Why is HIV/AIDS so deadly?

FYI… This is the fifth of ten posts that have nothing to do with vaccines.

Once in a while, a new loon is pointed out to me, and I read their insanity. This is the story of such an occasion:

Why is HIV/AIDS so deadly? According to the World Health Organization, AIDS kills about 1.6 million people per year. We know what causes AIDS. We know that HIV infection can be prevented through safe sex, no sex, proper screening of the blood supply, administering drugs to HIV-positive people to lower their virus counts. We have very good screening tests to administer to people and make sure they get the care that they need. And we can explain all this to millions at a time through the use of all sorts of media.

So what gives?

The answer can be a little complicated. There are some political interests involved that misuse (or don’t use) the resources given to them to combat HIV/AIDS. There are also people in very high positions of authority who believe that the disease is a proper and just punishment for all sorts of “immoral” ways of being, e.g. homosexuality.

But there is also a group of people who believe that HIV doesn’t cause AIDS, though they should know better. One of these people is Kelly Brogan, MD. According to her website, she received her medical degree from Cornell University and two science degrees from MIT. She did her residence in psychiatry and is board certified in it. With all that education, all those hours, days, weeks, and months invested in learning how to heal people, Dr. Kelly Brogan has some interesting thoughts on HIV and AIDS.

For example, women with HIV should not take drugs to reduce the chances of passing the virus on to their babies. Why? Because:

“This was the case with a now infamous, but little-publicized perinatal trial of the drug nevirapine for the prevention of transmission of HIV from mother to baby. An NIH-funded trial staged in Uganda, HIVNET 012, was hailed as demonstrating a 50% decrease in transmission, and set the stage for world-wide drug dissemination and coercion of women like Joyce Ann Hafford, to their death.”

UPDATE (9/25/14): It looks like Dr. Kelly Brogan has taken down her article. But here is Google cache to the rescue: http://webcache.googleusercontent.com/search?q=cache:http://kellybroganmd.com/snippet/hiv-pregnancy-pharma-abusing-women/

Dr. Kelly Brogan quotes a Harper’s Magazine author who seems to claim that there was no control (or placebo) group in that study. But there was a control group…

The HIVNET 012 trial was conducted in 1998 in Thailand, with some startling results:

“In February 1998, a randomized, double-blind, placebo-controlled trial sponsored by the U.S. Centers for Disease Control and Prevention in Thailand of 393 mother/infant pairs showed that a short course of oral ZDV could reduce HIV-1 transmission by about 50% over a placebo—to an overall rate of 10%—in a non-breastfeeding population (CDC, UNAIDS, NIH, and NRS, 1998; Shaffer et al., 1999). 1 As a result, HIVNET 012 researchers formally dropped the placebo arms in a letter of amendment (known as Amendment I) to the protocol, and stopped enrollment on February 18, 1998.”

The study didn’t stop there, though:

“HIVNET 012 was redesigned and reopened on April 6, 1998—with approval of the Ugandan and U.S. institutional review boards—as a randomized, open-label, Phase IIB clinical trial.2 In this newly approved protocol, the target enrollment was 400 to 600 mother/infant pairs randomized in a 1:1 ratio. Women in the NVP arm of the trial would receive a single, oral 200-milligram dose of NVP at the onset of labor. Their infants would receive a single, oral 2-milligram-per-kilogram-of-body-weight dose of NVP suspension within 72 hours of birth. Women in the ZDV arm would receive 600 milligrams of oral ZDV at the onset of labor, followed by 300-milligram doses every 3 hours during labor. Their infants would receive oral 4-milligram-per-kilogram-of-body-weight doses of ZDV twice daily for the first 7 days of life. Boehringer Ingelheim Pharmaceuticals and GlaxoWellcome, respectively, donated the study drugs.

The HIVNET 012 protocol specified follow-up of mothers for adverse events for 6 weeks after delivery. Infants were followed for adverse events until 6 weeks of age, and for serious adverse events until 18 months of age. Researchers graded such events based on toxicity tables from the National Institute of Allergy and Infectious Diseases (NIAID) Division of AIDS (DAIDS) for neonates, children, and adults, ranging from grade 1 (mild) to grade 4 (life-threatening). The 1997 Study Specific Procedures manual included the DAIDS toxicity tables, as well as a special grading system for adverse experiences related to skin rashes and dermatitis and hemoglobin in mothers (Jackson et al., 1997). As the medications were given for a week or less, the study did not modify drug doses for toxicity.”

It wasn’t all without some issues, though, and the trial was adjusted again:

“Researchers amended the study protocol in February 2000 (Amendment II) in response to findings in other studies that some women could develop viral resistance to NVP, and that some children treated with various antiretroviral drugs in utero or perinatally could possibly experience mitochondrial toxicity. The modification entailed extending follow-up of women in the NVP arm and all children in the 18-month study to 5 years, with yearly evaluations for NVP resistance in women who had received NVP (HIVNET 012 Investigators, 2000).”

