Dean's World

Defending the liberal tradition in history, science, and philosophy.

Falsifying the HIV/AIDS Hypothesis

As of this writing, the CDC clearly shows the prevalence* of HIV infection in the U.S. today at between 850,000 and 950,000 exactly as described below. My own efforts to find the raw amount of HIV infection for earlier years from the CDC web site were frustrating; CDC does not make the historical national incidence of simple HIV infection easy to find. But by checks through historical news archives and what I was able to find on the CDC web site, I was able to confirm it: I can find no fudging of numbers below. No surprise; real scientists do not do such things. Still, if anyone can find CDC numbers on the prevalence* of HIV infection for any year between 1985 and 2005 which do not fall within the range described, I will publish it immediately.

We here at Dean's World also wonder how it is that HIV could have shown up as a "new" virus in the 1980s when HIV has been found in frozen blood samples taken from people in the 1970s, at least one of whom was alive and healthy as of a year ago. The implications of that fact we leave as an exercise for the reader.

We will entertain questions from commenters to this article who wish to address the data presented and its implications. You are free to question the data or its implications--not the presenter, and not issues outside of the data presented here.

You may ask questions related to other HIV issues in other threads, which you'll find attached to the numbered links below.

Dean's World also hereby issues an open invitation: we will publish a response from any public health official, epidemiologist, biologist, or other professional researcher who wishes to refute the data presented in this article, or the implications we have drawn from same.

The following piece is by Dr. Harvey Bialy, member of the South African President's Advisory Panel on AIDS. More information on Dr. Bialy's background, if desired, can be found in the "HIV Discussion: Supplemental Materials" article in the numbered articles below.--Dean

FALSIFYING THE UNFALSIFIABLE HYPOTHESIS by Harvey Bialy, Ph.D.

The mighty wall, atop which sits what I and a few other "insurgents" call the Humpty Dumpty of all biomedical hypotheses, was made from two kinds of bricks — fashioned from the stuff of virology and epidemiology, and held by what we contend is scientific cement of the most dangerously thin consistency.

Six Questions demonstrates a few of the inconsistencies that have persisted in the vast databank of HIV/AIDS virology since 1987. The associated discussion thread speaks for itself. Also speaking for itself, and in a language close to "Tongues," is the epidemiological data.

While it is perfectly true that the hypothesis of infectious, HIV/AIDS cannot be falsified by any person's experimentation, like all poor hypotheses it can falsify itself given sufficient time.

The graphs below are adapted from: Duesberg, P. H., Koehnlein, C., and Rasnick, D. 2003. The chemical bases of the various AIDS epidemics: recreational drugs, anti-viral chemotherapy and malnutrition. J. Biosci. 28:383-412.

a. Incidence of AIDS in the U.S. Population (click on the image to enlarge it)

Incidence of AIDS in the U.S.

b. Prevalence* of HIV in the US Population (Click on the image to enlarge it)

Prevalence of HIV in U.S. Population

The data in the above graphs comes from the US, CDC.HIV/AIDS Annual Surveillance Reports for the years indicated.

What these show are:

a. The number of AIDS cases in the U.S. increased between 1985-1992, and has since decreased in almost a perfectly Gaussian manner.

b. The number of HIV-antibody positive people in the U.S. has remained constant from (at least) 1985 until (at least) 2000.

If HIV is the cause of AIDS, and the number of infected individuals is constant, then, other things being unchanged, the number of cases must remain constant.

Although there are reasons why a virus might stop causing a disease (such as immunity, or drugs that confer resistance - although neither apply in this case), there is no defensible reason in the clear light of these data for thinking that HIV ever began to cause one in the first instance.

* Update * As originally published, the second graph, B, was published as "incidence of HIV" when it should have read "prevalence." The fault for that is the editor's. It has been corrected. Since more in-depth references have been requested, they will be published in a later article.--Dean

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Voros (mail):
Not that this would change things that much, but shouldn't the two graphs have the same units?

IE, the first graph is incidences per 100,000 in the population and the second is simply total incidences. Shouldn't they both either be indexed to the population, or neither?
1.13.2005 10:19am
Dean Esmay (www):
If anybody has the energy to do that and can reference it reliably, I'll publish it.

But you're right--it would make no difference.
1.13.2005 10:21am
Voros (mail):
Yeah I mean I'm not trying to be a pain, it's just that I work with stats and it's the sort of the thing that just leaps out at me instantly. I know little about epidemiology though, so I'm not much help otherwise.
1.13.2005 10:24am
Chris Lansdown (mail) (www):
Please forgive me if this is a superficial question, but if a virus can take years to turn virulent and bring about the disease for which it is responsible, and if the time to virulence is not uniform but instread distrubted with, say, a gaussian distribution, wouldn't you expect to see a delay between prevelance of the virus in the population and prevelance of the disease? And if the creation of drugs to prevent said disease are timed correctly, couldn't that cause the bell shaped infection curve seen above?
1.13.2005 10:41am
Publius Rex (mail) (www):
Chris,

Just my opinion, and I'm no expert, but what is convincing to me is that there is no drop in HIV proportional to the drop in AIDS that preceded the AIDS drop. My guess is that sometime between 1985 and 1990 there would have been a big drop in HIV cases.
1.13.2005 10:46am
Alex Knapp (mail) (www):
Let's see... current AIDS treatment involves inhibiting the activity of HIV in order to delay the onset of AIDS. These treatments started being used broadly in the early 1990's.

Oddly enough, AIDS cases peaked in the 1990's.

This is a rather silly set of numbers, I think, to use as your model. It's like cataloguing deaths to to a bacterial infection 10 years before and after the beginning of its widespread treatment with penicillin and concluding that the bacterial infection never caused the deaths in the first place!

AIDS is the result of an untreated HIV infection. Treat the HIV infection, and the onset of AIDS is delayed. Perhaps indefinitely--the drugs are pretty good.

In countries without readily available treatments for HIV, HIV infection leads to the onset of AIDS.

Seriously, I was hoping for a better case than this.
1.13.2005 10:46am
Bill from INDC Journal (mail):
Chris - That is a smart theory.
1.13.2005 10:47am
Bill from INDC Journal (mail):
My guess is that sometime between 1985 and 1990 there would have been a big drop in HIV cases.

Why would there be a big drop in HIV cases? The drugs that came online inhibited HIV from becoming AIDS. the real question is, why did AID cases spike suddenly in the late 80's and early 90's, while the rate of HIV infection remained the same?

Chris's question makes a good deal of sense to me - if HIV was introduced into the population in force at a start point around '80, and the virus naturally takes years to develop into AIDS, with varying speed in different people with different lifestyles there would be a lag in the incidence of AIDS, and then a subsequent spike to reflect teh initial wave of HIV infection.

Then the subsequent dip on the chart in incidence of AIDS, even with the remaining constant of HIV, matches up almost exactly with the class of drugs introduced in 94. I'm not making a concrete assertion, it just makes sense to me, potentially.
1.13.2005 10:57am
maor (mail):
"a. The number of AIDS cases in the U.S. increased between 1985-1992, and has since decreased in almost a perfectly Gaussian manner."

The CDC data through 2003 (Duesberg's source)show AIDS levels as being steady since 1999. This is far from a Gaussian, which would require a continuous decline in AIDS.
Thus, the only large drop is in the early 90's. Because of the latency period, we should look at HIV rates in the 80's, which brings us to the next point:

"b. The number of HIV-antibody positive people in the U.S. has remained constant from (at least) 1985 until (at least) 2000."

The data from 1985-1995 (which is the most significant time period) consists of 3 estimates (the CDC terminology) of 1 million. I don't know about other people, but I take figures like that with a healthy dose of statistical error. I looked at the CDC's 1985 report and found no indication that they consider their own figure to be more than a crude estimate (This seems logical. How would the CDC know in 1985 how many HIV+ people exist? They don't even claim to be sure nowadays). If someone can show otherwise, I'll be grateful.

"If HIV is the cause of AIDS, and the number of infected individuals is constant, then, other things being unchanged, the number of cases must remain constant."

No, the likelihood of an HIV+ person having AIDS at any one time depends on how much time passes betwen HIV contraction and the onset of AIDS. A treatment which delayed the onset of AIDS would lower the AIDS/HIV ratio. Interestingly, that's exactly what AIDS treatments have always been claimed to do!
1.13.2005 10:58am
Alex Knapp (mail) (www):
Look, here's the real thing. If you want to show that HIV is not the cause of AIDS, I'm certainly open to evidence. But I'll tell you what would be a slam dunk case: find a patient who is diagnosed with AIDS who is NOT infected with HIV.

Do that, and I'll say you've falsified the hypothesis. It should be a pretty easy thing to do if what you're claiming is true. It's not like HIV infection is readily prevalent in the population.
1.13.2005 10:59am
Dave Schuler (mail) (www):
Well, Dean, you've succeeded in confusing me and that's a good thing. Learning can't take place in an environment of certainty. I read the paper that's linked to in the post and it's interesting. I then went to the NIH to see what they had to say and I was honestly shocked to find that they'd re-written Koch's postulates to satisfy what they'd discovered about HIV. Koch's postulates aren't perfect and there are exceptions but misstating them is at best bad science.

