Debunking Denialism

Defending science against the forces of irrationality.

The Scientific Ignorance of Stasia Bliss – Part VIII: HIV/AIDS

Note: This is the eight installment in an article series debunking the massive amount of pseudoscientific claims made by Stasia Bliss. This post will take on what appears to be her most despicable and dangerous beliefs I have come across, namely HIV/AIDS denialism. For more posts in this series, see the introduction post here.

Bliss and HIV/AIDS

In previous installments of this article series, we have seen Stasia Bliss make some astonishing assertions. She claims that individuals with cystic fibrosis (a genetic condition) caused their own disease by eating acidic food and thinking negative thoughts. She believes that eating genetically modified foods cause corporate mind control via alteration of gene regulation. She encourages people to stare into the sun and states that it will give people supernatural powers, such as astral projection. She asserts that human DNA has twelve strands and that gene transcription turns you into a silica-based life-form. She considers dark matter to be a psychological invention to hide reality. She thinks that quantum mechanics mean that the mind creates reality. She claims that a vital life force exists and does not even understand why basic hygiene practices are a good idea to limit the spread of infectious diseases.

Despite knowing that Bliss subscribes to a long list of crackpot ideas and quack treatment, nothing quite prepares you for reading the supreme ignorance contained in her post on HIV/AIDS in Africa. Bliss promotes “natural remedies” such as changes in diets, herbs, drinking water, consuming hydrochloric acid and colonic irrigation despite the fact that these treatments are ineffective and sometimes harmful. She rejects the mainstream mechanism for HIV pathogenesis by stating that HIV only kill a small portion of T helper cells directly, ignoring the fact that this is only the case for resting CD4+ T helper cells and that HIV can infect and kill active CD4+ T helper cells. In the end, HIV cause the decline of CD4+ T helper cells, but not by the mechanisms that Bliss claims.

Her quack explanation for HIV pathogenesis is that the HIV virus lives on undigested proteins in the large intestine, ignoring the fact that a virus needs a host cell to replicate. She claims that the undigested protein adhere to the intestine wall, enters the blood stream and cause chronic inflammation. As this alleged chronic inflammation continues, it exhausted the immune system. In reality, undigested proteins are usually too large to be taken in the digestive system (that is why they are digested), most of the uptake of digested protein occurs in the small intestine and not the large, eating a substance usually provides a tolerogenic response from the immune system rather than an inflammatory and chronic inflammation is not associated with immune suppression (quite the opposite, as immune suppression is used as a treatment for chronic inflammation).

In her post about HIV/AIDS, Bliss promotes pseudoscientific ignorance that is extremely harmful.

Blocking HIV medication led to the death of more than 340 000 people

Bliss might thinks that it is harmless to promote the denial of mainstream science about HIV/AIDS and the promoting of quack treatments. However, it can sometimes have very harmful and dangerous consequences. Thabo Mbeki (the former President of South Africa) blocked access to antiretroviral medication and suggested that individuals with HIV/AIDS should use lemon and garlic as treatment. Between 2000 and 2005, his denialist politics lead to the premature deaths of 330000 people and a total loss of over 3.8 million person-years (Chigwedere et al, 2008).

HIV cause CD4+ T helper cell count decline by various mechanisms

Bliss dismisses the mainstream scientific account of HIV pathogenesis by claiming that HIV only infects a small proportion of T helper cells.

Clinical observations have shown, however, that less than a single percent of T-4 helper cells are infected. According to the theory, you would think 90% or more of the T-4 cells to be infected, so what is the truth?

The truth is that Bliss does not understand HIV pathogenesis. While it is true that few resting CD4+ helper T cells are infected, the HIV virus rapidly replicates in activated helper T cells (Coiras et al, 2009). This is a contributing factor to massive CD4+ T cell death, which is the result of the destruction of mature CD4+ helper T cells and impaired CD4+ helper T cells through various mechanisms, including envelope-mediated apoptosis and infection-mediated death of progenitor cells (McCune, 2001), although this does not include the mechanism asserted by Bliss.

