Defeating HIV/AIDS — in the court-room

A few days ago I posted hurriedly  the splendid news that the Office of Medical and Scientific Justice  had been able to organize witnesses and defending lawyers to achieve a signal success against the HIV/AIDS true-believers and the misguided belief that “HIV-positive” individuals present a danger to their sexual partners.
An Army sergeant was acquitted despite admitting that he had not informed several women of his status as “HIV-positive” before they engaged in consensual condom-protected sexual intercourse. The crucial point: there was reasonable doubt as to whether the sergeant was “infected with HIV” because

it was established that
 no “HIV” tests prove infection

Lawyer David Steele was an observer at the proceedings and describes them in an audio piece  that makes fascinating hearing. Listen also to Steele’s interview on the Robert Scott Bell show.

I was reminded of the remark that “the most rigorous peer review . . . comes from cross-examination . . . in the courtroom” (Sheldon Krimsky, “Protecting scientific integrity”, Chemical Heritage, 27 [#1, Spring 2009[ 42-3).

In the Robert Scott Bell show, astonishment was expressed several times that someone could be found to be infected on the basis of antibody or PCR tests and in absence of any symptoms of illness. Actually, diagnosis on the basis of lab tests and irrespective of clinical condition or examination has become quite routine practice in medicine. As I had mentioned in “Medicine isn’t science — nor should it be”, Jeremy Greene in Prescribing by Numbers recounts the history of how this has come about. But surely everyone is now familiar with the constant refrain of “know your numbers” — about cholesterol, blood pressure, blood sugar, just about anything that can be measured by numbers.
So ingrained is this that even recommendations by mainstream medical associations have not been able to bring about change in actual practices. For example, for years competent clinicians and researchers have warned against routine use of PSA tests as a purported way of screening for prostate cancer, because PSA numbers produce so many false positives and unnecessary biopsies that carry a certain risk, for instance of infection; yet this abuse of PSA tests continues to be widespread. The Institute of Medicine has pointed out that many of the biomarkers in common use are simply not valid measures of the ailments that they supposedly detect: Tumor size is not a measure of cancer progression or prognosis. Blood pressure or cholesterol (“bad”, total, ratio, whatever) do not measure progression or prognosis of heart disease (Evaluation of Biomarkers and Surrogate Endpoints in Chronic Disease, Institute of Medicine, 2010).
Moreover, treatments intended purely to bring the numbers to a supposedly appropriate value have not been shown to preserve health; a recent article in the British Medical Journal points out that “there are no valid data on the effectiveness” of “statins, antihypertensives, and bisphosphanates” (the last are prescribed against osteoporosis; see Järvinen et al., “The true cost of pharmacological disease prevention”, British Medical Journal 342 [19 April 2011] d2175). doi: 10.1136/bmj.d2175. Indeed, statins do more harm than good: “side” effects include myalgia, fatigue, dyspnea, memory loss, and peripheral neuropathy (Langsjoen et al., BioFactors 25 [2005] 147–152).
But try telling that to your family physician or your specialist and see how they react.

The point is that HIV/AIDS is quite a natural consequence of deeply ingrained attitudes and practices in modern medicine. Once an approach has come into general use, it is extremely difficult to modify let alone discard it, no matter how much evidence accumulates that the approach does more harm than good. Too many interests become vested in the “standard” way of doing things: the authority and prestige of medical authorities, the unwillingness or inability of practicing physicians to question official doctrine or what drug companies tell them, the profits made by manufacturers and clinical labs from tests and devices, the profits made by Pharma which supplies the drugs used to treat the numbers . . . .
The HIV/AIDS blunder differs only in scale from present-day test- and drug-centered medical practice. Admittedly, antiretroviral drugs have done immediate harm to many more people (Hidden in plain sight: The damage done by antiretroviral drugs, 2011/07/25) than have the blood-pressure-lowerers and blood thinners and statins and bisphosphanates and the other popular prescription drugs — AZT alone killed about 150,000 in a decade in the USA alone (HAART saves lives — but doesn’t prolong them!?, 2008/09/17). Still, one has only to note the increasing rate at which drugs have to be withdrawn from the market, sooner and sooner after the initial approvals, and to note the proliferation of class-action lawsuits ( e.g. regarding Fosamax or Pradaxa) to realize that present-day drug-based medical practice represents a genuine danger to global public health.

