tested and conclusively dangerous -- just look at its label. A skull and crossbones, in any language, means poison.

"Desperate people consent to all sorts of things that aren't ethical." -- Then hey, doesn't that make seeking their consent un-ethical? Maybe that was the letter writer's point, so thanks if it was. If not, perhaps you should re-read the Nuremberg Code if you can get your hands on it on the Web. What made such people desperate was an unfounded interpretation of what HIV tests mean, for themselves and their babies. The people who participated in creating that desperation are the very ones offering the drug testing. If participating means free medical care, maybe the kinder, gentler liberalism we should be offering African women is simply free medical care, no guinea-pig strings attached.

And by the way, HIV tests are not the norm in Africa, because the definition of "AIDS" there doesn't require one.

Also, pregnancy is a documented cause of false-positive HIV test results. So many of these women are not HIV-positive. (Not that the meaning of "HIV-positive" has been clearly defined, either, but that's another story.)

If I were looking for a promising drug to stop herpes transmission to an infant during delivery, I would certainly not be looking at AZT, with its, by now, known toxicities. There has to be an easier way.

And I thank the Salon staff for highlighting my letter with an "Editor's Choice," but for the sake of anyone who might gain a new insight and caution about HIV drugs from reading it. If you are inspired, pass it on. I write out of sincere concern and hope that Salon will investigate these questions in further articles.

Make this a truly educational "AIDS Awareness Month."

The women were "enrolled in a drug-company sponsored research trial." I love how Schuklenk goes on throughout his article to refer to them as patients of GlaxoSmithKline, and it's a smooth transition from there to an assumption that their medical care was the responsibility of GlaxoSmithKline. They were not the in the medical care of GlaxoSmithKline, they either volunteered or were compensated by GlaxoSmithKline to help test a drug, which inherently means that some of them would receive placebos. None of them were put in any more danger than they were already in before. When you have genital herpes, you give birth through a C-section or have a blinded, sore-covered baby: that is just the way that it is and always has been. If GlaxoSmithKline is changnig that... we're going to bash them for testing it too thoroughly? I don't get it.

as a clinical pharmacist, the claims made by the authors of the study are slightly disingenuous. There is considerable controversy over whether it is appropriate to give Valacyclovir (Valtrex) during pregnancy. While there is a risk of transmission of the herpes virus to the newborn during a vaginal delivery, there is also great unknown as to the potential effects of the valacyclovir on the fetus. Careful and prudent testing of medications during pregnancy is extremely important to prevent tragedies such that occured when Thalidomide (Thalomid) was used without proper and conclusive testing.

Valacyclovir is currently regarded as a Pregnancy Category B drug, meaning there are no well designed trials to establish its safety. Thus, it is entirely etical and prudent to design a study where some of the patients are on placebo in an attempt to determine the risks and benefits associated with treatment.

I am an avid Salon reader, but I feel this story was not adequately researched before being published. I see not even the barest mention that the authors of the study were even contacted for a response. Let's not lose sight of good scientific and journalistic standards in our rush to muckrake.

We are living during a frightening media crisis. I believe in supporting independent journalism with something more than my "two cents." I don't like people who abuse their free sample by spewing idiocy and hatred all over this publication - and yes, I do feel some ownership, since I find so many like-minded writers here, and that makes me feel just a tiny bit more secure about being a crazy, open-minded liberal.

I guess some people consider me dumb for being a premium member. And I consider them self-centered, libertarian louts.

It has become a really annoying habit to say that in order to be a liberal you have to tolerate intolerable, intolerant garbage. I can be open to trying a lot of new foods - but if I say I don't want to eat shit does that make me "conservative"?

No, I don't have to read the letters, but they do sometimes include intelligent comments from writers I admire - just like the articles themselves do.