Belinda Beresford answers some of the most frequently raised claims put forward by the so-called dissidents A virus cannot cause a syndrome The orthodox viewpoint is that the human immunodeficiency virus – HIV – causes acquired immunodeficiency syndrome – Aids. HIV is just another virus. Different viruses tend to have preferences for attacking particular body cells. For example, influenza viruses tend to attack cells in the respiratory membranes, although they can attack other body tissues such as in the brain and gut as well. The result is that one virus can create a number of different symptoms. Chickenpox, for example, can cause pneumonia, as well as the more common rash or shingles. Herpes can cause meningitis as well as cold sores and genital ulcers. HIV attacks cells in the immune system, because the shape of its outer envelope fits neatly on to the outside of these cells. The virus uses the immune system cells to reproduce. By sheer force of numbers, eventually the infected person’s immune system becomes overwhelmed, and increasingly less effective. This means that it is unable to fight off other infections, which encroach and eventually kill the individual. The diseases which afflict HIV-positive people include pneumonia, tuberculosis, herpes, cancers, diarrhoea. Smuts Ngonyama, head of the African National Congress president’s office, says that ”it is absurd … to suggest that all these diseases can be caused by a single, common virus HIV”. True, such diseases are not caused by HIV – they are caused by other bacteria, viruses, fungi and even normal cellular mutations, which the immune system is simply unable to kill. It is unable to do so because so many immune system cells have been destroyed by HIV that the whole defence system itself has become overwhelmed.
HIV does not fulfil Koch’s postulates as the cause of Aids This very grand-sounding requirement is simply a set of three tests suggested more than a century ago as a way of checking the cause of an epidemic disease. There have been many suggested adaptations to Koch’s postulates, in particular in response to new technological discoveries and the increasing discoveries of viruses. The postulates are: 1) The suspected cause must be strongly associated with the disease. 2) The suspected pathogen must be isolated and propagated outside the host. 3) Transferring the suspect pathogen to an uninfected host must cause the disease. 1) International studies have shown the strong link between HIV and Aids. People who have HIV almost always eventually develop Aids. People with Aids almost always are HIV- positive. For example, research in 1993 found that of more than 230 000 Aids patients, 299 were HIV-negative. But 179 of these individuals were examined further and 131 were found to be HIV-positive. An additional 34 died before their status could be confirmed.
2) HIV has been isolated and reproduced outside the human body. 3) There have been many documented cases of laboratory workers who have developed Aids after being infected by HIV through needlestick injuries and who had no other risk factors.
The opportunistic infections characteristic of Aids are simply ‘old’ infections and have nothing to do with HIV Yes. Opportunistic infections are caused by infectious agents other than HIV. Infection with HIV simply assists other pathogens, many of which are normally kept in check by the immune system. The impact of HIV can be demonstrated by data produced by the American National Institutes of Health. According to its research, before the Aids epidemic only 32 people with widespread Mycobacterium avium complex had been described in medical literature. By the end of 1999 the Centers for Disease Control knew of almost 42 000 confirmed diagnoses of this illness. The increase is due to the destruction of human immune systems by HIV.
Anti-retroviral drugs such as AZT are toxic True, anti-retroviral drugs are highly toxic and people taking them can suffer distressing side effects. In fact there is a whole range of research looking at structured interruptions to anti-retroviral treatment – giving people drug-free periods to allow them to recover from the effects of the treatment. However, the drugs used in chemotherapy for cancer are also highly toxic: such treatment is notorious for the suffering it causes in patients. However, chemotherapy often saves, or at least extends, the lives of people afflicted with cancer, which is why they endure it. Anti-retroviral therapy has repeatedly been shown to save and extend the lives of people living with Aids. In addition, the dosages now being used in anti- retroviral therapy are often much lower than when such treatments first started. Mainstream doctors do not advocate the wholesale consumption and distribution of anti-retroviral drugs, and indeed there is still dispute about when to start this kind of treatment. One reason for this is therapeutic efficacy, but another undeniable reason is the toxicity and side effects. There is also uncertainty about the long-term efficacy of some of the drugs. However, here too there is a foundation upon which the mainstream bases its views, and that is the documented evidence of the effectiveness of these drugs in most (not all) people, in reducing illness, by restoring immune response and suppressing the amount of virus in the blood, often to undetectable levels. This has changed the epidemiology of Aids in countries where there is broad access to the drugs. Hospitals in the United States have closed Aids wards because anti-retrovirals have effectively restored health to so many people.
Anti-retroviral drugs such as AZT cause birth defects
Anti-retroviral drugs, in common with many other pharmaceutical and recreational drugs – including alcohol – can cause defects in unborn children. This is particularly true if they are taken at in the early stages of pregnancy, when the embryo is particularly vulnerable. If taken at the correct time and dosage, anti-retroviral drugs such as AZT and Nevirapine have been shown to decrease the chances of unborn children catching the virus from their mothers. Research on Nevirapine, which requires one pill only to be given to the mother during labour, and a small dose to the infant on birth, has indicated a very low level of abnormalities.
Aids is caused by anti-retroviral drugs. Alternatively Aids is caused by use of recreational drugs, malnutrition, promiscuity, anal sex, homosexuality … Many of the people suffering from Aids, particularly those in developing countries, have never had the privilege of seeing anti- retroviral drugs, let alone access to their use. Nor have they ever used recreational pharmaceuticals. There have been documented cases of people who are not promiscuous, who have only vaginal sex – and indeed whose only risk factor has been being pricked by a needle contaminated with HIV-infected blood or having blood transfusions, yet have caught the virus. The only consistent similarity between people around the world who have Aids is the existence of the HIV virus in their bodily fluids.
