HIV/AIDS Skepticism

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

Posts Tagged ‘AZT’

Penalties for Scientists’ Sins of Omission

Posted by Henry Bauer on 2012/10/23

Jail terms of 6 years have been imposed on Italian seismologists for misleading the public about the possible danger of a possibly impending major earthquake following a host of smaller tremors (Jailing of Italian seismologists leaves scientific community in shock):
“the seismologists got the science right, but left the job of public communication to a civil protection official with no specialist knowledge of seismology. His statement to the press was, to put it mildly, a grossly inaccurate reflection of the situation: “The scientific community tells us there is no danger, because there is an ongoing discharge of energy. The situation looks favourable.” At this point, the seismologists should have stepped in. But they did not” (Italian earthquake case is no anti-science witch-hunt).
Under this precedent, scientists are required to correct any public statement that they know to be inaccurate. So, for example, whenever it is publicly stated that positive HIV tests bespeak infection by a human immunodeficiency virus, every HIV/AIDS researcher should publicly correct that, given that no test is 100% certain: Stanley H. Weiss and Elliott P. Cowan, “Laboratory detection of human retroviral infection”, Chapter 8 in AIDS and Other Manifestations of HIV Infection, ed. Gary P. Wormser, 4th ed. 2004.
There are innumerable other aspects of HIV/AIDS dogma that persistently misrepresent reality as represented in data in the published mainstream literature. Thus every statement that a single act of unprotected intercourse can cause infection should be immediately accompanied by a correction that the probability is on the order of a few per thousand (and for most people hunderdds of teimes leess than that, since the probability that ones’s partner is infected is on average only a few per thousand). Every statement that AIDS has become a manageable chronic disease should be accompanied by detailed specification of the common “side” effects of antiretroviral drugs — including perhaps the information that the notorious AZT, acknowledged in practice if not in words to have been too toxic at the original high doses, is present in smaller but far from negligible amounts (typically 300 mg twice a day) in many treatment “cocktails” under pseudonym (zidovudine ZDV; Retrovir), for example in a recent “Preferred Regimen for Pregnant Women” [LPV/r (twice daily) + ZDV/3TC1 (AI) — Treatment Guidelines  updated to October 2011; the “AI” marks the strongest possible recommendation used in these Guidelines: “A: Strong recommendation for the statement; I: One or more randomized trials with clinical outcomes and/or validated laboratory endpoints”]. The first dosage of AZT was often 1500 mg/day, though at first as high as 2400 mg (400 mg every 4 hours). A clinical trial comparing this with 750 mg revealed no significant difference in mortality, less than 10% of AIDS patients on these regimens surviving for more than 33 months (Joseph Sonnabend, “Remembering the Original AZT Trial”, 29 January 2011).  One might wonder whether current regimens of 300 mg twice a day are appreciably less toxic than 750 mg/day had been in that long-ago trial.

But of course it is not only with respect to HIV/AIDS that experts fail to correct public statements. Whenever someone claims that there is no doubt that human-generated carbon dioxide is adding appreciably to the rate of global warming, for instance, the computer modelers should rush to point out that all they claim is some sort of statistical probability. When it is mentioned that the universe began about 13 billion years ago in a Big Bang, astrophysicists should hasten to remind us that this is an inference based on various other inferences and assumptions as well as evidence. Indeed, whenever any scientific conclusion is broadcast as tantamount to truth, scientists should leap to correct that and point out that science is perpetually self-correcting — in other words, changing all the time — and that it never claims or can claim or should be allowed to claim final certainty.

Current circumstances are quite different, though. In an increasing range of fields of science, one finds dogmatic adherence to and promulgation of a contemporary mainstream consensus as beyond doubt, together with excommunication of dissenters as heretics, under the more modern term of “denialist”, which the unwary may not recognize as synonymous with heretic — see my latest book, Dogmatism  in Science and Medicine: How Dominant Theories Monopolize Research and Stifle the Search for Truth.

