Mainstream Reseachers Question the HIV/AIDS Theory

by Dr. Robert O. Young / NOVEMBER 28, 2006

DrYoung Just in time for World AIDS Day: Three new studies and a journal article all authored by mainstream researchers that question popular ideas and conventional thinking about HIV and AIDS.

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The Failure of Viral Load TestsJAMA Study Shakes AIDS Science, Angers HIV Advocates A nationwide team of orthodox AIDS researchers led by doctors Benigno Rodriguez and Michael Lederman of Case Western Reserve University in Cleveland are disputing the value of viral load testsa standard used since 1996 to assess health, predict progression to disease, and grant approval to new AIDS drugsafter their study of 2,800 HIV positives concluded viral load measures failed in more than 90% of cases to predict or explain immune status.

Published in the September 27, 2006 issue of the Journal of the American Medical Association (JAMA), the findings by Rodriguez et al shake the foundation of the past decade of AIDS science to its core, inciting skepticism and anger among many HIV adherents. Belief in viral load spread quickly following the 1996 publication of a paper in the journal Science authored by Dr John Mellors and colleagues at the University of Pittsburgh. Mellor et al claimed that numbers produced by the viral load test could accurately predict progression to disease in HIV positives. Soon, use of this new technology extended far beyond conclusions drawn by the study and its approval by the FDA as a prognostic tool.

Claiming viral load numbers corresponded to actual amounts of infectious virus, scientists used the test as a glib response to unanswered questions about how HIV could cause AIDS (Its the virus, stupid!). Pharmaceutical companies jumped on the bandwagon, using changes in viral load numbers in place of actual health or survival benefits to gain FDA approval of highly toxic protease inhibitors, a primary ingredient of todays HAART. Treatment advocates began using viral load to encourage healthy HIV positives with unhealthy numbers to hit early and hard with the newly approved drugs, while AIDS doctors throughout the world started using viral load for everything from diagnosing illness to confirming HIV infection.

The new uses for viral load emerged and gained popular acceptance despite the fact that, according to manufacturers literature, the viral load test is not intended to be used as a screening test for HIV or as a diagnostic to confirm the presence of HIV infection.

In a September 29th news article regarding the Rodriguez study, Mellors announced he doesn't agree with the paper at all, insisting that viral load is the most powerful predictor of time to AIDS and death." Some AIDS rethinkers note that in defending his opinion, Mellors describes viral load as powerful, an adjective frequently found in the headlines of AIDS drug ads--drugs approved for use based on their ability to affect viral load numbers rather than to produce clinical health benefits or increase survival.

While Mellors and others protest or down play the significance of the JAMA article, Rodriguez's group stands by its conclusion that viral load is only able to predict progression to disease in 4% to 6% of HIV-positives studied, challenging much of the basis for current AIDS science and treatment policy.

For further information see: Cohen J. Study says HIV blood levels don't predict immune decline. Science 313(5795):1868, 2006; Rodriquez B, Sethi AK, Cheruvu VK, et al. Predictive value of plasma HIV RNA level on rate of CD4 T-cell decline in untreated HIV infection. JAMA 296(12):1498-506, 2006

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New Study Questions Reliability of T Cell Counts Finds HIV Negatives with AIDS Defining Numbers Following the news that viral load is not an accurate method of assessing or predicting immune status comes word from the Journal of Infectious Diseases that T cell counts may be less reliable measures of immune competence than previously believed.

A study in Africa conducted by the World Health Organization (WHO) revealed that HIV negative populations can have T cell counts below 350, a number that would, according to WHO guidelines, qualify for an AIDS diagnosis in HIV positive populations. Another surprising conclusion from the same WHOstudy: HIV positives that started AIDS drug treatment with low T cell counts had the same survival outcomes as HIV positives that began treatment with high T cell counts.

Check out the conundrums in this November 11 2006 article from New Scientist found online at www.newscientist.com

Are We Prescribing HIV Drugs Properly?

In cash-starved regions of the world, deciding who should get anti-retroviral drugs for HIV is a tough call. Now it seems that one of the main tools for making that decision may be less reliable than it appeared.

