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HIV Causes AIDS -- And Knowing It Could Save Your
      #49305 - 12/15/02 09:40 PM

HIV Causes AIDS -- And Knowing It Could Save Your Life
By San Francisco AIDS Foundation

While the global HIV/AIDS pandemic continues to rage, a small number of fringe groups have been aggressively promoting misinformation about AIDS. Some claim that "AIDS is over" or that "AIDS is a myth," and that HIV is a harmless virus. Peter Duesberg, a retrovirologist at UC Berkeley, has challenged the "AIDS establishment" for thirteen years, asserting that factors such as promiscuous homosexual activity, sexually transmitted diseases (STDs), recreational drugs, and AZT (Retrovir) are responsible for the AIDS pandemic. More recently, malnutrition, poverty, and illicit drug use have been cited as causes of AIDS. The individuals and groups who hold these views are often referred to as "AIDS dissidents" or "AIDS denialists."

The AIDS denialists deliberately ignore the overwhelming scientific evidence gathered over the past nineteen years concerning the relationship between HIV and AIDS. Unprotected sex, malnutrition, and a host of factors contribute to the spread of HIV and the development of AIDS.

They do not cause AIDS, however. And while scientists do not completely understand the precise mechanism by which HIV causes AIDS, one thing cannot be disputed: HIV is found in all people with AIDS -- and AIDS is not found in people who do not have HIV.

The HIV antibody test became widely available in 1985. Even in the earliest studies, 79 percent to 100 percent of people with symptoms of AIDS tested positive for HIV antibody. A 1995 study of 230,000 people with AIDS found only 168 HIV-seronegative people. Scientists now know that advanced AIDS -- and immune system depletion -- can result in the immune system's inability to continue to manufacture antibody, which likely explains why HIV antibody could not be found in everyone tested. However, newer, more sophisticated tests like the polymerase chain reaction (PCR) and branched DNA (bDNA) viral load tests have detected HIV (i.e., the virus itself) in everyone with AIDS who has undergone one of these assays.




HIV, AIDS, and CD4 T-Cell Counts
The higher the amount of HIV in the body, the lower the CD4 cell count will be. When the CD4 cell level drops below 200 cells/mm3, an AIDS diagnosis is given. People with low CD4 cell counts, and therefore weakened immune systems, are susceptible to certain diseases because their immune systems are compromised. For instance, many people carry the virus that causes cytomegalovirus (CMV -- an AIDS-defining illness -- but they do not develop CMV because their immune systems function normally. Other common opportunistic illnesses include Pneumocystis carinii pneumonia (PCP), Mycobacterium avium complex (MAC), toxo plasmosis, and Kaposi's sarcoma (KS).



Scientific Proof
In the nineteenth century, the German scientist Robert Koch established four requirements (postulates) that must be demonstrated to establish that a specific microorganism, or "bug," causes a particular disease. Recent developments in HIV/AIDS research have shown that HIV fulfills all four criteria as the cause of AIDS. This proof has been ignored by AIDS deniers for reasons that are unclear.
Reports over the past four years show that the numbers of new cases of AIDS, AIDS deaths, and new opportunistic diseases have been dramatically reduced in the U.S. The only factor that has changed during this period of time is the introduction of highly active antiretroviral therapy (HAART) which, despite its many problems, greatly inhibits HIV reproduction. HIV and AIDS have been repeatedly linked in time, place, and population groups.

Among people without HIV, AIDS-like symptoms are extraordinarily rare except among people receiving organ transplants or cancer chemotherapy whose immune systems are being intentionally suppressed. Only one common denominator exists for gay men, elderly transfusion recipients, heterosexual women, heterosexual men who inject drugs, and infants who have developed AIDS: infection with HIV.




What Are the Public Health Consequences?
The public health consequences of this misinformation remain largely speculative, at least in North America and Europe. In Africa, AIDS deniers have gained the ear of a few politicians, with potentially horrific consequences. There is evidence that AIDS deniers have already caused some damage, even in North America.
For example, about a year ago, an article in a respected Cleveland weekly paper touted the bravery of a few local men who, citing "AIDS is a myth" groups, decided to deal with the difficulties of HIV treatment by throwing out their medication, without consulting their doctors, because they concluded that the adverse effects were not worth the benefits.

