HIV/AIDS Skepticism

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

Posts Tagged ‘antiretroviral drugs’

FIRST: DO NO HARM!

Posted by Henry Bauer on 2007/12/19

That’s supposed to be the medical profession’s motto. If unsure whether available treatments will help, and especially if there’s a chance that they might harm—do nothing; practice “watchful waiting”.

HIV/AIDS practices take the opposite approach. In the determination to get rid of HIV, it is sometimes forgotten that the whole point is to make people better (WHAT HIV DRUGS DO, 15 December 2007).

“HIV-infection” has never been demonstrated in more than 1% of the immune-system cells that HIV supposedly targets. Antiretroviral drugs cannot discriminate between infected and non-infected cells of this class. To prevent the infected cells from producing more virus, we administer substances that kill all the cells. To get rid of 1 guilty party, we execute 100 or more innocent ones.

Cells are not persons, of course. But if we kill or damage enough innocent cells in a person—cells that are innocent but essential to health—, then we certainly harm and may kill that person.

* * * * * *

Inasmuch as ye have done it unto . . . the least of these . . . , ye have done it unto me
(attr. Jesus)

Babies are certainly persons.

It’s estimated that 15-30% of HIV-positive mothers pass “HIV infection” on to their babies—between 1 in 3 and 1 in 6 of their newborns are HIV-positive, in other words. To avoid that, HIV/AIDS experts recommend that all HIV-positive mothers be treated with substances that are known to produce serious damage to the babies. To perhaps safeguard 1 baby from the possible but not certain deleterious effects of HIV, harm is knowingly done to between 2 and 5 babies who would otherwise be healthy.

Dissidents would point out that this ratio, between 2 and 5 to 1, is excessively conservative. Being born HIV-positive does not prove the presence of active infection. Upwards of 75% of HIV-positive newborns revert spontaneously to HIV-negative in about the first year, because their HIV-positive test was triggered by “passive” antibodies transferred from the mother (see p. 97 ff. in The Origins, Persistence and Failings of HIV/AIDS Theory). So the odds are increased by a factor of at least 4: to prevent the birth of 1 “HIV-infected” baby, between 8 and 20 newborns who would otherwise be healthy are knowingly exposed to harm.

I said “possible but not certain” deleterious effects of “HIV infection” because
1. Some unknown proportion of HIV-positive people are “elite controllers” or “long-term non-progressors” who remain, untreated, in good health.
2. On average, it is supposed to take 10 years before “HIV infection” leads to symptoms of illness.

Research continues apace to develop better and less toxic treatments for “HIV infection”. Research continues apace for vaccines which, even if not effective in preventing “infection”, might nevertheless enable HIV-positive people to become, in effect, long-term non-progressors. With any luck, some success along those lines might be attained within a decade or so. That would be in time to help an appreciable proportion of babies now being born “HIV-infected”.

So: It is anything but certain that any given HIV-positive newborn will actually experience harmful consequences; and it is anything but certain, how serious those consequences will be if they do eventuate.

By contrast, the damage done by perinatal antiretroviral treatment is certain and serious. Very serious. Perinatal antiretroviral treatment brings both short-term and long-term harm, documented in considerable detail in the dozen-and-a-half articles in Environmental and Molecular Mutagenesis, 48, #3-4, April-May 2007, which a correspondent drew to my attention recently.

The lead review article (by Kohler & Lewis, pp. 166-72) cites “therapeutic experience”—that is, observations on human babies—that NRTIs, the backbones of standard antiretroviral treatment, damage the mitochondria.

Further: “Clinical and biological observations of mitochondrial dysfunction in children exposed to zidovudine (azidothymidine, AZT) during the perinatal period rapidly followed similar observations in animal experiments”—these were uninfected children born to HIV-infected mothers. One third of the babies had hyperlactatemia, which seemed to reverse within some months after treatment ceased but did sometimes lead to lactic acidosis, which can be life-threatening. Between 1 in 20 and 1 in 35 babies also developed severe neurological symptoms during the first 2 years of life, a phenomenon confirmed in several other studies (Benhammou et al., pp. 73-8).