And what were the final results?

“The 1999 Lancet paper also analyzed adverse events and toxic effects based on the first 556 mother/infant pairs assigned to treatment with ZDV (279 pairs) and NVP (277 pairs). The authors reported that “the rates of maternal serious adverse events were similar in the two groups (4.4% in the ZDV group and 4.7% in the NVP group),” and that “the occurrence of clinical or laboratory abnormalities in mothers was similar in the two groups.” The authors also reported that for infants, “the rate of occurrence of serious adverse events in the two groups was similar up to the 18-month visit (19.8% in the ZDV group and 20.5% in the NVP group).” The “frequency and severity of laboratory-detected toxic effects … were similar in the two groups.”

The second Lancet paper (Jackson et al., 2003), reported that infants assigned to the NVP arm continued to have a significantly lower rate of HIV-1 infection and a significantly greater likelihood of HIV-1-free survival through 18 months of age (Table 2.2). Specifically, the efficacy of NVP compared with ZDV was 41%.”

The Institute of Medicine, and others, back the study’s findings. That Harper’s Magazine article? It was widely chided for its inaccuracies regarding the relationship between HIV and AIDS.

So why does Dr. Kelly Brogan see this study as a bad thing? And who is Joyce Ann Hafford?

Joyce Ann Hafford was a 33 year-old woman who died from liver failure from the medications she was being given as she participated in a drug research study. She was HIV-positive, and she enrolled in the research study in an attempt to keep her unborn child from being born with HIV. The whole thing was an enormous mess. Ms. Hafford started showing signs of toxicity from one of the drugs, but her healthcare providers apparently put the blame on her condition and not on the drugs. The National Institutes of Health eventually confirmed that it was most likely the drug.

These things happen. I won’t deny that medications, even the life-saving ones, all have risks. At a population level, antiretrovirals are saving lives, but everyone needs to be monitored for side-effects. At the individual level, there are those who need to be treated for side-effects. Not treating HIV will inevitably lead to AIDS in 99.999999999% of people who are infected. Treating it will cause side-effects in a very, very small percentage of people being treated. It’s about weighing the risks.

Perhaps because Dr. Kelly Brogan is not an epidemiologist and most of her training appears to be in psychiatry, Dr. Kelly Brogan seems to believe that all antiretroviral drugs are the ultimate evil, which fits well with her statements about medical science:

“This medical-scientific-industrial marriage has brought us many a meme that we hold on to societally, as truths:

That depression is a chemical imbalance

That cholesterol causes heart disease

That exposure to bugs equals deadly infection, and vaccines protection

Cancer is a genetic time bomb

That HIV causes AIDS, the equivalent of certain death”

She links her last statement, the one about HIV and AIDS, to a known AIDS denialism group. I’m not even going to touch her statements and blog posts on vaccines. (She thinks that herd immunity is fiction, apparently. Something that made my head explode.)

And there you have it. People continue to die from HIV/AIDS in part because people who should know better continue to perpetuate the idea that HIV doesn’t cause AIDS, with variations to that theory. Some say that HIV is just a “passenger virus” and that it is an incidental finding with AIDS really being caused by the drugs used to treat HIV infection. Others say that HIV is a manufactured virus, aimed at homosexuals or at Africans, but still not a full-fledged cause for AIDS. And so on and so forth.

Without telling us her complete stance on the matter, Dr. Kelly Brogan certainly can seed some doubts in those who may not be initiated. But we are initiated, aren’t we, folks?

HIV leads to AIDS, plain and simple

FYI: This is the second of ten posts that will not be related with vaccines.

Back in the late 1970’s and early 1980’s, there was a lot of scientific confusion as to what the relationship was between Acquired Immunodeficiency Syndrome (AIDS) and a newly discovered retrovirus first known as HTLV-III and then renamed to HIV. Thirty-plus years and millions of dollars later, we have come to understand that HIV infection, if left untreated, progresses on to AIDS. We came to understand this because we observed people with HIV and people without it. Then we went one more step further and observed people infected with HIV who were treated and those who were not treated. We did these observations in real-world situations and also in controlled situations. We also did these observations in animal models.

All the evidence is there, and it is very clear that HIV causes AIDS.

Still, there are a group of people out there who honestly believe that HIV doesn’t cause AIDS, that AIDS is the result of things other than HIV, or that neither HIV nor AIDS actually exist. (There are wilder theories than those, if that is possible, but I don’t have time for them.)

A few years ago, I came upon the comments of a man who has some “interesting” views of the relationship between HIV and AIDS. Here is the comment:

“Whether ORAC knows anything about medicine or science is unclear, but he knows NOTHING about how to conduct an investigation.

