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HIV/AIDS denialism

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The AIDS reappraisal movement (or AIDS dissident movement) is a loosely connected group of activists — journalists, scientists, doctors, HIV-positive persons, and concerned citizens — who deny, challenge, or question aspects of the mainstream scientific view that the human immunodeficiency virus (HIV) is the cause of acquired immune deficiency syndrome (AIDS). The dissidents assert that the currently dominant view that HIV causes AIDS has resulted in inaccurate diagnoses, psychological terror, toxic treatments, and a squandering of public funds, as well as an unprecedented deviation from scientific method and standards. In turn, mainstream scientists and public health workers accuse dissidents of selectively ignoring evidence in favour of HIV's role in AIDS and of endangering public health.

A brief history

  • 1983: A group of scientists and doctors at the Pasteur Institute in France, led by Dr. Luc Montagnier, discovers a new virus in a patient with signs and symptoms that often precede AIDS.[1] They name their discovery lymphadenopathy-associated virus, or LAV.
  • 1984: Casper Schmidt responds to the publication of Gallo's papers by writing "The Group-Fantasy Origins of AIDS", which is published by the Journal of Psychohistory."[2] He posits that AIDS is an example of "epidemic hysteria" in which groups of people are subconsciously acting out social conflicts, and compares it to documented cases of epidemic hysteria in the past which were mistakenly thought to be infectious.
  • 1986: The viruses discovered by Montagnier and Gallo, having been found to be genetically indistinguishable, are renamed HIV.[3]
  • 1987: Peter Duesberg questions the HIV theory of AIDS for the first time in his paper "Retroviruses as Carcinogens and Pathogens: Expectations and Reality", published in the journal Cancer Research.[4] This publication coincides with the start of major public health campaigns and the promotion of AZT as a treatment.
  • 1988: The Perth Group, led by Eleni Papadopulos-Eleopulos, publishes their first article questioning aspects of the mainstream ideas about HIV and AIDS.[5] They conclude that there is "no compelling reason for preferring the viral hypothesis of AIDS to one based on the activity of oxidising agents."
  • 1990: Dr. Robert Root-Bernstein publishes his first peer-reviewed article detailing his objections to the mainstream view of AIDS and HIV, entitled "Do we know the cause(s) of AIDS?"[6]
  • 1995: The dissident group Continuum places an advertisement in The Pink Paper offering a £1,000 reward to "the first person finding one scientific paper establishing actual isolation of HIV" (according to their specific set of rules).[8]
  • 1996: Various scientists, including Dr. Duesberg, dismiss the Continuum challenge, asserting there is no doubt that HIV exists.[8]
  • 2000: South Africa's President, Thabo Mbeki, invites several dissidents to join his Presidential AIDS Advisory Panel.[9][10] The mainstream scientific community responds with the Durban declaration, a document affirming that HIV causes AIDS, signed by over 5,000 scientists and physicians.
  • 2006: Celia Farber, a journalist and prominent AIDS dissident, publishes an essay in the March issue of Harper's entitled Out of Control: AIDS and the Corruption of Medical Science, in which she summarizes a number of arguments for AIDS reappraisal and alleges incompetence, conspiracy, and fraud on the part of the mainstream medical community.

The AIDS dissident community

People critical of the mainstream view of AIDS include HIV-positive persons, government employees, scientists, doctors and activists in several countries.

Probably the most famous and influential AIDS dissident scientist is Dr. Peter Duesberg, professor of molecular and cell biology at the University of California, Berkeley, who has been contesting the mainstream view of AIDS causation since 1987[citation needed]. Other scientists include Dr. David Rasnick (who has patents on protease inhibitor drugs used for the treatment of AIDS)[11] and Dr. Rodney Richards (who helped to develop some of the first commercial HIV antibody tests).[12] Two Nobel Prize winners - Kary Mullis (inventor of PCR, used for the development of the viral load test) and Walter Gilbert - have expressed sympathy for dissident theories.

Other prominent AIDS dissidents include the journalist Celia Farber, and Christine Maggiore, whose 3-year-old daughter died of Pneumocystis pneumonia and AIDS after her mother's refusal to take medication during her pregnancy or to test her daughter for HIV.

Organizations of AIDS dissidents include the Perth Group and the Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis.

