Why HIV/AIDS Denialist Henry Bauer Fails to Understand Risk

Henry Bauer is the gift that just keeps on giving. He fails to understand the basic biology of viruses. He does not understand that birth rates can mask the results of HIV/AIDS. He does not understand that the difficulty of making an HIV vaccine lies in its high mutation rate or that HIV tests are extremely accurate.

A study, Scherzer et. al. (2012), was recently published online ahead of print. By studying almost 11000 HIV positive subjects undergoing combined antiretroviral therapy, they showed an association between the use of a specific type of antiretroviral medication (called tenofovir) and an increased risk for certain events associated with kidney disease. However, the researchers concluded that

Despite tenofovir’s association with progressive kidney disease, it is an important component of effective antiretroviral therapy that may be required in many patients to control viral load. The balance between its efficacy and probable adverse effects requires further study.

In other words, tenofovir has side effects, but you also have to look at the side effects of not taking the drug in question. Let’s see how Bauer put a spin these results. In the blog post What’s next for the HIV/AIDS vigilantes at Treatment Action Campaign?, Bauer quotes an article from the website of the University of California, San Francisco called Tenofovir, Leading HIV Medication, Linked with Risk of Kidney Damage. However, he chops up the quotes and forgets to quote the researchers saying that:

Shlipak noted that HIV, itself, increases the risk of kidney damage, while modern antiretroviral treatments clearly reduce that overall risk. “Patients need to be aware of their kidney disease risks before they start therapy, and this should influence the medications that they choose in consultation with their doctor,” he said. “For an otherwise healthy patient, the benefits of tenofovir are likely to exceed the risks, but for a patient with a combination of risk factors for kidney disease, tenofovir may not be the right medication.”

In other words, HIV/AIDS itself increases the risk of kidney damage, which is reduced by the use of modern ARVs. So in other words, the risk of kidney damage from treatment must be balanced against the risk of kidney damage from not being treated. Otherwise you will perform an irrational risk analysis as there is really no such thing as “no risk”, only “risk compared with what”.

To be fair, Bauer does mention that HIV is believed by researchers to increase the risk of kidney damage, but he scoffs at this and rejects it by saying that “HIV itself is blamed by HIV/AIDS believers for every ill that antiretroviral drugs bring”. However, it has been clearly shown that HIV does cause renal failure.

United States Department of Veteran Affairs explains that 30% of HIV/AIDS patients have abnormal renal function and that risk factors include low CD4 count and unsuppressed viral load. Also, the incidence of HIV-associated nephropathy has declined since the advent of cART.

This clearly demonstrates how Bauer cherry picks the research to support his denialist beliefs. Those studies that appears to support his position (like this one about Tenofovir) is accepted without skepticism, whereas studies that contradicts his position (such as those showing that HIV can lead to kidney damage) is rejected out of hand.