Now I'd like to address some common questions I received.
Many people inquired what impact the article would have on my job or career. I have not quit my job, nor have I been fired (so far). Iíve simply abandoned one area of research Ė I doubt Iíll ever be able to publish in mathematical biology again, but that was the risk I knew I was taking. Thank you all for your concern.
A few individuals kindly suggested that I inject myself with the blood of a late-stage AIDS patient. While such an act might sensationalize my viewpoint, there are a number of problems with such an "experiment." First, I can only imagine the non-HIV contaminants that might be found in such blood. Second, the data and results contained in the literature are sufficient to cast doubt on HIV. But most importantly, such an "experiment" would hardly settle anything, given the "latency period" of 10-15 years for progression to "AIDS."
Many people insisted that I donít know what Iím talking about because I offer no alternative explanations for AIDS. There are many alternative explanations for "AIDS," or severe immune deficiency. The immunosuppressive effects of malnutrition, chronic drug abuse (pharmaceutical as well as recreational), parasitic infections, psychological stress, and other risks were well-established long before "AIDS" became recognized in the early 1980s. The fact is that most (but not all) AIDS patients do belong to risk groups whose members are subject to one or more of the above assaults. This fact can be checked by reading the annual CDC surveillance reports, although drug use is hidden because the CDC gives priority to "sexual transmission." And I should point out that the correlation between positive antibody tests and immune deficiency doesnít necessarily imply that HIV is the cause. To shamelessly steal an analogy from Peter Duesberg, just because long-term smokers often tend to develop yellow fingers along with lung cancer, does not mean that yellow fingers cause lung cancer. This is what we refer to in statistics as a "lurking variable" Ė correlated but not the cause, and hence confounding the issue. In any case, pointing out the flaws in an existing theory in no way obliges me to produce an alternative.
I did receive several emails from people like myself who work or have worked with AIDS every day, people who have growing doubts or who have abandoned the theory altogether. These include doctors, pharmacists, biologists and social workers.
"I volunteer in a Community Health Center, which was started twenty years ago, mainly for HIV positive people, though our clientele has expanded to all sections of our community. Also, as a former physician and then a psychiatrist, I was never able to understand this mysterious 'disease', and your writing has clarified a lot of that mystery."
And there was also the following quote, from a social worker who works with HIV-positive prisoners:
"Having worked with women with HIV in a prison environment, they always seemed more scared than sick."
The letters that particularly affected me were those from people diagnosed with HIV, or who have lost loved ones to AIDS. I have lost count of the number of people who have told me that they are convinced their friends and lovers died from AZT poisoning rather than HIV. I have nothing to offer but my utmost sympathy. Iíve received mail from people who are HIV-positive and healthy for years without any AIDS medications. I have also gotten more letters than I was expecting from people whose lives have been seriously affected by false positive diagnoses, including a man who lost his position in the military after a positive HIV test, despite being at very little risk, and despite having had malaria and numerous vaccinations. Heís out of work now.
"I am a low-low-low-low risk group guy who has been diagnosed with HIV as a part of yearly tests (military). As a hetero[sexual], monogamous (10 years with one NEG[ATIVE] partner), non-IV drug using male...I was skeptical. However the "system" is not skeptical and it has subsequently tubed my previously successful career...The fact that I have had malaria and about a billion weird immunization shots (incl[uding] Anthrax) has not been brought up as possible source of false positive."
For everyone who has been affected by AIDS in one way or another, and for those of you who have an abiding concern about doing science correctly, please know that I read all of your letters and you are in my thoughts. What I wrote was very personal, but it was also intended to serve another purpose: the average person should be aware of all the information that exists, not just whatís been fed to us through the government propaganda machine. The individual citizen should be able to make informed choices about their health and their life. Letís not allow overzealous, misinformed public health agencies to take away that right from us.