Having conducted thousands of criminal, civil and military investigations since 1980, it was clear from the onset that Deer’s so-called investigation resembled more of a hit-piece than a real investigation. As such, it was the perfect pretext for the kangaroo court known as the medical board review.

ORAC’s outrage is also telling. Since truth is the best defense in such cases, Deer’s defense should be extremely easy – unless, of course, he lied to destroy Dr. Wakefield’s career.

Because I have been involved in more than 100 criminal, civil and military cases involving medical and scientific incompetence since 2009, I am not at all impressed that ORAC is funded by the DoD, NCI or any other US government agency. And having recently cleared a US Marine of criminal charges by impeaching a top military infectious disease expert, I’d say that ORAC’s outrage is likely based upon his fear that he will be eventually be discovered as a charlatan as well.

If ORAC is telling the truth, nothing would preclude the use of his real name. The fact that he blogs on this pharmaceutical marketing website is telling.

Clark Baker LAPD (ret)”

He did us all the favor of directing us to his website, the “Office of Medical and Scientific Justice”. It’s a pretty legit-sounding website that talks a lot about clearing people who are innocent from false accusations against them. Just read the “About” page:

“Having conducted thousands of criminal and civil investigations since 1980 with the LAPD and as a licensed investigator, Mr. Baker founded OMSJ in 2009 after witnessing the reluctance of government agencies and research centers to investigate allegations related to medical and scientific corruption (also known as JUNK SCIENCE).

Many of the agencies and companies that market junk science fund activist groups and local, state and national politicians who facilitate corruption that has cost taxpayers billions of dollars in wasted research dollars. Junk science is used to keep predators on the streets, convict the innocent and injure or kill 2-4 million Americans annually.”

Read in a vacuum, that all sounds great… Until you start reading into Mr. Baker’s ideas. (Tip o’ the hat to regular reader/commenter “Lilady” for the link.) It seems that Mr. Baker is an HIV/AIDS denialist. Among some of the claims on his website are the usual bits of anti-science strategy. First, deny the science and call it “junk science”, but never mind that 99.9% of scientists (that is, 100% of reputable scientists) know and understand that HIV does cause AIDS, that HIV is not a “passenger virus”, and that HIV without antiretroviral treatment is pretty much a death sentence. Second, to try and back up those anti-science claims, find something by a member of the 0.1% of whacky scientists and publish the hell out of it. Third, find instances of scientists misbehaving and then try and discredit their scientific work and that of their colleagues. Finally, cater to what the far right-wing groups and their members want to hear.

It really is quite humorous that Baker follows the same playbook of almost all other anti-science activists follow. Cherry pick and discredit. Cherry pick and discredit. Cherry pick and discredit and be mean about it. Cherry pick, discredit, be mean, and put yourself up on a pedestal as being more than you really are. Oh, and sue people. Don’t try and fight the science, just goddamn sue!

Unfortunately for humanity, Clark Baker is not the only AIDS denialist out there. There are plenty, and there are plenty with advanced degrees whose letters after their names give them some degree of credence. For one reason or another, people listen to them, and we all pay for it dearly.

Science and Reality and AIDS Denialism

In the late 1970’s and early 1980’s, physicians around the country started to notice that certain patients of theirs were coming down with some really weird infections. These infections, like pneumonia from a fungus, were not usually seen in otherwise healthy individuals. In fact, the fungal pneumonia being seeing at the time had only been seen in severely malnourished children and in people whose immune systems had been decimated. These physicians, being the astute people that they were, reported their findings among themselves and to health departments. It wasn’t until June of 1981 that a report from CDC documenting these cases of atypical pneumonias in gay men that the floodgates were opened. Healthcare providers from all over the nation started to report that, yes, there was something happening that people (usually gay men at the time) were coming down with atypical pneumonias and other infections termed “opportunistic” because they take advantage of weakened immune systems.

In 1983, two independent (and competing) groups of scientists in America and France isolated a new virus from people with what had come to be known as Acquired Immune Deficiency Syndrome (AIDS). The viruses they isolated were named HTLV-III and LAV by the two teams, respectively, but it would be renamed Human Immunodeficiency Virus (HIV) in 1986. It was then understood that HIV was the causative agent of AIDS because:

• AIDS patients all had HIV in their blood and anti-HIV antibodies in their serum.
• People without AIDS who were exposed to HIV and infected (by lab accidents and accidental needle sticks, NOT because they were deliberately infected) went on to develop AIDS.
• In the lab, HIV was grown in media from all cases of AIDS and people without AIDS were not found to have HIV in them.

