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 The presentations include an edited version of the Duesberg paper that was withdrawn from the Medical Hypotheses journal, as well as a rehash of a couple of papers whose main author is Prof.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.