Jan 18 2013: And still, you do not adress my main argument. Your hypothesis about non-viral cause for AIDS postulates that all scientists working on HIV (researchers, professors, virologists, epidemiologists, statisticians, technicians, pharmacologists, doctors) are either incompetent, either bribed or otherwise willing to disseminate lies to complete an obscure agenda, either brainwashed to the point that in three decades, none of them discovered the truth. Or maybe is it that some secret organisation is spiking just every sample in the world with synthetic RNA without anyone knowing, actually reproducing the genomic evolutionary pattern of a virus? Oh wait, maybe it is the same devil antechrist that buried fossils in the ground so that we could come up with darwinian evolution?
Please realize all these theses are ridicule. If you have another explanation for the blindness of millions of people, let me know. I do not say this ironically, I am really searching to understand your line of reasoning.
Regards,
I do not want to give the impression that your skepticism is not welcomed. Science is, to me, professional skepticism. But you are not very professional. By browsing the web, your research was probably skewed towards websites propagating false information (in the sense: opposite to the truth), understandably more thrilling to read than boring epidemiological records.
First, you should understand that in the eighties, knowledge of the disease was very limited, and that there was indeed a debate in the scientific community to know if AIDS was really transmissible: transmission rates are very low, symptoms are non-specific and take many years to manifest, and molecular biology techniques were limited. This debate however resolved quickly when confronted with increasing evidence, so stop with the Gallo thing. It is not the first or last time researchers stole each other results or Nobel prizes were questionably attributed.
I will respond to your comments about the epidemiology, because it is my domain. Africa has much higher levels of sexual concurency than western countries, this is well documented. More partners, more acts per person per year, more overlap. Your comment that "marriage commitments insulate from cross-infection" ignores the reality of widespread liberal behaviors, and western countries are much more conservative on this point. In many African countries, women marry earlier than men, and marriage does not equate sexual commitment (for both partners). This results in a gender imbalance where more women are infected with HIV than men. In western countries, HIV has been driven for some time by male homos (the transmission rate is about ten times higher for anal sex than vaginal sex) and drug injection. This first resulted in a gender imbalance where much more men where infected than women, but as the virus spread to the heterosexual population, this imbalance reduced. Your stats are outdated.
You can access all peer-reviewed articles on PubMed.
Jan 17 2013: I think the problem is in the contradiction: 1) it is desirable that everyone gets tested for HIV and 2) you cannot force people to get tested against their will.
So I would propose that whenever visiting a doctor, a HIV test would be systematically proposed to all patients, emphasizing the benefits for them and the community. If the patient does not opt out of the test for privacy reason, the test will be conducted.
Jan 17 2013: There is obvious financial interest for some companies to put more antiretrovirals on the market, while there is a clear incentive for them not to let the number of patients drop so low that they would loose money. Therefore, the kind of HIV research that is abundantly funded is directed towards drugs that can enter the existing pattern, while other strategies, like prevention, education, testing are underfunded.
My opinion, as a former HIV-researcher, is that we already have plenty of antiretrovirals that work just fine to prolong the life of HIV-infected individuals and decrease transmission rates, while eradication of the virus will not happen until comprehensive, integrated strategies are in place in a world-wide effort. And as you might have noticed, the UNAIDS budget have plumeted, and general awareness is decreasing.
Most of these clinical trials are therefore, if not unnecessary, at least impeding the implementation of the really effective strategies.
People lie to their doctors. People rarely admit to take injecting drugs, as long as they can hide it and it poses no other problem in their life. People go to the doctor with their wives and husbands. People have sometimes the same doctor as half of their families and are concerned that he would not keep the secret about their concurent relationships. People deny, sometimes to themselves, their homosexuality. So how do you REALLY assess that somebody is at zero-risk?
You seem to confuse two things. You are right to point that the financial interests of big pharmas do not necessarily serve public health. However the fact that governments failed to give appropriate response for three decades and that some companies are making billions out of patients does not mean the fundamental research about the disease is false. At worst, you could argue that it is misdirected, that instead of searching another antiviral to sell they could fund more comprehensive strategies. I took the time to debunk your point-by-point affirmations:
1. Yes indeed that's how it works. Please provide us a risk factor that correlates better with AIDS than HIV infection?
2. AZT is a potent drug with strong side-effects. It was used in retrovirus-induced cancers. Now we have better drugs.
3. Robert Gallo published in Science, vol. 220, no. 4599, pp. 865–867, 1983
4. That's what they all do...
5. The French team published at about the same time. The debate was about who to give the Nobel.
6. Most patients are not treated with AZT anymore. Do you mean that ALL retrovirals are lethal weapons from the big pharmas? How come nobody dies when the same compounds are used to treat another virus?