Alex Knapp the literature is full of cases of AIDS in the absence of HIV—nearly 5,000 cases. And, of course, HIV without AIDS.

So at this point I'm confused.
1.13.2005 11:10am
Alex Knapp (mail) (www):
Dave -

You gotta a source for your AIDS w/o HIV cases?
1.13.2005 11:18am
Aaron Pohle (mail):
To address the above about the drugs causing what we are seeing on the graphs, the numbers seem off for that to be the case.

AZT and other "chain-inhibitors" went into widespread use around 1987, yet incidents of HIV remained essentially constant and incidents of AIDS greatly increased.

Protease inhibiters were added to the "AIDS cocktail" in 1996 and were credited with helping to grreatly reduce the onset of AIDS. However, the drop began slightly in 1992 and more in 1994, with the largest drop in 1995.

One question I have about the graphs. What definition is being used to define AIDS patients? In 1993 the CDC changed their criteria to include HIV+ with a CD4 T-cell count below 200. If the above graph is based on CDC definitions, then it is likely that the drop in AIDS(as it was defined prior to 1993) is greater than shown.

The other question I have for those claiming that the graphs are supported by the effectiveness of the drugs is this: Even if your numbers are accurate and it was the introduction of AZT and the PIs that caused the drop, how do you explain the rise? HIV incidence was nearly constant from 1985-1992 yet AIDS cases were rapidly increasing. If HIV were a new epidemic woudn't it to still be rising in incidence? Are there any viruses that have this great of a disparity between infection and symptom curves?
1.13.2005 11:20am
Russell Newquist (www):
The latency/treatment issue doesn't hold up against these charts. You don't need to be an epidemiologist to see that, either.

Simplify the problem, and you'll see what you should expect. Suppose that in 1985 you have one million cases of HIV infection. Let's pretend for a minute that HIV has a constant, known latency of five years (I know, this is against the HIV-AIDS model - we'll correct back to that in a minute). What you would expect, then, is to have one million cases of AIDS in 1990. The AIDS chart would perfectly match the HIV chart, only it would be shifted by five years.

The HIV-AIDS hypothesis, however, posits that there is a variable latency period. Furthermore, let us suppose that the treatment is effective in delaying the onset of AIDS symptoms as claimed. With our nearly perfectly flat HIV curve, then, what we should see is a continuous gradual rise in the number of AIDS cases that should eventually stabilize into a roughly flat curve, although perhaps after a very small falloff from the peak.

If the number of HIV infections is constant, the AIDS curve shouldn't exhibit a dramatic falloff unless one or both of two things is happening. Perhaps large numbers of AIDS patients are dying - in numbers FAR larger than the HIV infection rate - in which case we have an epidemic that is well under control, because it's not spreading. Or two, a true cure for AIDS has been developed.

A drug that delays the onset of symptoms wouldn't cause a dramatic drop in total AIDS cases. It would cause a dramatic drop in NEW AIDS cases. In total AIDS cases, it would cause the curve to flatten. It would still be a growth curve, if indeed every person who contracts HIV eventually gets AIDS. It would just be much less steep.

These charts, by themselves, don't prove that HIV doesn't cause AIDS, but they do prove that there's something wrong with our model. There's something major that we don't know about AIDS, and whatever it is, it's important. It could be something out there that's inhibiting the HIV virus or curing people of it. Or it could be that HIV does not, in fact, cause AIDS. Occam's Razor suggests that the simpler explanation, HIV doesn't cause AIDS, is correct. But these charts alone do not in fact prove that.

They are enough, however, to give me personally a Dean-like "a ha!" moment.
1.13.2005 11:23am
Russell Newquist (www):
I should make it clear that when I said above that the "epidemic would be under control", I didn't mean to be heartless toward people who were suffering from it. But if people are dying faster than the disease spreads, it will eventually stop spreading, and thus there is no longer an epidemic to worry about for the population at large.
1.13.2005 11:25am
JDS (mail):
I'm somewhat agnostic on this issue, but I just had a thought. Could the use of AIDS drugs have caused the spike in 1992-93, rather than the later decline? Apparently AZT went on the market in 1987. I'm not sure how widespread the use was then, but I think the argument could be made that the drugs caused the spike rather than the decline. Also, didn't I read in a previous post that number AIDS related illnesses was expanded in 1993?

"Between 1987 and 1992, crucial years in the development of research into the causes of what many have accepted as AIDS, AZT was the sole drug licensed for the treatment of a HIV in people who had AIDS diagnoses." - Martin Walker

http://www.garynull.com/Documents/Continuum/HIVATZPart1.htm

Granted, in this quote he's referring to AIDS diagnoses rather than HIV diagnoses, but was AZT widely prescribed during this period for HIV diagnoses as well?

Also, didn't I read in a previous post that number AIDS related illnesses was expanded in 1993?
1.13.2005 11:25am
Russell Newquist (www):
Also, I do see a major problem with showing the AIDS chart as cases per thousand instead of using direct numbers and doing an apples-to-apples comparison.

The population of the US has not stayed constant over 20 years. In fact, it has risen greatly. So even though there are fewer cases per thousand of AIDS, the total number may in fact be showing a curve similar to what I described above. I think this is a non-trivial distinction, and the charts as shown must be held somewhat suspect until it's corrected.
1.13.2005 11:27am
Chris Lansdown (mail) (www):
Alex,

The problem is that you run into definitional problems. Immune deficiency w/o HIV is by definition not AIDS (from what I read in previous discussions). Thus it's definitionally impossible to find AIDS w/o HIV. (And there are cases of immune deficiency which have known causes which are not HIV — some chemicals are immunosupressants, for example.)
1.13.2005 11:29am
Chris Lansdown (mail) (www):
There is one thing which gets me about the graph of HIV infection. In 1985 there were 1 million cases of HIV, and it remained quite flat, eventually dipping a bit.

That doesn't suggest the infection rate of a virus which was recently introduced into the population. If we assume that HIV's introduction into the population followed the traditional S-curve, this suggests either that 1985 was pretty late in the introduction of HIV to the population, or that the spread of HIV was incredibly fast so that it peaked really fast (or that as soon as HIV was discovered public information about how to avoid infection spread so quickly that the spread of the virus virtually halted).

Does anyone have any information about HIV which would suggest which interpretation (of just that graph) is correct?
1.13.2005 11:35am
Mark Noonan (mail) (www):
I'll have to go with those who state that the charts don't really tell us much - though, for me, the beg the question of when HIV first started to appear in humans, and whether or not its always been there, just not noticed. After all, if someone died of a strange disease in 1955, might not that disease in 2005 been called AIDS?

Something cut a bloody scyth through our population - this is called AIDS, but it is clear that we still don't know precisely what this is, or what causes it, or why some people can apparently live fine for decades with it while others swiftly succumb. This is a major can of worms opening here, but I don't think that there is sufficient data to make a judgement against those who hold that HIV causes AIDS.
1.13.2005 11:36am
caltechgirl (www):
No Alex, all that would demonstrate is what I have been postulating all along, which is that AIDS has a complex etiology. Don't be confused, Dave.

However, I'm sorry but this is apples and oranges. One graph shows AIDS cases and the other shows HIV cases. These graphs must be interepreted in the light of 1) what maor pointed out earlier (error) and 2) historical significance.

It is entirely plausible that AIDS cases declined while HIV cases remains stable due to drug intervention. The downslope begins at approximately the same time as the widespread use of the triple cocktail, which by all published accounts has lengthened the amount of time that patients survive before developing AIDS.

You can discount the drug data all you like by expounding on its toxicity and its own likelihood to induce AIDS symptoms in people taking it. You can point out all the people who seem to be ok without taking medication. That's fine. But none of those things answer this fact: HIV+ patients who go on anti-retroviral therapy are up to 50% less likely to develop AIDS-defining illnesses (R. Baker, BETA(Mar 1997) 3-4; and P. Randall NIAID AIDS Agenda (Mar 1997) 1-2.) and if they don't meet the criteria, they won't be diagnosed as having AIDS, hence the decrease. If patients continue taking the cocktail, it appears (although we don't have more than 6-8 years of data) that MOST of them might never progress to AIDS, which accounts for the continuation of the drop.

I thought you were really gonna blow the doors off. This is more like a bad April Fool's joke. I should have known.
1.13.2005 11:37am
Mark Noonan (mail) (www):
Chris,

Could be that a lot of the AIDS cases were just ascribed - in other words, a person dies of an ill-defined disease and the bureaucracy calls it AIDS...and keep in mind that with the money spigot being opened wide in the late 1980's for AIDS, there was a vested economic interest in having as many cases as possible...now that the money spigot is constant, there's less incentive to call something AIDS.
1.13.2005 11:38am
Joe Katzman, Winds of Change.NET (www):
You ask:


We here at Dean's World also wonder how it is that HIV could have shown up as a "new" virus in the 1980s when HIV has been found in frozen blood samples taken from people in the 1970s, at least one of whom was alive and healthy as of a year ago. The implications of that fact we leave as an exercise for the reader


Simple... they didn't know what they were looking at (or looking for) in the 1970s. It wasn't until later that a connection was made, a classification produced, and a category started. I don't see anthing sinister there that can't be explained by normal scientific processes.