At the time, and until fairly recently, many people in the treatment arena -- especially researchers and clinicians -- felt that a public response to what they hoped were isolated cases of media-reported misinformation would backfire by dignifying the deniers' point of view. Since then, similar reports have appeared. Many of these stories have concerned the refusal of parents to give their HIV-positive children medication, based on the parents' ill-informed beliefs that HIV does not cause AIDS and that anti-HIV medicines would kill their children. It appears that several such cases are still being litigated.

Over the past few months, reports about the latest deceptions involving AIDS denialists have surfaced daily on the Internet or in the press. Nicholas Regush, the science editor for ABC News, has been particularly caustic toward those who have been working to control the spread and effects of HIV. Because ABC is a mainstream news source, the potential for unsuspecting people to trust Regush seems high.

Without a doubt, this is a confusing time in terms of HIV treatment. Since the XI International Conference on AIDS in Vancouver four years ago, when optimism about HAART was at its peak, new and serious side effects of anti-HIV drugs have emerged, including body fat abnormalities (lipodystrophy). While there is plenty of press on how HAART has decreased the death rate and emptied hospital wards, there is also news about how toxic these treatments can be, and activists continue to lobby for new and improved drugs. People with HIV are told that it is crucial to adhere faithfully to their medications -- to take every dose -- and yet reports about the new concept of treatment interruption have been increasing. What is a person to think when it comes to making treatment decisions?

Confusion about treatment could work in the denialists' favor, as they try to manipulate vulnerable HIV-positive people and claim that everyone has been misled -- and that HIV does not cause AIDS. While not everyone is susceptible to half-truths and outright lies, others might quit taking their medication, stop consulting their healthcare providers, and refuse treatment for themselves or for their HIV-positive children. And if people start believing that HIV is harmless, it won't be long before they start throwing away their condoms and forgoing the use of clean needles. This is an extreme scenario, but clearly the public health consequences of willful disregard of scientific and epidemiological evidence could be devastating.





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The Evidence that HIV causes AIDS new
      #49409 - 12/16/02 03:49 PM

The Evidence That HIV Causes AIDS
Created November 1994. Last updated November 29, 2000.

BACKGROUND
The acquired immunodeficiency syndrome (AIDS) was first recognized in 1981 and has since become a major worldwide pandemic. AIDS is caused by the human immunodeficiency virus (HIV). By leading to the destruction and/or functional impairment of cells of the immune system, notably CD4+ T cells, HIV progressively destroys the body's ability to fight infections and certain cancers.

An HIV-infected person is diagnosed with AIDS when his or her immune system is seriously compromised and manifestations of HIV infection are severe. The U.S. Centers for Disease Control and Prevention (CDC) currently defines AIDS in an adult or adolescent age 13 years or older as the presence of one of 26 conditions indicative of severe immunosuppression associated with HIV infection, such as Pneumocystis carinii pneumonia (PCP), a condition extraordinarily rare in people without HIV infection. Most other AIDS-defining conditions are also "opportunistic infections" which rarely cause harm in healthy individuals. A diagnosis of AIDS also is given to HIV-infected individuals when their CD4+ T-cell count falls below 200 cells/cubic millimeter (mm3) of blood. Healthy adults usually have CD4+ T-cell counts of 600-1,500/mm3 of blood. In HIV-infected children younger than 13 years, the CDC definition of AIDS is similar to that in adolescents and adults, except for the addition of certain infections commonly seen in pediatric patients with HIV. (CDC. MMWR 1992;41(RR-17):1; CDC. MMWR 1994;43(RR-12):1).

In many developing countries, where diagnostic facilities may be minimal, healthcare workers use a World Health Organization (WHO) AIDS case definiton based on the presence of clinical signs associated with immune deficiency and the exclusion of other known causes of immunosuppression, such as cancer or malnutrition. An expanded WHO AIDS case definition, with a broader spectrum of clinical manifestations of HIV infection, is employed in settings where HIV antibody tests are available (WHO. Wkly Epidemiol Rec. 1994;69:273).