It would have been unethical to randomize people in a study into the “give them HIV” and “don’t give them HIV” groups, so a lot of these observations were based on observational epidemiological studies. Later on, antiretroviral drugs (drugs against HIV) showed that:

• AIDS patients given antiretroviral drugs would get better, especially once their HIV levels went down.
• People with HIV who were given the drugs before AIDS set in did not develop AIDS, or developed it at a much later time.
• Pregnant women with HIV given antiretrovirals would have HIV-negative babies, while pregnant women with HIV who did not receive the drug would pass it on to their children.

Jesus once said that all who had ears should listen, but I’m going to take it one step further. Let all who have brains understand this:

No HIV, no AIDS. HIV, AIDS. Antiretrovirals, low HIV, no AIDS. No antiretrovirals, certain death from AIDS and the infections that come from it.

Sadly, not everyone has grasped this concept and there continue to be people who… Well… Read it yourself:

“The Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis came into existence as a group of signatories of an open letter to the scientific community. The letter (dated June 6, 1991) has been submitted to the editors of Nature, Science, The Lancet and The New England Journal of Medicine. All have refused to publish it. In 1995 The Group was able to get another letter published inScience.

Over the years more and more people have added their signature to the first letter. By signing the letter; the statement below, one becomes a member of The Group too.

It is widely believed by the general public that a retrovirus called HIV causes the group diseases called AIDS. Many biochemical scientists now question this hypothesis. We propose that a thorough reappraisal of the existing evidence for and against this hypothesis be conducted by a suitable independent group. We further propose that critical epidemiological studies be devised and undertaken.

There are 3100 signatories.”

There are 3,100 people who don’t believe that HIV causes AIDS, despite the overwhelming evidence that it does. They want “critical epidemiological studies be devised and undertaken.” Well, they have. They’ve been devised and undertaken. Since we can’t randomize people into the HIV infection and non-HIV infection groups, we looked at people with AIDS and tested them for HIV. They all had it. Then we looked at healthy people and tested them for HIV. They all didn’t have it. (Of course, there are a couple of people who were exposed to HIV and even mounted an immune response to it, becoming positive for antibody testing, but they shed the virus and were not infected.) Further, people exposed to the virus by accident (e.g. needle-stick at the hospital) before the time of antiretroviral therapy, who then became infected, went on to develop AIDS. Once antiretroviral therapy was developed, people exposed to the virus, and even those infected, did not develop AIDS, or recovered from AIDS if they had it.

The people that don’t believe this are known as “AIDS denialists.” They believe in their hearts that HIV does not cause AIDS. Some believe that HIV doesn’t even exist. Others believe that AIDS is the result of the antiretroviral drugs and that these drugs are not necessary. Still others believe that AIDS has been made up by pharmaceutical companies wanting to sell their drugs to third world countries. And then there are the fringe elements, those in the most extreme, who believe that the government (or some big, malevolent force) created the virus, but that it doesn’t cause AIDS.

Now, if I may get personal for a little bit, it is painfully obvious to me that these people have not been to Africa, have not done real virological research, or may be otherwise sick in the head. But that’s just me. Now, back to the story I’m trying to tell you…

AIDS denialists wrote the following passage and signed it. (Scroll down to read the statement.) It’s a long statement, and, if you’re inclined to live in reality, you might find your blood boiling. But it is worth reading because you need the full “flavor” of what I’m talking about. After listing everyone that has signed this statement, the following reads, with my emphasis in bold:

“There you have it. No “handful of wild-eyed conspiracy theorists.” No “right-wing racists,” as the Aids industry’s spinmeisters would have you believe. Just 2,916 very serious, concerned, highly educated people from every corner of the globe who sense that an enormous tragedy is unfolding due to the medical establishment’s unwillingness to face the evidence that the Hiv-Aids theory is a mistake.The people on this page were intellectually curious enough to have sought out and studied the arguments that discredit the Hiv-Aids theory. Since the mass media and professional journals censor these arguments, the vast majority of doctors and scientists, although decent people who want to do the right thing, have never been exposed to them, and so accept the biased conclusions of politicized bureaucracies like the CDC and WHO, whose coziness with the drug industry is legendary and whose recommendations always seems to dovetail perfectly with drug industry marketing plans.

Were it not for the massive media blackout of information that contradicts the Hiv theory, many more people would be asking tough questions.

The next time you hear the media say, “only a handful of scientists doubt Hiv’s role in Aids,” refer them to this page. Explain to them that it is wrong to misrepresent the fact that there is enormous dissent to the Hiv-Aids paradigm.

The next time you hear the media drone, “Hiv, the virus that causes Aids,” remind them that journalists are supposed to distinguish between what is a theory and what is a fact. That Hiv-Aids is only a theory and has never been proven, is admitted by top scientists even in the Aids establishment.