Points of contention

The AIDS dissident community is comprised of various people and organizations with a diverse viewpoints. The community is united by their disagreement with the concept that HIV is the cause of AIDS. Positions which have been put forward by members of the AIDS dissident community include the following:

  • HIV does not exist.
  • HIV is a harmless retrovirus, often associated with AIDS conditions.
  • HIV does exist, and might cause AIDS, but it hasn't been proven to cause AIDS.
  • HIV does exist, and might cause AIDS, but only in combination with other factors.
  • HIV does not cause AIDS; other infectious factors cause AIDS.
  • HIV does not cause AIDS; AIDS is not an infectious disease.
  • HIV does not cause AIDS; a combination of other infectious and non-infectious factors causes AIDS.
  • AIDS illnesses are often treatable and curable without antiretroviral medication.
  • AIDS is a complicated phenomenon with many causes and many valid treatments, and cannot be reduced to a single cause.
  • Anti-AIDS drugs, like AZT, often destroy the immune system, causing the very illnesses they are supposed to prevent or treat.
  • The theory that HIV causes AIDS has been promoted to further the interests of corrupt scientists and/or pharmaceutical companies.

Alleged suppression of debate

AIDS dissidents claim that mainstream AIDS researchers hold an orthodox viewpoint that prevents an open discussion or presentation of dissident positions. To AIDS dissidents, this closed mindset is the primary reason why the HIV-causes-AIDS paradigm persists; AIDS dissidents believe that an open, neutral discussion is considered unacceptable by the mainstream medical community, and that orthodox AIDS proponents often do not understand or truly investigate dissident theories. Evidence in support of this conclusion was compiled in Serge Lang's "files" on HIV and AIDS. Dissidents allege a lack of sound scientific method proving that HIV causes AIDS.

In reply to such claims, mainstream scientists point out that dissident theories have been published and discussed at length in peer-reviewed journals and have failed to convince more than a minority of scientists and doctors. AIDS has been the subject of many thousands of peer-reviewed studies over the past twenty years, and a clear consensus view has developed that HIV causes AIDS. For this group, the orthodox view of HIV is not a question of a 'closed' viewpoint, but rather an acknowledgement of medical reality as derived from empirical data.

Koch's postulates

Koch's postulates are a set of criteria formulated by Robert Koch and Friedrich Loeffler in the 19th century to establish a causal relationship between a suspected disease-causing organism and a disease[citation needed]. They are:

  • The suspected cause must be present in every case of the disease.
  • The suspected cause must be isolated from the host with the disease and grown in pure culture.
  • The disease must be reproduced when a pure culture of the suspected cause is introduced into a healthy susceptible host.
  • The suspected cause must be recoverable from the experimentally infected host.

Proof of the fulfillment of these postulates is considered a sufficient demonstration of the causality of a disease. According to dissidents, failure to satisfy these postulates, especially the first two, may cast doubt on HIV causing AIDS. Some dissidents, namely Peter Duesberg, claim that Koch's first postulate is not adequately fulfilled because there are individual cases of AIDS in which HIV cannot be isolated.[13] Others, namely the Perth Group (led by Eleni Papadopulos-Eleopulos), claim that scientists have failed to satisfy the second postulate; they claim that a precondition of isolation is (physical) purification of the virus and that HIV has not yet been purified.[14]

Mainstream scientists claim that numerous strains of HIV-1 and HIV-2 have been properly isolated and genotyped. They say that HIV does fulfill Koch's Postulates, and that exceptional cases are due to other causes of immunodefiency, or patients whose immune systems are too weak to create antibodies; other symptoms such as liver cirrhosis, they state, have multiple causes (hepatitis B and C, congenital disorders and alcoholism). Moreover, in cases where HIV was not isolated, PCR shows that the virus is present.[15] They also argue that, in any case, total fulfilment of Koch's postulates is not necessary to prove that HIV causes AIDS, since other evidence is abundant. Koch himself disregarded three postulates for cholera and typhoid.[16]

Koch's postulates were developed in the 19th century as general guidelines to identify pathogens that could be isolated with the techniques of the day.[17] Even in Koch's time, it was recognized that some infectious agents were clearly responsible for disease in spite of the fact that they did not fulfill all of the postulates.[16] Attempts to rigidly apply Koch's postulates to the diagnosis of viral diseases in the late 19th century, at a time when viruses could not be seen or isolated in culture, may have impeded the early development of the field of virology.[18][19] Currently, a number of infectious agents are accepted as the cause of disease in spite of the fact that they do not fulfill all of Koch's postulates.[20] Therefore, while there is dispute over whether HIV fulfills Koch's postulates as a cause of AIDS, these postulates are not required to demonstrate causality.

