Golden Fleece Award II: MENTAL ILLNESS MAY BE DISABLING

“Mental illness and substance use delay HIV treatment” [March 18, 2008]

“People with untreated mental illness or substance abuse, or both together, start HIV treatment later than people without mental illness or substance abuse, according to a study published in the March 1 issue of AIDS Patient Care and STDs. People who are receiving drug treatment for a mental illness, however, do not delay starting HIV treatment. . . . Given that rates of mental illness and substance abuse are more common in people living with HIV, and that these conditions have been found to interfere with adherence to HIV treatment, Mary Tegger, P.A.-C, MPH, and her colleagues from the University of Washington in Seattle set out to determine whether these conditions may also delay the start of antiretroviral therapy.”

Did they take any bets beforehand, as to what the study would find?

Among “all HIV-positive patients receiving primary care at the university’s Harborview Medical Center HIV Clinic during 2004 . . . . Of the 1,744 patients included in the study, 63 percent were found to have a mental illness, 45 percent had a substance use disorder and 38 percent had both. Alcohol was the most commonly abused substance, followed by cocaine and amphetamine. Depression and anxiety were the most commonly diagnosed mental illnesses.”

“Tegger’s team theorizes that there are multiple reasons for the delay in antiretroviral treatment observed in people with mental illness and substance abuse disorders. The team proposes that such individuals are less willing, on average, to comply with treatment recommendations, such as starting antiretroviral treatment.”

On the other hand, any sane and sober person reading the official treatment guidelines might well be inclined to delay treatment forever — see also DEATH, ANTIRETROVIRAL DRUGS, and COGNITIVE DISSONANCE, 9 May 2008; TO AVOID HIV LATER, DAMAGE YOUR KIDNEYS AND LIVER NOW, 19 January 2008; HISTORY OF AZT, 1 January 2008; FIRST: DO NO HARM!, 19 December 2007; WHAT HIV DRUGS DO, 15 December 2007; OFFICIAL GUIDELINES FOR HIV TREATMENT, 14 December 2007; ANTIRETROVIRAL DRUGS: HISTORY AND RHETORIC, 12 DECEMBER 2007; BEST TREATMENT FOR HIV: THIS YEAR’S ADVICE, LAST YEAR’S, OR NEXT YEAR’S?, 10 December 2007.

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Preview:

I’m working on several posts that call for much reading, and I’m away this week at the meeting of the Society for Scientific Exploration, presenting the data that show lack of benefit from antiretroviral drugs and absence of “latent period”, see “HIV DISEASE” IS NOT AN ILLNESS, 19 March 2008. Then I’ll get back to working on a deconstruction of the claim that treatments for AIDS have saved at least 3 million years of life; see Anthony S. Fauci, “Twenty-five years of HIV/AIDS”, Manila Times 29 May 2007, relying on Walensky et al., Journal of Infectious Diseases 194 [2006] 11-19; mentioned, unsurprisingly enough, among the News Items on the website of Fauci’s Institute.

VIRTUAL HIV/AIDS RESEARCH AND TREATMENT

Rian Malan had expressed a certain degree of astonishment when HIV/AIDS experts ventured that their computer programs were becoming so competent that it would soon be unnecessary to gather actual data about numbers of people infected with HIV, numbers dying from AIDS, and the like (“Africa isn’t dying of Aids”, The Spectator [London], 14 December 2003).

Since then, HIV/AIDS computers have certainly been gaining ground. The Centers for Disease Control and Prevention now likes to fill its reports with “Estimates” instead of with actual reported counts—the 2005 Surveillance Report, for example, has 7 tables of estimated cases of HIV/AIDS and AIDS; one of estimated deaths of people with AIDS; and for “Persons Living with HIV/AIDS, AIDS, or HIV Infection (Not AIDS)” there are 6 tables, 2 maps, and 3 figures of estimated data. All these estimates, of course, are outputs of computer models whose inputs include unsubstantiated assumptions plus — surely? — some counts of actually reported cases. Until about a decade ago, these Surveillance Reports had presented counts of reported cases. By disseminating estimates instead of empirical counts, the Centers for Disease Control and Prevention masks any evidence that there might be of inadequacies in the computer models or in the theories and assumptions that underlie the models.

