User:Randroide/Atelier AIDS

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The AIDS reappraisal movement (or AIDS dissident movement) is a loosely connected group of activists, journalists, scientists, and HIV-positive persons who dispute the scientific consensus that the human immunodeficiency virus (HIV) is the cause of acquired immune deficiency syndrome (AIDS). Dissidents assert that the consensus that HIV causes AIDS has resulted in inaccurate diagnoses, psychological terror, toxic treatments, and a squandering of public funds, as well as an unprecedented deviation from scientific method and standards. The majority of the scientific community considers the causative role of HIV to be proven; dissident arguments are felt to be the result of cherry-picking of predominantly outdated scientific data, with the potential to endanger public health by dissuading people from utilizing proven treatments. Given the existing scientific consensus on the causative role of HIV, AIDS reappraisal is currently a primarily political, rather than scientific, movement.

A brief history
--70.236.71.100 (talk) 21:01, 30 April 2012 (UTC)
 * 1983: A group of scientists and doctors at the Pasteur Institute in France, led by Dr. Luc Montagnier, discovers a new virus in a patient with signs and symptoms that often precede AIDS. They name their discovery lymphadenopathy-associated virus, or LAV, and send samples to Dr. Robert Gallo's team in the United States.
 * 1984: On April 23, at a Washington press conference held two weeks before the relevant papers are published, Margaret Heckler, then Secretary of Health and Human Services, announces that Dr. Robert Gallo and his co-workers have discovered a virus that is the "probable" cause of AIDS. This virus is called HTLV-III.

--70.236.71.100 (talk) 21:01, 30 April 2012 (UTC)--70.236.71.100 (talk) 21:01, 30 April 2012 (UTC)--70.236.71.100 (talk) 21:01, 30 April 2012 (UTC)--70.236.71.100 (talk) 21:01, 30 April 2012 (UTC)
 * 1984: Casper Schmidt responds to the publication of Gallo's papers by writing "The Group-Fantasy Origins of AIDS", which is published by the Journal of Psychohistory. He posits that AIDS is an example of "epidemic hysteria" in which groups of people are subconsciously acting out social conflicts, and compares it to documented cases of epidemic hysteria in the past which were mistakenly thought to be infectious.
 * 1986: The viruses discovered by Montagnier and Gallo, having been found to be genetically indistinguishable, are renamed HIV.


 * 1987: Peter Duesberg questions the HIV theory of AIDS for the first time in his paper "Retroviruses as Carcinogens and Pathogens: Expectations and Reality", published in the journal Cancer Research. This publication coincides with the start of major public health campaigns and the promotion of AZT as a treatment.


 * 1988: The Perth Group, led by Eleni Papadopulos-Eleopulos, publishes their first article questioning aspects of the mainstream ideas about HIV and AIDS. They conclude that there is "no compelling reason for preferring the viral hypothesis of AIDS to one based on the activity of oxidising agents."


 * 1990: Robert Root-Bernstein publishes his first peer-reviewed article detailing his objections to the mainstream view of AIDS and HIV, entitled "Do we know the cause(s) of AIDS?" In it, he questions both the mainstream view and the dissident view as potentially inaccurate.


 * 1991: The Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis, comprised of twelve scientists, doctors, and activists, submits a short letter to various journals. Another similar letter would be published 4 years later in the journal Science.


 * 1994: 28 October: Dr. Robert Willner, whose medical license was revoked for, among other things, treating an AIDS patient with ozone therapy, publicly jabs his finger with blood he says is from an HIV infected patient. Willner died the following year of a heart attack.


 * 1995: The dissident group Continuum places an advertisement in The Pink Paper offering a £1,000 reward to "the first person finding one scientific paper establishing actual isolation of HIV" (according to their specific set of rules).


 * 1996: Various scientists, including Dr. Duesberg, dismiss the Continuum challenge, asserting that HIV doubtlessly exists.


 * 2000: South Africa's President, Thabo Mbeki, invites several dissidents to join his Presidential AIDS Advisory Panel. The mainstream scientific community responds with the Durban declaration, a document affirming that HIV causes AIDS, signed by over 5,000 scientists and physicians.


 * 2006: Celia Farber, a journalist and prominent AIDS dissident, publishes an essay in the March issue of Harper's entitled Out of Control: AIDS and the Corruption of Medical Science, in which she summarizes a number of arguments for AIDS reappraisal and alleges incompetence, conspiracy, and fraud on the part of the mainstream medical community.


