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The End of Dissent: Sincere Congratulations, a Long Overdue Answer and a Cautionary Tale for the Benefit of Profs. Ruggiero and Bauer

On his personal website, Rethinking AIDS president, David Crowe, has published a comment attributed to Prof. Marco Ruggiero (we do suspect it received a “light edit” by Crowe), aptly headlined Firenze 2011, The End of Dissent.

It details the encouraging news that several (not so) dissenting papers were accepted for presentation at the Italian Conference on AIDS and Retroviruses. The presentations include an edited version of the Duesberg paper that was withdrawn from the Medical Hypotheses journal, as well as a rehash of a couple of papers whose main author is Prof. Bauer. They also include a presentation of some promising results achieved with the immune stimulant GcMAF.

We congratulate Prof. Marco Ruggiero, who is almost single-handedly responsible for the exposure and respectability RA has achieved in Italy. Although we may hold different opinions on the general quality of dissident scholarship on display in Firenze, it seems the standard is good enough to impress mainstream HIV/AIDS professionals (who admittedly have been trained during three decades to swallow almost anything raw) and the development is overall positive and exciting.

We also appreciate Prof. Ruggiero’s “Trojan Horse” game, and again, so far it seems to be working when it comes to mainstream HIV/AIDS professionals. But such a Trojan horse is most effective when we do not believe in it ourselves. It is therefore a little troubling that Ruggiero’s End of Dissent piece is almost entirely devoted to heaping praise on himself and his fellow “dissenting” scientists represented in Firenze, including an exhaustive list of all the prestigious persons and organisations that now “accept” “dissenters”. Since when have true dissidents stood in such awe of established institutions and organisations, or been so thrilled when patted on the head by those in power, that they rush to proclaim the “end of dissent”?

On occasion of the publication back in 2010 of Safety issues in didactic anatomical dissection in regions of high HIV prevalence, a prominent ingredient in at least one of the Firenze presentations, Prof. Ruggiero excitedly asked us, “Will Kalichman, Moore and Chigwedere recognize those results?” We were not sure if he was joking, and not wanting to ask him if he was, we did not answer then. But since it is now clear that he was not joking, we shall answer his question appropriately: “Prof Ruggiero, sir, you have got to be joking!”

In their presentation Towards Improvements in HIV Epidemiology, subheading “False-Positive HIV Tests”, Bauer et al write the following:

An estimate of the frequency of false positives can be made based on the following premises:

1. Untreated HIV infection leads almost inevitably to death after a median period of about a decade (this is a fundamental tenet of HIV/AIDS theory, an axiom not an assumption)

2. In the United States between one quarter and one third of HIV-positive individuals are not aware that they harbour HIV.

3. There were between 1 and 1.5 million HIV-positive Americans as early as 1986.

4. People not known to be HIV-positive would not be receiving antiretroviral treatment and could be expected to have died about a decade after becoming HIV positive.

Together with published data from the Centers for Disease Control and Prevention, of the numbers of deaths of HIV+ Americans and of American AIDS patients, the pertinent calculations show that approximately one half of all positive HIV tests are false positives.

Would Kalichman, Moore and Chigwedere recognize these results? Kalichman is probably too stupid to form his own opinion, but let us try putting ourselves in Moore’s and Chigwedere’s place and begin by making Profs. Ruggiero and Bauer aware that:

1. the 1-1.5 million HIV-positives as early as 1986 represent (early over)estimates, not actual positive tests. By what rule do we discredit the tests instead of adjusting the estimates?

2. the between one quarter and one third HIV-positive Americans unaware that they harbour HIV also represent estimates. By what rule do we discredit the tests instead of adjusting those estimates?

3. for the alleged discrepancy to arise between undiagnosed HIV infections and AIDS deaths, Bauer’s et al calculation assumes that a death would be registered as HIV-related in the absence of a positive HIV test. Posthumous HIV tests are occasionally performed, but a significant portion of those estimated undiagnosed HIV-positives would of necessity also become undiagnosed AIDS deaths. Thus, if actual or estimated AIDS deaths and estimated total HIV cases do not add up, it is due to oversights in the epidemiological (back-)calculations; that is, faulty epidemiological models, not faulty tests.

4. Bauer’s et al calculation also assumes that once unaware that one harbours HIV always unaware that one harbours HIV. Those unaware of their status are assumed to be a static quantity who never become aware of their status. But reality is that the longer one has been HIV+, and the worse one’s clinical condition becomes the more likely it is that one gets tested, becomes aware of one’s status and starts receiving life-saving antiretrovirals. Thus those most in need of antiretrovirals are those most likely to receive them, and the one third to one quarter estimate is kept constant by the influx of newly infected who are not yet aware of their status.