It is simply no longer possible to believe
 much of the clinical research that is published,
 or to rely on the judgment
 of trusted physicians or authoritative medical guidelines.
 I take no pleasure in this conclusion,
 which I reached slowly and reluctantly
 over my two decades as an editor
 of The New England Journal of Medicine

—— Marcia Angell
“Drug companies and doctors: a story of corruption”
New York Review of Books, 56 #1, 15 January 2009

Dogmatism in science and medicine

It never rains but it pours, as they say. On the same day as I learned of the exciting court decision exonerating an “HIV-positive” person because “HIV” tests do not  diagnose infection — see previous post (Federal court finds “HIV” tests flawed) — I also received the first copies of my new book, Dogmatism in Science and Medicine: How Dominant Theories Monopolize Research and Stifle the Search for Truth (McFarland 2012), which is now featured at the top of the left-hand sidebar of this blog.

The arrogant unscientific dogmatism of the HIV/AIDS true-believers is far from unique, there’s something quite similar in many other fields: Big-Bang cosmology, dinosaur extinction, theory of smell, string theory, Alzheimer’s amyloid theory, specificity and efficacy of psychotropic drugs, cold fusion, second-hand smoke, continental drift . . .
The consequences with HIV/AIDS are incomparably more damaging to innumerable people than in those other fields; but there are comparably damaging economic consequences of actions based on true belief in human-caused global warming. When a dogmatic opinion about a matter of science gets mixed up with politics and with corporate interests and with social activism, that view can become as set in stone and harmful in free societies as was Lysenkoism in the Soviet Union.

That’s what this book is about. It also argues that this is a distinctly new development in science, and suggests possible ways to limit the damage. There needs to be some way of separating and insulating truth-seeking science from State and Church and other institutions of that ilk.

AIDS Rethinkers will find that much of the supporting documentation in the book is drawn from inside knowledge of the HIV/AIDS mess; in particular, a whole chapter describes and analyzes the destruction of Medical Hypotheses by Elsevier. But there are ample data from other fields as well.

I would be very grateful if friends of this blog would recommend the book for purchase by their local libraries.

Federal court finds “HIV” tests flawed

The Office of Medical and Scientific Justice helped attorneys gain dismissal of all charges against an “HIV+” Army sergeant who had had sexual intercourse with several women. Read about this signal victory at Military Court Acquits Soldier in OMSJ Case

Spinning Truvada

Propaganda and spin seek to mislead without actually lying. Drug companies have mastered this strategy to a notable degree. Take the case of Truvada. As my previous post discussed, the data submitted as showing tenofovir successful in preventing “HIV transmission” don’t actually support the claim; and years of experience of using Truvada to treat “HIV infection” have shown that it is toxic, particularly to the kidneys.
Those unpleasant facts are hidden in plain view by adept techniques of spin. For example,  statistically non-significant results are displayed as though they were significant:

Missing is any discussion of whether that difference, which is not at all impressive, actually means anything. But worse than that, only fine print then acknowledges that the difference in fact doesn’t even exist:

I suggest that the average person who has not much familiarity with probability and statistics would not recognize that this fine print completely debunks the claim made in large red-highlighted print.

Caveats are also stated without explaining what they actually mean. For example,

Perhaps only AIDS Rethinkers will immediately recognize this as demolishing a whole raft of mainstream claims. There’s a sub-industry now of the larger HIV/AIDS industry basing its recommendations and actions on the shibboleth that treating “HIV infection” and lowering “viral load” decreases transmission of “HIV”; yet here we’re told that Truvada decreases “viral load”, ¾ of the time to an undetectable level, and yet doesn’t “lower the chance of passing HIV-1 to others”.

“Side” effects are swept under the rug:

What, one might wonder, did all the other studies show? After all, tenofovir is acknowledged to be particularly hard on kidneys, which is not mentioned here. Furthermore, “≥5%” has a superficial appearance of being negligible — 5% is small, after all — when in practice ≥5% might stand for 50% or 80% or 100%; that wouldn’t be lying, just misleading.