The next time the media announce that tens of millions of people are dying from Hiv in Africa, ask them how they know that. Remind them that journalists are supposed to question dubious assertions from powerful, drug-industry funded agencies like the WHO, not parrot them as if they were indisputable. Ask them why they report these numbers as if they were actual Aids cases, when in fact they are projections made by WHO’s computer programs, based on very questionable statistical methodologies and contradicted by many facts including the continual large population increases experienced in the countries supposedly worst affected.

Request that the media stop twisting the truth in support of a politicized, entrenched Aids establishment that profits financially by terrorizing people, pokes its nose shamelessly into people’s private sex lives, compels people to submit to inaccurate tests and literally forces mothers and babies to swallow toxic, unproven chemotherapy drugs with horrific, often-fatal side effects.

Explain to them that this is irresponsible, and that such actions cause needless anxiety, shatter people’s lives, tear families apart, destroy hope and trigger countless suicides. And that while we realize that sensational headlines about “killer viruses” sell newspapers, the social cost of these profits is unacceptable.

Make the media understand that keeping people in the dark about the large number of credentialed dissenters to the Hiv-Aids dogmas, and the financial conflicts of interest that are rampant among Hiv-Aids scientists and NGOs, is a violation of everyone’s human right to informed consent and freedom of information.”

If these statements sound familiar to you, they should. They’re the same kind of ploys used by anti-vaccine forces to try and discredit the proven science of vaccines. In their minds, there are conflicts of interest, secret arrangements, media blackouts, human rights violations, paradigms that need to be challenged, and mothers and babies dying. Never mind that independents organizations like Doctors Without Borders have been on the ground in Africa helping all these supposedly inexistent people dying from AIDS. Never mind that plenty of people here in the US have died from AIDS after being infected by HIV, not before. Never mind that our collective hearts have been broken time and time again at seeing children dying from AIDS after being born to HIV-positive women, only to be lifted up when we see thriving children whose mother received the antiretrovirals and didn’t pass on HIV to those children.

There is a sort of disconnection from reality that boggles the mind, really.

So why am I writing this? I am writing this because a friend alerted me to one of the people who apparently* signed this statement. That person has been described thus as “…one of the most influential voices in medical research today.” (NY Times). He was up until recently a post doctoral researcher at Johns Hopkins School of Medicine. He has participated in the Cochrane Collaborative, doing systematic reviews on research about influenza vaccines and Tamiflu. And now, he’s been hired as an associate editor of the British Medical Journal.

Let that settle in for a few seconds.

One Mississippi.

Two Mississippi.

Three Mississippi.

Four Mississippi.

Five Mississippi.

An associate editor of the British Medical Journal apparently* signed a statement supporting the idea that HIV doesn’t cause AIDS, that there are no such things as actual cases of AIDS or deaths from AIDS or a pandemic of AIDS, and that there are plenty of groups interested in killing mothers and babies with antiretroviral therapy.

Sleep on that tonight and tell me in the comments if reality hasn’t been just a little bit distorted for you.

Below is a screen shot of the names of a few signatories. The person in question is the fourth one down. The first one you’ll recognize too, I believe.

*Then again, everyone deserves the benefit of the doubt. This PhD may have come around to accept the fact that HIV causes AIDS and that’s why he’s now focusing on the idea that influenza is not a big deal. After all, the page does not tell us when he signed it, and the form to be signed is pretty easy to spook (sign anonymously or sign in place of a different person).

What do you all think?

You want me to “prove” to you that HIV causes AIDS?

Someone denies that HIV causes AIDS. They want me to prove it to them.

My response?

http://www.tubechop.com/watch/1532347

Anti-vaccine notions and the people who follow them are dangerous in more ways than one

I came across this the other day:

“Are vaccines causing more disease than they are curing?”

The answer, simply, is a resounding, astounding, non-confounding and unrelenting “NO!” Never mind that vaccines don’t “cure” diseases. They prevent them. Some vaccines are given after exposure to a pathogen, but they are not given to cure. They are given to give the immune system a head start in building a response to the pathogen. But, as always, facts and reality and stuff like that don’t get in the way of a juicy article that goes from being anti-vaccine to diving head-first into being an all-out AIDS denialism diatribe.

Denialism pure and simple (UPDATED)

When I was in college, I took a course on military science. This course talked about the scientific discoveries we have made through war. By trying to kill each other off in a simpler manner, we’ve discovered a lot, from a scientific point of view. During that course, we spent about three weeks focuses completely on the Nazi medical experiments. If you haven’t heard the story, I invite you to go to the Holocaust Museum in DC and take a look at their exhibits. In essence, Nazi medical “researchers” conducted unethical experiments on humans (concentration camp prisoners, prisoners of war, etc.). We discussed for three or four classes whether or not we — the then future scientists — should use any of the knowledge gained from those experiments in order to expand science.