But this is only a start, apparently. Soon, it seems, it will be possible to learn everything we need to know about HIV in human physiology through the use of supercomputers in the form of a VPH, the Virtual Physiological Human:

UCL in the News: Scientists use supercomputers to test HIV treatment
Rebecca Thomson, ‘Computer Weekly’, 30 January 2008
“Scientists in London are using networks of supercomputers to test a treatment for HIV.
The computing method, called the Virtual Physiological Human (VPH), links networks of computers across the world to simulate the internal workings of the human body. It can then be used to simulate the effects of a drug. …
Peter Coveney [UCL Chemistry] said that although nine drugs are currently available to inhibit the HIV virus, doctors have no way of matching a drug to the unique profile of the virus as it mutates in each patient. Instead, they prescribe a course of drugs and then test whether these are working by analysing the patient’s immune response.
One of the goals of VPH is for such ‘trial and error’ methods to eventually be replaced by patient-specific treatments tailored to a person’s unique genotype. …
Coveney said, ‘This study represents a first step towards the ultimate goal of “on-demand” medical computing, where doctors could one day “borrow” supercomputing time from the national grid to make critical decisions on life-saving treatments.
We have some difficult questions ahead of us, such as how much of our computing resources could be devoted to helping patients and at what price. At present, such simulations – requiring a substantial amount of computing power – might prove costly for the National Health Service, but technological advances and those in the economics of computing would bring costs down.'”

See also “‘Virtual Human’ tests HIV drugs”:
“Tests on a ‘virtual physiological human’ (VPH) have simulated how well an HIV drug blocks a key protein in the lethal virus”.

For the original scientific paper, see “Rapid and accurate prediction of binding free energies for saquinavir-bound HIV-1 proteases”, Stoica et al., J. Am. Chem. Soc., 130 [2008] 2639-48.

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The really desirable development, of course, will be when those toxic antiretrovirals are fed to machines instead of to people.

More De COCK AND BULL stuff and nonsense

In the face of undeniable facts about HIV/AIDS, cognitive dissonance and passionate defense of vested interests are eliciting from official sources statements that call for the talents of comedians in the tradition of Mort Sahl, Tom Lehrer, Jon Stewart, Stephen Colbert, for appropriate commentary.

Kevin De Cock, for example, chief white-coated HIV/AIDS guru at the World Health Organization, said that “Ten years ago a lot of people were saying there would be a generalised epidemic in Asia . . .  That doesn’t look likely” [emphasis added] (Jeremy Laurence, “Threat of world Aids pandemic among heterosexuals is over, report admits”, Independent.co.uk, 8 June 2008 ).

What’s comical here is that De Cock and his cohorts at WHO and UNAIDS were themselves this “lot of people”, and that they were not only saying it but strenuously insisting on it, trumpeting it, repeating it incessantly and brooking no contradiction.

De Cock’s mention that Swaziland suffers an infection rate of  40% also deserves at least a snigger if not a belly laugh. He bemoans that fewer than one third of people in those African countries are getting the antiretroviral drugs they need. Of course even fewer were getting them until quite recently. Since Swaziland and other sub-Saharan countries have had these high rates for a decade or more in absence of treatment, there should by now be few people left alive there. Where then are all the corpses? Rian Malan (1) looked and couldn’t find them. And how did Africa’s population manage to continue to grow at a few percent per year despite all this carnage?

De Cock’s admission that HIV/AIDS is not going to spread outside Africa might have reflected his encounter with reality as co-author of the review article featured in HIV/AIDS ILLUSTRATES COGNITIVE DISSONANCE, 29 April 2008. A colored graph in that article incorporates the assertion that HIV is disseminated by quite different means in different parts of the world. In sub-Saharan Africa, marital sex is indicted for more than 50% of the spread while commercial sex is responsible for only about 10%, whereas in Eastern Europe about 85% of transmission is owing to injection by drug addicts and only about 10% is ascribed to each of “casual sex” and sex between men—no noticeable amount from marital sex or from commercial sex, which latter is indicted in other parts of the world for between 10% and 20% of transmission. Aren’t some of the drug addicts in the former Warsaw pact countries married? Don’t they have sex with their wives? Are there no sex workers there? Don’t the injecting drug addicts there ever have sex with anyone, or do they have only homo-sex?