7. That's how most test work. When a test is positive the DNA of the virus is analysed, to know the strain and level of infection of the individuals.
8. HIV Tests are 99% accurate and performed in duplicate with different sets of reagents, on different machines, by different technicians and on different days. We rarely misdiagnose someone.
9. True, they are some cross-positive. See point 8.
10. The variability of the virus is huge. Vaccines are not yet efficient enough, nor are maternal antibodies.
11. Same as, for example, evolution theory or quantum physics.
12. The HIV mechanism is well understood. it does not contradict any part of biology.
13. Africa has polygamy, high sexual activity, early mariage, much less homosexuality and no injecting drugs.
14. Good reflex.
Medical professionals or any scientist who opposes a well-established theory has to provide an alternative theory, and evidence that supports it. Otherwise indeed, they face the ridicule of their peers. Scientific research does not exist for everybody to give his personal opinion, but to try to determine what is the absolute truth. You think you are a hero defying the worldwide conspiration of big pharmas? What about the millions of researchers who have conducted research on HIV? They are all in the conspiracy? I have personally amplified HIV DNA and compared sequences from patients. I searched databases, draw conclusions from evidence gathered after long months of painful research. If there was bribe money, me and my colleagues did not see the color of it.
For HIV to enter an immune cell, it needs to "hijack" one of two surface proteins: CCR5 or CxCR4 which are proteins your immune system normally uses to sense chemokines, a type of immune messenger. People who have a certain version of the CCR5 receptor (called delta-32 because it consist in a deletion of 32 amino acids in the protein sequence) are not immune to infection, but take much more time to progress to clinical AIDS. So much that they actually get old or die from something else before developping the disease. They have very low levels of virus in their blood, meaning they are unlikely to pass it to their partners. So yes, they were "immune" all the time (but not in the same sense that immune from a vaccine), and yes, they still develop antibodies that can be detected with a HIV test if they are infected. They do not develop these antibodies if they are not infected.
http://en.wikipedia.org/wiki/Delta_32#CCR5-.CE.9432
Jan 16 2013: I have worked on HIV and made computer models that fit the epidemic in Luxembourg. You can see my thesis here: files.figshare.com/97984/Thesis_Final20120824.pdf. I specifically tested several strategies, including yearly testing of the whole population, which appears as the most efficient one, at least in a mature epidemic like in Europe or the US (see figures 3.18 and 3.19).
The conclusions of my analysis on the whole population of a developed country point to the fact that the people participating most to the dissemination of the virus are the ones who stay undiagnosed and therefore fail to change their sexual behavior, rather than the ones having at-risk behaviors like highly sexually active people, male homosexuals and injecting drug users (note: this was not the case in the early epidemic, where these last two populations fueled the spread of the virus). I would therefore be supportive of such a strategy, but with strong restrictions:
- the test should not be legally mandatory, but the option to be freely tested should be presented to the patient by the doctor. The doctor should point to the benefits both for the individual and the community of an early diagnosis.
- everything should be done to ensure the confidentiality of the results. The patient still has the choice to be treated or not.
My analysis showed that virtually all other strategies are ineffective in the long-term, with the recently FDA-approved preventive antiretroviral having devastating effects on the levels of resistance, even with conservative assumptions.
I will not provide AIDS denialists with the evidence they could easily get from thousands of peer-reviewed litterature and three decades of research. I understand that such litterature demands some background knowledge in biology and I direct them to a more accessible version here:http://en.wikipedia.org/wiki/Misconceptions_about_HIV_and_AIDS
May 25 2012: 0.1% chance per act means you have 99.9% not to get the virus. Having sex 1000 times with an HIV-infect person means you have 1-(1-x)^1000 = still 36% chance to be HIV-negative. With receptive anal sex you only need about 67 sex acts to get the same number...