Pattern of spread

Many infectious diseases typically spread rapidly, even exponentially.[citation needed] AIDS has progressed relatively slowly in comparison with some other known infectious diseases; this is taken by dissidents to be evidence that AIDS is not caused by an infectious agent.[21]

Dissidents also note that in North America and Western Europe, AIDS spreads non-randomly, affecting specific groups of people, and moreover, that it is fragmented into distinct sub-epidemics with different distributions of AIDS-defining diseases[citation needed]. According to dissidents, AIDS in Africa looks completely different from the corresponding syndrome in North America and Western Europe[citation needed]; one example that has been cited is that in Africa AIDS affects roughly equal numbers of men and women, while in North America and Western Europe it affects more men than women.[citation needed] Dissidents also point out that the parts of the world worst affected by AIDS tend to have widespread malnutrition and poor living conditions[citation needed]. According to dissidents, these are indicators of non-infectious causes of AIDS.[21]

The consensus view is that regional variability in the pattern and spread of HIV/AIDS results from variation in the time of introduction of the virus, the social fabric of a given community, its culture, its sexual networks, the mobility of its people and the reaction of the government to mounting an AIDS control program.[22] There are many well-known infectious diseases that develop slowly with a long latency period between infection and disease, such as Creutzfeldt-Jakob Disease, syphilis, and Hepatitis C. Transmission via body fluid contact has been well-demonstrated and is typical of an infectious disease: HIV behaves exactly like many other viruses in terms of its transmission through blood, sexual fluids and breast milk[23], suggesting that HIV does in fact spread like an infectious disease.

HIV harm questioned

In addition to the claims regarding the variations in AIDS definition between North America, Western Europe, and Africa, another fact cited as supporting the hypothesis that HIV is harmless is that a small number of HIV-positive people remain relatively healthy 15 or 20 years after testing positive for HIV.[citation needed] Conversely, some HIV-seronegative people develop what would have been considered AIDS-defining diseases had they tested positive.[citation needed]

According to the mainstream perspective, the long period of HIV infection preceding AIDS manifestations is to be expected; HIV can take years to cause the immunosuppression necessary to permit opportunistic disease to occur[citation needed]. Extensive studies conducted before treatment was available found the mean duration between HIV infection and the development of AIDS to be eight to ten years.[24] By this measurement, Hepatitis C would also be a "harmless" virus, as its latent stage may run longer than 20 years.[25]

AIDS definition

Of substantial concern to AIDS dissidents is the use of HIV antibody or viral testing as part of the definition of AIDS.[26] Some of the approximately 30 AIDS-defining diseases, including Kaposi's Sarcoma (KS) and Pneumocystis jiroveci pneumonia (PCP, formerly Pneumocystis carinii), are considered diagnostic of AIDS only when serologic evidence of HIV is present. In the absence of such evidence, these diseases are thought to be related to other immune problems, and are not diagnostic of AIDS.[26] In other words, according to dissidents, the definition of AIDS is an example of circular logic: because a diagnosis of AIDS requires the presence of HIV antibodies, there can be no AIDS without HIV.[21]

Two major systems of AIDS diagnosis used today are the World Health Organization system, for use in resource-limited settings (see WHO Disease Staging System for HIV Infection and Disease)[27], and the CDC system used in the USA (see CDC Classification System for HIV Infection).[28] European countries and Canada use a variation of the CDC definition that excludes CD4 counts[citation needed]. Supporters of these definitions point out that AIDS-defining diseases such as KS and PCP (and also very low CD4 counts) are exceedingly rare in people who are HIV-negative, and that it is standard practice in medicine to include a microbial test in disease diagnosis.[29][30][31][32]

HIV test accuracy

Skeptics of the theory that HIV causes AIDS claim that the process of testing individuals for the presence of HIV is flawed. They assert there is a high probability of encountering a false positive, which would falsely identify someone as HIV-positive when in fact they were HIV-negative, e.g. because of pregnancy or cross-reactivity with malaria antibodies.[21]