The survival of one of the 1970s sample sources sure is interesting. I hope they're studying him closely.
1.13.2005 11:40am
Alex Knapp (mail) (www):
Russell -

One of the biggest problems in using these numbers to falsify the hypothesis is that HIV/AIDS just hasn't been around long enough.

The variable latency period goes anywhere from 3-10 years even without treatment. Throw in treatment on top of it and it's easy to see that a 20 year set of numbers is just insufficient to draw meaningful conclusions.
1.13.2005 11:40am
caltechgirl (www):
To be clear, I'm not talking about AZT, but there were any number of patients who "got better" after they started that drug as well. AZT would hit the map around 1985-1987, IIRC.
1.13.2005 11:41am
Chris Lansdown (mail) (www):
Aaron,

Well, part of the answer may well be that AZT only helps delay onset if you're not already close to the onset, or that its delay may be proportional to the closeness to onset (the earlier you use it the longer it delays onset). An effect something like that would produce a rise during the initial years of treatment with the drug (to say nothing of delays in rolling out the drug to universal treatment).
1.13.2005 11:42am
Aaron Pohle (mail):
I'm looking for good sources to refrence, perhaps someone else can assist as well, but prior to 1993 the CDC had over 4,000 cases of HIV negative people that were described as having AIDS.

I'm not finding a good refrence here at work, but there is this statement by the CDC.

http://www.aegis.com/pubs/cdchotb/1992/CDC00012.html

The CDC is essentially saying there are rare cases of AIDS (or something similar) wihout HIV, and that they are looking for a virus that may be the cause.
1.13.2005 11:47am
Chris Lansdown (mail) (www):
Caltechgirl,

I think that the part of the graph that they're concerned with is the part before the peak, not the part afterwards.
1.13.2005 11:55am
Tom DeGisi (mail):
This reminds me of Copernicus, Kepler and epicycles. The questions the insurgents have are generally in the category of simple things that are wrong with the HIV=AIDS hypothesis. The means used to counter them all add complications.

When people believed in the Platonic terrocentric model of planetary motion, each planet circled a point in space which circled the earth. This arrangement was called an epicycle. It came close to our observations, but didn't make it. Some astronomers added another point, so the planet circled a point, which circled a point, which circled the earth. Still didn't match.

Copernicus thought everything circled the sun, but the data didn't match for Mars. But Kepler came up with ellipses, and suddenly everything matched.

This is just a hunch, but right now HIV=AIDS appears to be adding epicycles.
1.13.2005 11:56am
Russell Newquist (www):
Alex,

Except that in that case, there still should only be an increase in AIDS cases, not a decrease.

With a variable latency between 3 and 20 years, your AIDS chart should show, for the first three years after the HIV chart, no cases (assuming that the first year of the HIV chart was actually the first year the virus existed - otherwise it would be some higher number of cases that is indetermineable). For year four, you would see X number of cases as people start to develop symptoms. For year five, you would see X' = X + Y - Z cases, where X is the number from year four, Y is the number of new infections, and Z is the number of people who died from previous infections. Z cannot be greater than X (the number of people who had the disease). So the only way that X' (a chart declining) could be less than X is if Z, the number of people who die from the disease, is greater than Y, the number of people who develop full blown AIDS that year.

Now, it is entirely possible that this could happen with the HIV-AIDS hypothesis. But everything we hear in the media tells us that this isn't what is happening. Instead, we're told that HIV always turns into AIDS, that it's always lethal. The conventional wisdom is that AIDS drugs merely delay this process, they don't stop it. And we're told that AIDS is a massive, uncontrolled epidemic that threatents to spread to the general population.

One of these claims is wrong, if these graphs are correct (and if the AIDS graph still looks similar when converted to a correct format). If, indeed, HIV causes AIDS, then the last claim is incorrect, and AIDS is indeed well under control - which is possible. It's also possible that there is some unknown factor that is skewing these results.

My point isn't that HIV isn't causing AIDS, although these charts do sway me toward that opinion. My point is that these charts definitively show that there is something we don't understand going on.

All, of course, assuming that the curves look the same when the first chart is corrected. That is, far and away, the single biggest vulnerability of this presentation.
1.13.2005 11:58am
Russell Newquist (www):
Alex,

Sorry, I got going and lost my point. My point is that even under a truncated timecycle, this is still the behavior you should expect out of this graph by simple mathematics.
1.13.2005 12:00pm
Alex Knapp (mail) (www):
To everyone: particularly germane to this topic is this NIH paper detailing why HIV is the cause of AIDS.

http://www.niaid.nih.gov/factsheets/evidhiv.htm

Of particular note is the twin study. One baby was infected with HIV in utero, the other wasn't. The HIV infected baby later developed AIDS. The HIV negative baby didn't. It's hard to get a better control than that in an experiment.
1.13.2005 12:06pm
Publius Rex (mail) (www):
Bill,

I did a bit of Googling and came up with a very bland timeline (pdf) that included approval dates for various HIV/AIDS drugs. If we agree that the peak number in the chart presented is 1992, let's focus around that year. Nothing was listed for 1992 and 1 drug was listed, DdI. AZT was approved in 1987. There really isn't anything in between these two. According to the charts, AZT did nothing to slow the rate of AIDS cases and it would have taken DdI a whole year to become effective within the bodies of patients. Now, I cannot and will not rule out that one has to take the drug for a while for it to become effective. I read two sites with info on the drug and neither said anything about how long you had to take the drug before it became effective. Additional information is that the drug was improved in 2000 and is more effective when taken with another, as yet, unapporved drug.

Again, I'm not an expert, but the timing seems as if it is off for it to be explained by the drugs. Also, maybe it is just me, but wouldn't the drop in AIDS cases be more significant?

I'm not 100% sure the AIDS "skeptics" have totally made their case, but the HIV=AIDS defenders aren't setting the world on fire,IMO.
1.13.2005 12:11pm
Alex Knapp (mail) (www):
Russell -

One of the bigger problems with these charts is that AIDS first started appearing in about 1980. No viral infection of HIV is found prior to 1978. These charts start in 1985. Don't you think that skews the data a bit? I don't know the numbers for HIV incidence between 1978 and 1985. And likely HIV infections began two or three years earlier than 1978. So let's say that the first person infected with HIV was so infected in 1975.

That's 10 years of data we don't have. As another commentator pointed out, the early 80's data in terms of numbers of people who are HIV positive is pretty unreliable, because widespread testing didn't exist. Who knows what the margin of error in those early studies was?

All of these factors show the problem in taking these graphs as definitive "proof" that HIV doesn't cause AIDS.
1.13.2005 12:19pm
caltechgirl (www):
you can't discount any part of the graph out of hand. That's a type 2 error.
1.13.2005 12:28pm
Russell Newquist (www):
Alex,

How could it possibly skew the data? Would the data for the years 1985-2000 be somehow different if we had different data for the ten years before that?

Having those additional ten years might shed more light on the subject, but missing them doesn't make what we do have "wrong".

However, the point that you, and others, have already made about parts of the graph being estimates is very important. Unfortunately, I don't think we're going to be able to do much better. The chart wasn't made with guestimates because somebody was to lazy to look up better figures, they're made with guestimates because that's the best data we have. Before widespread testing began, there's simply no way to get good data.

Even so, the data after widespread testing began should be quite reliable. And even if we can't see the whole chart reliably, we can make a good guess at what the part of the chart we can see should look like. If it doesn't look like that, we have to start asking why.
1.13.2005 12:35pm
JDS (mail):
Another question: How is it that HIV incidence is remaining stable in absolute numbers (and thus, decreasing in per capita numbers)? If HIV+ people are living longer, wouldn't an increase in HIV incidence be occurring? Not only would there be an increased lifespan, but they would have greater opportunity to spread it. I'm a little too cynical about human nature to assume that most of those diagnosed as HIV+ would suddenly change the behavior that got them the disease in the first place. Maybe, but I'm not convinced.

Also, I would expect a spike in HIV incidence shortly after a new drug came out, since it should lead to fewer HIV+ people developing AIDS.
1.13.2005 12:37pm
maor (mail):
I think the most important factor is that there has been NO evidence presented so far showing that the HIV stats for 1985-1995 are at all accurate.
1 million is a conspicuously round number and it IS an estimate.
You can't debate the reason for the drop in AIDS in the early 90's without clearing that up.

Besides that, possible reasons for a drop would include AZT, protease inhibitors, improved cocktails and natural selection of milder strains of the virus, all of which would have their own timescales. There are just too many potential explanations.
1.13.2005 12:47pm
Brian (formerly bb) (mail) (www):
The shapes of the graphs are largely the same when you use total number of cases for both. The first one's a little flatter, but it tells the same story.

I just e-mailed Dean a copy of the Excel and .csv file I made to check it.

I got the Census data from http://www.census.gov/ipc/www/idbpyr.html Shift-click or Control-click to get all the years at once.

The raw numbers are behind the button at the bottom of the graphs it will produce after you select the years you want.
1.13.2005 1:05pm
JDS (mail):
maor,

If the HIV incidence numbers aren't all that accurate, then I suppose this whole line of argument is pointless.