May 25 2012: You are right. Some transmission probabilities using the correct terminology...
- penile-vaginal sex (insertive) = 0.1% per act
- penile-vaginal sex (receptive) = 0.2% per act (yes, ladies it is not fair...)
- anal sex (insertive) = 0.5% per act
- anal sex (receptive) = 1.5% per act
TEDCred score: +0.90 TEDCred reflects your contribution to the TED community.
A reply on Conversation: Should we support national legislations for mandatory, free of charge and confidential HIV testing of everyone who does blood test?
Please realize all these theses are ridicule. If you have another explanation for the blindness of millions of people, let me know. I do not say this ironically, I am really searching to understand your line of reasoning.
Regards,
A reply on Conversation: Should we support national legislations for mandatory, free of charge and confidential HIV testing of everyone who does blood test?
I do not want to give the impression that your skepticism is not welcomed. Science is, to me, professional skepticism. But you are not very professional. By browsing the web, your research was probably skewed towards websites propagating false information (in the sense: opposite to the truth), understandably more thrilling to read than boring epidemiological records.
First, you should understand that in the eighties, knowledge of the disease was very limited, and that there was indeed a debate in the scientific community to know if AIDS was really transmissible: transmission rates are very low, symptoms are non-specific and take many years to manifest, and molecular biology techniques were limited. This debate however resolved quickly when confronted with increasing evidence, so stop with the Gallo thing. It is not the first or last time researchers stole each other results or Nobel prizes were questionably attributed.
I will respond to your comments about the epidemiology, because it is my domain. Africa has much higher levels of sexual concurency than western countries, this is well documented. More partners, more acts per person per year, more overlap. Your comment that "marriage commitments insulate from cross-infection" ignores the reality of widespread liberal behaviors, and western countries are much more conservative on this point. In many African countries, women marry earlier than men, and marriage does not equate sexual commitment (for both partners). This results in a gender imbalance where more women are infected with HIV than men. In western countries, HIV has been driven for some time by male homos (the transmission rate is about ten times higher for anal sex than vaginal sex) and drug injection. This first resulted in a gender imbalance where much more men where infected than women, but as the virus spread to the heterosexual population, this imbalance reduced. Your stats are outdated.
You can access all peer-reviewed articles on PubMed.
A reply on Conversation: Should we support national legislations for mandatory, free of charge and confidential HIV testing of everyone who does blood test?
So I would propose that whenever visiting a doctor, a HIV test would be systematically proposed to all patients, emphasizing the benefits for them and the community. If the patient does not opt out of the test for privacy reason, the test will be conducted.
A comment on Talk: Boghuma Kabisen Titanji: Ethical riddles in HIV research
My opinion, as a former HIV-researcher, is that we already have plenty of antiretrovirals that work just fine to prolong the life of HIV-infected individuals and decrease transmission rates, while eradication of the virus will not happen until comprehensive, integrated strategies are in place in a world-wide effort. And as you might have noticed, the UNAIDS budget have plumeted, and general awareness is decreasing.
Most of these clinical trials are therefore, if not unnecessary, at least impeding the implementation of the really effective strategies.
A reply on Conversation: Should we support national legislations for mandatory, free of charge and confidential HIV testing of everyone who does blood test?
People lie to their doctors. People rarely admit to take injecting drugs, as long as they can hide it and it poses no other problem in their life. People go to the doctor with their wives and husbands. People have sometimes the same doctor as half of their families and are concerned that he would not keep the secret about their concurent relationships. People deny, sometimes to themselves, their homosexuality. So how do you REALLY assess that somebody is at zero-risk?
A reply on Conversation: Should we support national legislations for mandatory, free of charge and confidential HIV testing of everyone who does blood test?
You seem to confuse two things. You are right to point that the financial interests of big pharmas do not necessarily serve public health. However the fact that governments failed to give appropriate response for three decades and that some companies are making billions out of patients does not mean the fundamental research about the disease is false. At worst, you could argue that it is misdirected, that instead of searching another antiviral to sell they could fund more comprehensive strategies. I took the time to debunk your point-by-point affirmations:
1. Yes indeed that's how it works. Please provide us a risk factor that correlates better with AIDS than HIV infection?
2. AZT is a potent drug with strong side-effects. It was used in retrovirus-induced cancers. Now we have better drugs.
3. Robert Gallo published in Science, vol. 220, no. 4599, pp. 865–867, 1983
4. That's what they all do...
5. The French team published at about the same time. The debate was about who to give the Nobel.
6. Most patients are not treated with AZT anymore. Do you mean that ALL retrovirals are lethal weapons from the big pharmas? How come nobody dies when the same compounds are used to treat another virus?
