Debunking HIV/AIDS Denialism

Debunking the new Duesberg HIV/AIDS Denialist “paper” in IJAE

Peter Duesberg is the among the forefathers of the HIV/AIDS denialist movement. They reject the notion that HIV causes AIDS, despite being contradicted by a massive amount of scientific evidence and has held on to this view for three decades.

Duesberg has recently got an article called “AIDS since 1984: No evidence for a new, viral epidemic – not even in Africa” published in the obscure Italian Journal of Anatomy and Embryology. This is after getting rejected from four other journals and having gotten a previous version of the article pulled from the journal Medical Hypotheses, itself a crank journal.

One of the co-authors is Henry Bauer. He is a homophobic professor emeritus in chemistry and science studies at Virgina Tech. He is also, apparently, a world-renowned proponent of the existence of the Loch Ness monster. I kid you not. He was also an editor of the woo-woo journal Journal of Scientific Exploration. All of these three journals mentioned have an impact factor well below 1, making them shoddy and unreliable at best.

The Duesberg et. al. (2011) paper itself is just a rehashing of the same old falsehoods that HIV/AIDS denialists have peddled for many decades, this time, yet again, published in an obscure and unimportant journal. Other commentators have already started picking the “paper” apart, but there are additional things that should be added, so the following is a combination of criticism so far, with my own contributions and expansions.

The Spread of Plague is not analogous to HIV/AIDS

–> Duesberg et. al. (2011) tries to compare the spread of infectious diseases such as plague caused by Y. pestis with HIV and concludes that since the spread of HIV and incidence of AIDS does not match that of the typical infectious diseases, this means that HIV cannot be the cause of AIDS or of an infectious epidemic. This is a flawed analogy, because unlike plague, HIV does not spread through casual, non-sexual contact as Y. pestis can and HIV/AIDS can take several years to be clinically obvious, rather than having an incubation time of a couple of days (Hoofnagle, 2011).

Data on population growth does not refute the severe impact of HIV/AIDS

–> Duesberg et. al. (2011) then claims that there cannot be an HIV/AIDS epidemic, since the population growth of the countries hit by HIV/AIDS the hardest, such as South Africa, is still positive.

–> Hoofnagle (2011) points out that even if we accept that, it does not necessarily support the conclusion made, since HIV/AIDS is attached to a strong social stigma, and South Africa use an entire government infested by HIV/AIDS denialism.

–> Also, population growth is not a good measure of the impact of HIV/AIDS, because the birth rates are quite high, thereby masking the effect. Kalichman (2009, pp. 77-78) points out that countries in southern Africa, including South Africa, have seen a massive decrease in life expectancy over the years that correspond to the occurrence of AIDS pandemic. He writes that: “Life expectancy in many countries that were improving during the post-colonial years of the 1960s and 1907s began to erode in the 1980s and 1990s, and life expectancy in many countries is now worse than even during the 1950s, the last full decade of colonialism. The reason why some countries afflicted by AIDS sustain positive population growth is simply due to high birth rates.” This shows the effects of the AIDS pandemic.

–> In a paper published in PNAS, Gregson et. al. (2007), the authors make a similar point about Zimbabwe.

–> Researchers at Harvard School of Public Health concludes in Chigwedere et. al. (2008) that over 330000 individuals with HIV/AIDS died earlier than needed because the previous President of South Africa, Thabo Mbeki, and his government refused to let his people have access to antiretrovirals. They believed that it was just a western pharmaceutical plot to destroy the future of the country and instead, he suggested garlic and lemon as treatment (Kalichman, 2009). We can easily see what horrible results that led to.

Duesberg false claims about antiretrovirals (ARVs)

–> Duesberg et. al. (2010) tries to use the Concorde Study (Concorde Coordinating Committee, 1994) to show that AZT is useless as treatment for HIV/AIDS. However, Hoofnagle (2011) convincingly demonstrate that Duesberg incorrectly characterize the paper by claiming that the study was about an experimental group and a placebo group, when in fact, it had two experimental groups, one before the onset of AIDS and the other after. All the subjects where treated with AZT. The study did not show that treatment was useless, only that there was no point in treating patients with a single drug before the condition had progressed to AIDS.

–> Duesberg does not seem to understand that because of the evolution of drug resistance, treatment with a single drug is no longer the standard of care for HIV/AIDS. The so called HAART treatment uses multiple combined drugs to reduce the risk of resistance, as even if some virus particles become resistant to one of the drugs, the other drugs in the regiment can destroy them and prevent the resistance from spreading. Duesberg therefore attacks a straw man.

–> Overall, Duesberg et. al. (2011) promotes an irrational analysis of risk, overemphasizing risks with treatments, while vastly underestimating the risk of not being treated. These, and other factors, must be viewed against each other. They even criticize the process of trying to prevent mother-to-child preventing in the same manner: overstating the risks, ignoring the benefits.

Conclusion

The Duesberg et. al. (2011) article makes the same flawed claims as HIV/AIDS denialists usually do and it is not worth taking any of them seriously. Not all infectious diseases are equivalent. It is more reasonable to look at life expectancy rather than population growth when trying to find the severe impact of HIV/AIDS on countries in Southern Africa, because a high birth rate masks changes in population. Duesberg incorrectly characterizes the research of other scientists in his attempt to make ARVs look like ineffective poisons and performs multiple, irrational analysis of risk when he ignores benefits and focus on risks instead.