Again, in the article by Sherine Chan et al. (pp. 190-200): “mitochondrial DNA (mtDNA) damage has been observed in both human and mouse neonates following perinatal exposure to AZT and AZT/3TC” as well as “NRTI-induced heart damage . . . in human infants”. Divi et al. confirm that “Transplacentally exposed human and monkey newborn infants show similar evidence of nucleoside reverse transcriptase inhibitor-induced mitochondrial toxicity”. Witt et al. (pp. 322-9) reiterate that “transplacental ZDV exposure is genotoxic in humans”.

One can predict with reasonable certainty that damage to the mitochondria of infants will have seriously debilitating consequences, probably during the whole span of a life that is also significantly shortened. Mitochondria are the energy centers of all mammalian cells. Their dysfunction can lead to a number of degenerative diseases and their deterioration over time, as mutations in their mtDNA accumulate, is one of the causes of senescence, perhaps even the most important one (Linnane et al., “Mitochondrial mutations as an important contributor to ageing and degenerative diseases”, Lancet 1989: 642-5 and further references in Linnane & Eastwood, Mitochondrion 2004: 1-11).

Should the children with damaged mitochondria live long enough, they are likely to contract cancers: “perinatal exposure to nucleoside analogs puts children at elevated risk of developing cancers later in life” (Wogan, pp. 210-4). In cultured cells, AZT produced “micronuclei, chromosomal aberrations, sister chromatid exchange, shortened telomeres, and other genotoxic effects” (Olivero, pp. 215-23). In experiments with mice, “Mutagenicity experiments with ABC [abacavir] alone, or in combination with AZT-3TC, were complicated by the extreme cytotoxicity of ABC” (Torres et al., pp. 224-38); “all NRTIs with antiviral activity against HIV-1 may cause host cell DNA damage and mutations, and impose a cancer risk” (Carter et al., pp. 239-47). “AZT, 3TC, and the combination of AZT and 3TC are transplacental mutagens” (Von Tungeln et al., pp. 258-69). Rats and mice dosed with AZT developed hemangiosarcoma (a “rare, rapidly growing, highly invasive variety of cancer”), mononuclear cell leukemia, liver cancers, and gliomas (brain tumors) (Walker et al., pp. 283-98); also “alveolar/bronchiolar adenomas and carcinomas . . . benign and malignant lung neoplasms”, since “incorporation of AZT or its metabolites into DNA, oxidative stress, and genomic instability may be the contributing factors to the mutation profile and development of lung cancer” (Hue-Hua Hong et al., pp. 299-306).

* * * * * *

AZT and its cousin NRTIs damage the mitochondria, whose proper functioning in all cells is essential to health. AZT and its cousin NRTIs also cause mutations that lead to all sorts of cancers.

The toxicity of AZT was known long before its introduction as an antiretroviral drug: it had been found too toxic to be used in cancer chemotherapy. Several of the papers cited above refer to similar damage in humans as in rats, mice, and monkeys: either there had not been studies in animals before the drugs were used in human beings, or the drugs were used in humans even though animal studies had shown cell and mitochondrial toxicities and carcinogenicity. Olivero (215-23) attempts an excuse: “Detailed information on the mechanisms underlying NRTI-associated antiretroviral efficacy, toxicity, and metabolic resistance were not available when AZT was first approved for use as an antiretroviral agent”; sure, “detailed information” wasn’t available, but it was certainly well known that AZT is toxic—see the oft-reproduced label below, and note the irony of “For laboratory use only. Not for drug, household, or other uses.” That’s how this chemical was described when it was introduced as an antiretroviral drug.

aztlabel.jpg

* * * * * *

Trying to understand how anyone could treat pregnant women and babies in this fashion, I can only conclude that the single-minded determination to wipe out HIV has outweighed all other considerations. Half-a-dozen of the cited articles emphasize that perinatal antiretroviral treatment has been shown to reduce mother-to-child transmission of HIV, as though this were the prime necessity by comparison to the damage known to be done by the drugs:

Acknowledged was “the necessity for effective protective strategies against NRTI-induced side effects” (Walker et al., 283-998). But what “protective” strategies are conceivable? Other than not using NRTIs, of course.

There is a repeated disingenuous call for careful monitoring of the damaged children, as though any amount of monitoring could undo the damage:
“the importance of continued surveillance of these children for increased cancer risk and . . . less genotoxic alternative agents” (Wogan, 210-4) ; “the mutagenic effects found in mother-child pairs receiving AZT-based treatments justify their surveillance for long-term genotoxic consequences” (Escobar et al., 330-43). “While these data support the continued use of AZT-based therapies during pregnancy, infants receiving prepartum AZT should be monitored long-term for adverse health effects” (Meng et al., 307-21). “Long-term monitoring of HIV-uninfected ZDV-exposed infants is recommended to ensure their continued health” (Witt et al., 322-9)–as though monitoring could “ensure continued health”!