World Health Organization guidelines recommend starting anti-retroviral drugs when someone's CD4 cell count has fallen below 350 cells per microlitre, an indicator of HIV infection, or for people with symptoms of AIDS whose CD4 count has dropped to below 200.

Brian Williams of the WHO and his colleagues studied HIV-positive and HIV-negative populations in eight African countries including Ethiopia, South Africa, Uganda and Zambia. They found that between 3 and 5 per cent of HIV-negative people had CD4 counts below 350.

What's more, when people with low pre-infection cell counts did contract HIV, and received anti-retrovirals, they survived for about nine years - the same as people with high counts (Journal of Infectious Diseases, vol 194, p 1450).

The new findings call into question just how much we understand about CD4 cells and their interaction with HIV, says Williams. "Generally, if you have high CD4 counts you can be considered to be doing pretty well and if you have very low counts, you're in trouble," says Williams. But CD4 counts can vary a lot naturally so if you follow the WHO guidelines to the letter, then some people started on anti-retrovirals would not even be infected with HIV, he concludes.

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Lancet Study Challenges Claims about HAART Treatment Does Not = Life The surprising conclusion from a recent study published in the medical journal, The Lancet: After starting treatment with HARRT, viral response improved but such improvement has not translated into a decrease in mortality.

The multi-center study reported in The Lancet article tracked the effects of HAART on some 22,000 previously treatment naove HIV positives between 1995 and 2003 at 12 locations in Europe and the USA. Instead of finding data that provide a ringing endorsement of anti-HIV drug therapy, the studys results refute popular claims that the newer anti-HIV meds extend life or improve health.

Commenting on the article, Felix de Fries of Study Group AIDS-Therapy in Zurich, Switzerland had this to say: The Lancet study shows that after a short period of time, HAART treatment led to increases in precisely those opportunistic infections that define AIDSfrom fungal infections of the lungs, skin and intestines to various mycobacterial infections. De Fries also notes that while HAART has led to no sustained increases in CD4 counts, no reduction in AIDS-defining illness and no decrease in mortality rates, its use is associated with a list of serious adverse events including cardiovascular disease, lipodystrophy, lactacidosis, liver and kidney failure, osteoporosis, thyroid dysfunction, neuropathy, and non-AIDS cancers among users.

For more information, please refer to The Lancet, issue 368:451-58 and/or The Study Group AIDS-Therapy by telephone or fax at 0041 44 401 34 24 or by email at felix.defries@tele2.ch

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Journal Article Advocates Radical Approach to AIDS Prevention Questions Popular Ideas about HIV in Africa Excerpted from www.health-e.org.za

Taking a swipe at those who try to blame sexual behaviour for the rampant HIV epidemic in southern Africa, Professor Eileen Stillwaggon says that they are caught up in "exotic notions" about Africans. Instead, AIDS prevention efforts will be more successful if they focus on "biological and socio-economic factors" that can be addressed relatively easily and cheaply, she argues persuasively in the latest edition of Africa Policy Journal.

"Differences in sexual behaviour cannot explain 50-fold differences in HIV prevalence around the world," writes the economics professor from Gettysburg College. "Yet global AIDS policy relies almost entirely on behavioural interventions - abstinence or condoms - for HIV prevention. Southern Africa's very high AIDS rate has been a source of much speculation. President Thabo Mbeki has been the most vocal proponent for poverty to be put on the global AIDS agenda, and has also condemned Western notions of African sexuality in the context of AIDS.

Stillwaggon is no AIDS denialist, but she doesn't mince words when she condemns those who propose that changing sexual behaviour is the main solution to Africa's AIDS epidemic. "Policymakers seem to be convinced (without evidence) that Africans are having more sex than Americans. They do not ask why US college campuses, where rates of chlamydia and genital herpes are as high as 30 to 40 percent, do not have high rates of HIV." She argues compelling for a return to "the fundamental causes" of the raid spread of AIDS in poor countries - biological and socio-economic factors.