 * 2007: South African advocate Anthony Brink and the Treatment Information Group serve a file of indictment at the International Criminal Court against Zackie Achmat and the Treatment Action Campaign (TAC), charging that their efforts to expand access to antiretroviral medication in South Africa constitute "genocide" and suggesting that Achmat be locked in "a small white steel and concrete cage" and "eradicated". The TAC responds by describing the indictment as "truly delusional".

The AIDS dissident community
People critical of the mainstream view of AIDS include HIV-positive persons, government employees, scientists, doctors and activists in several countries.

Probably the most famous and influential AIDS dissident scientist is Dr. Peter Duesberg, professor of molecular and cell biology at the University of California, Berkeley, who has been contesting the mainstream view of AIDS causation since 1987. Other scientists include Dr. David Rasnick (who has patents on protease inhibitor drugs used for the treatment of AIDS) and Dr. Rodney Richards (who helped to develop some of the first commercial HIV antibody tests). Nobel Prize winner Kary Mullis (inventor of PCR, used for the development of the viral load test) has expressed sympathy for dissident theories.

Some prominent AIDS dissidents, such as Tom Bethell and Phillip E. Johnson, have expressed support for a wide range of controversial or pseudoscientific beliefs, including intelligent design and global warming skepticism.

Other notable AIDS dissidents include Australian academic Hiram Caton, the journalist Celia Farber and the activist Christine Maggiore. Nate Mendel, bassist with the rock band Foo Fighters, has expressed support for AIDS dissident ideas and organized a benefit concert in January 2000 for the AIDS dissident organization Alive & Well AIDS Alternatives.

Organizations of AIDS dissidents include the Perth Group and the Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis.

Former dissidents
Several prominent figures once associated with AIDS reappraisal have since changed their views and accepted that HIV plays a role in causing AIDS, in response to an accumulation of newer studies and data. Robert Root-Bernstein, author of Rethinking AIDS: The Tragic Cost of Premature Consensus and formerly a critic of the HIV/AIDS paradigm, has since distanced himself from the AIDS dissident movement, saying, "The denialists make claims that are clearly inconsistent with existing studies. When I check the existing studies, I don’t agree with the interpretation of the data, or, worse, I can’t find the studies [at all]." In a 2005 article, Root-Bernstein and his coauthor wrote that "It is well-known that HIV-1 infection results in a gradual decline of the CD4+ T-lymphocytes." In a 2006 article, he and coauthors described therapeutic anti-HIV vaccination as a "promising strategy" in AIDS treatment research.

Joseph Sonnabend, who until the late 1990s regarded the issue of AIDS causation as unresolved, has reconsidered in light of the success of newer antiretroviral drugs, stating, "The evidence now strongly supports a role for HIV... Drugs that can save your life can also under different circumstances kill you. This is a distinction that denialists do not seem to understand."

Both Sonnabend and Root-Bernstein now favor a less controversial hypothesis, suggesting that cofactors in addition to HIV are necessary to cause AIDS.

Nonetheless, as of November 2006, some dissident websites continue to claim that Root-Bernstein and Sonnabend deny the role of HIV in AIDS.

Points of contention
The AIDS dissident community is comprised of various people and organizations with a diverse viewpoints. The community is united by their disagreement with the concept that HIV is the cause of AIDS.

Alleged suppression of debate
AIDS dissidents claim that mainstream AIDS researchers hold an orthodox viewpoint that prevents an open discussion or presentation of dissident positions. To AIDS dissidents, this closed mindset is the primary reason why the HIV-causes-AIDS paradigm persists; AIDS dissidents believe that an open, neutral discussion is considered unacceptable by the mainstream medical community, and that orthodox AIDS proponents often do not understand or truly investigate dissident theories. The mathematician Serge Lang compiled a set of "files" on HIV and AIDS alleging such suppression.

In reply to such claims, mainstream scientists point out that, far from being suppressed, dissident theories have been published and discussed at length in peer-reviewed journals and have failed to convince more than a minority of scientists; for example, Peter Duesberg has had 43 AIDS-related articles and letters published in the scientific literature. AIDS has been the subject of many thousands of peer-reviewed studies since it was first detected in 1981, and a clear scientific consensus has developed that HIV causes AIDS. For this group, the "orthodox" view of HIV is not a question of a "closed" viewpoint, but rather an acknowledgment of medical reality as derived from empirical data.