* * * * * *

When AIDS was first noticed, the belief became embedded that it is inevitably fatal. When HIV was subsequently designated the cause of AIDS, the belief became that “HIV-positive” is inevitably fatal. That belief has continued to co-exist in company with its own disproof: the knowledge that some proportion of HIV-positive people (“elite controllers”, “long-term non-progressors”) never become ill, that HIV-positive people live a healthy life on average for 10 years before HIV-induced symptoms appear, and the shibboleth that “HIV is now a manageable disease”.

Damaging the mitochondria of newborns and subjecting them to significant risk of cancers is incompatible with current knowledge. A doubtful benefit to one newborn is being achieved at the cost of serious damage to at least 2, and perhaps 20 or more newborns who were never at any risk in the first place.

Is anyone reminded of burning witches at the stake in order to save their souls and wipe out the devils that had possessed them? Or, in more recent times, destroying a village in Vietnam in order to save it for democracy?

Posted in antiretroviral drugs, experts, HIV in children, HIV tests, HIV transmission, HIV varies with age, HIV/AIDS numbers | Tagged: , , , , , , | 1 Comment »

CONFLICTS OF INTEREST

Posted by Henry Bauer on 2007/12/15

Healthy people are told to take drugs known to cause severe “side” effects that some find literally intolerable (see WHAT HIV DRUGS DO, 15 December; OFFICIAL GUIDELINES FOR HIV TREATMENT, 14 December; ANTIRETROVIRAL DRUGS: HISTORY AND RHETORIC, 12 December; BEST TREATMENT FOR HIV: THIS YEAR’S ADVICE, LAST YEAR’S, OR NEXT YEAR’S? , 10 December 2007).

These debilitating drugs are recommended by people who have vested financial and career interests in them through connections with drug companies–a clear case of conflicts of interest. This in itself should discredit, thoroughly and completely, everything in the Treatment Guidelines featured in those recent posts.

The Panel responsible for the December 2007 Guidelines had two co-chairs, both with financial connections to drug companies. Only 3 of the 24 Panel members disclaimed such a conflict of interest. More details about the connections of some HIV experts to drug companies can be found at http://www.shillfactor.net/.

Recall that the most important criterion for each recommendation is “expert opinion” (BEST TREATMENT…, 10 December). Perhaps the most basic fact about conflicts of interest is that they influence opinions.

The significance of conflicts of interest is widely ignored in contemporary affairs in the United States, and not only in science and medicine. Circumstances have become accepted as normal which, if occurring in other countries, would be easily recognized as utterly corrupt. Here’s a synopsis of Conflicts of Interest 101.

If I teach a class that has my daughter in it, no conscious effort on my part can ensure that she will be treated in exactly the same manner as the other students. Subconscious and unconscious emotions can influence my thoughts and actions in ways that I am unaware of and therefore cannot do anything about. No matter how consciously honorable and upright I may be, no matter how unfailingly rule-abiding and law-abiding and ethical in all my other interactions, there can be no guarantee that my daughter will not receive some degree of special treatment.

THE ONLY SAFEGUARD AGAINST THE POSSIBLE INFLUENCE
OF CONFLICTS OF INTEREST IS TO HAVE NO CONFLICTS OF INTEREST.
PERIOD.

Once upon a time, this was widely understood. That time was not even so long ago. When President Eisenhower nominated Charlie Wilson, the CEO of General Motors, as Secretary of Defense, Wilson was asked about a possible conflict of interest. His response was,

“What’s good for General Motors is good for the country,
and what’s good for the country is good for General Motors”.

The naive absurdity of that response was so widely appreciated at the time that it was featured in cartoons and comic strips and late-night comedy shows. Collections of quotations and infamous sayings still feature it. Check it out: just Google “What’s good for General Motors”.

Nowadays, the experts who draw up Treatment Guidelines, and the people who choose those experts to make up the Panel, are telling us implicitly that what’s good for the drug companies and for those who consult for them and get grants and presents from them is also good for the rest of us, for the people who will be using the drugs and for those who will be paying for the drugs.