Posted in antiretroviral drugs, clinical trials, experts, HIV tests, HIV transmission, Legal aspects, sexual transmission, uncritical media | Tagged: , | Leave a Comment »

HISTORY OF AZT

Posted by Henry Bauer on 2008/01/01

In FIRST: DO NO HARM! (19 December), I wrote, “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”. A knowledgeable correspondent informed me that AZT failed to qualify for cancer chemotherapy not because it was too toxic but because it wasn’t effective.

As always, I’m grateful for the comment; I do wish to be as accurate as possible, and can’t check everything that I’ve absorbed from a lot of reading, not all of which I can recall in any detail. A very positive benefit of being set straight is that when I try to learn more in order to correct errors, it sometimes leads to unsuspected new grist for the dissident mill; for instance, Sharon Stone’s assertion about AIDS deaths among women (WORLD AIDS DAY, 22 December) caused me to look at the official statistics for AIDS deaths and to discover the category of death-causing “HIV DISEASE” (28 December). Those death statistics will be featured again in later posts, for the way they vary with age is yet another illustration of the vacuity of HIV/AIDS theory.

Back to AZT and toxicity and cancer. Looking further into it, there seems to be some doubt about the matter. AIDS WIKI says this:
“AZT was originally intended to treat cancer, but failed to show efficacy and had an unacceptably high toxicity profile. (Note: There is some dispute over whether a high toxicity profile contributed to the shelving of AZT. Horwitz himself appears to have given conflicting testimony in various interviews.)”

I came across a confirmation that AZT had been found useless against leukemia in mice by Horwitz in 1964, but had shown possible promise against breast cancer (Science News, 28 June 1997, 151 #26, p. 397, citing a June 15 article in Cancer Research).

At any rate, AZT was known to be highly toxic at the time it was tried against AIDS. For a very readable account of the intrigues and machinations that led to its approval, read Bruce Nussbaum’s “Good Intentions: How Big Business and the Medical Establishment Are Corrupting the Fight Against AIDS” (1990, Atlantic Monthly Press).

Nothing about that book’s title and sub-title has become obsolete in the nearly two decades since it was written. Nussbaum is hardly a radical, and he isn’t a dissident who questions whether HIV causes AIDS. He was an investigative reporter and is now a senior editor at Business Week. His book describes “the puppet master, the brilliant Dr. David Barry, Burroughs Wellcome’s chief strategist; Dr. Tony Fauci, who grabbed control of the government’s AIDS research program only to squander $1 billion without developing a single new drug. . . . An old-boy network of powerful medical researchers dominates in every disease field . . . . They control the major committees, they run the most important trials. They are accountable to no one. despite the billions of taxpayers’ dollars that go to them every year, there is no public oversight. Medical scientists have convinced society that only they can police themselves” (from the jacket blurb).

That’s a pretty good summary of what dissidents are still up against today.

It’s not just that there’s a powerful medical establishment, it’s also that HIV/AIDS theory has tentacles reaching not only into medical practice but also into several different fields of research—epidemiology, immunology, virology. The epidemiologists have recognized that the observed rates of apparent sexual transmission of HIV are far too low to cause epidemics; but they don’t dare stand up and tell the immunologists and virologists and physicians that they are wrong, because they imagine that those people know what they are doing within their own areas of expertise. So the epidemiologists leave their observations as anomalies to be cleared up at some future time and speculate about special circumstances that might somehow make transmission more efficient—when it’s not being observed, of course. The immunologists are happy to have as an excuse for getting nowhere with vaccines, the virologists’ assertions that HIV mutates in an unprecedented fashion. Physicians can only treat their patients with what they are told to try by those whom they must trust to have carried out proper studies. There’s nothing unusual about this general state of affairs: scientists in closely related fields tend not to question what their colleagues in those other fields tell them, and apparently unexplainable anomalies are shoved aside in the belief that later on they will become explicable. That’s what Thomas Kuhn described in his much cited and little understood “Structure of Scientific Revolutions”, and it fits the realities much better than Karl Popper’s suggestion that contradictory evidence at once falsifies a theory; as Imre Lakatos pointed out, the mainstream belief is continually propped up by subsidiary ad hoc hypotheses made up more or less on the spur of each bit of contradictory evidence. If science really is self-correcting, it often takes its own good time about it—like 4 decades over the laws of heredity.

