HIV/AIDS Skepticism

Pointing to evidence that HIV is not the necessary and sufficient cause of AIDS

Archive for November, 2008

Misleading is worse than lying — The case of “HIV-associated” lipodystrophy

Posted by Henry Bauer on 2008/11/10

Years ago, I found instructive — and have remembered ever since — the distinction Paul Halmos makes between misleading and lying:

“There is a difference between misleading statements and false ones; striving for ‘the clear reception of the message’ you are sometimes allowed to lie a little, but you must never mislead….. A part of the art of lecturing is to know when and how to lie. Don’t insist on protecting yourself by being cowardly legalistic, but lead the audience to the truth”
(I Want to Be a Mathematician, 1985, pp. 113 14; for further applications, see To Rise above Principle, p. 168 ff.).

That insight was obviously ignored in a recent blurb from Theratechnologies and its media dissemination:

“MONTREAL, QUEBEC, Nov 06, 2008 (MARKET WIRE via COMTEX)
Theratechnologies presents additional results from its Tesamorelin Phase 3 Studies at the 10th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV
. . . new 26-week data from a combined analysis . . . testing tesamorelin in HIV-associated lipodystrophy were presented as a poster (Poster Number 19) at the 10th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV, in London, England. . . . a daily administration of 2 mg of tesamorelin is beneficial in reducing visceral adipose tissue (VAT) in HIV-infected patients regardless of the type of antiretroviral therapy (ART) regimen used to treat the HIV infection”.

Note “HIV-associated lipodystrophy”, underscored by “regardless of the type of antiretroviral therapy (ART) regimen”: the impression is left, and surely intended, that lipodystrophy is one of the effects of infection by HIV. Neither phrase is a straight-out lie, yet the result is completely misleading:

1. Lipodystrophy is associated with HIV only because antiretroviral drugs are administered to HIV-positive people.

2. That tesamorelin acts against lipodystrophy irrespective of ART regimen is only because all the antiretroviral drugs so far used have been reported at one time or another to induce lipodystrophy.

Those misleading statements are underscored by “Several factors including the antiretroviral drug regimen and the virus itself are thought to contribute to HIV-associated lipodystrophy” [emphasis added]. No source is given, of course, to identify those who “think” “the virus itself” contributes to lipodystrophy.

“The combined trials represented 816 patients who were treated with the following ART regimens: NRTI/PI 45%, NNRTI/NRTI 33%, NNRTI/NRTI/PI 10%, NRTI monotherapy 5% with the remaining other combinations representing 7%. The average time since initial diagnosis of HIV infection was 13 years with the average duration of ART therapy being 4.5 years. Patients in these studies, on average, had been diagnosed with lipodystrophy syndrome for 3.9 years”.

In other words, patients were free of lipodystrophy for an average of more than 9 years (13 minus 3.9) following diagnosis of HIV infection, and contracted lipodystrophy an average of about 7 months (0.6 years, 4.5 minus 3.9) after beginning ART therapy — rather obvious proof that it’s the antiretroviral drugs and not HIV that causes “HIV-associated” lipodystrophy.

Minor points of misleading by omission include that tesasmorelin doesn’t prevent or cure, and addresses only one of several aspects of lipodystrophy, which is “characterized by body composition changes, dyslipidemia and glucose intolerance. The changes in body composition include excess abdominal fat accumulation” [emphasis added]. All that’s claimed for tesasmorelin is that it decreases by about one sixth the amount of fat accumulated around the stomach area; no mention is made of the lipodystrophy-associated loss of fat from other parts of the body, commonly the face: “VAT decreased from baseline by 13% in tesamorelin-treated patients after 26 weeks”.

Wanting to check published scientific sources, I was temporarily frustrated by the statement, “Long term safety results from the first Phase 3 study were published in the Journal of the International AIDS Society, on September 2, 2008”; the actual publication is in AIDS, which is not the Journal of the International AIDS Society, and it appeared on 12 (not 2) September: “Long-term safety and effects of tesamorelin, a growth hormone-releasing factor analogue, in HIV patients with abdominal fat accumulation” by Julian Falutz et al. (corresponding author, Stephen Grinspoon), AIDS  22 [2008] 1719-28.

That article concludes that “Treatment with tesamorelin was generally well tolerated”. However, the detailed results provide grounds for questioning that conclusion. Only 62% completed the one-year study (256 out of the initial 412 patients), presumably because they didn’t tolerate it, for one reason or another. The specific reasons for that large drop-out rate given in Figure 1 include “lack of compliance” (10), “withdrew consent” (22), “lost to follow-up” (6), “discontinued” (59), “had adverse event” (20) — all reasons that could be subsumed under “ NOT well tolerated”, after all. Moreover, Table 3 reports a much larger rate of adverse (162) and serious adverse (9) events; admittedly, only 71 of these are said to be “related to treatment”, prompting the obvious question, to what were the other 100 adverse events related?