But I'm less concerned about the actual numbers than the trend. It would seem unlikely that HIV incidence would remain largely stable over this 15 year period, during which time we had scare campaigns, new drugs being developed, safe sex campaigns, etc. Maybe the HIV incidence estimates are inaccurate, but they would have to be wildly so.
1.13.2005 1:10pm
Voros (mail):
"But I'll tell you what would be a slam dunk case: find a patient who is diagnosed with AIDS who is NOT infected with HIV."

Someone said that there are such cases and again I know nothing about epidemiology so that may be.

But even if there aren't, what you're stating isn't necessarily true. There are two (and possibly more my addled brain can't think of right now) counters I can come up with:

1. Even if HIV+ does not cause AIDS, it could be infinitely possible that AIDS makes one highly susceptible to the virus. Meaning instead of HIV+ -> AIDS, AIDS -> HIV+.

2. Even if the above isn't true (I haven't a clue), there is also the problem of a bias in diagnoses. Is it possible that doctors may simply be diagnosing only those people who are HIV+ with AIDS, while patients with the same symptoms who are not HIV+ are not diagnosed with the disease? Again I know nothing about any of this, but these sorts of things have happened in the medical field and other fields.
1.13.2005 1:10pm
O. F. Jay (www):
Alex, the thing is, ever since HIV was declared as being the cause of AIDS, you wouldn't *get* an AIDS diagnosis without the patient being HIV+, even if a similar complex of symptoms appears in someone.
1.13.2005 1:15pm
Mark Jaquith (www):
We need more information. First, we need the percentage of population date turned into raw numbers. You can get this by getting population estimates for each of those years, and multiplying the percent given by that population. So take 1985... 5 cases per 100,000 people. Population was roughly 235 million. 5 cases per 100,000 means .00005% of Americans have AIDS (and are HIV+) which translates into 11,750 people. And you could do that for each of the years, using the population estimates here.

Yet this is still not enough information. We need the death rate for both HIV+ and AIDS/HIV+ (and we'd need to know how many of them died from AIDS symptoms, as opposed to automobile accidents.)

If you got that data, I think you'd have a fairly impressive argument against the correlation. Even at the peak of AIDS cases, only ~8% of those who were HIV+ had AIDS. And that number even has a built-in "fluff" effect because of the new definition whereby you don't even have to have any symptoms to be an AIDS patient, so the percentage of people with symptoms was even lower.
1.13.2005 1:17pm
TLHeart:
Simple math will convert the charts to the same base, and then it is seen visually that although the actual number of hiv cases stays constants, or with a slight drop, the actual number of AID's cases is also decreasing, after a spike in the early 90's.

Throw in the changing definition of AIDs, and the truth is very hard to find. Has AIDS every really been an epidemic in the US? or just a political football? More people die in car crashes every year, than die from AIDs. Are car crashes an epidemic?

Is HIV the sole cause of AID's? I doubt it. Does life style, genetics, and other factors contribute to one's immune system shutting down. YES.
1.13.2005 1:19pm
Russell Newquist (www):
I couldn't find the raw numbers that these charts came from on the CDC's web site, but I did find these numbers from AVERT, and they cite the CDC as their source. The last year (2003) does in fact match up with the numbers on the CDC page that Dean links to in his main post.

I'm working on getting an image file to send Dean, but I have put together a quick and dirty chart using these numbers and while it's slightly different, it's basic form does basically resemble the one Dean has already published.

The page also lists deaths from HIV, which I haven't even started to factor into my own analysis yet, but the data's there for anybody who wants to look at it.
1.13.2005 1:35pm
Russell Newquist (www):
I'm going to retract part of my last statement. After looking more at this new chart, I think it shows something different. I will try and get a copy of it to Dean soon, and post more after I've considered it some.
1.13.2005 1:41pm
Alex Knapp (mail) (www):
BTW, for those who doubt the hypothesis, I really would like to see some counterarguments to the evidence provided on the NIH report I cited earlier.
1.13.2005 2:02pm
Russell Newquist (www):
You can see my version of the AIDS cases chart here. To me, this version casts serious doubts on Dean's and Dr. Bialy's claims, since it very closely matches with my own predicted chart based on an HIV-AIDS theory, as quoted from earlier in this discussion:

"The HIV-AIDS hypothesis, however, posits that there is a variable latency period. Furthermore, let us suppose that the treatment is effective in delaying the onset of AIDS symptoms as claimed. With our nearly perfectly flat HIV curve, then, what we should see is a continuous gradual rise in the number of AIDS cases that should eventually stabilize into a roughly flat curve, although perhaps after a very small falloff from the peak."

The only variation from my prediction is that the "very small fallof" is in fact a large falloff, but with the stabilization afteward this dropoff can, at least to me, be explained by effective treatment methods.
1.13.2005 2:03pm
Alex Knapp (mail) (www):
Russell - that's excellent work.

Also, also looking at the numbers it seems that if the population is growing but the incidence of HIV is declining/constant, that represents a decrease in the RATE of infection. Since the rate of infection is declining, this should result in fewer incidences of AIDS per 100,000 people, which is also what we see.
1.13.2005 2:11pm
Chris Lansdown (mail) (www):
Russell,

I agree with you that your prediction makes sense. What I'm wondering about, though, is the HIV curve — it's extremely flat, which suggests that HIV saturated before the data starts. This brings up the question: when did HIV actually enter the population, and how long was it there.

Like you (see my original comment) I agree that one would expect to see a fairly rapidly growing AIDS incidence which trails HIV infection rates by probably 3-8 years (I haven't done any of the arithmetic, so I'm not sure).

Unless HIV took off like wildfire from the very start then saturated some small subset of the US which it couldn't escape from, I would not expect to see zero deaths from AIDS just 4 years before HIV infection rates were stable at 1E6 individuals.

Is there any evidence that HIV went from zero to a stable 1E6 in only a few years?

(granted, the early stuff is really difficult to tell due to misdiagnosis, etc. Also, IV drug users would have the ability to spread a blood-borne disease really quickly, I imagine.)

By the way, does anyone know the incubation period after infection but before a person has enough HIVs to pass on to someone else?
1.13.2005 2:20pm
Chris Lansdown (mail) (www):
For those explaining the falloff in AIDS despite a relatively constant HIV infection, you forgot one of the obvious explanations: evolution.

The first people to die are the ones most vulnerable. The viruses least likely to spread are the most virulent ones. After the most succeptible die off, you're left with those who are less succeptible. After the really virulent viruses kill off their hosts and die themselves, you're left with the less virulent ones.

Even absent drugs, you'd expect to see a falloff in mortality from a disease caused by a virus (though how big a falloff depends greatly on the details of the virus, the population, and the disease).
1.13.2005 2:26pm
Hank Barnes (mail):
My take on the graphs (which ain't earth-shattering):

1. At one point in the U.S., people died of disease caused polio, caused by the virus called poliomyelitis. (I think).

2. A vaccine was developed.

3. Consequently, U.S. polio deaths dwindled to nearly zil. (I think. I've never heard of anyone dying of polio in 25-35 years).

4. I would expect that concomittant with a vast decrease in polio cases and polio deaths, that the number of people INFECTED with the polio virus (Polio positive?), would roughly decrease in proportion.

Does anyone contest this very simple, basic, uncontroversial analysis?

Let's compare to AIDS.

5. The graphs show that while AIDS deaths have declined to 15,000/year (less than the flu), the number of HIV infected people (Ahh, HIV positive!) has NOT decreased, but rather remains stuck at about 1 million.

6. Like polio, I would expect the number of HIV positive folks to roughly track the number of AIDS deaths. The number SHOULD be going DOWN It is not.

Conversely, it should have been going UP from 1981 to at least 1995. It didn't.

So, what conclusion can we draw?

A reasonable conclusion is that HIV and AIDS ain't connected. [Ducks head, as cyber rotten tomatos are hurled at 'ole Hank].

Association ain't causation.

This doesn't seem that controversial to me. Why is it so controversial to some of you guys?

Also, feel free to show me where I erred -- I admit that my skill sets are quite pronounced, but even I have limitations:)
1.13.2005 2:26pm
Alex Knapp (mail) (www):
Chris,

Building on that, we also know that being infected with 2 or more different strains of HIV will markedly decrease the amount of time before the onset of AIDS. Reinfection by other HIV strains was probably more likely in the time period where people didn't know about AIDS, safe sex wasn't part of the culture, etc...
1.13.2005 2:27pm
Alex Knapp (mail) (www):
Hank,

The reason why is because there is no vaccine for HIV, like there is for polio. Folks who are HIV+ can still infect others.

Also, we're better at treating AIDS itself, which means that even people who have full blown AIDS can expect to live longer, which also causes a decrease in AIDS deaths.

The two cases simply aren't analogous.
1.13.2005 2:31pm
Chris Lansdown (mail) (www):
Hank,

The problem with your analysis is that a vaccine conditions someone's immune system to destroy the target virus.

The AIDS cocktails are only designed to prevent HIV from causing AIDS, not to supress or destroy HIV. Thus even if they shoved AIDS down to 0, there could be a 100% infection rate.

As Dean has noted, there's a 100% infection rate for some forms of pneumonia which are immune system easily keeps in check. The virus is ubiquitous, the disease it causes nearly unknown.

That's not a problem.
1.13.2005 2:32pm
Harvey Bialy (mail) (www):
Chris,

You write:<i>That's not a problem.</i>

It is if you're the NIH. They claim HIV is a deadly viral pathogen.