Koch's postulates
According to dissidents, HIV has failed to satisfy the Koch's postulates postulates. Peter Duesberg, among others, have claimed that Koch's first postulate is not adequately fulfilled because there are individual cases of AIDS in which HIV cannot be isolated. The Perth Group, led by Eleni Papadopulos-Eleopulos, has claimed that scientists have failed to satisfy the second postulate; they claim that a precondition of isolation is purification of the virus and that current isolates of HIV are not "pure".

Mainstream scientists argue that HIV does, in fact, fulfill Koch's postulates completely. In cases such as those cited by Duesberg, where HIV cannot be isolated, PCR shows that the virus is present. In any case, Koch's postulates have never been universally applicable. Even in Koch's time, it was recognized that some infectious agents were clearly responsible for disease in spite of the fact that they did not fulfill all of the postulates; Koch himself disregarded three postulates for cholera and typhoid fever. Currently, a number of infectious agents are accepted as the cause of disease despite not fulfilling all of Koch's postulates.

Pattern of spread
AIDS has spread relatively slowly in comparison with some other known infectious diseases; this is taken by dissidents to be evidence that AIDS is not caused by an infectious agent.

Dissidents also note that in North America and Western Europe, AIDS is non-randomly distributed, affecting certain groups of people more than others, and moreover it is fragmented into distinct sub-epidemics with different distributions of AIDS-defining diseases. According to dissidents, AIDS in Africa looks completely different from the corresponding syndrome in North America and Western Europe; one example that has been cited is that in Africa AIDS affects roughly equal numbers of men and women, while in North America and Western Europe it affects more men than women. Dissidents also point out that the parts of the world worst affected by AIDS tend to have widespread malnutrition and poor living conditions. According to dissidents, these are indicators of non-infectious causes of AIDS.

The consensus view is that regional variability in the pattern and spread of HIV/AIDS results from differences in the time of introduction of the virus, the social fabric of a given community, its culture, its sexual networks, the mobility of its people and the reaction of the government in mounting an AIDS control program. Regional variation in infection rates and infected populations is not unique to HIV/AIDS; for example, the epidemiology of hepatitis B is very different in the U.S. as compared to Asia. Transmission via bodily fluids has been well-demonstrated and is typical of an infectious disease: HIV behaves exactly like many other viruses in terms of its transmission through blood, sexual fluids,   and breast milk, suggesting that HIV does in fact spread like an infectious disease.

HIV harm questioned
In addition to the claims regarding the variations in AIDS definition between North America, Western Europe, and Africa, another fact cited as supporting the hypothesis that HIV is harmless is that a small number of HIV-positive people remain relatively healthy 15 or 20 years after testing positive for HIV. Conversely, some HIV-seronegative people develop what would have been considered AIDS-defining diseases had they tested positive.

According to the mainstream perspective, the long period of HIV infection preceding AIDS manifestations is to be expected; HIV can take years to cause the immunosuppression necessary to permit opportunistic disease to occur. Extensive studies conducted before treatment was available found the mean duration between HIV infection and the development of AIDS to be eight to ten years. By this measurement, Hepatitis C would also be a "harmless" virus, as its latent stage may run longer than 20 years. There are many other well-known infectious diseases that develop slowly with a long latency period between infection and disease, such as Creutzfeldt-Jakob Disease, syphilis, and leprosy; AIDS is hardly unique in this respect.

AIDS definition
Of substantial concern to AIDS dissidents is the use of HIV antibody or viral testing as part of the definition of AIDS. Some of the approximately 30 AIDS-defining diseases, including Kaposi's Sarcoma (KS) and Pneumocystis jiroveci pneumonia (PCP, formerly Pneumocystis carinii), are considered diagnostic of AIDS only when serologic evidence of HIV is present. In the absence of such evidence, these diseases are thought to be related to other immune problems, and are not diagnostic of AIDS. In other words, according to dissidents, the definition of AIDS is an example of circular logic: because a diagnosis of AIDS requires the presence of HIV antibodies, there can be no AIDS without HIV.

Two major systems of AIDS diagnosis used today are the World Health Organization system, for use in resource-limited settings (see WHO Disease Staging System for HIV Infection and Disease), and the CDC system used in the USA (see CDC Classification System for HIV Infection). European countries and Canada use a variation of the CDC definition that excludes CD4 counts. Supporters of these definitions point out that AIDS-defining diseases such as KS and PCP (and also very low CD4 counts) are exceedingly rare in people who are HIV-negative, and that it is standard practice in medicine to include a microbial test in disease diagnosis.