In both Latin American and the Caribbean, sex between men is supposed to be responsible for about 60% of the spread—but the overall rate in Latin America is twice that in the Caribbean. Is the proportion of gay men in the Latin American population twice that in the Caribbean?

One shouldn’t in any case speak of any spread at all in those regions, given that there has been no reported increase for at least a decade. UNAIDS in its Global Reports and Updates reported for HIV in Latin America, 0.5% for both 1997 and 2007; in the Caribbean, 1.9% in 1997 and only 1.0% for 2007.

Mother-to-child transmission, according to that review article, accounts for 15% of all transmission in sub-Saharan Africa but is barely noticeable in Latin America and the Caribbean and is not even mentioned for Asia and Eastern Europe. Yet in Asia, 25% of transmission is supposed to be via marital sex. How does it come about that all those married women infected via marital sex never pass their infection on to their newborns?

Someone like De Cock who collaborated in authorship of this review article would, I suggest, find unbidden doubts making themselves felt about the whole business of HIV/AIDS epidemics; albeit those doubts might express themselves only in dreams—or nightmares.

Expressing such doubts in the light of day, and from within the World Health Organization, is tantamount to treason. No surprise, then, that WHO and UNAIDS quickly issued a joint “correction” (“Correction to AIDS story in Independent article 8 June 2008; Joint Note for the Media WHO/UNAIDS – Wed, 11 Jun 2008”).

This correction reiterates that “the global HIV epidemic is by no means over. . . . AIDS remains the leading cause of death in Africa. . . . Worldwide, HIV is still largely driven by heterosexual transmission. The majority of new infections in sub-Saharan Africa occur through heterosexual transmission. We have also seen a number of generalized epidemics outside of Africa, such as in Haiti and Papua New Guinea.”

But this in no way speaks to, let alone contradicts, De Cock’s admission that there are not and will not be heterosexual epidemics in the Americas, Asia, Australia, or Europe. That takes all the wind out of the sails of this “correction”; and the last assertion in this press release deserves to be laughed off the stage:
“AIDS remains the leading infectious disease challenge in global health. To suggest otherwise is irresponsible and misleading.”

As already pointed out in our earlier post (WHO SAYS that WE’VE BEEN VERY WRONG about HIV and AIDS? (Clue: WHO = World Health Organization), 10 June 2008 ), numerous official sources have presented evidence over and over again that more people even in Africa die of malaria and other scourges traditionally present there, than die of AIDS.

Peter Piot, collaborator with de Cock in creating “the Belgian disease” of HIV/AIDS in Africa, seems to have acted with better self-preservation instincts than De Cock: “In a little noticed statement in April, Piot said he would step down when his term ended at the end of this year” (“June 11, 2008: First shoe at UN drops: Peter Piot resigns”  and “Liam Scheff at GNN: The Aids machine grinds to a halt” ). When a Director of UNAIDS and Under-Secretary of the United Nations steps down with a “little noticed statement”, something is awry. Why not the traditional press-release citing his desire to spend more time with his family after having accomplished all that he had aimed to accomplish? That no successor was announced amplifies the smell of fish here, in  its indication of haste and confusion rather than orderly transition at the normal end of a term of service.

The cat is out of the bag. HIV is not fueling heterosexually transmitted epidemics—at least not in most of the world. Outside sub-Saharan Africa, heterosexual epidemics are apparent only among other dark-skinned people, according to WHO/UNAIDS in Haiti and Papua New Guinea. It’s just shameful what those black people do in the way of sex—particularly those married ones in sub-Saharan Africa, see TO AVOID HIV INFECTION, DON’T GET MARRIED, 18 November; HIV/AIDS ABSURDITIES AND WORSE, 9 DECEMBER 2007; B***S*** about HIV from ACADEME via THE PRESS, 4 March 2008.
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Citation:
(1) Rian Malan, “AIDS in Africa: In search of the truth” Rolling Stone Magazine, 22 November 2001; “Africa isn’t dying of Aids”, The Spectator (London), 14 December 2003.