A virus is not alive and needs a cell to replicate

Bliss claims that the HIV virus feeds on and adheres to undigested protein in the large intestine. However, this misunderstands the basic biology of viruses. Viruses are not themselves alive, but needs to infect a susceptible cell to be able to replicate. This occurs by hijacking the replication system of that cell. Viruses are not like bacteria or animals in that they must eat nutritious material. A virus is more or less nucleic acid in a protein capsid (some have a membrane as well). The infected cell produce all components of all the new viruses, including the nucleic acid and protein capsid. Thus, the first component of the model provided by Bliss falls apart. As we will see, other parts of this model will share an identical fate.

Digested proteins are taken up in the small intestine

According to the scientifically flawed model discussed by Bliss, the next step is where the large intestine take up undigested protein. However, a cursory reading of the basics of the human digestion system (e. g. Mayo Clinic, 2011) shows that the body primarily take up digested protein and that this absorption of protein occurs primarily in the smaller intestine. The material that reaches the large intestine consists mainly of water, salts and waste material. The larger intestine takes up most of the water before the material reaches the rectum. Another component of the model down the drain.

Eating a protein usually promote a tolerogenic response and not chronic inflammation

Bliss believes that these undigested protein cause chronic inflammation after being allegedly taken up the the large intestine. However, if the immune system reacts uncontrollably against the food we eat without limitation, then everyone would have chronic inflammation in the intestine all the time. However, this is not the case, which means that the body must have a method of inducing tolerance against food stuff. This mechanism is called oral tolerance. It sometimes fail, resulting in chronic inflammatory conditions such as ulcerative colitis and Crohn’s disease, but works for the vast majority of individuals. Thus, the uptake of random undigested protein does not cause chronic inflammation. This means that the third component breaks down.

Chronic inflammation is not immune suppression

The final component of the model promoted by Bliss claims that chronic inflammation leads immune suppression due to the deaths of T helper cells. However, chronic inflammation does not lead to immune suppression. If it did, then chronic inflammatory diseases would not be chronic. In fact, the treatment of chronic inflammation often includes immune suppression. The existence of individuals suffering from chronic inflammation is clear evidence against this aspect of their models.

Colon cleansing is ineffective and dangerous

Among one of the recommendations listed by Bliss for controlling HIV infection is colon cleansing. This is based on ancient and outdated ideas about how unspecified “toxins” would form and accumulate in the large intestine and harm the individual. In reality, the human body has efficient systems form the elimination of waste and toxins, so colon cleansing is not beneficial and not based on scientific evidence. Here is what the American Cancer Society has to say about colon cleansing (American Cancer Society, 2012):

Available scientific evidence does not support the claims on which colon therapy is based. It is known that most digestive processes take place in the small intestine, where nutrients are absorbed into the body. What remains enters the large intestine, where it passes to the rectum for elimination after water and minerals are extracted. Available scientific evidence does not support the premise that toxins accumulate on intestinal walls or that toxicity results from poor elimination of waste from the colon.

The dangers of colon cleansing include cramping, abdominal pain, dehydration, infections, perforation of the colon, electrolyte imbalance and renal failure (American Cancer Society, 2012; Picco, 2012). The latter two (electrolyte imbalance and renal failure) has the potential to be lethal.

A paper by Mishori et. al (2011) makes the following conclusions and recommendations:

4 things to tell patients about colon cleansing

1. Colon irrigation is not wise—particularly if you have a history of gastrointestinal disease (including diverticulitis, Crohn’s disease, or ulcerative colitis) or a history of colon surgery, severe hemorrhoids, kidney disease, or heart disease. These conditions increase the risk of adverse effects.2,3,11,16

2. Side effects of colon cleansing include nausea, vomiting, diarrhea, dizziness, dehydration, electrolyte abnormalities, acute kidney insufficiency, pancreatitis, bowel perforation, heart failure, and infection. 2,3,11,16

3. The devices that practitioners use for the procedure are not approved for colon cleansing by the US Food and Drug Administration. Inadequately disinfected or sterilized irrigation machines have been linked to bacterial contamination.2,11,19

4. Colon cleansing practitioners are not licensed by a scientifically based organization. Rather, practitioners have undergone a training process structured by an organization that is attempting to institute its own certification and licensing requirements.