At a conscious level, no doubt these are all ethical, well-intentioned, upright people who would never allow possible financial gain to sway their expert scientific judgment. But they are no more able to control their subconscious drives than I could control mine about my daughter in class.

In fact, to venture some amateur psychological speculation, the most consciously upright and ethical people are also those most likely to succumb to subconscious corruption, because they are least on guard against the possibility. Furthermore, human beings are protected against acknowledging to themselves their own misdeeds, through the phenomenon of compartmentalization: we can and do hold incompatible views simultaneously, and we manage to do things while imagining not only that we are not doing them but even that we never would do them:
Think Jimmy Swaggart and other sinners who preach against sin.
Think ex-Senator-to-be Larry Craig.
Recall the sublimely naïve response of David Baltimore when asked about a potential conflict of interest: “I think people are entitled to ask that of me. But I do think the statements and decisions I make come from the highest sense of integrity” (Chemical & Engineering News, 15 March 1982, 12).

Of course he thinks that. They all do. WE all do.
That’s why we have to be protected against ourselves, against doing for unconscious reasons what we would not wish to do. That’s why the only protection against undue influence is to have no conflicts of interest at all.

THE ONLY SAFEGUARD AGAINST THE POSSIBLE INFLUENCE
OF CONFLICTS OF INTEREST IS TO HAVE NO CONFLICTS OF INTEREST.
PERIOD.

 

Andrew Stark, in the book “Conflict of Interest in Public Life”, makes it very clear. There are three aspects of a conflict of interest:
1. The connections
2. The associated state of mind
3. Actions that may stem therefrom

For example:
1. My daughter is a student in the class I teach
2. My feelings about her and my attitudes toward grading
3. I assign a grade

Or:
1. X consults for a drug company
2. X’s judgments about the drug company’s products
3. X recommends wider use of the company’s product

Stark points out that there is no way of knowing or finding out, what my state of mind was when I awarded the grade, whether my love for my daughter influenced it one way or the other, favoring her or overcompensating against favoring her; and there is no way of knowing whether X’s attitude toward the drug company influenced the decision to recommend its product.

However, any number of studies have amply confirmed that on average, statistically, such situations do influence the resulting actions: those experts with conflicts of interest are more likely than others to judge favorably toward approval of a drug. For instance, when the question was, should Vioxx and the other drugs in this class, Bextra and Celebrex, be allowed to remain on the market, this is how the experts voted:

Vioxx: Full panel: 17 yes, 15 no. Panel without those with conflicts of interest: 8 yes, 14 no.
Bextra: Full panel: 17 yes, 13 no. Panel without those with conflicts of interest: 8 yes, 12 no.
Celebrex: Full panel: 31 yes, 1 no. Panel without those with conflicts of interest: 21 yes, 1 no.
(Goozner, AARP Bulletin, May 2006, p. 10, citing New York Times, 25 February 2005).

Industry sponsorship made studies 4 to 8 times more likely to be favorable to beverage companies (Chronicle of Higher Education, 19 January 2007, A27-8). “Psychiatric drugs fare favorably when companies pay for studies” (Elias, USA Today, 25 May 2006, 1A). Those are just a few of the innumerable such social-science studies all confirming what plain common sense already knows. Doctors with financial stakes in analytical labs prescribe more lab tests than those without such interests. And so on and on.

THE ONLY SAFEGUARD AGAINST THE POSSIBLE INFLUENCE
OF CONFLICTS OF INTEREST IS TO HAVE NO CONFLICTS OF INTEREST.
PERIOD.

 

Many individuals, institutions, and organizations simply don’t understand that when they blather about “apparent” or “negligible” or “potential” conflicts of interest. There are no such things. A conflict of interest is Stark’s aspect 1: the connections.
Either there is a connection or there isn’t.
PERIOD.
“Apparent”, “negligible”, “potential” are intended to address stage 3, to express doubt as to whether the connections will actually exert an influence. As Stark points out, that cannot be known. What is known, beyond any doubt, is that conflicts of interest exert a statistical influence. No matter how hard human beings may try, they cannot know or control or counteract their subconscious or unconscious motives.

To recuse people who have conflicts of interest, to exclude them from particular activities, is not to accuse them of being consciously swayed by those conflicts of interest, still less is it to accuse them of being consciously self-serving evil-doers. Recusing people with conflicts of interest is to their own benefit, to protect them from doing what they would not consciously wish to do. Recusing people with conflicts of interest is simply an acknowledgment of the fact that paths to Hell are paved with good intentions.