A detailed criticism of the Western blot test and the "gold standard" of HIV isolation was published by Eleni Papadopulos-Eleopulos et al. in Bio/technology in 1993: Is a Western Blot Proof of HIV Infection? Their arguments rest on non-specificity of HIV proteins and lack of standardisation and reproducibility of HIV tests. In their conclusion, the authors state, "It is axiomatic that the use of antibody tests must be verified against a gold standard. The presently available data fail to provide such a gold standard for the HIV antibody tests. The inescapable conclusion from the above discussion is that the use of HIV antibody tests as predictive, diagnostic and epidemiological tools for HIV infection needs to be carefully reappraised." In fact, the accuracy of serologic testing was verified by isolation and culture of HIV and by detection of HIV RNA by PCR; these are widely accepted "gold standards" in microbiology.[33][34]

The consensus view of the scientific community is that current methods of HIV antibody testing are remarkably accurate. The false-positive rate among the American public ranges from 0.0006 to 0.0007 percent.[34][35] The false-negative rate for HIV antibody testing ranges from 0.001% to 0.3%, depending on the risk factors of the tested population.[36][37][38]

Critics assert that many AIDS dissidents' claims of inaccuracy result from an incorrect understanding of how HIV antibody testing is performed and interpreted.[39] In the USA, the standard HIV diagnostic procedure combines two methods of detecting HIV antibodies: ELISA and Western blot.[40] While either of these tests (ELISA or Western blot) individually may yield a significant number of false-positives and false-negatives, the combination of these two methods results in the extremely high accuracy rates cited above. Many of the AIDS dissident claims focus on the inaccuracy of one individual component of HIV antibody testing, without acknowledging that the tests are used in combination to accurately diagnose HIV infection.[21]

Antibodies to HIV

AIDS dissidents claim another reason that HIV cannot cause AIDS is that the virus is neutralized by antibodies. As noted above, a variety of antibodies to HIV are detectable in the serum of infected patients. Celia Farber, in her essay Out of Control, summarized the argument thus:

In fact, most AIDS patients have no active HIV in their systems, because the virus has been neutralized by antibodies. (With all other viral diseases, by the way, the presence of antibodies signals immunity from the disease. Why this is not the case with HIV has never been demonstrated.)[21]

Robert Gallo and others, in a rebuttal to Farber's article[41], pointed out that in reality a number of viruses cause disease in spite of the presence of antibodies. Examples include herpes zoster[42], herpes simplex[43], and hepatitis C.[44] Gallo et al. emphasized the importance of understanding the difference between binding and neutralizing antibodies; HIV provokes a number of binding antibodies which can be detected on a blood test, but these antibodies cannot neutralize the virus.[41]

AIDS treatment toxicity

Dissidents claim the antiretroviral treatments prescribed to AIDS patients often cause the very symptoms they are supposed to delay.[21] To support this claim, they cite two studies from the late 1980s whose authors said they found it difficult to distinguish adverse events possibly associated with administration of Retrovir (AZT) from underlying signs of HIV disease or intercurrent illnesses.[45] Dissidents also claim that protease inhibitors can cause a temporary increase in CD4 cell counts due to the sequestering of these immune cells in lymph nodes as the body enters into "toxic shock."[citation needed] Dissidents claim that eventually, because protease is an enzyme required for life, AIDS medications in the class of protease inhibitors will kill HIV-positive people, regardless of whether HIV is the cause of AIDS.[citation needed]

Mainstream scientists and doctors argue that dissidents are ignoring or unjustifiably dismissing abundant evidence in favor of antiretroviral medication. Numerous studies - conducted in Africa as well as in the West - have concluded that treatment is associated with decreased incidence of opportunistic infections and increased survival among people diagnosed with HIV infection. People taking three types of drugs simultaneously (known as highly active anti-retroviral therapy, or HAART) have been found to fare much better than those on mono- or dual therapy[citation needed]. Harmful side effects do occur, and in some cases these can be severe or even deadly. However, multiple studies in Europe and the USA have found that, overall, anti-retroviral drug treatment increases survival in HIV-positive people.[46] [47][48][49]

Impact beyond the scientific community

The concept that HIV causes AIDS is widely regarded as proven in the scientific community. However, the AIDS dissident movement continues to have a significant impact outside of scientific spheres, in public perception and social policy.