The article also attracted some comments from the blogosphere. The following comments appeared at a blog called Aetiology, which is owned and maintained by Seed magazine:
"That's rich. First, as I mentioned, she's a mathematician. I don't know what her background is in infectious disease epi[demiology] (I contacted her but she did not respond), and she obviously shows little understanding of molecular biology in her comments about PCR (by her logic, any microbe shouldn't cause us harm because they are so tiny)." March 9, 2006 10:43 AM
Yes, I am just a mathematician. Iíve never treated an AIDS patient, nor have I worked with HIV in the lab. But in the course of my work, I have studied both the microbiological and epidemiological aspects of AIDS, and the current HIV theory fails to explain either of these. Ever more convoluted explanations for HIV pathogenesis and epidemiology are not the signs of a mysterious virus, but rather the signs of a theory that is being shaped to fit the facts.
The following quote, as well as the quote above, indicate some confusion over what I had to say about PCR. This comes from an aspiring microbiology student:
"To understand my shock at the content of this article, you have to understand how incredibly steeped in the doctrine of the AIDS generation current education in Microbiology is. In the several years I have been working on my B.Sc, I have taken probably five courses that featured HIV or AIDS as prime examples of their precepts, have taken a course from one AIDS researcher, and have read about AIDS from several more. The idea of the AIDS virus has been one of the best known and studied examples of classical virology that weíve ever had...I havenít read the whole article yet, but from the part Iíve read, it seems that itís written by a disgruntled HIV mathematician who got out of the race when she discovered that her paradigm and that of the establishment in this medical research field were radically different. From what I read, her science seems fine, except for some pretty disdainful and poorly-educated opinions on some of the best-used and most well-understood DNA techniques, such as PCR, or Polymerase Chain Reaction (the technique used by crime-scene units to amplify very small amounts of DNA so it can be identified, matched or analyzed):
If something has to be mass-produced to even be seen, and the result of that mass-production is used to estimate how much of a pathogen there is, it might lead a person to wonder how relevant the pathogen was in the first place.
First of all Ė to say this, a person needs to have absolutely no concept of how small DNA is, the degree of virulence of the pathogen being studied, and essentially no concept of how microbiology works. In short Ė a mathematician." The AIDS "Theory."
To be very clear, I did not mean that HIV cannot be pathogenic because it is so small, I meant it cannot be pathogenic because it is so sparse; there is so little of it to be found. I was comparing PCR to a Xerox machine, rather than a magnifying glass. We need the Xerox machine because traditional virus culture techniques fail to detect HIV. Worse yet, PCR is used to measure "viral load," but this quantitative use of PCR has never been validated. As mathematician Mark Craddock has said, "If PCR is the only way that the virus can be detected, then how do you establish the precise viral load independently of PCR, so that you can be certain that the figures PCR gives are correct?" An alarmingly simple question, when you think about it; perhaps too simple for an AIDS establishment already fully committed to "surrogate markers," protease inhibitors and "combination therapies."
And finally, a random blogger at LibertyPost.org appears to be lauding the toxicities of protease inhibitors:
"And worse, she claims that protease inhibitors are killing HIV patients, 'And the leading cause of death in HIV-positives in the last few years has been liver failure, not an AIDS-defining disease in any way, but rather an acknowledged side effect of protease inhibitors, which asymptomatic individuals take in massive daily doses, for years,' when that's exactly what you would hope for (mortality drastically decreasing to the point that more deaths were the result of side effects) if protease inhibitors were in fact EFFECTIVE treatment for AIDS." posted on 2006-03-03
Finally, I received a series of odd emails from a prominent government HIV researcher, which includes the following quote:
"The AIDS denialists are making some noise about you being the Ďlatest PhD researcherí to refute HIV as the cause of AIDS. The document they are citing...does not contain any new research, but only repeats a lot of the standard denialist disinformation."