HIV test accuracy
Skeptics of the theory that HIV causes AIDS claim that the process of testing individuals for the presence of HIV is flawed. They assert there is a high probability of encountering a false positive, which would falsely identify someone as HIV-positive when in fact they were HIV-negative, e.g. because of pregnancy or cross-reactivity with malaria antibodies.

A detailed criticism of the Western blot test and the "gold standard" of HIV isolation was published by Eleni Papadopulos-Eleopulos et al. in Bio/technology in 1993: Is a Western Blot Proof of HIV Infection? Their arguments rest on non-specificity of antibodies and lack of standardisation and reproducibility of HIV tests. In their conclusion, the authors state, "It is axiomatic that the use of antibody tests must be verified against a gold standard. The presently available data fail to provide such a gold standard for the HIV antibody tests. The inescapable conclusion from the above discussion is that the use of HIV antibody tests as predictive, diagnostic and epidemiological tools for HIV infection needs to be carefully reappraised."

In response, virologists contend that the accuracy of serologic testing has been verified by isolation and culture of HIV and by detection of HIV RNA by PCR, which are widely accepted "gold standards" in microbiology. The consensus view of the scientific community is that current methods of HIV antibody testing are remarkably accurate. The false-positive rate among the American public ranges from 0.0006 to 0.0007 percent. The false-negative rate for HIV antibody testing ranges from 0.001% to 0.3%, depending on the risk factors of the tested population.

Critics assert that many AIDS dissidents' claims of inaccuracy result from an incorrect or outdated understanding of how HIV antibody testing is performed and interpreted. In the USA, the standard HIV diagnostic procedure combines two methods of detecting HIV antibodies: ELISA and Western blot. While either of these tests (ELISA or Western blot) individually may yield a significant number of false-positives and false-negatives, the combination of these two methods results in the extremely high accuracy rates cited above. Many of the AIDS dissident claims focus on the inaccuracy of one individual component of HIV antibody testing, without acknowledging that the tests are used in combination to accurately diagnose HIV infection.

Antibodies to HIV
Some AIDS dissidents claim that HIV cannot cause AIDS because the virus is neutralized by antibodies. As noted above, a variety of antibodies to HIV are detectable in the serum of infected patients. Celia Farber, in her essay Out of Control, summarized the argument thus: In fact, most AIDS patients have no active HIV in their systems, because the virus has been neutralized by antibodies. (With all other viral diseases, by the way, the presence of antibodies signals immunity from the disease. Why this is not the case with HIV has never been demonstrated.)

Robert Gallo and the National Institutes of Health have pointed out, in response, that a number of other viruses can cause disease in spite of the presence of antibodies. Examples include herpes zoster, herpes simplex, and hepatitis C. Gallo et al. emphasized the well-documented mechanisms by which HIV can evade the antibody response, such as cell-to-cell spread and rapid mutation.

AIDS treatment toxicity
Dissidents claim the antiretroviral treatments prescribed to AIDS patients often cause the very symptoms they are supposed to delay. To support this claim, they cite two studies from the late 1980s whose authors said they found it difficult to distinguish adverse events possibly associated with administration of Retrovir (AZT) from underlying signs of HIV disease or intercurrent illnesses.

Mainstream scientists and doctors argue that dissidents are ignoring or unjustifiably dismissing abundant evidence demonstrating the effectiveness of modern antiretroviral medication. Harmful side effects do occur, and in some cases these can be severe or even deadly. However, multiple studies — conducted in Africa as well as Western countries — have found that, overall, anti-retroviral drug treatment is associated with a greatly decreased incidence of opportunistic infections and increased survival among HIV-positive people.

Impact beyond the scientific community
The concept that HIV causes AIDS is widely regarded as proven in the scientific community. However, the AIDS dissident movement has had a significant impact outside of scientific spheres, making the debate a civil and political as well as a scientific and public health issue.

Impact in North America and Europe
Skepticism about HIV as the cause of AIDS began almost immediately after the discovery of HIV was announced. One of the earliest prominent skeptics was the journalist John Lauritsen, who argued in his writings for The New York Native that AIDS was in fact caused by amyl nitrite poppers, and that the government had conspired to hide the truth.

The publication of Dr. Peter Duesberg's first AIDS paper in 1987 fueled further support for dissident theories. Shortly afterwards, the journal Science reported that Duesberg's remarks had won him "a large amount of media attention, particularly in the gay press where he is something of a hero." However, Duesberg's support in the gay community dried up as he made a series of statements perceived as homophobic; in an interview with the Village Voice in 1988, Duesberg stated his belief that the AIDS epidemic was "caused by a lifestyle that was criminal twenty years ago."