You have just defined HIV as an AIDS <i>passeneger</i>.

Congratulations on joining the insurgency.
1.13.2005 2:41pm
Richard Bennett (www):
Congratulations, Dean, this is your best troll ever.
1.13.2005 2:42pm
Hank Barnes (mail):
Man, there ought to be a gold medal for ad hoc reasoning and uncited propositions. Some of you boys would be Olympic champs!

I almost forgot my daily request:

To anyone who holds the opinion that HIV causes AIDS:

Please cite me the paper in the mid-80's where this causal connection was first made. Author. Journal. Page Number.Year. I'm sure that fellow/lady must have won the Nobel Prize for that breakthrough acheievement, right? Another Fleming? Another Salk?

If you can't (or won't) do this, then it seems to me you believe stuff, without evidence.

Now, believing stuff without evidence is a wonderful thing in Buddhism, or Christianity or perhaps even the Kaballistic strains of Judaism. It's called faith.

But, of course, faith ain't science.

Regards to all,

Hank Barnes
1.13.2005 2:52pm
Dave Schuler (mail) (www):
I don't have any dog in this hunt but, Alex Knapp, the NIH report that you linked to is the same one I found. It misstates Koch's postulates and it misstates them in a way that enables them to claim HIV satisfies Koch's postulates.

Here's Koch's first postulate

The suspected causal organism must be constantly associated with the disease.

Here's the way it's stated in the NIH report:

Epidemiological association: the suspected cause must be strongly associated with the disease.

If you define AIDS tautologically i.e. Kaposis's sarcoma, TB, etc. in the presence of HIV infection, of course it's caused by HIV. In the definition. But that's not particularly helpful.

And the citation you were looking for for non-HIV AIDS cases is in the paper that Dean links to in the body of the post.
1.13.2005 3:04pm
Alex Knapp (mail) (www):
Dave,

Here's a much longer NIH treatment of the HIV-AIDS stuff:

http://www.niaid.nih.gov/publications/hivaids/hivaids.htm

Note in particular:

http://www.niaid.nih.gov/publications/hivaids/12.htm
1.13.2005 3:10pm
pennywit (mail) (www):
'Fraid I can't find this data convincing, largely for reasons that others here have outlined.

--|PW|--
1.13.2005 3:12pm
Sam Muldia (mail) (www):
Far be it from me to argue with a Ph.D., but here's why these charts don't impress me, the layman.

Factoring in population growth, the incidence of HIV in the US population is slowly but surely declining - AIDS awareness. Comparing HIV to airborne viruses seems, umm, obtuse, as there's hardly any good ways to contain those apart from quarantines, whereas all it takes to stop HIV is clean needles and condoms (and less wild monkey sex).

The incidence of of AIDS cases climbing in pretty much a straight line from 1985 to circa 1993 seems (to me as a layperson) simply a reflection that AIDS, as a mysterious syndrome whose definition has changed over the years, was simply not diagnosed prior to the early 80s, and as it became more and more widely known, it was diagnosed more often, until the triple cocktail started to successfully postpone the onset of AIDS, and bringing down the number of HIV+ patients developing the syndrome. 7 years is hardly a large enough sample to make the two charts incompatible.

I'll keep an open mind, but I'm beginning to think you might be in the 'keep my original pick' camp on this one, Dean.

Also, if your statistical proof that HIV doesn't cause AIDS is correct, there should be a sizable number of AIDS patients who were HIV negative. Since that is not the case, all these charts say is that all AIDS patients have HIV, HIV incidence is slowly declining, and HIV+ patients used to be at higher risk of contracting AIDS from 85-93, and with better treatment and lifestyle changes, that risk can be reduced. Which is what the official line is, unless I'm mistaken.
1.13.2005 3:16pm
maor (mail):
Hank,
"I would expect the number of HIV positive folks to roughly track the number of AIDS deaths."

The flaw in that reasoning is that AIDS deaths would expected to be proportional to HIV+ folks DIVIDED by the time until death.
Increasing time until death => less AIDS deaths per HIV+ folks.

"Conversely, it should have been going UP from 1981 to at least 1995. It didn't."

The flaw here is that there's a lag time between HIV contraction and onset of AIDS. An increase in AIDS until the early 90's corresponds to an increase in HIV until the mid 80's. There is no data for whether that happened.
1.13.2005 3:25pm
Alex Knapp (mail) (www):
What really has struck me about the stuff I've read in the NIH reports is this: controlling for other factors, HIV exposure leads to AIDS. This appears to me to be a pretty big hurdle for HIV-AIDS opponents to overcome.

Take, for example, the twin study I mentioned earlier. You have identical twins, one infected with HIV in utero, the other not. The infected baby develops AIDS. The other baby doesn't. In this case, you have control over genetic and environmental factors. The only substantial variable is the presence of HIV.

That's pretty compelling. And it's not the only study with similar control.
1.13.2005 3:28pm
maor (mail):
JDS,
you said "But I'm less concerned about the actual numbers than the trend. It would seem unlikely that HIV incidence would remain largely stable over this 15 year period, during which time we had scare campaigns, new drugs being developed, safe sex campaigns, etc."

Keep in mind that HIV carriers live for a few years, so decreases in new HIV+ cases only gradually change the HIV statistics.
Drugs do not prevent HIV contraction. They help people who are already HIV+.
Also the scare campaigns are up against the natural tendency of the virus to spread. It's not that surprising if they partially cancel each other out.

And the correct HIV stats for 1985 and 1990 could easily be anywhere between 500,000 and 2 million (how would you translate "an estimated 1 million" based on very little data?), making the whole point moot.
1.13.2005 3:35pm
Alex Knapp (mail) (www):
This link was in the trackbacks, but it deserves pointing out:

http://themusctiger.com/blog/index.php?p=418
1.13.2005 3:39pm
Dave Schuler (mail) (www):
Dean, perhaps Dr. Bialy has read the twin study and would like to comment. I haven't read the study and have just seen the snippet mentioned in the NIH report. If the HIV-infected twin is treated with anti-AIDS drugs, the study may as easily demonstrate the chemical hypothesis as the HIV hypothesis.

As I said in my earlier comment I don't have a dog in this hunt. But I'm seeing a lot of loosey-goosey language in the NIH reports that I don't much care for.
1.13.2005 3:41pm
Harvey Bialy (mail) (www):
Dave,

Yup, could very well be.

Read more, if you have an exceptionally strong stomach. The more you read the lossier and goosier it get.
1.13.2005 3:44pm
Alex Knapp (mail) (www):
Dave,

The NIH links I just pointed you to use the exact phraseology of the Kuch Postulates, not the rewritten phrases.
1.13.2005 3:52pm
Russell Newquist (www):
Alex, thanks for pointing that out. I should've noticed what he notices myself - this chart does only show new cases of AIDS, not total cases. The page I linked to even states this clearly, yet somehow I missed it when I created my own version of the chart (which matches up with the version on the MUSC Tiger site).
1.13.2005 4:02pm
Dave Schuler (mail) (www):
The NIH links I just pointed you to use the exact phraseology of the Kuch Postulates, not the rewritten phrases.

Yes, but the reported results (in the NIH report) don't satisfy the first postulate. In every instance they qualify their findings e.g. “most cases” and that doesn't satisfy the postulate.
1.13.2005 4:10pm
Alex Knapp (mail) (www):
Russell,

Exactly. The number of people with HIV remains constant and the number of living people with AIDS increases. New cases of AIDS decline because of treatment.

These numbers don't show a thing to disprove the HIV-AIDS hypothesis.
1.13.2005 4:14pm
Hank Barnes (mail):
Alex Knapp,

The NIH link paper you cited is (a) anonymous and (b) not published in the peer-review literature.

It was designed to make certain, er, gullible people feel good about holding the opinion that HIV causes AIDS, without a scientific basis for so holding.

Find me THE PAPER IN THE 1980'S WHICH DEMONSTRATED THAT HIV CAUSES AIDS!

That would end the discussion. Or, at least make it more fruitful.

To the impartial folks:

1. If I want to state that asbestos is "reasonably safe," I can cite Fleischer et al (1946), a Health Survey of Pipecovering Operations in Constructing Naval Vessels, J INDUST HYG, 28-916.

2. Of course, those folks were like the precursors to the tobacco executives, who insisted there was no causal connection between smoking and lung cancer. They were later proven dead wrong -- after hundreds of thousands of blue-collar workers died from asbestos exposure.

3. So, If I want to state that asbestos is unsafe and causes a hideous cancer called mesothelioma I can cite a later study, (Wagner, et al, Diffuse Pleural Mesothelioma and Asbestos Exposure in the Northwestern Cape Province, (Brit J. Ind Med, 12, 260-271 (1960).)

4. In fact, on every single scientific discovery (Theory of Relativity, DNA Structure, lung cancer=smoking, polio vaccination, etc, etc), I can find and cite the definitive study. Without exception.

Are you surprised that nobody yet (on this blog) has produced the definitive paper that proved the causal connection between HIV and AIDS? Surely, one exists, no?

Wouldn't this paper prove Dean wrong?