As of the end of 2000, an estimated 36.1 million people worldwide – 34.7 million adults and 1.4 million children younger than 15 years – were living with HIV/AIDS. Through 2000, cumulative HIV/AIDS-associated deaths worldwide numbered approximately 21.8 million – 17.5 million adults and 4.3 million children younger than 15 years. In the United States, an estimated 800,000 to 900,000 people are living with HIV infection. As of December 31, 1999, 733,374 cases of AIDS and 430,441 AIDS-related deaths had been reported to the CDC. AIDS is the fifth leading cause of death among all adults aged 25 to 44 in the United States. Among African-Americans in the 25 to 44 age group, AIDS is the leading cause of death for men and the second leading cause of death for women (UNAIDS. AIDS epidemic update: December 2000; CDC. HIV/AIDS Surveillance Report 1999;11[2]:1; National Vital Statistics Report 2000;48[11]:1; CDC. MMWR 1999;48[RR13]:1).

This document summarizes the abundant evidence that HIV causes AIDS. Questions and answers at the end of this document address the specific claims of those who assert that HIV is not the cause of AIDS.
EVIDENCE THAT HIV CAUSES AIDS
HIV fulfills Koch's postulates as the cause of AIDS.

Among many criteria used over the years to prove the link between putative pathogenic (disease-causing) agents and disease, perhaps the most-cited are Koch's postulates, developed in the late 19th century. Koch's postulates have been variously interpreted by many scientists, and modifications have been suggested to accommodate new technologies, particularly with regard to viruses (Harden. Pubbl Stn Zool Napoli [II] 1992;14:249; O'Brien, Goedert. Curr Opin Immunol 1996;8:613). However, the basic tenets remain the same, and for more than a century Koch's postulates, as listed below, have served as the litmus test for determining the cause of any epidemic disease:
Epidemiological association: the suspected cause must be strongly associated with the disease.
Isolation: the suspected pathogen can be isolated - and propagated - outside the host.
Transmission pathogenesis: transfer of the suspected pathogen to an uninfected host, man or animal, produces the disease in that host.
With regard to postulate #1, numerous studies from around the world show that virtually all AIDS patients are HIV-seropositive; that is they carry antibodies that indicate HIV infection. With regard to postulate #2, modern culture techniques have allowed the isolation of HIV in virtually all AIDS patients, as well as in almost all HIV-seropositive individuals with both early- and late-stage disease. In addition, the polymerase chain (PCR) and other sophisticated molecular techniques have enabled researchers to document the presence of HIV genes in virtually all patients with AIDS, as well as in individuals in earlier stages of HIV disease.

Postulate #3 has been fulfilled in tragic incidents involving three laboratory workers with no other risk factors who have developed AIDS or severe immunosuppression after accidental exposure to concentrated, cloned HIV in the laboratory. In all three cases, HIV was isolated from the infected individual, sequenced and shown to be the infecting strain of virus. In another tragic incident, transmission of HIV from a Florida dentist to six patients has been documented by genetic analyses of virus isolated from both the dentist and the patients. The dentist and three of the patients developed AIDS and died, and at least one of the other patients has developed AIDS. Five of the patients had no HIV risk factors other than multiple visits to the dentist for invasive procedures (O'Brien, Goedert. Curr Opin Immunol 1996;8:613; O'Brien, 1997; Ciesielski et al. Ann Intern Med 1994;121:886).

In addition, through December 1999, the CDC had received reports of 56 health care workers in the United States with documented, occupationally acquired HIV infection, of whom 25 have developed AIDS in the absence of other risk factors. The development of AIDS following known HIV seroconversion also has been repeatedly observed in pediatric and adult blood transfusion cases, in mother-to-child transmission, and in studies of hemophilia, injection-drug use and sexual transmission in which seroconversion can be documented using serial blood samples (CDC. HIV AIDS Surveillance Report 1999;11[2]:1; AIDS Knowledge Base, 1999). For example, in a 10-year study in the Netherlands, researchers followed 11 children who had become infected with HIV as neonates by small aliquots of plasma from a single HIV-infected donor. During the 10-year period, eight of the children died of AIDS. Of the remaining three children, all showed a progressive decline in cellular immunity, and two of the three had symptoms probably related to HIV infection (van den Berg et al. Acta Paediatr 1994;83:17).