In the following few years, others became skeptical of the HIV theory as researchers initially failed to produce an effective treatment or vaccine for AIDS. Journalists such as Neville Hodgkinson and Celia Farber regularly promoted dissident ideas in the American and British media; several television documentaries were also produced to increase awareness of the alternative viewpoint.

With the introduction of highly active antiretroviral therapy (HAART) in 1996-1997, the survival and general health of people with HIV improved significantly. The positive response to treatment with anti-HIV medication is regarded as further proof of HIV's causative role in AIDS, and has led several prominent AIDS dissidents to accept the causative role of HIV. Today, AIDS dissident arguments are widely regarded as pseudoscience, on par with Lysenkoism. Nevertheless, these theories continue to exert a significant influence in some communities; a survey conducted at minority gay pride events in four American cities in 2005 found that 33% of attendees doubted that HIV caused AIDS.

Impact in South Africa
In 2000, when the International AIDS Conference was held in Durban, South African President Thabo Mbeki convened a Presidential Advisory Panel containing a number of AIDS dissidents, including Peter Duesberg and David Rasnick. The Advisory Panel meetings were closed to the general press; an invited reporter wrote that Rasnick advocated that HIV testing be legally banned and denied that he had seen "any evidence" of an AIDS catastrophe in South Africa, while Duesberg "gave a presentation so removed from African medical reality that it left several local doctors shaking their heads."

In his address to the International AIDS Conference, Mbeki reiterated his view that HIV was not wholly responsible for AIDS, leading hundreds of delegates to walk out on his speech. Mbeki also sent a letter to a number of world leaders expressing mistrust of superimposing "Western experience on African reality" and likening the mainstream AIDS research community to supporters of the apartheid regime. The tone and content of Mbeki's letter led diplomats in the U.S. to initially question its authenticity.

Mainstream AIDS scientists and activists were dismayed at the president's behavior and responded with the Durban declaration, a document affirming that HIV causes AIDS, signed by over 5,000 scientists and physicians.

South African health minister Manto Tshabalala-Msimang has also attracted heavy criticism, as she has often promoted nutritional remedies such as garlic, lemons and olive oil to people suffering from AIDS, while emphasizing possible toxicities of antiretroviral drugs, which she has referred to as "poison".

Mbeki's government was charged with delaying the rollout of an antiretroviral drug program for HIV-positive pregnant women. The national program began only after the Treatment Action Campaign (TAC) brought a legal case against Government ministers, claiming they were responsible for the deaths of 600 HIV-positive people a day who could not access medication. South Africa was one of the last countries in the region to begin such a treatment program, and roll-out has been much slower than planned.

In 2002, Mbeki requested that AIDS dissidents no longer use his name in dissident literature, and requested that dissidents stop signing documents with "Member of President Mbeki's AIDS Advisory Panel".

In early 2005, former South African president Nelson Mandela announced that his son had died of complications of AIDS. Mandela's public announcement was seen as both an effort to combat the stigma associated with AIDS, and as a "political statement designed to... force the President [Mbeki] out of his denial."

Alleged harm caused by dissident views
At the seminar on HIV and Responsible Journalism at the 16th International AIDS Conference, Nathan Geffen of the South African Treatment Action Campaign stated:

John Moore, Ph.D., argued at the same seminar that:

In response to Dr. Moore's comments, the dissident Perth Group has denied encouraging unsafe sex or drug use; indeed, they agree that these behaviors increase risk of AIDS and should be avoided. Dr. Duesberg also argues that condoms have a role in preventing AIDS:

Dissident

 * Virusmyth
 * Peter Duesberg website
 * HEAL Toronto
 * The Perth Group
 * Alive & Well AIDS Alternatives
 * Video: Clip from "HIV=AIDS: Fact or Fraud?"
 * Video: Clips from "The other side of AIDS"

Mainstream

 * National Institute of Allergy and Infectious Diseases (NIAID) Focus on the HIV-AIDS Connection: Resources and Links
 * Series of articles in Science magazine debunking dissident claims
 * HIV Science and Responsible Journalism seminar, presented at the 16th International AIDS Conference, accessed 7 Sept 2006.
 * AIDS Treatment News Denialist Series
 * AVERT.org: Evidence that HIV causes AIDS
 * AEGiS: News and Views on AIDS Causality
 * Aidsmap: Dissident views
 * AidsTruth.org

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