Why am I picking low-hanging fruit?
Henry Bauer is professor emeritus in chemistry and science studies at Virgina Tech, he has done very little scientific research, no scientific research on retroviruses, believes in the existence of the Loch Ness monster, considers homosexuality an “aberration or illness” (although he has apparently a more generous view these days) and is a former editor of the woo-woo journal called Journal of Scientific Exploration. This hardly sounds like a formidable adversary. However, Bauer is one of the most prolific HIV/AIDS denialists and those supporting science-based medicine should strive to defend rational science from the pseudoscientific falsehoods that Bauer keeps peddling.
I have in many previous articles shown that his claims fall incredibly short of scientific accuracy, but now it is time to release the sharks with frickin’ laser beams on their heads and focus our rational and science-based thinking on his central falsehoods that he lists on the about page of his WP blog. In the end, none shall survive.
In general, the so called “problems” for HIV science that Bauer lists adds up to nothing more than the classic pseudoscientific debating tactic vulgarly known as JAQing off. It is “the act of spouting accusations while cowardly hiding behind the claim of ‘Just Asking Questions’. The strategy is to keep asking leading questions in an attempt to influence listeners’ views […]”. But regardless, it is important for scientific skeptics to clearly address denialist assertions, if just to influence people on the fence or give scientific skeptics more ammo against denialism. Some may be a repeat of earlier articles, but I wanted to keep everything against Bauer’s core claims gathered in one spot.
Long-term nonprogressors are very few
—> Fewer than 1% of HIV-infected individuals are termed long-term nonprogressors. This means that they have viral particles in their blood, but do not develop AIDS. This does not qualify as “many” by any stretch of the imagination.
—> The exact genetic basis of this phenomena is largely unknown, but genome association studies suggests that the MHC locus may be involved. Specific HLA class I loci have also been linked to lack of disease progression (Abbas, 2012, pp. 467-468). This just means that HIV does not cause AIDS in these very few individuals. It does nothing against the well-supported evidence that HIV causes AIDS in the other ~99% of infected individuals. It is merely a feeble attempt by Bauer to deploy an argument from ignorance by focusing on what is unknown why ignoring the vast amount of accumulated knowledge.
Difficulties in HIV vaccine development is due to rapid mutation rate and evolution
—> Vaccine research can sometimes be hard. HIV has many unique challenges associated with it. The nature of the infection involves undermining central components of adaptive immunity and it has a fairly high mutation rate. It is estimated that HIV has an very high mutation rate due to the error-prone nature of reverse transcriptase, which is an enzyme that makes DNA from RNA for host integration. It is estimated that all theoretically possible point mutations in the viral genome occurs every day. Another issue is that viral integration into the host genome and becoming transcriptionally silent means that it is more difficult for the immune system to clear it from the body of a vaccinated individual. Also, there are many different version of HIV, and it is possible to be infected by more than one strain, making vaccine development difficult (Abbas et. al. 2012 p. 467; Murphy, 2012, pp. 560-561).
Drop in lifespan reveals the severe impact of the HIV/AIDS pandemic
—> While it is true that e. g. South Africa has a positive population growth, this is due to high birthrates. The severe impact of HIV/AIDS can be seen by looking at changes in average lifespan over time. As discussed in a previous blog entry, 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.”
Combined antiretroviral therapies are reasonably safe, even in the long-term
—> There are so many studies that you could point to that demonstrates this, but let us look at a very recent one to avoid making this another extremely long entry. Now, a single study does not conclusively demonstrate anything, but there are so many by now and they all point in the same general direction that we can tentatively accept their conclusions.
—> Kowalska et. al (2012) studied over 12000 patients over a period of almost four years and found no increase in the risk of death due to long-term use of combined antiretroviral therapy (cART) and that the risk of dying by HIV/AIDS while you where on cART was lower during the time.
Combined antiretroviral therapy are effective
—> Again, there are so many studies that one can point to here, but I will settle with just a few. Deeks et. al. (1997) explains the huge success of protease inhibitors, Murphy et. al. 2002 shows that the introduction of HAART (highly active antiretroviral therapy) decreases both mortality and morbidity in AIDS-patients and Bangsberg et. al. (2001) shows that patients who do not adhere to their HAART treatment are more likely to progress to AIDS.
Different HIV tests can directly and indirectly detect HIV
—> There are many different tests that can be used to directly or indirectly detect HIV. An ELISA test detects the presence of antibodies to HIV, a PCR test can detect the genetic material of the HIV virus, a Western blot to test for viral proteins and so on (Constantine, 2006).
HIV tests are extremely accurate
—> While it is true that an ELISA test may, on rare occasions, yield a false positive, a positive ELISA test is always followed up by a Western Blot. If the tests are used correctly, the probability that you can get a positive ELISA test and a positive Western blot and not have HIV is less than 0.01%. In other words, this type of HIV testing are 99.99% accurate (Kalichman, 2009, pp. 62-64). This is about as good as any medical test can be. Naturally, tests for viral load and so on are carried out throughout the treatment, so that is another boundary for false positives. Also, it can also be tested by PCR above, so the combined probability that you could get a false positive on all of these different tests are astronomically small and for all intents and purposes negligible.
—> The central falsehoods of HIV/AIDS denialist Henry Bauer has been destroyed by science-based medicine.
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References and Further Reading
Abbas, A. K., Lichtman, A. H., & Pillai, S. (2012). Cellular and Molecular Immunology. Philadelphia: Elsevier Saunders.
Bangsberg, D. R., Perry, S., Charlebois, E. D., Clark, R. A., Roberston, M., Zolopa, A. R., & Moss, A. (2001). Non-adherence to highly active antiretroviral therapy predicts progression to AIDS. AIDS, 15(9), 1181-1183.
Constantine, Niel. (2006). HIV Antibody Assays. HIV InSite at University of California, San Francisco. Accessed: 2012-02-01.
Deeks, S. G., Smith, M., Holodniy, M., & Kahn, J. O. (1997). HIV-1 Protease Inhibitors. JAMA: The Journal of the American Medical Association, 277(2), 145-153.
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.
Kowalska, J. D., Reekie, J., Mocroft, A., Reiss, P., Ledergerber, B., Gatell, J (2012). Long-term exposure to combination antiretroviral therapy and risk of death from specific causes: no evidence for any previously unidentified increased risk due to antiretroviral therapy. AIDS, 26(3), 315-323.
Murphy, K. (2012). Janeway’s Immunobiology (8th ed.). New York: Garland Science.
Murphy, E. L., Collier, A. C., Kalish, L. A., Assmann, S. F., Para, M. F., Flanigan, T. P. (2001). Highly Active Antiretroviral Therapy Decreases Mortality and Morbidity in Patients with Advanced HIV Disease. Annals of Internal Medicine, 135(1), 17-26.