Where is it, I ask for the 5th consecutive day.
1.13.2005 4:14pm
Alex Knapp (mail) (www):
Dave,

I doubt you could ever show it in EVERY case, no matter what the disease. But take note of the study study where they retested people with AIDS who were HIV negative and found that they were in fact HIV positive.

Given the controlled studies, plus the statistical correlation between HIV and AIDS, plus the decrease in the onset of new AIDS cases after treatments become available that specifically target HIV's ability to replicate, and I think you add up to a damn strong case that HIV causes AIDS.

Certainly, Dr. Bialy's numbers don't disprove the hypothesis. Indeed, as Russell and others have pointed out, they practically confirm it!
1.13.2005 4:18pm
caltechgirl (www):
Hank, I wouldn't ask for citations given your track record of late......
1.13.2005 4:28pm
Jason the Samurai (mail) (www):
Before jumping into this, I must note that while I am a mathematician (only a senior - I haven't earned the capital 'M' yet), my emphasis is pure math, and I have not (to my severe discredit) played much with stats.

That said, my opinion on the graph and its implications:

Well, I just had one thing to mention, really. After the spike in the AIDS graph, shouldn't the HIV graph be going down as well? Specifically that little dip in the HIV graph. It seems to me that if the number of new AIDS cases drops that dramatically, the dip in the HIV graph should be offset (left or right) more than it is, and it should be steeper.

Again, I waited till this semester to do all my stats, so I'm looking at this through a calculus/numerical analysis lens.

Please don't hurt the new guy.
1.13.2005 4:48pm
Alex Knapp (mail) (www):
Dean, I just want to say that I appreciate this post. I'd always assumed that HIV caused AIDS because people said so. Now as a result of this discussion, I'm convinced by the evidence I've encountered that HIV causes AIDS. Thanks.
1.13.2005 4:48pm
Alex Knapp (mail) (www):
P.S. The above isn't sarcasm, I really do appreciate it, even though I disagree with you, the discussion was, for me at least, very fruitful.
1.13.2005 4:49pm
Hank Barnes (mail):
Caltechgirl,

I'll bet $100 you did not read Padian, only the abstract on the internet

I'm quoting now from Padian, the entire paper, in my hands, wise-gal.

PROSPECTIVE STUDIES:

"We followed 175 HIV-discordant couples over time for a total of approximately 282 couple-years of follow-up (table 3). Because of deaths and break-up of couples, attrition rate was severe, only 175 couples are represented in table 3. The longest duration of follow-up was 12 visits (6 years). WE OBSERVED NO SEROCONVERSIONS AFTER ENTRY INTO THE STUDY"

(Padian, pg 354.)

Also, try to avoid going ad hominem. I'll resist my tempation as well.

If you had the study demonstrating HIV causes AIDS, you would have played it by now. You don't. And, remarkably, your unsupported opinion remains unchanged. George Orwell would be spinning in his grave.

Bring back Feynman!!!!

Fondly,

Hank Barnes

Out of curiousity, were you part of the CIA team pre-Iraq invasion, warning us about Saddam's weapons of mass destruction?:)
1.13.2005 4:51pm
Richard Bennett (www):
So Dean, how long are you going to let these comments run before you admit you're trolling and expose the scam? It's really amusing, in a scary kind of a way, to see how many people you've snookered with your little chart.

Hint: US HIV rates are uncertain, for a number of mostly political reasons, but there are other countries who track HIV rates very diligently, and no more than 10 minutes on Google will show you some real infection data.

Second hint: The real HIV infection rate isn't a flat line.
1.13.2005 4:53pm
Alex Knapp (mail) (www):
Hank,

There are 11,000+ papers on Medline related to HIV. Feel free to do your own damn research.
1.13.2005 5:14pm
Hank Barnes (mail):
Alex,

Damn research done, my friend. You're the one who cites anonymous papers from the internet, not moi:)
1.13.2005 5:23pm
Alex Knapp (mail) (www):
Hank,

The internet sites I've linked to provide citations from peer-reviewed journals to back their claims.
1.13.2005 5:48pm
Catch 22:
The bottom graph HERE charts actual California cases. If it is representative of USA statistics, then I suspect that AIDS incidences is not the steep roller coaster phenomena as seen in Dr. Bialy’s graph 1.

Is it reasonable to ask why is the California graph so very different than the other ? There are many other stats here that others my find useful.

If my comment is off topic to this discussion kindly ignore.
1.13.2005 5:55pm
Hank Barnes (mail):
Alex,

Well, I got you a birthday gift, but I left it at the store:)

Catch 22,

I found those stats you cited useful. The number that jumps out for me is San Francisco:

From 1981 to 2003 (23 years): ~19,000 AIDS deaths.

So, that's less than 1,000 AIDS deaths per year for the duration of the "epidemic" in a City with ~750,000 people.

That's ground zero of this "epidemic"?

Not to minimize loss of life, but that seems like awfully small numbers. 500,000 people each year die from cancer in the US. 35,000 die from the Flu.
1.13.2005 6:11pm
Harvey Bialy (mail) (www):
It might help, in an analysis of what the two curves above imply, to consider them independently of the words HIV and AIDS. Redraw them without any units on the axes. Ask yourself, or any epidemiologist, if the flat line incidence curve of the presumed pathogen is consistent with it being a cause of the epidemic curve?

If he or she tells you yes, ask them to explain.

If you post your explanations here, I will reply to them carefully. In the event the discussion thread has gone the way HIV infected persons are said to go if they don't take the wonder drugs with "religious devotion" (see the links here that are related to these drugs), you can email me.
1.13.2005 6:40pm
silvermine (mail) (www):

See, the problem is that you have two assertions you're making, and they're entangled. You are saying that both AIDS drugs are ineffective and that HIV causes AIDS. However, you've failed to prove either one individually, and taken together -- well, the people aren't dying because they're taking the drugs.

Let's take this to the next level -- what is your hypothesis, and what is the mechanism?

Because there's a lot of information about the mechanism of HIV action, where it goes in the body and what it does, that corroborates the HIV-AIDS theory.

Here's a good overview of what happens in the initial stages of HIV infection, with citations:
http://www.hivmedicine.com/textbook/acuteinf.htm



HIV infects T cells. Open one up, and you can find it in there.
1.13.2005 6:41pm
silvermine (mail) (www):
Er... *doesn't* cause AIDS.
1.13.2005 6:43pm
Phelps (www):

well, the people aren't dying because they're taking the drugs.


Silvermine, that is exactly what a lot of people are saying. The drug cocktail is independantly toxic, and will kill a healthy uninfected person if taken long enough.
1.13.2005 7:51pm
Hank Barnes (mail):
I know, I know it irritates folks when I insist on citing from the published literataure, but.....


New England Journal of Medicine:
Sepkowitz, "AIDS -- The First 20 Years" (344:1766 (2001)

"Zidovudine (earlier known as azidothymidine, or AZT) was among the earliest compounds tested and, in 1987, became the first drug approved for the treatment of AIDS."

So far, so good.

"After initial exuberance, many in the community of AIDS patients turned against the drug (cite). They came to see its promotion as an almost hostile act on the part of the NIH and Burroughs Wellcome and treating physicians."

Uh-oh. NIH folks forgot to tell AIDS patients that AZT was toxic cancer chemo, that will either kill you in the short run or cause cancer (lymphoma)in the long run if you can survive it.

"Accusations abounded that cheap and simple treatments had been overlooked in favor of a mediocre, costly and toxic agent."

You got that right, pard. Here's the kicker though:

"Patients soon claimed that everyone they knew who took [AZT] was dead -- a familiar lament."

See, that's the problem. AZT killed a lot of patients, whose deaths, though, were blamed on the virus.

And Duesberg was the only one pointing this out,...... for which he was not haled as a hero, but ostracized by an inferior crowd of bean-counting health bureacrats who couldn't interpret properly what was going on. Very sad.

But the real tragedy is that ignorant doctors and scientists are still touting AZT and still forcing pregnant mothers to take it or give it to their kids, under threat of removing custody of the child.

Quite shocking, no?

Great thread, Dean.
1.13.2005 8:38pm
Dave Schuler (mail) (www):
P.S. The above isn't sarcasm, I really do appreciate it, even though I disagree with you, the discussion was, for me at least, very fruitful.

And that's exactly the reason that I linked to this post. In order to really come to conclusions and understand what you believe you must consider alternatives.
1.13.2005 8:41pm
John Van Laer (mail):
I don't want to add to the confusion here, but what the hell...

The trouble with these data on HIV/AIDS infections is that they do not warrant serious study. The epidemiology of the disease and of the infection is a political minefield. The CDC and NIH have been pussyfooting around it for years. I don't know what the CDC does now, but in the 80's, in the absence of solid data, they used a technique of estimation dreamed up by the RAND Corp, called the Delphi Method.

Yep, Delphi, after the classic oracle. How it works: you sit a bunch of recognized experts around a table. You ask: "How many cases of AIDS are out there?" Everyone writes down a number, like a secret ballot. The results go up on a blackboard, and another round of guesses takes place. And another, and another, until all but maybe 1 or 2 outliers fall within a range that seems tolerably narrow. Then, for maximum impact, you publish the upper end of the consensus range.