The safety of tesamorelin is further said to be supported by the fact that “the death rate in terms of overall person-year exposure to tesamorelin (2/270 patient years, 7.4/1000 person-year), is well below expected mortality rate of patients treated in the modern era of ART (25.4/1000 person-year)”; which prompts further questions:
That ART-era mortality of 25.4/1000 is about 3 times the overall age-adjusted mortality in the United States (see data in annual “Health, United States” reports ), scarcely in keeping with the popular shibboleth that “life-saving” HAART has made HIV/AIDS  a chronic but manageable disease. On top of that, it is simply not to be believed that the mortality could actually be so much less among people treated with tesamorelin , since the only claimed effect is on lipodystrophy, and moreover —as pointed out above — on only one aspect of that.

As so often with the primary literature of HIV/AIDS, the numbers don’t inspire much confidence, and the claimed conclusions inspire even less confidence. In the present case, that may be why the press release — though not, of course, the scientific article about safety — ends with several paragraphs of disclaimers about the claims made for tesamorelin.

Posted in antiretroviral drugs, clinical trials, HIV/AIDS numbers, Legal aspects, uncritical media | Tagged: , , , , , | 12 Comments »

HIV/AIDS comes in, thinking departs and ignorance reigns

Posted by Henry Bauer on 2008/11/09

“Everyone knows” that HIV causes AIDS and that HIV is spread by sex and infected needles. No further thought is then needed to explain facts and propose public policies. For example, in Ghana, the cultural practice of marrying one’s brother’s widow is indicted without further ado for the alleged spread of HIV/AIDS:

“Widowhood inheritance, . . . a cultural practice in the Upper West Region that allows brothers of a deceased to marry his widow after the funeral rites of the deceased, is said to be one of the major causes of the spread of HIV/AIDS in the Jirapa and Lambussie districts.
A Senior Nursing Officer in charge of Public Health for Jirapa, Cecilia Kakariba revealed this during the launching ceremony of the Ghana Congress on Evangelization (GHACOE) Women’s Ministry HIV/AIDS project. . . .
Mrs Kakariba said the scramble by brothers to inherit their deceased brothers’ widows without knowing the cause of death . . . was contributing significantly to the spread of HIV/AIDS as some die of the disease.”

But Mrs Kakariba can’t know that “some die of the disease” . Were it known, then of course the brothers wouldn’t “scramble” to marry the widow; or, if they did, would only take her financial inheritance and avoid the sex part — after all, we know from James Chin (“The AIDS Pandemic” ), among others, that adultery and promiscuity are so rampant throughout sub-Saharan Africa that 20 to 40% of adults are continually engaged in “multiple concurrent” relationships — several sex partners at any given time, and changing partners every few weeks or months; evidently, no male and no female need ever remain without sexual satisfaction for more than a few hours. In that context, a few extra infections from “widowhood inheritance” would be neither here nor there, they would make no noticeable difference.

The worrying spread that is to be curbed has brought “a prevalence rate of 3.3 per cent” — But that’s a level lower than in Ghana’s neighboring countries (Ivory Coast, Togo, Burkina Faso) surrounding, and indeed lower than in all the other countries in sub-Saharan Africa where rates vary from 3.4 to as high as 38%  [Deconstructing HIV/AIDS in “Sub-Saharan Africa” and “The Caribbean”, 21 April 2008]. If any country in sub-Saharan Africa should not be worrying about HIV/AIDS, it’s Ghana!.

The facts are, of course, that HIV isn’t sexually transmitted, and neither is AIDS. Even the mainstream acknowledges that male-to-female transmission (which is, as we know, only apparent transmission) is merely on the order of 1 per thousand, and female-to-male an order of magnitude lower still. But Mrs Kakariba and other nurses, and indeed practicing physicians, can’t spend their time delving into the technical literature. They have to accept what the authorities tell them. So when “The project with financial support from the Ghana AIDS Commission seeks to intensify education to help reduce the spread of the disease in the two districts in particular and the region as a whole”, no nurse and no doctor has reason to question the conventional wisdom; surely governments don’t provide “financial support” unless there’s a very good reason to do so. And the media, of course, simply parrot official pronouncements without looking into what the facts are. “Investigative journalism” all too often amounts to no more than asking the experts.

Posted in experts, Funds for HIV/AIDS, HIV transmission, HIV/AIDS numbers, sexual transmission, uncritical media | Tagged: , | 2 Comments »

Defenders of the HIV/AIDS Faith: Why Anonymous?

Posted by Henry Bauer on 2008/11/06

I’ve used the Internet pretty much from its inception, at first chiefly for e-mail, of course. I tried a few on-line lists, groups, discussions on various topics pertinent to my academic interests — for example, fraud in science — or on my hobbies — Loch Ness monsters, say. These were open to all who wanted to participate, and participants were open about their identity; electronic communication was just adding some speed and convenience to exchanges that we’d been engaged in via letters, conferences, phone calls.