I won’t bore you with the philosophical and ethical discussions that erupted then. No, I will entertain you with the story of the one guy in class who decided that he was going debunk the “myth” of the Holocaust. Actually, it’s a short story; he was kicked out of class at the discretion of the professor. The guy actually wanted to argue with our professor, a Holocaust survivor.

I laughed out loud. That fool of a student.

But it does lead to an interesting question: How do you know what is true to be the truth? How do we know that the Holocaust really did happen? What evidence for and against can we believe?

Of course, this is a non-starter for many people who are reasonable and understand the concepts of historical evidence. There were thousands upon thousands of first-hand accounts of what happened in Nazi-occupied Europe. There are movies and records kept by the Nazis themselves. There are movies and documents from Allied Forces that liberated the concentration camps. In short, the Holocaust happened. There is no doubt about it.

Yet there are those who walk on this earth and deny that the Holocaust happened. Whether or not they believe that it happened is between them and their god. They go around telling everyone they can that it didn’t happen, that’s is a Jewish conspiracy, or that the Holocaust is a misrepresentation of what really happened. (I’m sure it was nothing but kittens and puppies in Auschwitz.)

Then there are those Holocaust deniers who also deny that the HIV virus causes AIDS. Even better, some of them deny that HIV even exists. They say that it’s all an attempt from the pharmaceutical industry to bleed the public dry through the sale of laboratory tests and unnecessary drugs. (I guess all of those dead people in Africa and elsewhere died of kitten and puppy overdoses.)

There is a particularly interesting person out there who goes by the moniker of “Putin Reloaded“. PR is interesting because there is no conspiracy theory that he doesn’t like. For example, this is what he has to say about HIV not being the cause for AIDS:

Antibody tests are not valid surrogates of virus detection, for all antibodies are heterophile and promiscuous. 

If you don’t know what those words mean look it up! 

About 30% of people have at least one “hiv” antibody in their blood, that’s how absurd the assumption is: http://www.ncbi.nlm.nih.gov/pubmed/2230270 Frequency of indeterminate western blot tests in healthy adults at low risk for human immunodeficiency virus infection. ” 32% (low risk controls) had indeterminate Western blot tests, most of which demonstrated a single band of lowintensity. The most common bands were p24 (47%), GAG p17 p55 (34%), and POL p31 p66 (36%); envelope bands were unusual (gp41, 2%; gp120, 2%).” Confirmed by: http://elcid.demon.nl/1995_Western_blot_35pc_of_donors_have_1_band_at_least.png Antibodies to Human Immunodeficiency Virus (HIV-1) in Autoimmune Diseases. ” 126 blood donors as a control group…At least one band was shown on immunoblotting in 26% of patients with autoimmune diseases and 35% of controls. ” 

So HIV tests are basically tools to fool perfectly healthy individuals into believing they’re carriers of a deadly virus and put them on deadly drugs. A self-fulfilled prophecy.

Oh, really? When PR is confronted with questions about PCR and viral cultures being used to confirm antibody tests, he gets really defensive and claims that one is personally attacking him.

PR is also into Holocaust denial, as I stated before:

“Recall that the Holocaust is an unfalsifiable theory, ie, it is impossible to refute because it is expressly prohibited by law in many European countries. Therefore, the Jewish Holocaust is not a historical fact but a legend that it takes an act of faith to believe.”

(Thanks to Pedro [not her real name] for the translation.)

So why am I writing about PR?

I’m writing about PR because he is exactly the kind of person that needs to be countered at all possible opportunities. In your private life (e.g. at work, in your family) and in your public life (e.g. out with friends) you must counter the ramblings of people who deny historical facts and scientific evidence. I’d advice you to be gentle and respectful, but you know me better than that by now.

To the AIDS denier, you must explain to anyone within earshot of that AIDS denier that we know that HIV causes AIDS because the grand majority of people who are infected with HIV go on to develop AIDS if they are not treated. They also go on to die. We know that the grand majority of people with AIDS have HIV infection. We know that the virus multiplies inside of immune cells, thus killing the immune system and allowing for opportunistic infections. Plenty of us have held the hand of a dying AIDS patient. Are there infected people who do not develop AIDS? Yes. Are there people who develop AIDS but were not infected with HIV? Yes. AIDS is a collection of diseases and conditions, a syndrome. But we see it in people with HIV infection for the most part (almost 100%).

The AIDS denier will try to use rare occurrences as clear evidence of their point. Don’t let them.

Likewise, the Holocaust denier will say that there were no extermination camps in Germany during the Nazi regime. This is true. The extermination camps were outside the country of Germany and in Nazi-occupied Europe. Here’s a map. They will also tell you that Hitler never signed an order to exterminate 6 million Jews and another 6 million “undesirables”. For that, read this.