The opening of this email begins with the use of the pejorative and entirely unnecessary term "denialist," and this was followed by an "elucidation" of various aspects of virology that I imagine were intended to persuade me to change my mind, despite the fact that the arguments given were precisely those arguments that led me to doubt HIV in the first place.
The arguments I presented were not intended to be "new research," but rather a short summary of the rather substantive questions that scientists such as Peter Duesberg and others have raised, which have still not been adequately answered. If the AIDS establishment is so convinced of the validity of what they say, they should have no fear of a public, adjudicated debate between the major orthodox and dissenting scientists to settle the matter once and for all. Yet all the major AIDS researchers have averted such a public debate, either by claiming that the "overwhelming scientific consensus" makes such a debate superfluous, or by saying that they are "too busy saving lives." In place of public debate, clearly politically motivated documents such as the Durban Declaration remain the establishmentís standard response to dissenting voices. Even a cursory reading of this pathetic document reveals it to be a statement of faith, designed to divert attention from dissenters at the very moment when they were threatening to expose the orthodoxy in South Africa in 2000.
To clarify an issue that has caused some confusion, it was not the mathematical models themselves that caused me to doubt HIV, but rather the scientific literature on which the models are based. Billions of dollars have been spent on HIV, and this has not led to a greater understanding of the virus, but rather to a series of unproven or incorrect speculations which have been widely trumpeted in both the scientific and lay press. Such a track record is indicative of institutional problems in modern biomedicine.
The famous Ho/Shaw 1995 Nature papers are a typical example of this phenomenon. These were the papers largely responsible for popularizing HAART (the so-called "Highly Active Anti-Retroviral Therapy") and the "Hit hard, hit early" regime as a treatment for "HIV disease" and "viral load" as a measure of treatment success. The mathematical models used in these papers were claimed to show that HIV replicated furiously from day one Ė in contrast to earlier evidence suggesting it to be quite inactive. Even now, few people are aware that these conclusions were based on very poorly constructed mathematical models. Anyone who has taken a first course in differential equations can see that, if analyzed properly, the models predict the onset of AIDS within weeks or months after infection by HIV, before antiviral immunity. (For anyone interested in a mathematical refutation of the Ho paper, I refer you to Mark Craddock's analysis. Similar criticisms have been directed at the Shaw paper.)
This example illustrates a central flaw in the HIV theory. The vast majority of the literature Iíve seen uses what is known as circular logic Ė you assume that something will happen, and then you mold the definitions, models, experiments, and results to support that conclusion. Craddock describes a typical example of circular logic in the Shaw paper:
"They are trying to estimate viral production rates by measuring viral loads at different times and trying to fit the numbers to their formula for free virus. But if their formula is wrong, then their estimates for viral production will be wrong too."
Such tactics, by definition, are excellent at maintaining the faÁade of a near-perfect correlation between HIV and AIDS, and of providing seemingly convincing explanations of HIV pathogenesis. But the resultant science does little to expand our actual understanding.
To fully appreciate how such tactics became common, one needs to revisit the beginning of AIDS science. In 1984, HIV was announced as the cause of AIDS at a press conference before any supporting literature was published and had a chance to be critiqued by the scientific community. By the time the supporting papers were published, the lay press had all but declared HIV to be "the AIDS virus," and debate in the scientific arena was squelched. The current commonly used orthodox tactic of arguing by intimidation and forcing the conclusions to fit the facts became entrenched. Consider the time period in the scientific literature, when HIV went from being "the probable cause of AIDS" (1984) to simply "the cause of AIDS" (1985). What changed? What happened to make scientists come to such certainty? If you look at the actual papers, youíll see quite clearly that the answer is: Nothing.