7. That's how most test work. When a test is positive the DNA of the virus is analysed, to know the strain and level of infection of the individuals.
8. HIV Tests are 99% accurate and performed in duplicate with different sets of reagents, on different machines, by different technicians and on different days. We rarely misdiagnose someone.
9. True, they are some cross-positive. See point 8.
10. The variability of the virus is huge. Vaccines are not yet efficient enough, nor are maternal antibodies.
11. Same as, for example, evolution theory or quantum physics.
12. The HIV mechanism is well understood. it does not contradict any part of biology.
13. Africa has polygamy, high sexual activity, early mariage, much less homosexuality and no injecting drugs.
14. Good reflex.
A reply on Conversation: Should we support national legislations for mandatory, free of charge and confidential HIV testing of everyone who does blood test?
Medical professionals or any scientist who opposes a well-established theory has to provide an alternative theory, and evidence that supports it. Otherwise indeed, they face the ridicule of their peers. Scientific research does not exist for everybody to give his personal opinion, but to try to determine what is the absolute truth. You think you are a hero defying the worldwide conspiration of big pharmas? What about the millions of researchers who have conducted research on HIV? They are all in the conspiracy? I have personally amplified HIV DNA and compared sequences from patients. I searched databases, draw conclusions from evidence gathered after long months of painful research. If there was bribe money, me and my colleagues did not see the color of it.
For HIV to enter an immune cell, it needs to "hijack" one of two surface proteins: CCR5 or CxCR4 which are proteins your immune system normally uses to sense chemokines, a type of immune messenger. People who have a certain version of the CCR5 receptor (called delta-32 because it consist in a deletion of 32 amino acids in the protein sequence) are not immune to infection, but take much more time to progress to clinical AIDS. So much that they actually get old or die from something else before developping the disease. They have very low levels of virus in their blood, meaning they are unlikely to pass it to their partners. So yes, they were "immune" all the time (but not in the same sense that immune from a vaccine), and yes, they still develop antibodies that can be detected with a HIV test if they are infected. They do not develop these antibodies if they are not infected.
http://en.wikipedia.org/wiki/Delta_32#CCR5-.CE.9432
A comment on Conversation: Should we support national legislations for mandatory, free of charge and confidential HIV testing of everyone who does blood test?
The conclusions of my analysis on the whole population of a developed country point to the fact that the people participating most to the dissemination of the virus are the ones who stay undiagnosed and therefore fail to change their sexual behavior, rather than the ones having at-risk behaviors like highly sexually active people, male homosexuals and injecting drug users (note: this was not the case in the early epidemic, where these last two populations fueled the spread of the virus). I would therefore be supportive of such a strategy, but with strong restrictions:
- the test should not be legally mandatory, but the option to be freely tested should be presented to the patient by the doctor. The doctor should point to the benefits both for the individual and the community of an early diagnosis.
- everything should be done to ensure the confidentiality of the results. The patient still has the choice to be treated or not.
My analysis showed that virtually all other strategies are ineffective in the long-term, with the recently FDA-approved preventive antiretroviral having devastating effects on the levels of resistance, even with conservative assumptions.
I will not provide AIDS denialists with the evidence they could easily get from thousands of peer-reviewed litterature and three decades of research. I understand that such litterature demands some background knowledge in biology and I direct them to a more accessible version here:http://en.wikipedia.org/wiki/Misconceptions_about_HIV_and_AIDS
A reply on Talk: Hans Rosling on HIV: New facts and stunning data visuals
A reply on Talk: Hans Rosling on HIV: New facts and stunning data visuals
- penile-vaginal sex (insertive) = 0.1% per act
- penile-vaginal sex (receptive) = 0.2% per act (yes, ladies it is not fair...)
- anal sex (insertive) = 0.5% per act
- anal sex (receptive) = 1.5% per act