Koch's postulates also have been fulfilled in animal models of human AIDS. Chimpanzees experimentally infected with HIV have developed severe immunosuppression and AIDS. In severe combined immunodeficiency (SCID) mice given a human immune system, HIV produces similar patterns of cell killing and pathogenesis as seen in people. HIV-2, a less virulent variant of HIV which causes AIDS in people, also causes an AIDS-like syndrome in baboons. More than a dozen strains of simian immunodeficiency virus (SIV), a close cousin of HIV, cause AIDS in Asian macaques. In addition, chimeric viruses known as SHIVs, which contain an SIV backbone with various HIV genes in place of the corresponding SIV genes, cause AIDS in macaques. Further strengthening the association of these viruses with AIDS, researchers have shown that SIV/SHIVs isolated from animals with AIDS cause AIDS when transmitted to uninfected animals (O'Neil et al. J Infect Dis 2000;182:1051; Aldrovandi et al. Nature 1993;363:732; Liska et al. AIDS Res Hum Retroviruses 1999;15:445; Locher et al. Arch Pathol Lab Med 1998;22:523; Hirsch et al. Virus Res 1994;32:183; Joag et al. J Virol 1996;70:3189).

AIDS and HIV infection are invariably linked in time, place and population group.

Historically, the occurence of AIDS in human populations around the world has closely followed the appearance of HIV. In the United States, the first cases of AIDS were reported in 1981 among homosexual men in New York and California, and retrospective examination of frozen blood samples from a U.S. cohort of gay men showed the presence of HIV antibodies as early as 1978, but not before then. Subsequently, in every region, country and city where AIDS has appeared, evidence of HIV infection has preceded AIDS by just a few years (CDC. MMWR 1981;30:250; CDC. MMWR 1981;30:305; Jaffe et al. Ann Intern Med 1985;103:210; U.S. Census Bureau; UNAIDS).

Many studies agree that only a single factor, HIV, predicts whether a person will develop AIDS.

Other viral infections, bacterial infections, sexual behavior patterns and drug abuse patterns do not predict who develops AIDS. Individuals from diverse backgrounds, including heterosexual men and women, homosexual men and women, hemophiliacs, sexual partners of hemophiliacs and transfusion recipients, injection-drug users and infants have all developed AIDS, with the only common denominator being their infection with HIV (NIAID, 1995).

In cohort studies, severe immunosuppression and AIDS-defining illnesses occur almost exclusively in individuals who are HIV-infected.

For example, analysis of data from more than 8,000 participants in the Multicenter AIDS Cohort Study (MACS) and the Women's Interagency HIV Study (WIHS) demonstrated that participants who were HIV-seropositive were 1,100 times more likely to develop an AIDS-associated illness than those who were HIV-seronegative. These overwhelming odds provide a clarity of association that is unusual in medical research (MACS and WIHS Principal Investigators, 2000).

In a Canadian cohort, investigators followed 715 homosexual men for a median of 8.6 years. Every case of AIDS in this cohort occurred in individuals who were HIV-seropositive. No AIDS-defining illnesses occurred in men who remained negative for HIV antibodies, despite the fact that these individuals had appreciable patterns of illicit drug use and receptive anal intercourse (Schechter et al. Lancet 1993;341:658).

Before the appearance of HIV, AIDS-related diseases such as PCP, KS and MAC were rare in developed countries; today, they are common in HIV-infected individuals.

Prior to the appearance of HIV, AIDS-related conditions such as Pneumocystis carinii pneumonia (PCP), Kaposi's sarcoma (KS) and disseminated infection with the Mycobacterium avium complex (MAC) were extraordinarily rare in the United States. In a 1967 survey, only 107 cases of PCP in the United States had been described in the medical literature, virtually all among individuals with underlying immunosuppressive conditions. Before the AIDS epidemic, the annual incidence of Kaposi's sarcoma in the United States was only 0.2 to 0.6 cases per million population, and only 32 individuals with disseminated MAC disease had been described in the medical literature (Safai. Ann NY Acad Sci 1984;437:373; Le Clair. Am Rev Respir Dis 1969;99:542; Masur. JAMA 1982;248:3013).

