HIV Dissidents

Last week, Hit and Run noted the saga of Christine Maggiore, a HIV-positive mother who leads a movement whose followers deny the HIV-causation hypothesis of AIDS and refuse to take anti-retroviral drugs during their pregnancy and obstain from breast-feeding. Maggiore's 3-year-old daughter died suddenly after receiving antibiotics for mild upper respiratory symtpoms, fever, and a earache. Three months later, the autopsy had reported "AIDS-related pneumonia". You can read more at the LA Times story here or at H&R.

The posts ignited a little cyber-dust-up over merits of arguments by self-professed HIV-dissidents and/or insurgents. Prominent critic Harvey Bialy appeared on the thread there, as well as one at Dean Emsay's Dean's World, to take on all comers. He and fellow dissident Peter Duesberg wrote a response letter to the Times, which Emsay printed on his blog:

The Silence of The LA Times

Dear Sirs,

This is in response to the story you published yesterday regarding the death of the daughter of Christine Maggiore and Robin Scovill.

In order to have a diagnosis of 'aids related pneumonia', two conditions must be met. The patient must be HIV antibody positive, and there must be a clinical pneumonia. Whether Eliza Jane was in fact Ab+ is information that neither the LA Times nor the coroner's office has as yet made public. However, according to *all* reports it is acknowledged the child suffered none of the textbook symptoms of pneumonia, and had previously been in excellent health for several years. Thus the crucial second condition appears completely unsatisfied. (A post mortem finding of PCP in the lungs means nothing since it is 100% ubiquitous in human beings). Thus we are left to ponder the only significant fact, and it is one of omission, in your story. On what basis did the coroner conclude the child died of 'AIDS related pneumonia'?

After more than 20 years of attempting to get straight answers about HIV/AIDS from so-called authorities, we are less than sanguine that this latest, simple query will be satisfactorily answered.

Sincerely,

Prof. Peter H. Duesberg
Dept of Molecular and Cell Biology
Univ. of California, Berkeley

Dr. Harvey Bialy
Resident scholar
Institute of Biotechnology
Autonomous National University of Mexico
Cuernavaca, Mexico

I wrote the following to Dean to correct some factual errors made in the letter:

First, their assertion that "a post mortem finding of PCP in the lungs means nothing since it is 100% ubiquitous in human beings" is patently false. While P. carinii is not pathogenic in immunocompetent individuals and theoretically a rare organism could be found under histologic examination, this would be a rare finding. I have conducted numerous autopsies, and never have found such organisms in patients without AIDS. But more importantly, any finding of a significant number of organisms (and that number for "significance" would be low) would define the case as AIDS, since almost every case of PCP occurs in AIDS patients. I fear the authors are merely planting a false seed for the inevitable report of PCP in this child.

Relatedly, neither of the authors' conditions for "AIDS-related" pneumonia, that the patient be HIV positive or that a classical clinical pneumonia be present, are correct. The absence of HIV positivity (or even a single test) means nothing in the face of an AIDS-defining illness. And PCP is known for often presenting "atypically" in a small but non-trivial number of cases (even with negative chest X-rays).

Trent McBride, MD
Resident, Pathology and Laboratory Medicine
University of Kentucky

You can read more about the arguments against the HIV-hypothesis here.

Read the government's detailed and well-referenced response to the myriad of arguments here.


Link Round-Up:
HIV Dissidents
HIV Dissidents, Continued
HIV Dissidents: The Continuing Saga
Parents Vs. The State
Maggiore on PrimeTime Live

Respectful Insolence 1
Respectful Insolence 2
Respectful Insolence 3
Nick Bennett's Rebuttal to Al-Bayati's Report

The Medical Examiner's Report
Mohammed Al-Bayati's Comment on ME's Report

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However as I understand it

However as I understand it Duesberg was a highly respected scientist whose reputation was destroyed by this. So "reward" does not seem to be his reason.

No, you seem to have missed

No, you seem to have missed the point. You just don't see organims on histology unless they are abundant - so if the report comes back saying "PCP", you know they were there in abundnace. Why, then, do wee pathologists ever see special stains for PCP that are negative?

And the other doctor's examinations mean nothing to me, for they are clincal examinations that have nowhere near the sensitivity that biopsy/autopsy have.

This whole story is full of

This whole story is full of red herrings. First, only 30% of children born to HIV positive mothers get the disease. Second the disease usually pursues a chronic course with failure to thrive and the child slowly going down hill. If the child dies of Pneumocystes pneumonia, it should be very obvious to the pathologist who should find a chronically ill child with severe lung disease and characteristic findings of chronics respiratory disease that should lead any halfway competent pathologist to order special stains that will reveal the offending organism.
To me there is no question that Acquired Immune Deficiency Syndrome is caused by Human Immunodeficiency Virus.

Why do people take an contrarian view and hold to it in the face of overwhelming opposing evidence?