Another talk scheduled

On Wednesday next, 18th June, 11 am to noon Eastern time, I’ll be talking again with George Whitehurst Berry at HEARITONLIINE: click on the pink box, top right, “HEAR IT ONLINE! Listen to CRASH!…”.

The program is now set for the Annual Meeting of the Society for Scientific Exploration, Boulder CO, 26-28 June, where I’ll be talking about the “Disproof of HIV/AIDS Theory”, which draws on data in my blog post of 19 March 2008, “HIV DISEASE” IS NOT AN ILLNESS; I’m scheduled for 9-9.20 am Saturday 28th.

COCAINE AND HEROIN AREN’T GOOD FOR YOU! — a Golden Fleece Award

My generation of scientists was familiar with the Golden Fleece Awards bestowed by Senator William Proxmire on federally funded research to find answers that were already known or on topics of no importance. Proxmire would certainly have given an award for the work described by the headline,

HIV-positive illicit drug users have increased risk for opportunistic infections, death, study says (Kaiser Daily HIV/AIDS Report, 8 March 2006)

When Google Alerts delivered me this headline, I naturally inferred that the study had found that “HIV”-positive drug users had a poorer prognosis than HIV-negative drug users. That would have made this just another study showing that if you were “HIV”-positive you were more likely to be ill than if you were HIV-negative, given that testing “HIV”-positive is a sign of physiological stress, albeit not necessarily serious enough to worry about unless your physician decided that you needed to take antiretroviral drugs. Moreover it would have been consistent with several reports that “HIV”-positive drug addicts reverted to HIV-negative, as well as to better health, upon conquering the addiction.

Imagine my delight, not to say surprise, on finding that my inference was dead wrong:

“HIV-positive users of cocaine and heroine have an increased risk for opportunistic infections and death compared with HIV-positive nonusers, according to a study published in the January 4 on-line edition of the American Journal of Epidemiology, Reuters reports. Gregory Lucas of the Johns Hopkins University School of Medicine and colleagues surveyed a total of 1,851 HIV-positive individuals every six months starting in 1998. Researchers grouped the participants into different categories: 1,028 ‘nonusers’; 588 ‘intermittent users,’ who had used illicit drugs an average of 14 days in the last six months; and 235 ‘persistent users,’ who had used illicit drugs an average of 27 days in the last six months. After three years, researchers found that the approximate survival rates were 87% for nonusers, 80% for intermittent users and 68% for persistent users. After adjusting for various factors — including age, race, gender and CD4+ T-cell counts — researchers found that the risk of death was almost double in intermittent users and almost triple in persistent users. During periods when users abstained from illicit drug use, the risk of opportunistic infections decreased to the level associated with nonusers, according to the study.”

Imagine that!

Congress, The National Drug Enforcement Agency, indeed all law enforcement entities, as well as the NGOs that preach “Just say NO to drugs”, will be greatly relieved at this proof that their work has actually had a genuinely substantive basis. No longer need they worry, whether they have an objective basis for their animus against cocaine, crack, crystal, heroin, etc., etc.—now it’s been scientifically proven at last that those substances are health-threatening.

“The observed increase in risk might be attributed to the effect illicit drugs have on the immune system…”
Well. Yes, that seems plausible enough.

But let us not overlook that this whole study involved “HIV”-positive people. So the really major question is, how do cocaine and heroin interfere with treating HIV? So, as Jon Stewart of the Daily Show would say, “Here’s your moment of Zen”:

“The observed increase in risk might be attributed to … failure to adhere to antiretroviral therapy”.

So therefore:

“Effectively targeting and treating active substance abuse in HIV treatment settings may provide a mechanism to improve clinical outcomes”.

Would anyone disagree?

Would anyone have disagreed before this study was ever done??