That ≥5% is followed immediately by

Some people” — sounds like maybe one or two or three, doesn’t it? Certainly in this context much fewer than 5% . . . .

The main Truvada website is skillfully designed to illustrate that its greatest concern is to help people, with links to more information:

One of the psychological ploys commonly used by drug companies is to make sure “patients” understand that they are permanently in need of medication because the “illness” belongs to them: “managing your HIV” drives home the message that you have no choice about it, it belongs to you, it’s a part of you. Similarly, ads for anti-depressants show cheerful people talking about “managing my depression” (when anti-depressants are hardly better than placebo, and might be beneficial only in the most severe depressions, during which no one would be talking cheerily about managing it).
This personalizing of ownership of a disease with implication of permanent patient-hood is facilitated by making it a non-technical, sort of friendly, everyday thing to have. One of the current fads is to tell everyone whose electrocardiogram shows the slightest occasional flutter that they have atrial fibrillation, and that Pradaxa — for example — can reduce the risk of stroke by a factor of 5. But “atrial fibrillation” is quite a mouthful, so the ads very helpfully tell you that it’s also called “Afib”. Easy to talk about with friends, even sounds quite cute.

Truvada uses another semantic ploy to underscore subliminally what a great medication it is:

Ask anyone in the street what “nuke” means, and they’ll tell you it’s an atomic bomb that can wipe out anything. Clearly we’re being sent the message that Truvada and other NRTIs can wipe “HIV” off our maps.
That’s true, in a sense. But the collateral damage is that they also kill us, albeit a bit more slowly by damaging mitochondria, liver, kidneys, heart . . . .

Unlimited insanity: Truvada to prevent HIV

In my memoir of serving as an academic dean, I had written “I would find myself thinking, Now I’ve seen everything; nothing can surprise me anymore, only to experience a novel surprise the next day or the next week”. That’s how I’ve been feeling the last few days as the media have being hyping the approval by the Food and Drug Administration of prescribing Truvada to prevent HIV infection — administering Truvada to perfectly healthy people as supposed prevention.

Truvada is emtricitabine (FTC) plus tenofovir (TDF). In “HAART is toxic: Mainstream concedes it, in backhanded ways”, I cited earlier blogs about the toxicity of tenofovir  and a few salient bits:
— The federal warning that “Tenofovir  . . . alone or in combination . . . may cause serious damage to the liver and . . .  lactic acidosis”
— The manufacturer’s warning that “Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with . . . nucleoside analogs, including tenofovir”
— “increasing exposure to tenofovir was associated with a higher incidence of CKD [chronic kidney disease] . . . . and there are numerous studies . . . demonstrating that tenofovir is associated with impaired kidney function”.

For the combination of  FTC plus TDF, the NIH Treatment Guidelines (updated 14 October 2011) cite as advantages superiority in suppressing viral load and also these disadvantages:
“• Potential for renal impairment, including rare reports of Fanconi syndrome and acute renal insufficiency
• Potential for decrease in bone mineral density”
(as well as failure to suppress viral load when combined with nevirapine [!])