As far as biology is concerned, says Stillwaggon, the immune systems of people in southern Africa are weakened by malnutrition and parasitic illnesses. Malnutrition - a deficiency of energy, protein and minerals such as iron, zinc and vitamins - makes a person far more susceptible to infectious and parasitic diseases. These deficiencies make it hard for new cells to be built, including CD4 cells that protect the body from infections.

"A malnourished, parasite-laden population gives rise to a very different epidemic dynamics from that of a healthier population, but models used by the major AIDS organisations do not take this into consideration," says Stillwater. Instead, she says, they use a "one-size-fits-all" approach based on behaviour change that ignores factors that make poor people especially vulnerable. The easier, cheaper approach would be to address nutritional deficiencies and parasite infections.

Stillwaggon's approach is a radical departure from the norm, and offers fresh solutions to AIDS prevention where the decades-old mantra of "abstain, be faithful and condomise" has been unable to stop the spread.

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AIDS and the Ecology of Poverty More on Stillwaggons ideas from the Oxford University Press web site: www.us.oup.com

Why does AIDS policy ignore much of what is known about epidemics and why they spread? HIV/AIDS flourishes where people are dying of myriad other diseases that are almost unknown among affluent populations. In her book "AIDS and the Ecology of Poverty," Eileen Stillwaggon draws on conventional epidemiology, which recognizes that people who are malnourished, burdened with parasites and infectious diseases, and who lack access to medical care are vulnerable to other diseases, regardless of whether they are transmitted by air, water, food, or sexual contact. HIV/AIDS is no exception.

This book delivers a telling critique of the behavioral explanation of epidemic AIDS and the stereotypes that lie beneath it. It also shows how the methodologies applied in recent epidemiology and health economics are based on a one-risk-fits-all model that ignores the greater vulnerability of poor people and gives rise to policies that are narrow, shortsighted, and dead-end.

Stillwaggon combines the insights of economics and biology to explain the epidemic spread of HIV/AIDS in poor populations in developing and transition countries. Drawing on a wealth of scientific evidence, the author demonstrates that the HIV/AIDS epidemic cannot be stopped in isolation. She offers pragmatic solutions to economic, social, and health problems that beset poor populations and contribute to the spread of HIV/AIDS.

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New Web Sites

Former State Senator Stephen Davis just launched two new web sites, both designed specifically as starting points for people whove tested HIV positive to help them begin to explore the other side of AIDS.

www.HelpForHIV.com offers a gentle introduction to the concept that test results may be wrong and provides supporting scientific literature. The site includes links to 50 podcasts featuring recorded interviews with various dissident experts, along with links to videos, scientific papers and newspaper and magazine articles dealing specifically with HIV tests and AIDS drugs. The site also lists books, links to all AIDS rethinking websites and blogs, and has a questionnaire people can fill out to help build a database for future legal action.

The second new site www.livingwithouthivdrugs.com/ archives a growing collection of true-life stories of HIV positives living healthy and happy lives without HIV medications.

Davis plans to promote HelpForHIV.com in the coming weeks and months through blogs and chat rooms, radio interviews, Google and Yahoo ads, and if all goes well, some TV spots. Davis says, My hope is that these new websites can attract a large number of HIV positives and help them learn the truth about the HIV tests and HIV drugs, creating a powerful community of support at the grassroots level.

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Not So New Web Sites Worth A Second Look

- Theres a whole new links page at the pH Miracle Living web site enabling visitors to find new science and medical information, lots of health resources and more. Check it out at www.phmircleliving.com or www.articlesofhealth.blogspot.com

- Visit http://aras.ab.ca to find new links to recent articles on topics ranging from the AIDS drug tenofovir to routine HIV testing and several new pieces inspired by Celia Farber's March 2006 article in Harpers magazine, AIDS and the Corruption of Science.

- Dont miss the new Challenges page at the Rethinking AIDS web site, which features a collection of informative and entertaining exchanges with AIDS and other medical experts on a variety of related subjects. See www.rethinkingaids.com/Challenges/index.html

 
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