Impact in North America and Europe

Skepticism about HIV as the cause of AIDS began almost immediately after the discovery of HIV was announced. One of the earliest prominent skeptics was the journalist John Lauritsen, who argued in his writings for The New York Native that AIDS was in fact caused by amyl nitrite poppers, and that the government had conspired to hide the truth.[50]

The publication of Dr. Peter Duesberg's first AIDS paper in 1987 fueled further support for dissident theories. Shortly afterwards, the journal Science reported that Duesberg's remarks had won him "a large amount of media attention, particularly in the gay press where he is something of a hero."[51] In the following few years, others became skeptical of the HIV theory as researchers failed to produce an effective treatment or vaccine for AIDS.[52] The officially recommended treatment - AZT monotherapy - was found to confer no long-term benefit, and sometimes caused severe side effects[citation needed]. Journalists, including Neville Hodgkinson and Celia Farber, regularly promoted dissident ideas in the mainstream American and British media; several television documentaries were also produced to increase awareness of the alternative viewpoint.[53] Nevertheless, the vast majority of scientists, HIV-positive people and members of the general public continued to favor the scientific consensus.

Following the introduction of highly active antiretroviral therapy (HAART) in 1996-1997, the survival and general health of people with HIV improved significantly.[citation needed] The positive response to treatment with specific anti-HIV medication is regarded as further proof that HIV causes AIDS. Today, AIDS dissident theories are widely regarded as pseudoscience, on par with Lysenkoism. Nevertheless, these theories continue to exert a significant influence in some communities; a survey conducted at minority gay pride events in four American cities in 2005 found that 33% of attendees doubted that HIV caused AIDS.[54]

Impact in South Africa

South African President Thabo Mbeki has said he first became aware of the alternative view in October 1999[citation needed]. In 2000, when the International AIDS Conference was held in Durban, Mbeki convened a Presidential AIDS Advisory Panel, one-third of whose members were AIDS dissidents[citation needed]. In his address to the conference, Mbeki said, "As I listened and heard the whole story about our own country, it seemed to me that we could not blame everything on a single virus."[55]

Mainstream AIDS scientists and activists were dismayed at the president's behavior and responded with the Durban declaration, a document affirming that HIV causes AIDS, signed by over 5,000 scientists and physicians[55].

Later in the year, Mbeki told Time Magazine that he thought HIV was only partly responsible for AIDS, and that improving nutrition and water quality would be the best way to tackle the epidemic[citation needed]. The president said in October 2000 that he was withdrawing from the debate about AIDS causation, but since then he has continued to question the extent of South Africa's AIDS epidemic.[56]

South African health minister Manto Tshabalala-Msimang has also attracted heavy criticism for her statements on AIDS. The minister has often promoted nutritional remedies such as garlic, lemons and olive oil to people suffering from AIDS[citation needed], while emphasising possible toxicities of antiretroviral drugs, which she has referred to as "poison".[57]

The Government for a long time delayed antiretroviral drugs to HIV-positive pregnant women (intended to prevent them from infecting their children), because it said it had concerns about the drugs' toxicity[citation needed]. The national antiretroviral treatment program began only after the Treatment Action Campaign (TAC) brought culpable homicide charges against Government ministers, claiming they were responsible for the deaths of 600 HIV-positive people a day who could not access medication.[58] South Africa was one of the last countries in the region to begin such a treatment program, and roll-out has been much slower than planned.[59]

Allegued harm caused by dissident views

Dissident views continue to have a significant influence in South Africa.[60] Critics, including the TAC, say that the South African government's support for such views has done immense damage. They say that mixed messages have undermined HIV prevention campaigns and have helped entrepeneurs such as Matthias Rath to market ineffective alternative therapies. The delay in providing antiretroviral treatment in South Africa is believed to have cost many thousands of lives.[61] [62]

Nathan Geffen of the South African AIDS group Treatment Action Campaign has stated:

AIDS denialism is real. We’re not having a theoretical discussion over here. People are dying because of it. I have dozens of cases on my desk in my office at home of people who have suffered at the hands of charlatans and pseudo scientists and quacks.[63]

At the seminar on HIV and Responsible Journalism at the 16th International AIDS Conference, John Moore, Ph.D., argued that:

Any one, man or woman, who’s persuaded that safe sex or using clean needles is not necessary and then becomes HIV infected and dies of AIDS, the person advising them inappropriately bears responsibility. Anyone persuaded not to take antiretrovirals and use instead alternative medicines — lemon and garlic, potatoes and whatever — is also dying unnecessarily. Anyone persuaded not to be screened for HIV status and deprived of the chance of treatment or counseling dies unnecessarily. And infants whose HIV infected mothers listen to AIDS denialists never got the chance to make their own decisions.[63]

See also

References

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  50. ^ Biography of John Lauritsen at Virusmyth.com, a dissident website. Accessed 7 Sept 2006.
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Dissident

Mainstream

General reference

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