Some of the discussion groups touched on fairly controversial matters, like political correctness and associated sensitive topics like race, IQ, affirmative action. Still, we knew who everyone was, where they worked, what their professional credentials were; and — possibly for that reason — lack of civility was rare, even as disagreements could be stark and forcefully expressed; ad hominem innuendo or direct attacks didn’t feature. I didn’t stay long with any list or discussion, though, because I so rarely learned anything new.

I came late to the ranks of HIV/AIDS Rethinkers and Skeptics. It was around 1995 that I first discovered, through reading Ellison & Duesberg, “Why we will NEVER win the war on AIDS”, that some people question whether HIV is the cause of AIDS — people with impressive and relevant credentials. I was sufficiently intrigued to read more. Bialy’s scientific biography of Duesberg caused me to consult primary sources about HIV tests, and thereby to discover that “HIV” is not infectious and doesn’t correlate with “AIDS”. Astonished, bemused, I looked for people with whom I could discuss the matter, and that caused me to visit, and sometimes to send comments and questions to, a number of web-sites and blogs. In too many cases, I was appalled at the level of “flaming” as well as the lack of substantive discussion, indeed the prevalence of violently asserted claims on factual matters without the benefit of supporting citations to reliable publications.

Those experiences informed my decisions when I set up this present blog as a means of furthering substantive discussion:

“All comments are moderated, and may be edited.
I have a  great preference for comments that are concise, substantive, and not ad hominem.
Giving a fake e-mail address makes it less likely that your comment will be accepted.
. . .  please understand that I can only respond if the e-mail address you give is a valid one. For example, e-mails cannot be delivered to ‘anonymous@anonymous.com’.”

Because of the blog, I’ve learned a great deal from commentators and correspondents, and I’ve been stimulated to look into an increasing range of HIV/AIDS-related matters. Tony Lance provided to the salient question, “So what did cause AIDS?”, a highly plausible suggestion supported by a large variety of published evidence [“What really caused AIDS: Slicing through the Gordian Knot”, 20 February 2008]. Invitations to comment on various “news” items led me to look, for the first time, into statistics about deaths from “HIV disease”, and to discover another clear disproof, or set of disproofs, of HIV/AIDS theory [“’HIV Disease’ is not an illness”, 19 March 2008;  “HAART saves lives — but doesn’t prolong them!?”, 17 September 2008]. I’ve heard from a number of individuals who have experienced at first hand the psychological and physical damages wrought on healthy people by diagnoses of “HIV-positive” followed by antiretroviral “therapy”; and those interactions in particular keep me constantly aware of how important it is that HIV/AIDS theory be publicly discarded.

But I’ve also learned quite a lot about the deplorable behavior of fanatical HIV/AIDS true-believers, groupies, and vigilantes [“Dissenting from HIV/AIDS theory”, 8 December 2007]. It’s not only the disgustingly ad hominem nature and sadly lacking-in-intellectual-substance content of so many of the “mainstream” HIV/AIDS blogs, I’ve also been taken aback at underhanded approaches, via comments sent to my blog as well as e-mails to me direct, from individuals (I suppose individuals, but of course it could be groups) whose purpose is not to discuss substantive issues but to find ways to discredit and undermine AIDS Rethinking. For example, a graduate student evidently took the trouble to read my memoir about academic deaning and at least some  issues of a newsletter that I had edited for a number of years in order to mis-interpret as homophobic and racist a few out-of-context quotes in a “review” of my book on amazon.com (that review is no longer there, at one time there was a note that it had been withdrawn by the author, but even that note is no longer there). Another vigilante posed as a graduate student in personal e-mails to me, fishing for information about Rethinker doings. Several comments have been submitted anonymously to my blog — for example by “Fulano de Tal” [“John Doe and his ilk: pitfalls of pseudonymity”, 28 August 2008], alleging mistakes in factual matters, yet when I requested citation of sources for those facts, I never heard more.

Those communications led me to ponder the apparently common practice of participating anonymously in Internet discussions. Why would one do that? (I would be interested to learn of any scholarly discussions of Internet anonymity, how the practice started, what justifications there might be for it, and so on.)

I can’t bring myself to engage in discussion with people who are unwilling to tell me who they are. It throws immediate doubt on their bona fides. Signing one’s name to one’s opinions seems to me the natural as well as proper thing to do, and I’m one of those who always signed manuscript reviews even when the journal policy did not require it. I think it’s a useful form of self-discipline, to ensure that one is being as honest and unbiased as humanly possible.

I can understand why whistle blowers must practice anonymity — except with the appropriate investigating authority to whom they bring grievance; and I understand why HIV/AIDS Skeptics are sometimes forced to remain anonymous in view of the career-threatening activities boasted of by people of the ilk of Wainberg and Moore (“AIDS and the dangers of denial”, Globe and Mail, 4 July 4 2007). But why would AIDStruth groupies and other supporters of mainstream views be unwilling to communicate openly and honestly? What are they afraid of? Do they sense subconsciously that they have no substantive grounds to stand on and that they must fight by innuendo and attempted character assassination? Why are they ashamed to let others know who they are?

Posted in HIV skepticism, Legal aspects | Tagged: , , , | 14 Comments »