In other words, stand up to the bigots, the denialists. Tell them and anyone around them why, how, when, and where they are wrong. Be ready to present the evidence, like radioactive decay to young Earth creationists, the physics of water vapor to those who believe that airplanes are dropping chemicals in contrails, or simple epidemiology to those who believe vaccines cause autism. It is important that we do this because they can do a lot of damage with their ideas.

A lot of damage.

**** UPDATE ****

The troll decided to show up in the comments section. Let me make this clear to you, Mr. PR, this is not your blog. This is not your platform to spread more antisemitism, misogyny  and AIDS denialism. Your comments are not accepted, and they will be deleted. (What’s that about misogyny  Mr. PR has told a group of female scientists that women naturally lack initiative and need father figures to guide them and tell them what to do next.)

Movies You Should Watch: "My Own Country"

“My Own Country” (1998) is a movie based on the book by the same name by Dr. Abraham Verghese. It tells the story of Dr. Verghese’s experiences in the South in the beginning days of the HIV/AIDS epidemic. The movie, like the book, is not for people who are still, to this day, close-minded about the origins of the epidemic. They should read the book and watch the movie, yes, but it is presented in such brutal honesty that it will only make them revolt against it even more. People who see this movie and are inspired to see human beings as the frail and fallible beings that we are will also come to see people as capable of unconditional love… Something reserved in literature and history only to the deity of the highest order.

Dr. Verghese was an outsider in the town of Johnson City, Tennessee. Ethiopian by birth and Indian by heritage, the movie makes it clear that he was accepted in the town only because of his education. But race is not the issue with this town, not the way the movie is framed. The issue is this new epidemic that has arrived in the form of young, gay men with AIDS. Men who were otherwise healthy and full of life begin to lose weight at a phenomenal rate, become too weak to go on in life, and eventually succumb to the disease.

The people around these young men are scared to death of what is going on. If you are too young to remember those days — and I’m not — you will see how people truly reacted to HIV and AIDS. They would not touch a person who was infected. They would not hug, kiss, or want to be around an infected person. Even Dr. Verghese’s wife asks him once when he gets home, “Did you wash your hands?” The stigmas and stereotyping are all there, and they are presented without judgment, more as the natural response of society to something that is scaring them to death — sometimes literally.

But it’s not just homosexuals that are seen to be affected in the movie. A heterosexual couple become infected when the husband has sex with men. He is dragged to the hospital by his wife and children and sheepishly admits to having sex with men and women. “I like sex,” he admits. Later, when the wife is told that both she and her sister are also infected, both from the husband, she is seen contemplating suicide. That is what I meant by being scared to death.

Dr. Verghese continues musing about homosexuality and what he is seeing all around him. It is touching because he seems to be trying to rationalize what is going on around him. We all do this. We see such horrors and unspeakable things through the news or in person and we try to tell ourselves that we, humans, are not really that evil. We can’t be. If we were, we would have never progressed as much as we have in this world.

In a post-HIPAA society, it is shocking to see how news of peoples’ diagnoses spreads through town. People are said to stand up in church and “out” their relatives with AIDS. Employees of the hospital are rumored to be spreading diagnoses to people in the community. When you realize that people who were diagnosed with HIV infection, or AIDS, were fired from their jobs, shunned by their families, or worse, you come to understand why it became necessary to have stronger privacy laws.

Somewhat humorous is a scene where a young man we meet earlier in the film has passed away. His sister comes to make sure that his body looks presentable for the funeral. The mortician is asked to put on socks on the body and returns with a silly-looking pair of rubber gloves that are more fitting for an electrician working with a high-tension wire. The sister remarks that the body is “pickled” and that there “is no bug in the world that’s going to survive that”.

We also see something that is still going on to this day: A family overriding the wishes of their dying relative while the relative’s helpless partner looks on. “We have legal authority,” they claim while the partner is brought to tears at the prospect of extending his beloved’s suffering. Without preaching, just by presenting the facts, we see how this is not the best thing for the patient, only for the family.

Threaded throughout the movie are scenes where the audience gets to see that unconditional love I wrote above about. When a gay man embraces his partner, both crying over the diagnosis, a nurse states that she wishes a man loved her like that. That embrace is powerful because people with AIDS at that time were shunned to the point that people did not want to be in the same room with them at times. Handshakes were questioned, and hugs were forbidden. Ignorance and fear, the most virulent contagions, guided people’s responses. Science and reason, the antidotes to these things, were set aside back then as they continue to be ignored today.

Yet there is hope, there is always hope. We see the hope in this young infectious disease doctor who is doing his best to inform the public on what HIV and AIDS are and what they are not. We see the hope in his staff who work with him and start to understand what is going on and what the best course of action is. And we see hope in the family members of those who are stricken with the disease and come to accept their relatives, love them, take care of them until their dying day, and become advocates in the community for those who are shunned and too weak to defend themselves.