* * * * * *

Some of the above I’ve taken from my seminar “Ethics in science” posted at http://www.chem.vt.edu/chem-ed/ethics/hbauer/hbauer-ref.html and being reprinted in “Against the Tide: A Critical Review by Scientists of how Physics and Astronomy get done”, M. López-Corredoira & C. Castro (Eds.), 2007 (in press).

While the titles of some of the following books may suggest sensationalist muckraking, that is far from the case. All the authors are respectable mainstream figures: senior tenured faculty, a couple of former editors of top medical journals, a former university president, and several respected journalists. All the books are written in matter-of-fact prose with proper citation of sources.

For corruption at the National Institutes of Health through conflicts of interest, see the series of articles by David Willman in the Los Angeles Times, 7 December 2003, pp. A1, A32-35, and 22 December 2004.

For further reading on the corruption of science and medicine in general, start with Daniel Greenberg (2001) “Science, Money and Politics: Political Triumph and Ethical Erosion” and Sheldon Krimsky (2003) “Science in the Private Interest”.

For the corrupting influence of Big Pharma, see John Abramson (2004) “Overdosed America: The Broken Promise of American Medicine”; Marcia Angell (2004) “The Truth about the Drug Companies: How They Deceive Us and What To Do about It”; Jerry Avorn (2004) “Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs”; Merrill Goozner (2004) “The $800 Million Pill: The Truth behind the Cost of New Drugs”; Jerome Kassirer (2004) “On The Take: How Medicine’s Complicity with Big Business Can Endanger Your Health”.

For the commercial corruption of contemporary academe, see for example Derek Bok (2003) “Universities in the Marketplace: The Commercialization of Higher Education” and Jennifer Washburn (2005) “University, Inc.: The Corporate Corruption of American Higher Education”.

Posted in antiretroviral drugs, experts, prejudice | Tagged: , | 2 Comments »

BEST TREATMENT FOR HIV: THIS YEAR’S ADVICE, LAST YEAR’S, OR NEXT YEAR’S?

Posted by Henry Bauer on 2007/12/10

Antiretrovirals are often referred to as “life-saving” drugs. Wainberg even says that they enable many HIV-positive people to “survive indefinitely with good quality of life”. By contrast, the NIH Fact Sheet reports deaths “from liver failure, kidney disease, and cardiovascular complications” in the first decade of HAART (“cocktail”) therapy, and the largest study to date (of 22,000 patients) found that the drugs do not decrease mortality–in other words, they don’t save lives (Wainberg’s Hammer, 5 December).

Further help in assessing these opposing views comes from the Treatment Guidelines issued by the National Institutes of Health. However, I would caution HIV-positive people against reading this document, because it inspires little confidence in the grounds for its recommendations.

For one thing, these Guidelines change, and not infrequently. I was annotating the version of 10 October 2006 when I found that it has been superseded by a 1 December 2007 edition. Not only that: the latter’s front cover already warns that “concepts relevant to HIV management evolve rapidly”. Page i then lists changes from the previous guidelines and foreshadows further changes as well, to be released in 2008.

For another thing, recommendations are ranked by criteria that have two parts. A, B, C, D, E reflect the “strength of recommendation” as judged by a panel of experts; the grades correspond respectively to “strong”, “moderate”, “optional”, “should not usually be offered”, “should never be offered”. Roman numerals I, II, III represent the “quality of evidence for recommendation”:
I: at least one randomized trial with clinical results;
II: clinical trials with laboratory results;
III: expert opinion.

It inspires little confidence when the highest quality of available evidence calls for no more than a single randomized trial with clinical results, which means, whether the patients actually improve under treatment. In other circumstances than HIV/AIDS, clinical results of a single randomized trial, even if double-blinded, would merely be reason to carry out more trials in order to confirm or disprove that result. After all, the usual criterion for “statistical significance” is p ≤ 0.05, a 19 in 20 chance that the result is trustworthy–which is also a 1 in 20 chance that it is not, perhaps too high an uncertainty when it comes to matters of fatal diseases and toxic drugs. Moreover, 1 in 20 is only the mathematical chance that the result is wrong; additional uncertainty comes from the fact that protocols are rarely perfect or perfectly adhered to, humans make mistakes, and unforeseeable variables or circumstances may have played a role. A single non-blinded trial is not much to rely on.