At any rate, that so many different specialties are involved in HIV/AIDS underscores why I’m so grateful when others check what I write, because one can hardly say much about HIV/AIDS without touching on questions of immunology, epidemiology, virology, and more.

Just now, what I would very much like to understand is, what criteria are used in the trials of potential vaccines? I know there’s been controversy over whether “HIV antibodies” represent a successful or potentially successful reaction against a retrovirus. I’ve learned that there are several different sorts of antibodies. I’ve learned that vaccinology often makes use of “adjuvants”, which stimulate the immune system in a non-specific fashion. What I’m curious about is this: The standard way of detecting infection by HIV is via tests for antibodies; but aren’t vaccines designed to stimulate the generation of antibodies?

That’s a genuine plea for explanation, not a rhetorical question.

Posted in antiretroviral drugs, vaccines | Tagged: , , , , , , , , | 16 Comments »

ANTIRETROVIRAL DRUGS: HISTORY AND RHETORIC

Posted by Henry Bauer on 2007/12/12

The previous post (BEST TREATMENT…, 10 December) mentioned these aspects of the official Treatment Guidelines:
—They change incessantly.
—The recommendations are based more on opinion than on scientific evidence.
—The available evidence is overwhelmingly about surrogate markers rather than patient health.
—The recommendations are so complex and change so often that physicians must suffer constant dilemmas over how to advise their patients.
Several further posts will examine aspects of these Guidelines in more detail, in particular, “side” effects of the drugs and conflicts of interest among those who draw up the Guidelines. First, however, a quick look back at how and why antiretroviral treatment began.

* * * * * *

Wainberg, in his single-minded lauding of “lifesaving” antiretrovirals (WAINBERG’S HAMMER, 5 December), suggested that “Many people had forgotten” what went on in the early days of AIDS. Wainberg himself seems to have forgotten the genesis and rationale of antiretroviral treatment.

In the early 1980s, small clusters of people were coming down, it seemed suddenly, with otherwise rare opportunistic infections, predominantly fungal ones; and death was following within months. There were two obvious possibilities as to cause: either some shared environmental exposure, activity, or lifestyle; or perhaps a previously unknown infectious agent.

The question was effectively settled by fiat rather than freely attained scientific consensus with the official announcement by the Secretary of Health and Human Services that HIV (then called HTLV-III) was the probable cause. Since that came from the prime source of research funds, those seeking grant support naturally framed their proposals in that vein. The immediate goal became to find an HIV-killer. A desperate rummage among all conceivable chemicals turned up AZT, a twenty-year old candidate for cancer chemotherapy that had never been used because it is too toxic. AZT seemed effective against HIV in the test-tube and, in brief trials, AIDS patients appeared to survive for several months on AZT treatment. Given that the prognosis for a person newly diagnosed with AIDS was death within months, an apparent extension of a few months was regarded as worthwhile. Moreover, activists were clamoring for rapid approval of anything that offered some hope, so AZT was approved without the evidence of “safety and efficacy” that was normally demanded before drugs were allowed into general use.

The situation nowadays is entirely different. Although HIV is still regarded as the agent causing AIDS, the official belief holds that there is an average period of about 10 years between infection with HIV and the first appearance of symptoms of illness. This is very different than expected death within months, and should–but apparently has not–set a very different basis for weighing possible benefits of treatment against the known risks from drug toxicity.