Colon cleansing is unnecessary, ineffective and dangerous. It should certainly not be attempted as a “treatment” for HIV/AIDS.

Skip the hydrochloric acid!

Another one of the recommendations provided Betty Hewitt and endorsed by Bliss is hydrochloric acid supplementation. They are actually suggesting that people with HIV/AIDS should ingest hydrochloric acid (a strong inorganic acid) to prevent the alleged accumulation of undigested protein.

The quack supplementation in question is called “betaine hydrochloride” and advertised on thousands of alternative medicine websites. However, there is no evidence of efficacy or safety and this led to the product being banned 20 years ago for over-the-counter products. Here is one description of the substance (WebMD, 2009):

Betaine hydrochloride has an interesting history. Betaine hydrochloride used to be included in over-the-counter (OTC) products as a “stomach acidifier and digestive aid.” But a federal law that went into effect in 1993 banned betaine hydrochloride from use in OTC products because there wasn’t enough evidence to classify it “generally recognized as safe and effective.” Betaine hydrochloride is now available only as a dietary supplement whose purity and strength can vary. Promoters still claim that some health conditions are due to inadequate stomach acid, but this claim has not been proven. Even if it were true, betaine hydrochloride wouldn’t help. It only delivers hydrochloric acid but does not itself alter stomach acidity.

There is insufficient evidence that betaine hydrochloride is effective for most of the conditions that proponents of alternative medicine promote it for (including asthma, anemia, yeast infection, rheumatoid arthritis, atherosclerosis etc.). There is not even enough evidence to determine what dosages are appropriate. There is also concerns that the substance can irritate ulcers. Thus, the promotion of betaine hydrochloride is crankery.

Medications reduce likelihood of HIV progressing to AIDS

There is no evidence that “alternative treatments” are effective against HIV/AIDS or slows progression to AIDS. However, there is plenty of evidence that mainstream medical treatment improve prognosis and delays progression to AIDS. National Institute of Allergy and Infectious Disease has assembled an impressive overview of the scientific evidence that HIV causes AIDS (NIAID, 2010), and it describes the efficacy of antiretroviral in the following way:

The availability of potent combinations of drugs that specifically block HIV replication has dramatically improved the prognosis for HIV-infected individuals. Such an effect would not be seen if HIV did not have a central role in causing AIDS.

Clinical trials have shown that potent three-drug combinations of anti-HIV drugs, known as highly active antiretroviral therapy (HAART), can significantly reduce the incidence of AIDS and death among HIV-infected individuals as compared to previously available HIV treatment regimens (Hammer et al. NEJM 1997;337:725; Cameron et al. Lancet 1998;351:543).

Use of these potent anti-HIV combination therapies has contributed to dramatic reductions in the incidence of AIDS and AIDS-related deaths in populations where these drugs are widely available, among both adults and children (Figure 1; CDC. HIV AIDS Surveillance Report 1999;11[2]:1; Palella et al. NEJM 1998;338:853; Mocroft et al. Lancet 1998;352:1725; Mocroft et al. Lancet 2000;356:291; Vittinghoff et al. J Infect Dis 1999;179:717; Detels et al. JAMA 1998;280:1497; de Martino et al. JAMA 2000;284:190; CASCADE Collaboration. Lancet 2000;355:1158; Hogg et al. CMAJ 1999;160:659; Schwarcz et al. Am J Epidemiol 2000;152:178; Kaplan et al. Clin Infect Dis 2000;30:S5; McNaghten et al. AIDS 1999;13:1687;).

For example, in a prospective study of more than 7,300 HIV-infected patients in 52 European outpatient clinics, the incidence of new AIDS-defining illnesses declined from 30.7 per 100 patient-years of observation in 1994 (before the availability of HAART) to 2.5 per 100 patient years in 1998, when the majority of patients received HAART (Mocroft et al. Lancet 2000;356:291).

Among HIV-infected patients who receive anti-HIV therapy, those whose viral loads are driven to low levels are much less likely to develop AIDS or die than patients who do not respond to therapy. Such an effect would not be seen if HIV did not have a central role in causing AIDS.