Returning to the Ho/Shaw papers, these have essentially been debunked by both establishment and dissenting researchers, on biological as well as mathematical grounds; they are now acknowledged to be wrong by the scientific community, and it remains a mystery how they were ever able to pass peer review in the first place. It is often asked, "Why should we care at this point? Those papers are 11 years old; our understanding has progressed since then." The short answer is that "viral load" and combination therapies are used to this day, despite the fact that they were originally based on these incorrect papers. Although current therapeutic regimens have been scaled back from the "Hit hard, hit early" dogma that was popular ten years ago, the fact remains that a large population of people have been, and continue to be, treated on the basis of a theory that is fundamentally unsupportable.
Yet there is another answer to this question which is even more fundamental. It is a curious fact that few HIV researchers seem to be bothered by the events surrounding the Ho/Shaw papers. You might imagine that people might "care at this point" because of concern over the integrity of science. You might imagine that people might feel an urge to discuss how the papers got published, and if other such mistakes have happened since that time. You might imagine that the failure of the peer review process to detect such patently inept research would send off alarm bells within the HIV research community.
You would be wrong.
HIV researchers know the Ho/Shaw papers are wrong, yet they continue along the clinical path charted by the papers. They know that the quantitative use of PCR has never been validated, yet they continue to use "viral load" to make clinical decisions. They know that the history of HIV/AIDS is littered with documented cases of fraud, incompetence, and poor quality research, yet they find it almost impossible to imagine that this could be happening at the present moment. They know their predictions have never panned out, yet they keep inventing mysterious mechanisms for HIV pathogenesis. They know many therapies of the past are now acknowledged to be mistakes (AZT monotherapy, Hit hard, hit early), yet they never imagine that their current therapies (the ever-growing list of combination therapies) might one day be acknowledged as mistakes themselves.
As a final thought, I am often asked, "How could medicine have made such a big mistake? How could so many people be wrong?." I believe the answer lies in the disintegration of scientific standards that have resulted, in large part, from the changing expectations of academic scientists. Iím an assistant professor, and my father is also a professor in the physical sciences, so I have had plenty of opportunity to see exactly how research expectations affect the quality of work we produce. It is clear to me that the pressure to obtain big government grants and to publish as many papers as possible is not necessarily helping the advancement of science. Rather, academics (and in particular, young ones) are pressured to choose projects that can be completed quickly and easily, so as to increase their publication list as fast as possible. As a result, quality suffers.
This lowering of scientific standards and critical thinking has been apparent in many aspects of research for some time, and after several generations of students, it is now beginning to infiltrate the classroom Ė the textbooks and the undergraduate curriculum. It is germane at this point to indicate that many of the common arguments presented in response to the queries of HIV/AIDS skeptics are essentially some form of appeal to the use of low standards. (For example, "You donít need a reference that HIV causes AIDS," "The fact that HIV and AIDS are so well correlated indicates that it must be the cause," "HIV is a new virus, and new viruses will meet new standards," "Koch's postulates are outdated and don't apply in this day and age," "We donít need to worry about actual infectious virus, viral Ďmarkersí should suffice," or "Real scientists do experiments; they don't write review articles on the literature.") All of these observations are eloquently summed up, again by Craddock:
"Science is about making observations and trying to fit them into a theoretical framework. Having the theoretical framework allows us to make predictions about phenomena that we can then test. HIV "science" long ago set off on a different path...People who ask simple, straightforward questions are labeled as loonies who are dangerous to public health."
It is this decline in scientific standards that I point to, when I am asked how so many people could be so wrong. Given the current research atmosphere, it was almost inevitable that a really, really big scientific mistake was going to be made. But we can still have hope for the future Ė hope that institutional and political pressures will no longer continue to cost lives, and hope that we will soon see honest dialogue and debate, free of name-calling and intimidation.
March 21, 2006
Rebecca V. Culshaw, Ph.D. [firstname.lastname@example.org], is a mathematical biologist who has been working on mathematical models of HIV infection for the past ten years. She received her Ph.D. (mathematics with a specialization in mathematical biology) from Dalhousie University in Canada in 2002 and is currently employed as an Assistant Professor of Mathematics at a university in Texas.