II is what was paraphrased in my post of 5 December as “operation succeeds, patients dies”. Lab results are merely surrogate markers; the only thing that ought to matter is the outcome for the patient. Moreover, a number of publications have reported that in fact these surrogate markers do not necessarily correspond with better outcomes for patients (for example, Antiretroviral Collaboration, Lancet, 368 [2006] 451-8); and furthermore the two commonly used surrogate markers, CD4 counts and viral load, do not even correlate significantly with one another (for example, Rodriguez et al., JAMA, 296 [2006] 1498-1506).

III, “expert opinion” as “quality of evidence” implies that there is no scientific evidence on which to base an opinion.

Indeed, this whole set of criteria, I to III, indicates that there is really very little in the way of appropriate scientific data on which to base treatment. Beyond that, it is puzzling, troubling, incongruous to find that the strength of recommendation does not correlate with the quality of the evidence. One finds all the combinations AII, BII, CII, DII, EII and AIII, BIII, CIII, DIII, EIII, and even the occasional BI. So “strong” recommendations may be based on no evidence beyond expert opinion (AIII), while occasionally a merely moderately strong recommendation results from evidence based on an actual clinical trial (BI). Recommendations from “strong” all the way to “should never be offered” may be based either on trials with laboratory results or solely on “expert opinion”.

Pity the physician who must advise an HIV-positive patient, when the official guidelines are so insecurely based on scientifically reliable knowledge. The warning that guidelines change frequently makes the physician’s task yet more onerous, asking that a daily check be made at the pertinent website. And as if that were not enough, the Guidelines are quite ambivalent about interruptions of treatment, which are however obviously necessary if treatment is to be modified in accordance with a changed recommendation.

* * * * * *

These deficiencies in the official treatment guidelines underscore the desperate need to learn exactly what produces a positive HIV-test in each individual instance. Current practices ignore the demonstrable fact that testing HIV-positive does not necessarily show the presence of active infection by an agent that destroys the immune system:
—Johnson (http://virusmyth.net/aids/data/cjtestfp.htm) cites 64 scientific articles that found 66 conditions capable of producing a false-positive test, conditions ranging from as harmless as vaccination against flu or the presence of normal human ribonucleoproteins to as serious as cirrhosis, malaria, myeloma, or tuberculosis.
—The epidemiology of HIV tests in the United States shows that what is typically detected is not a sexually or otherwise transmitted infectious agent.
—Test kits, whether for antibodies (ELISA, Western Blot) or viral RNA, are annotated with disclaimers that the tests cannot be used validly for diagnosis of HIV infection.

Despite these facts, anyone who tests HIV-positive is typically presumed to be infected with HIV. That person’s physician is then confronted with highly complicated, indeed confusing guidelines for offering advice. The stakes are as high as life and death: if the positive test actually stems from a harmless condition, toxic “treatment” may be advised by physicians who prefer to take action than to not take action in ambiguous circumstances. On the other hand, if the positive test stems from a serious condition like malaria or myeloma, the physician may be led to recommend toxic chemotherapy instead of the correct treatment for the actual condition.

HIV tests are most likely to be undergone by those in high-risk groups. False positives among people who seem to be at little or no risk may well be checked carefully and repeated a number of times, with the likelihood of eventual negative results, or even shrugged off if the physician is sure enough that the patient couldn’t have been infected. For example, should a positive test result in the case of one of the celebrities who take HIV tests as an encouragement to others–high-risk people–to be tested, one may be quite sure that no effort will be spared to find some way of judging it a false result. So the people most at risk of inappropriate antiretroviral treatment as a result of HIV testing are those in the classic high-risk groups of gay men and drug abusers; to which in recent years have been added African-Americans who seem always, in every group, to test positive more frequently than others. If only for the sake of people in those groups, there is a desperate need to find out precisely what has produced the positive HIV-test in every individual instance so that subsequent actions can be as beneficial and as little harmful as possible. That information is also desperately needed in order to understand why some proportion of patients have experienced symptomatic relief from antiretroviral treatment; it has been pointed out, for example, that the relief could stem from antibacterial or antifungal action of these drugs rather than from antiviral action.

Posted in antiretroviral drugs, experts, HIV risk groups, HIV tests, prejudice | Tagged: , , , , | 5 Comments »