It is not a scientific paper, just rehashing of the same old denialists falsehoods about HIV and AIDS that has been debunked over and over again many times before.

References and Further Reading:

Chigwedere, P., Seage, G.R., III, Gruskin, S., Lee, T.-H., and Essex, M. Estimating the Lost Benefits of Antiretroviral Drug Use in South Africa. J. Acquir. Immune Defic. Syndr. 49:410–415 (2008).

Concorde Coordinating Committee. (1994) Concorde: MRC/ANRS randomised double-blind controlled trial of immediate and deferred zidovudine in symptom-free HIV infection. Concorde Coordinating Committee. Lancet. 343(8902):871-81.

Corbyn, Zoë. (2011). Paper denying HIV–AIDS link secures publication: Work by infamous AIDS contrarian passes peer review. Nature News. Accessed: 2010-01-06.

Gregson S; Nyamukapa C; Lopman B; Mushati P; Garnett G.P; Chandiwana S.K; Anderson R. M. (2007). Critique of early models of the demographic impact of HIV/AIDS in sub-Saharan Africa based on contemporary empirical data from Zimbabwe. Proc Natl Acad Sci. 104:14586-14591.

Hoofnagle, M. (2011). Duesberg Strikes a blow for HIV/AIDS denialism. Denialism blog. Accessed: 2012-01-06.

Kalichman, S. (2009). Denying AIDS: Conspiracy Theories, Pseudoscience and Human Tragedy. New York: Copernicus Books.

emilskeptic

Debunker of pseudoscience.

13 thoughts on “Debunking the new Duesberg HIV/AIDS Denialist “paper” in IJAE

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  • The English journalist Alexander Baron has said that this blog post “seems to be based largely on ad hominem” in a (incredibly credulous) interview with Peter Duesberg published here.

    Hilarious.

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  • You have concurred with Deusberg that the Concorde Study shows that (the single drug) AZT is useless as treatment for HIV.
    Are there any scientific studies that show the efficacy of cocktails as a treatment for HIV?
    Do all the cocktails include AZT?

    • No, I have not “concurred with Deusberg” that AZT is “useless as treatment for HIV”. I suggest reading the actual blog post before making a comment. Here is the quote from the Hoofnagle reference:

      The study was not between treated and untreated groups. Subjects were divided between treatment before and after onset of AIDS. All subjects received AZT when they became ill. This study did not suggest patients should not receive AZT with onset of AIDS, only that there was no benefit to treatment with a single drug before onset of symptoms.

      The study did not show that AZT is useless for HIV treatment, only that there was no benefit with a treatment using a only AZT as a single compound before the onset of symptoms. Since the discovery of AZT, many newer and more effective treatments have been discovered that has less side effects.

      As for the efficacy of HAART / cART, I suggest you look at the article The Evidence that HIV Causes AIDS at the National Institute of Allergy and Infectious Diseases:

      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).

      There are many different HAART / cART combos. Some of the early combos did include AZT, but most modern ones do not (because we have newer and better anti-HIV medication of that drug class with less side-effects now). The U. S. Department of Health and Human Services recommends one of the following as a part of the treatment regime for individuals taking HIV medication for the first time:

      – Atripla (efavirenz + tenofovir/emtricitabine)
      – Reyataz, Norvir, Truvada (the latter containing tenofovir/emtricitabine)
      – Prezista, Norvir, Truvada
      – Isentress, Truvada

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  • What is so credulous about my interview with Duesberg, dickhead? I never said I believe everything he said uncritically, but there are many possibilities regarding AIDS and HIV; it doesn’t hurt to air them, and it would certainly be a good idea both to stop the spread of homosexual propaganda and like he said to ensure people eat properly, have good sanitation, etc.

    • Where do I begin?

      – You claim that HIV/AIDS denialism represents an “alternative hypothesis”, thereby deploying the classical denialist tactic of false balance.
      – You approvingly quote Eysenck claiming that we “we know so little about any disease”, when in reality, HIV/AIDS is one of the most studies diseases in human history and the accumulated knowledge fill literally thousands of papers.
      – AIDS did not first appear among gay men in the U. S as the first documented cases occurred in Africa.
      – Insinuate that condoms to not reduce the risk of HIV transmission.
      – Claim that HIV statistics is pulled from the Kinsey report.
      – Claim that AIDS is the result of malnutrition.
      – Claim that diseases in general arise from poor sanitation and poor diet, which is essentially germ theory denialism.
      – Claim that there is no universal diagnostic criteria for AIDS when such a set of criteria exist.
      – Claim that by blog post refuting the claims of his IJEA paper is “largely ad hominem” when no such ad hominem existed.
      – Did not address any of the criticisms I or others put forward.
      – Claim that HIV/AIDS medication “may be killing people” without providing a shred of evidence.

      ….and those are just the examples of immense credulity in the post you wrote. We can add the following from the comment you wrote above:

      – Another appeal to false balance.
      – Use conspiracy language like “homosexual propaganda”.

      Do I need to continue?

      Needless to say, because you did not provide any evidence or argument whatsoever and instead decided to call me a “dickhead”, you will not be commenting on this blog in the future.

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