May 23rd, 2002, 3:46 pm
Although I think the NIH is probably right and Duesberg wrong, I did not find the NIH site convincing. Instead of presenting the evidence, it starts by asserting the conclusion, and justifying it with regard to Koch's postulates, which in turn are supported because they have been used for more than a century. This arrogance, giving primacy to the length of time doctors have believed something rather than any direct evidence, is what makes people hope Duesberg is right.Koch had three postulates, the first two of which are not disputed by anyone in the case of AIDS. Number three, "Transmission pathogenesis: transfer of the suspected pathogen to an uninfected host, man or animal, produces the disease in that host" is the key. After all the words to introduce and explain Koch's postulates and defend #1 and #2, we get "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." Three workers? Maybe some of them had unreported risk factors? Maybe something else in the lab caused the immunosuppression? Maybe people were looking for immunosuppression? Did they take the AIDS drugs like AZT that Duesberg thinks cause AIDS?The evidence is summarized in a sloppy fashion. Results from different times are juxtaposed in misleading ways, also anecdotes are mixed with studies. Almost all the evidence speaks only to the undisputed fact that AIDS and HIV are associated, and both are associated with certain behaviors. No consideration is given to the charges that medical researchers choose their designs and censor their data to support conventional wisdom; and journals and funding agencies do a additional filters. This is particularly hard to swallow when some of the evidence is stuff like "Many studies agree that only a single factor, HIV, predicts whether a person will develop AIDS." How about the ones that didn't? How about adjusting for publication bias? How about considering things many studies agreed about that later turned out to be false? I would prefer to see something like, "the evidence for HIV causing AIDS is three times as strong as the evidence that stress causes peptic ulcers."Or here's another example of the things I dislike: "MYTH: HIV antibody testing is unreliable. FACT: Diagnosis of infection using antibody testing is one of the best-established concepts in medicine." Note that the FACT does not address the MYTH, and in any case, seems to assume that "well-established in medicine" means "true." It is true that modern, expensive tests are 98% consistent, they give the same results for the same people, that doesn't mean they are correct. And the vast majority of AIDS studies, including all those before 1998 and virtually all outside a few major research centers in the US and Europe, used tests that were far less consistent.Or "MYTH: The distribution of AIDS cases casts doubt on HIV as the cause. Viruses are not gender-specific, yet only a small proportion of AIDS cases are among women. FACT: The distribution of AIDS cases, whether in the United States or elsewhere in the world, invariably mirrors the prevalence of HIV in a population." Again, the FACT does not address the MYTH. It does indicate that AIDS and HIV are related, but does not explain the sexual difference in incidence.Still, when you strip all that away, there are some pretty solid reasons to believe HIV causes AIDS. I hate the arrogant tone and poor arguments, but that doesn't mean the NIH is wrong.