By the end of 1999, CDC had received reports of 166,368 HIV-infected patients in the United States with definitive diagnoses of PCP, 46,684 with definitive diagnoses of KS, and 41,873 with definitive diagnoses of disseminated MAC (personal communication).

In developing countries, patterns of both rare and endemic diseases have changed dramatically as HIV has spread, with a far greater toll now being exacted among the young and middle-aged, including well-educated members of the middle class.

In developing countries, the emergence of the HIV epidemic has dramatically changed patterns of disease in affected communities. As in developed countries, previously rare, "opportunistic" diseases such as PCP and certain forms of meningitis have become more commonplace. In addition, as HIV seroprevalence rates have risen, there have been significant increases in the burden of endemic conditions such as tuberculosis (TB), particularly among young people. For example, as HIV seroprevalence increased sharply in Blantyre, Malawi from 1986 to 1995, tuberculosis admissions at the city's main hospital rose more than 400 percent, with the largest increase in cases among children and young adults. In the rural Hlabisa District of South Africa, admissions to tuberculosis wards increased 360 percent from 1992 to 1998, concomitant with a steep rise in HIV seroprevalence. High rates of mortality due to endemic conditions such as TB, diarrheal diseases and wasting syndromes, formerly confined to the elderly and malnourished, are now common among HIV-infected young and middle-aged people in many developing countries (UNAIDS, 2000; Harries et al. Int J Tuberc Lung Dis 1997;1:346; Floyd et al. JAMA 1999;282:1087).

In studies conducted in both developing and developed countries, death rates are markedly higher among HIV-seropositive individuals than among HIV-seronegative individuals.

For example, Nunn and colleagues (BMJ 1997;315:767) assessed the impact of HIV infection over five years in a rural population in the Masaka District of Uganda. Among 8,833 individuals of all ages who had an unambiguous result on testing for HIV-antibodies (either 2 or 3 different test kits were used for blood samples from each individual), HIV-seropositive people were 16 times more likely to die over five years than HIV-seronegative people (see table). Among individuals ages 25 to 34, HIV-seropositive people were 27 times more likely to die than HIV-seronegative people.

In another study in Uganda, 19,983 adults in the rural Rakai District were followed for 10 to 30 months (Sewankambo et al. AIDS 2000;14:2391). In this cohort, HIV-seropositive people were 20 times more likely to die than HIV-seronegative people during 31,432 person-years of observation.

Similar findings have emerged from other studies (Boerma et al. AIDS 1998;12(suppl 1):S3); for example,
in Tanzania, HIV-seropositive people were 12.9 time more likely to die over two years than HIV-seronegative people (Borgdorff et al. Genitourin Med 1995;71:212)
in Malawi, mortality over three years among children who survived the first year of life was 9.5 times higher among HIV-seropositive children than among HIV-seronegative children (Taha et al. Pediatr Infect Dis J 1999;18:689)
in Rwanda, mortality was 21 times higher for HIV-seropositive children than for HIV-seronegative children after five years (Spira et al. Pediatrics 1999;14:e56). Among the mothers of these children, mortality was 9 times higher among HIV-seropositive women than among HIV-seronegative women in four years of follow-up (Leroy et al. J Acquir Immune Defic Syndr Hum Retrovirol 1995;9:415).
in Cote d'Ivoire, HIV-seropositive individuals with pulmonary tuberculosis (TB) were 17 times more likely to die within six months than HIV-seronegative individuals with pulmonary TB (Ackah et al. Lancet 1995; 345:607).
in the former Zaire (now the Democratic Republic of Congo), HIV-infected infants were 11 times more likely to die from diarrhea than uninfected infants (Thea et al. NEJM 1993;329:1696).
in South Africa, the death rate for children hospitalized with severe lower respiratory tract infections was 6.5 times higher for HIV-infected infants than for uninfected children (Madhi et al. Clin Infect Dis 2000;31:170).
Kilmarx and colleagues (Lancet 2000; 356:770) recently reported data on HIV infection and mortality in a cohort of female commercial sex workers in Chiang Rai, Thailand. Among 500 women enrolled in the study between 1991 and 1994, the mortality rate through October 1998 among women who were HIV-infected at enrollment (59 deaths among 160 HIV-infected women) was 52.7 times higher than among women who remained uninfected with HIV (2 deaths among 306 uninfected women). The mortality rate among women who became infected during the study (7 deaths among 34 seroconverting women) was 22.5 higher than among persistently uninfected women. Among the HIV-infected women, only 3 of whom received antiretroviral medications, all reported causes of death were associated with immunosuppression, whereas the reported causes of death of the two uninfected women were postpartum amniotic embolism and gunshot wound.