In point of fact, the official treatment guidelines of October 2006, introduced in the previous post (10 December), make abundantly clear the high risk of serious, indeed often fatal “side” effects of antiretroviral treatment. The risks and possible benefits are summarized in this way in the Introduction to those Guidelines (p. 10):

Potential Benefits of Deferred Therapy include:
—avoidance of treatment-related negative effects on quality of life and drug-related toxicities;
—preservation of treatment options;
—delay in development of drug resistance if there is incomplete viral suppression;
—more time for the patient to have a greater understanding of treatment demands;
—decreased total time on medication with reduced chance of treatment fatigue; and
—more time for the development of more potent, less toxic, and better studied combinations of antiretrovirals.
Potential Risks of Deferred Therapy include:
— the possibility that damage to the immune system, which might otherwise be salvaged by earlier therapy, is irreversible;
—the increased possibility of progression to AIDS; and
—the increased risk for HIV transmission to others during a longer untreated period.

A conspiracy theorist might wonder why this useful summary has been shifted in the December 2007 revision of the Guidelines to an inconspicuous place following Table 5 at the bottom of p. 58. Was it perhaps realized that having it up front is too unintentionally revealing of the grave and common risks associated with these drugs?

An analyst of rhetoric might point to a choice of words designed to play down the risks. Since the drugs supposedly do something good, the only reason not to use them is because of their harmful “side” effects; so “Potential benefits of deferred therapy” is a euphemism for “Treatment-associated risks”. Furthermore, those risks are spoken of in a rather masked way–“negative effects” on quality of life, “drug-related toxicities” instead of simply “drug toxicities”. The revealing need for “less toxic” drugs is inserted between the two hoped-for benefits of “more potent” and “better studied”. “Treatment demands” and “treatment fatigue” are euphemisms for the fact that a large proportion of patients find the “side” effects of antiretroviral treatment intolerable.

(Another common euphemism in mainstream discourse about antiretroviral drugs is “HIV lipodystrophy” or “HIV-associated lipodystrophy” for the dysfunctional distribution of body fat occasioned particularly by protease inhibitors. The drugs, not the HIV, are responsible for the lipodystrophy, but the terms in quotes are designed to give the opposite impression.)

In any case, the question nowadays is–or should be–whether the acknowledged, well known toxicity of all antiretroviral drugs calls for their use when people are not yet ill. It is highly pertinent here that the consensus in the United States asserts that “illness” warranting antiretroviral drugs can be diagnosed purely on the basis of laboratory tests, for example, CD4 cell counts below 200 (not to mention the HIV test itself!–see HIV TESTS: DANGER TO LIFE AND LIBERTY, 16 Nov ), whereas the consensus elsewhere, for instance in Canada, does not accept this as a conclusive marker of AIDS-illness.

A further, important datum not mentioned in these Treatment Guidelines is the fact that large numbers of HIV-positive people have lived healthy lives for a couple of decades or more without antiretroviral treatment. That was not known in the early days when an AIDS diagnosis presaged early death, and when HIV was first suggested as the culprit.

We cannot know, of course, how many HIV-positive people are quietly living healthy lives. People are rarely tested for HIV unless they are in high-risk groups or need medical attention for some reason. Official estimates that about one quarter or one third of HIV-positives don’t know their status implies that many of them suffer no ill effects from that condition–after all, about 1 million Americans have supposedly been HIV-positive steadily since the mid-1980s. The “long-term non-progressors” or “elite controllers” acknowledged in mainstream discourse have been estimated to number in the thousands, but this is surely an under-estimate because, again, only people with known risks tend to be tested; so these thousands represent chiefly high-risk non-progressors or controllers; there are likely to be a larger proportion of such people in low-risk groups. In addition and not usually acknowledged in mainstream discourse are those HIV-positive people who have eschewed treatment by their own decision; though many of them have joined in support groups, there is no reliable way to estimate their numbers, but it is certainly in the thousands.
************
Drugs too toxic for cancer chemotherapy were approved for use at a time when a few months of extra life seemed a worthy objective. Infection by HIV is believed to produce no serious symptoms for an average of 10 years. Where is the rationale for feeding highly toxic medications to asymptomatic people? When moreover the mechanism by which HIV is supposed slowly or eventually to destroy the immune system is unknown? When it turns out that people being treated with these drugs are experiencing typical drug toxicities, and cancers, within the 10-year period during which it is officially acknowledged that HIV by itself on average does no harm?

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