5. in the Safety issues in didactic anatomical dissection in regions of high HIV prevalence paper Bauer himself argues that the same one third to one quarter unaware of their HIV+ status represent non-progressors rather than false positives. So which is it, Profs. Ruggiero & Bauer, non-progressors or false positives? Bauer resolves the contradiction in a truly original manner. He defines a non-progressor, or elite controller, as someone who has HIV antibodies but no active infection as measured by the viral load tests, and someone who has no detectable viral load as someone who has “no virions”, and someone who has no virions/detectable active infection as a false-positive. The only way for this to make sense is that the elite controller, is not “controlling” the infection, but has eradicated it completely, including latent proviruses. It is the inescapable “eradication of HIV” theme that seems to be obligatory in every dissident paper or commentary since Montagnier’s comments in HoN – except Montagnier is specifically talking about disappearing antibodies, whereas in Bauer’s version antibodies is the only thing that hasn’t disappeared.

In the same paper, as well as in Iatrogenic Harm Following HIV Testing, Bauer also argues that these non-progressors/false positives make up ”more than half of all those who would test positive currently—if there were universal testing in the United States”, and that they therefore would be prescribed ARVs needlessly. That amounts to saying that more than half of all HIV positives are completely viral load-free. With the widespread testing going on, it is truly astounding that more of these “false-positives”/elite controllers have not been discovered. Bauer seems to think it’s because they are put on ARVs and killed based on the initial antibody tests, but as Papadopulos points out:

The proportion of non-progressors, no matter how large, cannot be used “To estimate the proportion of people receiving ART who should not be doing so”. The reason is simple. By definition the non-progressors are individuals who have a positive antibody test but never developed any laboratory (T4 decrease/or clinical abnormality).  These individuals are not treated with ART.


(…) in low-risk individuals the results are “confirmed” with non-antibody tests i.e. PCR.

In other words, those most likely to be antibody positive and viral RNA-free, according to Bauer, are all confirmed positive by the “active infection” test.

6. in another presentation from the same Firenze conference, Bauer argues along with Duesberg that the lacking AIDS epidemic and unusually “slow” spread of HIV antibody prevalence in South Africa, from 0.7% in 1990 to 30% in 2000, is evidence that HIV is a harmless passenger virus. If HIV is harmless, how can Bauer use AIDS deaths as a gold standard for the HIV tests the way he does above (if you are a true positive you get AIDS and die within a median period of ten years, if you are a false positive you don’t)?

Bauer claims that the HIV tests are invalid because of the many false-positives in low prevalence populations. The broader claim is that not only the individual HIV test, but the test algorithm (standard combination of tests, including PCR) produces a prodigious number of false positives, far beyond what’s acceptable for any diagnostic test. The only evidence he has of that is the above hapless epidemiological argument about non-progressors/false-positives. When that argument is shot down - as Bauer himself does by signing the Duesberg paper – so is Bauer’s entire elaborate case against the HIV tests.

And herein, good professors, lies the danger in beginning to believe in one’s own Trojan horses; you risk waking up one day to find that your serious, career-defining hypotheses depend on what started out as just another careless prank.

UPDATE: A reader has privately asked why it matters that the Duesberg paper contradicts Bauer’s HIV test paper, since Bauer presumably does not really believe in either the passenger virus or the HIV/AIDS theory, and the different arguments are for different purposes. We would like to remind all of our readers that Bauer thinks the high false-positive rates in low-risk populations argument is so brillant that it should be the dissidents’ main weapon in the courtroom as well as with the general population and the media. This means that Bauer et al. would begin a court case by conceding that a positive HIV test means there’s on average, depending on whether you are in a risk group or not, an approximately 50% chance that you are currently infected with a real virus, HIV, and will die of  AIDS. Bauer has no evidence that HIV tests are more unreliable than any other test without making this initial concession. This is one reason why one shouldn’t start believing in one’s own Trojan horses, or take seriously conclusions reached on what one knows are false premises.


3 Responses to “The End of Dissent: Sincere Congratulations, a Long Overdue Answer and a Cautionary Tale for the Benefit of Profs. Ruggiero and Bauer”

  1. Gene Semon says:

    Nice, very nice Claus!

    If one wants to go into a courtroom and pretend mathematical guessing can be the foundation of anything forensic, I say good luck.

    However, after reading through this once, I have to admire Professor Bauer’s ingenuity in appearing to be an hiv expert right out of the mold of our good friend Professor Moore.

    Here’s the thing. I can play HIV expert too.

    So Point 5, safety issues, is a subject dear to my heart given my past career.