The non-cynical explanation might be that they have some vested interest or they simply have some mental glitch that does not enable them to accept the truth. Or maybe they are out on a limb and are too embarrassed to admit that they were wrong.
The cynical explanation might have something to do with publicity, ego massage and money. How many times would a non- scientist, non physician get invited to the 20/20 television show if one promoted the establishment position concerning AIDS? How many books could the lay person sell promoting the AIDS/HIV link? How much publicity would you get promoting Newton’s law of gravity? It most probably has to do with ego gratification and reward. Each outrageous assertion is followed by an ego gratifying dollop of publicity in tomorrow’s newspaper. Ditto for Cindy Sheehan and other creatures of the media.

But as we know, the report

But as we know, the report didn't come back "PCP" initially. They found clear lungs and no signs of pneumonia even at the autopsy. Not until almost 4 months after this child was buried did they come up with that diagnosis. So how is that four months later they suddenly come up with PCP, unless they did some special test to go out of their way to look for P. Carinii? (Something that's always there, although most are not aware of it because it's usually so hard to spot?)

If you're speaking as a pathologist, you should be looking at the report, or at least asking what the justification for the diagnosis is or was. The LA Times doesn't say, and the coroner's office hasn't answered my mail.

As I've noted, two other pathologists are now looking at this and we should know more when they're done.

By the way, as compared to that strange NIH document--non-peer reviewed, with no author or anyone else who has to answer for it--a better response, fully peer reviewed and with a scientist who'll actually respond to inquiries, is right here:

http://duesberg.com/papers/chemical-bases.html

But there's a far better response still; I'll be offering it up on my blog on Monday. A 156 page peer-reviewed analsyis, with a copy of all significant supporting documentation on CD. You'll probably want to see it.

Be careful not to make the

Be careful not to make the timetable of the autopsy report the cornerstone of your case, because there is absolutely nothing there to make me suspicious. Procedures vary at different institutions, but where I work, a "preliminary anatomic diagnosis" is made within 24 hours. This consists of all the gross anatomical findings seen initially. This, of course, is only preliminary, and more importantly, does not include any microscopic findings whatsoever. Thus, if there were PCP there, and it was done by me, the preliminary report would not say anything about PCP, because, of course, you can't see microorganisms grossly. (You do understand this, right? The "special tests" you allude to is simple microscopic examination. PCP can sometimes be seen on regular H&E stains, and has a characteristic diffuse alveolar infiltrate that, in the absence of seeing organisms on H&E, would lead a thorough pathologist to order a special stain that lights up the organism. No real "searching" that you describe.)

After that, we prepare and look at histology and any special stains, lab studies, cytogenetics, etc., and write a report based on clinical histroy, microscopic findings, and maybe a discussion of the pathophysiology and/or the literature of the given entities involved. This routinely can take 2-3 months. So again, the timeline you present as evidence of fishiness is actually business as ususal.

Finally, it's odd you describe the NIH document as "non-peer-reviewed" when almost every thing in it is cited to a peer-reviewed journal.

...although to clarify the

...although to clarify the point, I would assume that a pathologist would have to go out of his way to find PCP and normally would not. It's there--it's always there--but presumably not detectable by normal means unless it's either a raging infection or you're going way out of your way to look for it.

I'll get Harvey in here to help you with that.

Self-styled dissidents? I

Self-styled dissidents? I suppose I've done that, although mostly the term I use is skeptic. Dr. Bialy is more prone to use the term "dissident," probably as a result of his days as a radical back in the '60s when he got his PhD at Berkeley.

You seem to have missed the point that if you go looking for PCP, you'll find it since it's present in everybody's lungs. Not having the pathologist's report before us, and given the incredibly sloppy reporting by the LA Times, we cannot know what the basis of the diagnosis is here, however, we know for a fact that three different physicians examined the child and found her lungs clear.

You should probably also have a look at this:

http://www.deanesmay.com/posts/1128337408.shtml

We are currently awaiting review from two independent pathologists before more is said, but, a number of us suspect a political rather than a medical finding here. There are several things wrong here beyond what Drs. Duesberg and Bialy said; Christine's letter points to some of it, but not all of it.

I'll be freer to say more once the independent pathologists are done with their work.

Kerry Mullis has a few

Kerry Mullis has a few things to say on the subject.

I have a few things to say about some other drugs here.

:stupid: HIV/AIDS is real

:stupid: HIV/AIDS is real from my experiences, I have watched friends die from quiting meds or not taking meds. I myself have AIDS, got HIV from open heart surgery back in the nineteen-eighties...

Dean has started making hay

Dean has started making hay of a report on the autopsy by a fellow denialist:

http://www.deanesmay.com/posts/1132416234.shtml

EJ obviously had chronic

EJ obviously had chronic disease.

She remained below percentile 30 of weight for age her entire life, and below percentile 5 for a long while.

Blood tests are compatible with chronic disease anemia.

About P. carinii, yes it's found in HIV- people, but not in alveolii. Lower respiratory tract is known to be sterile.

Rgds,

Luis Fernando Waib, MD, MSc
Infectious Diseases Practitioner
Brazil