If you are an advocate for public health, for social justice, for equality, then this is a great movie for you to see. The book goes into even more detail, of course, but the movie is powerful enough. When you see that the issues of those days are still here today, you can’t help but to want to rise up and fight it, do something about it. And we must.

We must.

How Many Was That Again?

Have you ever noticed that reports of case counts from public health sources usually have the word “reported” included in them? You have, haven’t you? Well, have you ever wondered why that is so?

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The reason for that is because of the inherent nature of epidemiological surveillance and the barriers to getting an exact case count for every single disease or condition out there. Some of these issues with surveillance make for an overestimation of the number of cases. Other issues make for an underestimation of the number of cases. In all cases, it is highly unlikely that you are seeing the true number of cases in any report from public health.

Does that make these reports not useful or even – as some will claim – “manipulated” in any way? Not necessarily, and let me tell you why…

CASE DEFINITIONS
The first thing you need to understand in analyzing descriptive data presented to you from public health sources is the case definition being used in counting cases. A case definition is usually presented in terms of person, place, and time. For example, a case of Salmonella food poisoning may be defined as “anyone with a stool culture positive for Salmonella who ate avocados in Pittsburgh in the week of December 8 to 15″. That’s pretty specific, right?

Case definitions can also be very broad, like saying that a case of Salmonella food poisoning is “anyone with gastrointestinal disease with an onset of December 10 to 17”. This definition would surely bring up many more cases than the cases from the previous, more stringent case definition. So you can see why you need to know exactly what defines a case.

DIAGNOSTIC TOOLS
Likewise, you need to know what diagnostic tools are being used to define a case. In our example above, we used a stool culture to define the specific case definition and a clinical description of “gastrointestinal disease” to define the second. When being presented with data, make sure that you know what diagnostic tool – or tools – was (were) used. It makes a big difference.

For example, in the late 1970’s and early 1980’s, we had very little with regards to technology to isolate the Human Immunodeficiency Virus (HIV). So an HIV infection had to progress to Acquired Immune Deficiency Syndrome (AIDS) – a collection of signs and symptoms of the deterioration of the immune system – in order to define a case of HIV infection. AIDS itself was very broad at first, and the definition then was refined. As more and more diagnostic tools have been made available, the case definition of HIV and AIDS has changed. Where the presence of an opportunistic infection was once enough to diagnose a person with AIDS, there are now lab tests to look at the white blood cell counts and diagnose earlier in order to intervene and treat earlier.

AUTISM
The example with HIV/AIDS above is true of autism as well. It used to be that there was no uniform diagnosis for autism – or any of the conditions that fall within the autism spectrum. Children were either “hyper”, or “retarded”, or “slow”, or had some other condition. As medical science began to understand what it meant to be on the autism spectrum, the definition of someone with autism changed, leading to better recognition of cases and a subsequent rise in the prevalence – the underlying rate of disease in a population – that we see now.

Incidentally, the case definition for autism became more sensitive and specific – and thus more accurate – around the same time that vaccines began to be more abundant and more recommended. This lead to the misperception that vaccines raised the rates of autism and not the better diagnostic tools. But that is for a whole other discussion.

BETTER SURVEILLANCE
It goes without saying that an improvement in surveillance methods also leads to a change in the number of cases observed and counted. For example, infant mortality reporting has gotten better as more and more health care providers in the United States are able to report infant deaths electronically. Health departments at all levels of government are more active in their surveillance of cases by surveying hospitals, clinics, and even midwives on the survival numbers of infants. So you can see how this extra effort to count the deaths that were previously not reported has led to the belief that the infant mortality rate in the country has increased.

Other countries don’t have the same systems as we do in the United States. As a result, their infant mortality rates are different – even lower –  than those observed here. Is it true, then, that the US is failing in controlling infant mortality compared to countries with less resources? Nope. It’s all in how we’ve been counting the numbers. Apples to apples, the rates are much better in the United States, where expectant mothers have better access to prenatal care and children are – for the most part – born in medical facilities capable of caring for them if they are in trouble.

CONCLUSION
So here is what you do when you compare two rates of a single disease either across time, across location, or even across populations of people. You need to make sure that the case definitions of both datasets are comparable and as close to matching as possible. Otherwise, you really are comparing apples to oranges. You also need to look at the diagnostic methods used for each dataset. There is no use in comparing one dataset whose cases were diagnosed based on symptoms – a subjective way of diagnosing – and another dataset whose cases were diagnosed by a lab – an objective way of diagnosing. Finally, you need to look at the surveillance system that collected these data and make sure that the systems for both sets of data are – yet again – comparable. If one relied on providers reporting cases while the other went out and looked for cases, then – yet again – you will find yourself comparing apples to oranges.