Clinical trials in both HIV-infected children and adults have demonstrated a link between a good virologic response to therapy (i.e. much less virus in the body) and a reduced risk of developing AIDS or dying (Montaner et al. AIDS 1998;12:F23; Palumbo et al. JAMA 1998;279:756; O’Brien et al. NEJM 1996;334:426; Katzenstein et al. NEJM 1996;335:1091; Marschner et al. J Infect Dis 1998;177:40; Hammer et al. NEJM 1997;337:725; Cameron et al. Lancet 1998;351:543).

This effect has also been seen in routine clinical practice. For example, in an analysis of 2,674 HIV-infected patients who started highly active antiretroviral therapy (HAART) in 1995-1998, 6.6 percent of patients who achieved and maintained undetectable viral loads (<400 copies/mL of blood) developed AIDS or died within 30 months, compared with 20.1 percent of patients who never achieved undetectable concentrations (Ledergerber et al. Lancet 1999;353:863).

Against the overwhelming force of mainstream science, Bliss approvingly quotes Betty Hewitt stating that if you eat fruits and vegetables, you will never develop AIDS. This is not just HIV/AIDS denialism. It is full-blown reality denialism.

Science is needed, not superstitious quack medicine

With number of people with AIDS in the millions and research in the tens of millions, wouldn’t it be miraculous to find out that help was as close as the foods these people eat and the efficiency of their digestion?

Yes, that would be a miracle in the sense of being a highly improbable event contradicted by the evidence. That is why real scientists do not take it seriously. What is needed to combat the HIV/AIDS pandemic is continued biomedical research that does not involve quackery and additional focus on prevention. The promotion of crank “treatments” is scientifically vacuous and demonstrably harmful. If you do not think there is any harm to such nonsense, try telling that to the families of those 330000 people that got killed by institutionalized HIV/AIDS denialism in South Africa.

Conclusion

Promotion of HIV/AIDS denialism is an all-time low for Stasia Bliss. Her post completely misunderstands HIV pathogenesis, the human digestive system, the basic biology of viruses, oral tolerance, chronic inflammation and immune suppression. She promotes colon cleansing and hydrochloric acid supplements despite the fact that there is no evidence for efficacy and, in the case of colon cleansing, evidence of harm. Antiretroviral medication is highly effective in improving the prognosis and delays progression to AIDS.

References

American Cancer Society. (2012). Colon Therapy. Accessed: 2013-08-03.

Chigwedere P, Seage GR 3rd, Gruskin S, Lee TH, Essex M. (2008) Estimating the lost benefits of antiretroviral drug use in South Africa. J Acquir Immune Defic Syndr. 49(4):410-5.

Coiras, Mayte, Lopez-Huertas, Maria Rosa, Perez-Olmeda, Mayte, & Alcami, Jose. (2009). Understanding HIV-1 latency provides clues for the eradication of long-term reservoirs. Nat Rev Micro, 7(11), 798-812.

Mayo Clinic. (2011). Slide show: See how your digestive system works. Accessed: 2013-08-03.

McCune, Joseph M. (2001). The dynamics of CD4+ T-cell depletion in HIV disease. Nature, 410(6831), 974-979.

NIAID. (2010). The Evidence that HIV Causes AIDS. National Institutes of Allergy and Infectious Diseases. Accessed: 2013-08-03.

Pabst, O., & Mowat, A. M. (2012). Oral tolerance to food protein. Mucosal Immunol, 5(3), 232-239.

Picco, M. F. (2012). Is colon cleansing a good way to eliminate toxins from your body?. The Mayo Clinic. Accessed: 2013-08-03.

Mishori R, Otubu A, Jones A.A. (2011). The dangers of colon cleansing. J Fam Pract. 60(8):454-7.

WebMD. (2009). Betaine hydrochloride. Accessed: 2013-08-03.

3 responses to “The Scientific Ignorance of Stasia Bliss – Part VIII: HIV/AIDS

  1. Pingback: The Scientific Ignorance of Stasia Bliss – Introduction | Debunking Denialism

  2. Pingback: The Scientific Ignorance of Stasia Bliss – Part IX: Ageing and Death | Debunking Denialism

  3. Pingback: The Scientific Ignorance of Stasia Bliss – Part X: Measles | Debunking Denialism

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