Excess mortality among HIV-seropositive people also has been repeatedly observed in studies in developed countries, perhaps most dramatically among hemophiliacs. For example, Darby et al. (Nature 1995;377:79) studied 6,278 hemophiliacs living in the United Kingdom during the period 1977-91. Among 2,448 individuals with severe hemophilia, the annual death rate was stable at 8 per 1,000 during 1977-84. While death rates remained stable at 8 per 1,000 from 1985-1992 among HIV-seronegative persons with severe hemophilia, deaths rose steeply among those who had become HIV-seropositive following HIV-tainted transfusions during 1979-1986, reaching 81 per 1,000 in 1991-92. Among 3,830 individuals with mild or moderate hemophilia, the pattern was similar, with an initial death rate of 4 per 1,000 in 1977-84 that remained stable among HIV-seronegative individuals but rose to 85 per 1,000 in 1991-92 among seropositive individuals.

Similar data have emerged from the Multicenter Hemophilia Cohort Study. Among 1,028 hemophiliacs followed for a median of 10.3 years, HIV-infected individuals (n=321) were 11 times more likely to die than HIV-negative subjects (n=707), with the dose of Factor VIII having no effect on survival in either group (Goedert. Lancet 1995;346:1425).

In the Multicenter AIDS Cohort Study (MACS), a 16-year study of 5,622 homosexual and bisexual men, 1,668 of 2,761 HIV-seropositive men have died (60 percent), 1,547 after a diagnosis of AIDS. In contrast, among 2,861 HIV-seronegative participants, only 66 men (2.3 percent) have died (A. Munoz, MACS, personal communication).

HIV can be detected in virtually everyone with AIDS.

Recently developed sensitive testing methods, including the polymerase chain reaction (PCR) and improved culture techniques, have enabled researchers to find HIV in patients with AIDS with few exceptions. HIV has been repeatedly isolated from the blood, semen and vaginal secretions of patients with AIDS, findings consistent with the epidemiologic data demonstrating AIDS transmission via sexual activity and contact with infected blood (Bartlett, 1999; Hammer et al. J Clin Microbiol 1993;31:2557; Jackson et al. J Clin Microbiol 1990;28:16).




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Re: HIV does not cuse AIDS new
      #49414 - 12/16/02 05:03 PM

Let us examine just a few lines from the first few paragrafs written by this anonymous person...

Kary Mullis, Nobel Prize winner in Chemistry

The following was written by Kary Mullis...1996

Please note that Kary Mullis won the Nobel Prize in Chemistry in 1993...see http://almaz.com/nobel/chemistry/1993a.html, yet the poster claims Dr. Mullis wrote in 1996 (after winning the Nobel Prize in Chemistry) that he had no particular knowlege of AIDS...yet this anonymous poster is perpetually claiming, against Dr. Mullis' own statements that his Nobel Prize in Chemistry makes him an expert on hiv to be quoted to us ad nauseum.

....Acquired Immune Deficiency Syndrome (AIDS), on the other hand, was something I did not know a lot about. (much like a certain poster on this board, I might add...)

...when I found myself writing a report on our progress and goals for the project... and then ...After ten or fifteen meetings over a couple years... His employer must be pretty patient to wait a couple years for a progress report...mine usually wants them within a week!





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