That may be good staff work in the face of great uncertainty, but it isn't statistics. It has nothing to do with standard error of estimate, or confidence intervals or any of the stuff that Jason the Samurai will have to struggle with if he has the misfortune to need to dip into the Annals of Math Stat.
1.13.2005 9:57pm
Maniakes (mail) (www):
[Dean, sorry for the lack of a first initial in my username. I've tried unsuccessfully to modify my user info.]

HIV treatment guidlines

According to this, the Panel on Clinical Practices for Treatment of HIV only recommends antiretroviral therapy be started for patients with either a very low (<200) CD4 count or a low (<350) CD4 count combined with a a very high viral load.

Virology online page for HIV

According to this, "within 2-4 weeks of starting [antiviral drug] treatment, CD4 count should be increased by at least 30 cells/mm3. If this is not achieved, then the therapy should be changed"

The former appears to me to undermine the argument that the drugs are causing widespread deaths in otherwise-healthy patients. The latter seems to indicate a direct causal link between HIV levels and CD4 count; otherwise why would antiviral treatment lead to an immediate improvement in CD4 count?
1.13.2005 10:06pm
Catch 22:
Hank,

If you examine graph A by Bialy you will note that the highest AIDS incidents are about 1993 and the rate is 30 per 100,000 people. In San Francisco that would mean 7.5 times 30 or 225 cases per year. From 1981 to 2001 it would mean a maximum of 4500 cases of AIDS over the twenty year period. That would be the maximum if you look at just the highest point of the bell curve. But the reality is different. If you examine the link I posted you will see the actual figured of reported AIDS cases in San Francisco at 28830 of which 19443 died. That is 60+ % of all reported AIDS cases not including those that went back home.

If you chose to crunch the numbers you will soon realize that the actual SF rate of death in those figures exceeds both California and the USA which you discount to “oh, no matter, never mind— many others have died of other stuff “. So if you look at graph A extrapolate that to SF, you find an error rate of 28830 minus 4500 AIDS cases.

It is also fair to say that graph A is an overview. Nothing specific can be correlated to say San Francisco, or LA or New York. Then we are presented with graph B---another generalization and a flatline diagram. These two generalizations disprove one another we are told.

In the chart 2 linked here we are informed that estimated persons living with HIV/AIDS is between 800,000 and 900,000 people. Co-incidentally this matches exactly Bialy’s
Graph B—a flatliner—at 850,000 HIV incidences. But in chart two, a footnote:

[2] U.S. figures were reported by the U.S. Centers for Disease Control and Prevention (CDC) as of December 31, 2001, except estimated persons living with HIV/AIDS which was originally reported by the CDC in 1999. ……. Is it unfair to suggest that Duesberg plugged into a 1999 statistic,
grabbed an inconsequential diagram to suit his own purposes and put that in his report ?

Now we are lead to believe by scientists that these two graphs disprove each other, therefore, HIV as a causative for AIDS or infection is bogus and that those grafts are in themselves the scientific proof of something. .

I remain unconvinced. .
1.13.2005 10:14pm
Harvey Bialy (mail) (www):

Hank,

Thanks for providing the quotation from the body of the Padian study.

I had actually not looked at this paper for a long time, and like many of us had to rely on an online abstract, which while providing some fascinating pieces of data, like the per contact transmission rate -- even though they hide it, and apparently quite well judging from some of the comments here, by presenting irrelevant percent of couples who converted figures -- is no substitute for the real deal hardcopy.

Unfortunately however, even the text you quote does not answer my questions about how many deaths were reported, and how many of the couples were taking anti-retrovirals, and what kinds.

.....282 couple-years of follow-up (table 3). Because of deaths and break-up of couples, attrition rate was severe, only 175 couples are represented in table 3.

Since I am still paperless and clueless, would you be so kind as to tell me, and the blogosphere, if Table 3 provides a more quantitative estimate of the deaths "even though recording them was not part of the study design", as our aspiring young Dr. Kildare so helpfully informed earlier?

Is there by the slimmest of chances any information, anywhere in the paper, on what meds they might have been on? I have no memory of any, but it's been a while since I read the great SF cohort study with a mixture of "Hah, we told you so all along" and "Oy vey, how are they going to spin this?" I found out quick enough, and we have seen it here in its full display, as we have every other specious NIH-concocted weapon of no destruction-argument against the insurgency. Maybe Anthony (only his sister Denise calls him that) Fauci would like to deploy some newer and improved firepower models here, or in the pages of Nature or Science if he prefers. Maybe somebody will put this discussion in front of him, if they can get his attention between running from one lawyer's office to another making sure his payments from Chiron and his use of tens of millions of taxpayer money to fund Chiron anti-HIV/AIDS trials in whose outcome he had a non-negligible financial interest do not keep him from his tireless occupation of "saving lives". If they do get his attention, or that of his deputy Clifford Lane, or the cabron the brave Dr. Fishbein outed as a cheat and racist and whose name I refuse to type, I hope one can find the few minutes it will take them to reply to this since it since their evidence is "so overwhleming". Because from my brief, but incredibly rewarding and enlightening experience with the blog, I know that the Gaussian distribution of very fine to not-so-fine but still working minds out there will afford them the same astute attention that has been afforded me today.

They would never debate Duesberg in the pages of Nature, maybe they will be forced by People Power to do so on the blog. I can see the headline of the post-post, post now: The Blog Busts The Bug.

Oh, I almost forgot. I have a final couple of questions for the retrograde man who reads papers not quickly googled, and even more quickly skimmed, abstracts.

Do you think the 442, 10 year, healthy, sexually active and constant couples don't really count, since death in the Ab+ part of the cohort was "severe"?

Do they tell us causes of death or are we just to assume they all died of AIDS?

(If I may be permitted another aside. It is often quoted in the press that South Africa's president, Thabo Mbeki, famously said, "I don't know anybody who died of AIDS". Well he did say exactly and precisely that. Quite plainly what he meant was that AIDS is not a disease, it is a collection of diseases --- although not a single reporter anywhere in the mainstream media of several continents has to this day managed to get it, despite the ANC publishing a press memo explaining exactly what the President meant. People die from specific causes, like Mandela's son, who died of complications of gall bladder surgery. Gall bladder operation? Maybe you physicians who are out there can tell me if I am correct in thinking that gall bladder problems are quite often linked to hepatic malfunction, which coincidently is the most frequently reported complication of HAART therapy, which coincidently is what the man was enduring for at least a year. But I digress sufficient. Everybody knows Mbeki is a foolish, internet surfer with a degree in economics not epidemiology (and silly me I thought math was math...but I digress again), and is a big denialist to boot, and anyway Mandela's son died of AIDS, so would he say that now?.)

So, my last question is, if we don't just discount all those couple-years of, one hopes, happy copulation, as being a fluke and parlor game like the CDC's statistics as I just authoratively learned from reading this most enlightening thread -- I wonder what my friend Helene Gayle who was formerly the director of the CDC's HIV/AIDS Africa division and now heads a similar division at the Gates Foundation thought when I mailed that comment to her --- how do we explain these supermen and women who have resisted the, "horrible, deadly" virus for so long?

Please don't tell me maybe they have a special anti-HIV-AIDS gene.
1.14.2005 12:26am
willem:
The CDC December 1996 Surveillance Report states: "Acquired immunodeficiency syndrome (AIDS) is a specific group of diseases or conditions which are indicative of severe immunosuppression related to infection with the human immunodeficiency virus (HIV)."

This definition, that the diseases or conditions defining AIDS "are indicative of severe immunosuppression", is completely inconsistent with the December 1992 definition by the CDC, which defined AIDS to be any one of 29 diseases if and only if the person is also HIV positive. Indeed, one of the defining diseases is a low T-cell count, but about 40% of the 29 diseases defining AIDS in the 1992-1993 CDC list do not involve immunosuppression. For instance, Kaposi’s sarcoma and cervical cancer are not "indicative of severe immunosuppression", but according to the December 1992 definition, they are among the AIDS defining diseases in the presence of HIV including cases when there is no immunosuppression.

Duesberg and Bialy are well on point and have made reasonable use of the charts being discussed here. There was nothing better to use. Sadly, the charts being debated are made from migrating definitions, diagnostic duplicity, circuitous data and leaps of orthodoxy. This is emblematic of the HIV-AIDS scandal that continues to emerge. A tragic mess has been made from great suffering, flawed assumptions and premature conclusions.

We need to awaken to the greater issues being raised these scientists. We need to appreciate the magnitude of human error that has accumulated and become falsely established in our desperate race to find a cure. If you have a deepened interest in HIV-AIDS, then CAREFULLY READ Duesberg's paper cited by Dave above. If that is too much, then just read about the destroyed lives of history-changing physicians Ignaz Semmelweis or James Lind.

Western medical orthodoxy has a long, well established tradition of intellectual thuggery and indifference to fact. The unfolding tragicomic scandal of present HIV-AIDS orthodoxy sadly repeats a recurring pattern in western medicine's scientific and cultural history.

We need to remember the wisdom of Schopenhauer's observation that new thought and new truths go through three stages. First, they are ridiculed. Next they are violently opposed. Then, finally they are accepted as self-evident.

It normally takes a generation for flawed medical orthodoxy to be overthrown. With the help of scientists like Duesberg and Bialy, let us pray this one will not take so long.
1.14.2005 12:51am
Hank Barnes (mail):
Dr. Harvey,

Sadly, I'm away from my office, so I don't have the Padian paper in front of me. Also, I'm on the road tomorrow so, won't be able to get it until probably Tuesday.