    Thus, I can give my expert opinion that a professional risk analyst would find “didactic anatomical dissection” incoherent. This attempt to distinguish the truly positive from false positive patients (‘HIV antibodies but no active infection as measured by the viral load tests’) founders on the made-up fact of true positives.

    But let’s assume for sake of argument that a true positive is one with detectable proviruses AND RNA viral load AND antibody reactivity with the big three proteins gag pol and env.

    These essential data points can only be determined by epidemiological surveillance, not mathematical modeling. What needs to be analyzed, based on these accurate measurements of the “truly positive” and differential diagnosis of “long term” NPs in a large cohort of patients, is the timing of those who get AIDS, sorting out the short term from the long-term statistically.

    Of course this proposal should forever remain in the realm of a Gedanken experiment. It’s only offered to substantiate a plea to Ruggiero and Bauer and their Trojan Horse approach: you can’t bullshit a bullshitter.

  2. Administrator says:

    From Charles Stein’s introduction to the Debate of the Great Gambit on deanesmay.com.

    Dr. Bialy, whose opening gambit (and why it is a gambit will appear forthwith) includes a pair of graphs meant to get discussion going. One graph shows the constant presence of HIV in the American population from 1985 until 2000, the other the precipitous rise and fall of AIDS over the same period among the same people. The two images are incompatible. They spell the impossibility of the AIDS hypothesis.

    The clarity with which they do so provokes a flurry of blogger response. There must be something wrong with the graphs. Post after post appears, attempting to unmask or correct them, demonstrating in several quite contradictory ways how the graphs were ignorantly, amateurishly, or viciously constructed. But the sense of the graphs taken as a question, (rather than as an argument) pervades the discussion. If HIV infection is constant (in whatever sense) while AIDS rises and falls (whatever the details) can HIV possibly cause AIDS? (…) what comes to light is a welter of contradictory assertions regarding the state of our information about HIV and AIDS—not at all limited to the information captured or occulted by the graphs—so that, as the discussion advances, the graphs become somewhat irrelevant, and the state of our knowledge gets rather clear; that is to say, it grows clear that our knowledge is anything but clear, regarding almost every aspect of the illness. (…) As for the graphs themselves, one might perhaps see that it comes to this: the data that the Center for Disease Control (CDC) has published (and on the basis of which the graphs were produced may have been shoddily compiled; it may comprise 3 methodologically unsound extrapolations; it may be inaccurate, inconsistent, and/or based on mere guestimates. But the data is nevertheless the basis on which the CDC currently confirms the HIV hypothesis. The graphs may fail to represent the truth of the HIV/AIDS situation, but they were cobbled up from the CDC data, so the question is this: Is it possible to maintain the HIV hypothesis if the graphs and the data from which they are constructed are credited? The answer is clearly no. Therefore, the effort that is expended by the AIDS defenders at the beginning of the blog and sporadically throughout it to impugn the graphs by revealing just how uncertain and unclear the data behind them is to impugn the hypothesis itself! (Hence the gambit). (My bold highlights)

    This was before dissidents began taking Trojan horses, gambits or themselves too seriously. But the seed was already sown, since Duesberg used what Stein rightly interprets as merely a gambit, a question rather than an argument, to prove that HIV is a harmless, vertically transmitted passenger virus.

    Notwithstanding his disbelief in HIV, Prof. Bauer is essentially a Duesbergian. His epidemiological “proofs” that (take your pick) AIDS is not caused by HIV, the false-positive rate / rate of elite controllers is around 50%, the HIV tests do not detect a sexually transmitted agent are all gambits on the order of the notorious Flat Line Prevalence curve, some as elegant, some not, but none surpass the simple beauty of Bialy/Duesberg’s original Master Gambit.

    It is thus by inclination rather than accident that amateur epidemiologist Bauer signed amateur epidemiologist Duesberg’s Medical Hypotheses paper claiming to not only disprove the HIV/AIDS hypothesis, but to prove the competing Passenger Virus hypothesis, based on what both knew was fundamentally flawed epidemiology.

    • Gene Semon says:

      Being a part of that initiative, I most certainly agree.

      I recall the absurdity of bloggers talking about error bars, etc and defending Peter with the simple response: it’s his expert judgement you idiots. The horizontal/flat-line curve is the most educated guess and even supported by more recent statements of John Coffin and Paul Ewald.

      It remains as the Master Gambit, all by itself.

      And it was so much fun sharpshooting the Double D, Nick Bennett, who made a few astonishing errors.
      With a 50-50 chance of getting it right, he informed the blogosphere that hep c was a negative strand RNA virus. And thus began my failed attempts to convince the world that HIV “really is” a HERV …

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