The suggestion that highly active anti- retroviral therapy (Haart) causes Aids was the subject of a recent e-mail sent out by Aids dissident Anita Allan. She directed recipients to a website containing a scientific paper that ”proves once again that Haart causes Aids”. But reading the whole paper suggests nothing of the sort. The paper, which appears in the Annals of Internal Medicine (www.annals.org), carefully details cases where initiating Haart has resulted in a patient’s displaying ”Aids- defining events” (infections which are commonly regarded as indicators for Aids). The paper refers to the development of disease in some people (not all, not a majority) ”in the first two months” after commencing HAART. It makes it clear that such situations are not unknown from other medical treatments. ”Other mycobacterial diseases, such as tuberculosis and leprosy, have long been known to present with paradoxical reactions shortly after initiation of antimycobacterial chemotherapy, presumably because delayed-type hypersensitivity is restored. Also, patients not infected with HIV-1 have developed similar inflammatory reactions after withdrawal of medical immunosuppression, probably because cellular immunity has returned.”
No one has ever managed to photograph the virus in human blood According to Dr Lynn Morris of the National Institute of Virology, it is technically very difficult to directly visualise HIV in the blood by electronmicroscopy. HIV is not alone in being difficult to photograph. For example, the hepatitis C virus has only recently been visualised – and then with great difficulty – even though its RNA has been analysed and there are tests to detect its presence. However HIV is readily seen in the lymph nodes of infected patients, where it replicates and concentrations are far higher than in the blood. Morris points out that the fact that the virus can be cultured from blood in the laboratory in itself shows that it exists. ”You can’t grow something out of nothing. We’re growing it because it’s there.”
HIV/Aids tests are not accurate, often giving false positive results Ideally, in testing whether a person has a disease, the test should be positive for all those who have the disease and negative for those without it. In reality no test can be accurate 100% of the time. The sensitivity of a test measures how often the test is positive in people who really have the disease. The specificity of a test indicates how often the test gives a negative result when a person truly does not have the disease. Ideally tests should have both a high sensitivity and specificity, that is, low levels of false negative and false positives. HIV tests such as the latest generation Elisa test are now more than 99% accurate on both scores. A positive result is usually double-checked using another kind of test. Over time HIV tests have become more accurate and techniques have been discovered and refined; this is true of many other medical diagnostic tools as well.
Aids is the result of poverty The spread and effects of Aids are worsened by poverty, and the same applies to many other diseases. Poor people tend to be malnourished, be lacking in micronutrients, lack access to health care and are unable to gain access to fundamental human needs such as clean water and safe sanitation. Living in unhealthy conditions means that people are more exposed to pathogens, and so more likely to get illnesses such as tuberculosis, typhoid, pneumonias and diarrhoea, and they tend to be more severe. But the impact of HIV is changing the way people die. For example tuberculosis is more likely to be found in found in uncommon places, such as the brain, in HIV-positive people. Poverty also increases the chances of becoming infected with HIV because the poor, especially women, are more likely to exchange sex for money or other necessities, and are also less likely have access to good health care to treat diseases such as sexually transmitted diseases which facilitate transmission of the virus.
There is no proof that deaths attributed to Aids really are the result of the disease because there is often no infrastructure or money to do tests This allegation was reprinted as follows in the July 2000 version of Rethinking Aids, a dissident publication. ”The World Health Organisation defines an Aids case in Africa as a combination of fever, persistent cough, diarrhoea, and a 10% loss of body weight in two months. No HIV test is needed. It is impossible to distinguish these common symptoms … from those of … the indigenous disease of impoverished lands.” The World Health Organisation definition does make allowance for clinical diagnosis of HIV/Aids in countries where HIV testing is difficult or impossible. The major signs are those listed above, although the diarrhoea and fever must be present for more than one month. In addition other causes of immunosuppression – such as cancer or malnutrition – must be absent. This rider is regularly missed by people putting forward this argument. Diagnosing disease clinically by using major and minor symptoms is not exclusive to HIV/Aids. Other diseases where it is done include rheumatoid arthritis, rheumatic heart disease, and many mental illnesses.
Destruction of the human immune system can be caused by other factors than HIV Yes. Illnesses such as leukaemia and cancer, and viruses such as hepatitis, can all damage and destroy immune systems. So can drugs used for chemotherapy, transplant medication and certain genetic illnesses. But HIV operates differently. For example, chemotherapy kills off all fast-replicating cells including the immune system. However, HIV preferentially slowly erodes the immune system. All of these other immune-damaging factors are quite rare, and cannot account for the massive amounts of immune deficiency being seen by doctors. Malnutrition is very common and damages the immune system, but it manifests itself differently to HIV.
Aids among haemophiliacs is due to the underlying cause of the blood disorder, rather than to HIV/Aids No. Haemophiliacs who are HIV-positive die more frequently and faster than those who are HIV-negative. Among 2 448 men in Britain who had severe haemophilia between 1977 and 1984, the death rate was 8 per 1E000 per year. Between 1985 and 1992 this stayed the same for the men who were HIV-negative. However it climbed to 81 per 1000 per year for HIV- positive patients by 1991.
If Aids were caused by a virus, then the body would become immune to it Antibodies are a defence against a pathogen, not a marker that it has been cleared. HIV, like the flu viruses, mutates readily – even if a person becomes immune to one strain he or she can fall victim to another. This is amply demonstrated in the difficulty in producing a flu vaccine, which must be tailored to the predominant strains affecting people each year. There are many viruses, such as the herpes viruses, that lie dormant in the body, despite the best attempts of the body to mount an immune response. In addition, the measles virus can exist in the brain of people, steadily destroying the brain tissue, even though the body has mounted an antibody defence. Chickenpox can lie dormant in the spine, and reappear as shingles.