But, from memory:

1. The study started in 1985, so there were no licensed drugs to treat AIDS then. And, I recall no mention that anyone in the study was taking those dreaded drugs;

2. I recall nothing in the study on the cause of death of anyone. Not even a suggestion that anyone died of AIDS. The focus was on sex, the whole sex and nothing but the sex.

3. Table 3 says, essentially, some couples used condoms, some did not; some couples had anal sex, some did not. I can't recall the actual numbers.

My bottom line on Padian:

Raw data: Out of 175 discordant couples having a lot of sex over 10 years, exactly ZERO contract HIV.

Adjusted Data: Padian is bewildered by her own findings, does some goofy "meta-analysis" extrapolation, concludes:

a. 1/1000 odds of woman getting HIV from sex with HIV+ man
b. 1/10000 odds of man getting HIV from sex with HIV+ woman.

So, even if you accept Padian's spin, most men (certainly the nerds on this blog) are never gonna have 10,000 sexual liaisons in their life, so are never gonna get HIV from sex.

So, the Hank question:

How can you have a sexually transmitted disease that is never transmitted by sex?

Good day, Gentlemen

Hank Barnes
1.14.2005 12:57am
Harvey Bialy (mail) (www):
H.B.

Thanks, mucho. I knew I wanted to delay getting some sleep until you answered.

Viaje seguro y con dios compadre. You have been a delight to get to know a little over the past days.

H.B.
1.14.2005 1:13am
Harvey Bialy (mail) (www):
101 Dalmatians

Six and a half in the morning of the second day seems an appropriate time to make a final contribution to a discussion that I think it is fair to say I started. I hope no one who has been so understanding for the past 18 or so hours will feel that I am slighting them or in any other way being discourteous. I would hope such a pre-apologia is as unnecessary as losing even a wink of sleep over the fact that your boyfriend's condom broke, given the seriously stimulating exchange of <i>ideas</i> that has gone on here all day yesterday, and all through last night.

So in exactly the same spirit of collegial challenge and answer, and riposte and counter in which the <i>Falsification</i> was offered --a spirit that I defined as the special thrill all lovers of deep "brain teasers" share -- I make my final point.

The only way <i>I </i>can find to rationalize the two curves is to postulate sub-epidemics, and or cofactors. Both of which stretch the meanings of pandemic and cause to beyond a six place floating decimal.

--------------

P.S.I am commanded, by Zaida, to thank Zaida, Tempo and Attila for putting up with me, not only this past week <i>pero por siempre</i>!
1.14.2005 7:34am
daf9:
I find the comparisons between arguments used by religious fundamentalists to refute the "theory" of evolution and AIDS Dissidents to refute the "theory" of hiv/AIDS interesting and instructive. Members of both groups carefully cull the literature for data and then formulate questions that they say are unanswerable. I have no doubt the questions are unanswerable as formulated. Trying to answer them is like trying to beat a shell game. But the flaw is in the formulation of the question. Why should HIV cause AIDS when two closely genetically related viruses HTLV-1 and HTLV-2 do not? And I ask you, if all three are dogs, why should a greyhound be able to run 50 miles an hour when a dachshund or a toy poodle can't? Either the greyhound isn't really a dog or the many many attendees at dog races must be suffering mass halucinations? Or does something about that argument not seem quite right?

if you look at the early AIDS literature what it 'says' is that the epidemiological data is most consistant with an infectious agent transmitted via body fluids. That conclusion was drawn by looking for a common denominator among the groups of individuals who first showed up with AIDS. An infectious agent, hiv, was subsequently found and shown to be transmissible through body fluids. Reducing the incidence of that infectious agent in the blood supply reduced the incidence of AIDS defining illnesses in hemophiliacs and others receiving blood transfusions. The hiv/AIDS hypothesis also predicted that treating patients with antiretrovirals should improve outcome. The data I've seen seem to support that prediction as well, at least on the short term. To me those are pretty practical outcomes arising from predictions made by the hiv/AIDS hypothesis. And that's what hypotheses are for - to make useful predictions.

Someone else in this discussion asked what it would take for an AIDS Apologist to accept that HIV does not cause AIDS. For myself, the answer is an alternative hypothesis that better explains ALL the existing data. I haven't seen one.

daf9
1.14.2005 6:51pm
Richard Bennett (www):
Indeed, daf9. Going back the charts in this posting, we notice that the incidence of AIDS in the US Population is doing exactly what we want it to do - steadily going down from the peak in 1992. So whatever the truth or falsity of the primary theory about AIDS causation may be - and I happen to believe it's true - we must be doing something right. I don't believe you'll see a similar curve for South Africa during the Mbeki HIV denial period.

Also, if you look at the kinds of things AIDS researchers are finding these days, it's clear that they're getting results based on the HIV theory. It's always easy to get thrown off track in obscure areas of science in which we aren't experts and the data isn't as clear and complete as we'd like it to be, so it's therefore instructive to look at the problem from other angles.

As long as the overall rate of AIDS is going down, I'm convinced that we're doing the right things. And Dean, while it's virtuous to be a rebel and question the establishment, being contrary for its own sake is not a virtue, nor is seeing conspiracies in every corner of the world. Sometimes the common wisdom really is wise, and sometimes the people who label our buddies and heroes "crackpot" are correct.
1.14.2005 7:05pm
daf9:
Dr. Bialy,

In case you come back I would like to suggest that there is an alternative way to rationalize the two curves you presented which is simply that your premise is wrong. I will agree that "If HIV is the cause of AIDS, and the number of infected individuals is constant, then, other things being unchanged, the number of cases must remain constant." But other things didn't remain unchanged. Among other factors, public awareness appears to have altered behaviours that would put individuals at high risk for acquiring a pathogen transmitted through contact with body fluids and medical interventions appear to have altered both the time from progression from seropositivity to AIDS and from AIDS diagnosis to death. The characteristics of the people being diagnosed as HIV+ have also been shifting from predominantly male homosexuals to other groups and that may also affect the relationship between your two curves.

daf9
1.14.2005 8:13pm
AnthonyL (mail):
daf9, what you say is true in that In that there are various changes in the "other things", but it is hard to see how any of them could account for the profound disconnect betwen this totally FLAT incidence of HIV in the population (the descent to another level is just a different estimate, not an actual sudden drop) and a bell curve of newly detected AIDS disease.

If I may reply point by point to your previous post and that of Richard:

daf9 I find the comparisons between arguments used by religious fundamentalists to refute the "theory" of evolution and AIDS Dissidents to refute the "theory" of hiv/AIDS interesting and instructive.

AL -Surely those who cling fixedly to a questioned belief are the ones behaving as if they were members of a church....

daf9 Members of both groups carefully cull the literature for data and then formulate questions that they say are unanswerable.

AL In this case the believers produce belief and the data and the heathens accept the data but point out that it doesn't accord with the belief.

daf9 I have no doubt the questions are unanswerable as formulated. Trying to answer them is like trying to beat a shell game.

AL - You imply that responders on either side are concealing data. I don't think anyone I know is making such accusations. If one muddies the issue with accusations, it doesn't help resolve it, it merely makes it unscientific. As a matter of fact, the dissidents in AIDS accept the peer--reviwed study data in the scientific literature for the purposes of their argument that it doesn't fit the theory.

daf9 But the flaw is in the formulation of the question. Why should HIV cause AIDS when two closely genetically related viruses HTLV-1 and HTLV-2 do not? And I ask you, if all three are dogs, why should a greyhound be able to run 50 miles an hour when a dachshund or a toy poodle can't? Either the greyhound isn't really a dog or the many many attendees at dog races must be suffering mass halucinations? Or does something about that argument not seem quite right?

AL - I agree it is not quite right. Dogs or viruses, as you point out, it is quite possible that each type has varying characteristics. But I dont think anyone involved ever argued that HTLV-1 and HTLV-2 are harmless, therefore HTLV-3 must be. HTLV-1 is actually said by Robert Gallo to give you leukemia.

daf9 if you look at the early AIDS literature what it 'says' is that the epidemiological data is most consistent with an infectious agent transmitted via body fluids. That conclusion was drawn by looking for a common denominator among the groups of individuals who first showed up with AIDS.

AL - I believe they first supposed or at least entertained the idea that it was a toxic chemical or chemicals, specifically the amyl and butyl nitrites that were later blamed by dissidents for causing the purple skin cancer Kaposi's sarcoma. This idea seemed to prove out when KS dwindled as a prime symptom of AIDS as gays stopped taking so much those nitrites, which are reported to boost your sexual performance through expanding blood vessels. Now KS has not been the leading symptom of US AIDS for some time. Yet in the beginning it was the lead symptom. Suggestive?

daf9 An infectious agent, hiv, was subsequently found and shown to be transmissible through body fluids.

AL Far from infectious, it turned out. In fact, HIV is the least infectious agent ever blamed for a disease. Don't you recall that even using the same towels and toothbrush as an HIV positive person is not a concern? As noted above, hemophiliac husbands had to sleep with their wives 500-1000 times to transfer the virus, a peer reviewed study showe