Given these serious and quite common toxicities, what is the supposed benefit of PrEP — pre-exposure prevention or prophylaxis — with Truvada?
A couple of years ago I discussed the failure of TDF in a PrEP trial: “Pre-exposure prophylaxis: A flawed clinical trial that no one should take seriously”. The media descriptions of the evidence on which the FDA and its Advisory Panel approved Truvada for PrEP suggest that this evidence is again anything but trustworthy:
“The committee voted 19-3 in favor of approval for the prevention indication — PrEP for HIV-uninfected men who have sex with men and 19-2 with one abstention for HIV-uninfected partners in couples where the other partner is infected. The committee recommended by 12-8 with two abstentions in favor of approving the drug for individuals who engage in risky sexual behavior that could result in their contracting the virus” (Panel recommends approving Truvada to prevent HIV infection, Sandra Young, CNN, 10 May). Those votes mean that the panel judged it a greater risk when HIV-negative men have sex with men, or when the uninfected partner in a couple where the other is infected, than when “individuals . . . engage in risky sexual behavior that could result in their contracting the virus”? What possible basis could there be for such a comparative judgment?
“Committee members also heard concerns about the drug’s side effects, which can include nausea, vomiting, dizziness, loss of appetite and diarrhea, liver and kidney toxicity and loss of bone density”. Those committee members will not be able in the future to deny that they were voting to cause iatrogenic harm to healthy individuals who had other options for protecting themselves.
As history lauds in retrospect the FDA officer who held off from approving thalidomide, so in future we may look back approvingly on the attempt to block Truvada PrEP by one member of the committee:
“Dr. Lauren Wood of the National Cancer Institute said she voted against all preventive applications because clinical studies did not measure the dangers of drug-related renal problems among black people, who are among the hardest impacted by HIV infection and the most susceptible to kidney problems linked to AIDS drugs”.

Two-faced arguments are ubiquitous in the HIV/AIDS Wonderland. Typical of the mainstream Janus-faced propaganda were such comments as, on the one hand,  “What we need currently is additional tools” even though, on the other hand, there already exists a “powerful tool box” which nevertheless hasn’t been any good: “We are not winning the battle” — all these comments are from the same individual.
“”Existing interventions have not reduced the number of new infections annually” (FDA panel backs Gilead’s Truvada to prevent HIV).
“Truvada first made headlines in 2010, when government researchers showed it could prevent people from contracting HIV. A three-year study found that daily doses cut the risk of infection in healthy gay and bisexual men by 42 percent, when accompanied by condoms and counseling” (Truvada for HIV prevention backed by advisory panel, FDA may decide by June). That’s the study I debunked in “Pre-exposure prophylaxis: A flawed clinical trial that no one should take seriously

Apparently this panel of experts was not aware of Nancy Padian’s success, more than a decade ago, in totally preventing infections merely by counseling and advising use of condoms: “We observed no seroconversions  after  entry  into the study” (Padian et al., American Journal of Epidemiology 146 [1997] 350-7) among 175 discordant couples with >280 couple-years of follow-up; and they attributed the lack of transmission to the success of counseling. Since counseling brings no serious physiological side-effects, and the preventive success is 100%, there would seem to be no need for Truvada with its serious side-effects.

The case against approving Truvada PrEP is entirely separate from AIDS Rethinking: Mainstream data speak against administering so toxic a drug to healthy people, no matter how high may be estimated their risk of contracting a virus that supposedly causes illness only after an average latent period of a decade or so, and that is controlled without medication among some proportion of the infected, the “elite controllers”. Truvada PrEP incurs the certainty of early iatrogenic illness in exchange for some probability, which is undoubtedly low, given that the transmissibility of HIV with sex is on the order of 1 per 1000 unprotected acts.

On the PBS NewsHour on May 11, Anthony Fauci was featured. Not a single word was spoken about the toxic “side” effects. Not mentioned was the very low transmissibility, nor Padian’s astounding success with counseling and condoms. The only concerns mentioned had to do with cost and the need to adhere strictly to a pill-a-day. Fauci’s statements were fine examples of bureaucratic mumbo-jumbo, for instance:
“[I]t would add to the armamentarium of proven prevention modalities.
Prevention for HIV is really a comprehensive, multifaceted group of prevention modalities that’s kind of a tool kit. This one can be potentially very effective. So if it’s approved and added to the recognized prevention modalities, it would be an important advance in making available for certain people a very effective way to prevent HIV infection.”

To me, Fauci looked very stiff, as though he was unenthusiastic but trying to make up for it with plenty of “clearly”, “absolutely”, and the like. Could the utter absurdity of this FDA approval perhaps have penetrated his armamentarium of cognitive-dissonance modalities?

As I said at the outset: I thought I was familiar with all the aspects of the HIV/AIDS blunder, only to hear about this scandalous extrapolation of earlier misdeeds: hyping faulty evidence to give official approval to the poisoning of innumerable healthy individuals in a hugely expensive way ($12,000-14,000 annually).