Just about every major paper in North America ran a story like this (Oct 8 '98) based on an HHS press release.* Should we buy the hype? Here are some reasons not to. Judge for yourself. (*US Department of Health and Human Services: "AIDS falls from Top Ten Causes of Death", October 7th, 1998)
(1) AIDS cases and deaths have been declining for years AIDS cases leveled off in 1991 and increased in 1993 only because of an expanded definition introduced that year. Since 1993, over 50% of new AIDS cases are among people who have no clinical symptoms or illness thanks to adding "less than 200 CD4 count" to the official AIDS definition. (see fig. 1)
Figure 1. Adult/adolescent AIDS cases reported 1987 through 1997, United States. "AIDS case reports received after January 1, 1993 were influenced by the expanded AIDS surveillance case definition and chiefly represent reporting of persons who had CD4+ cell counts below 200/ul with or without illness. This change greatly altered the pattern of case reports and was most pronounced in the first quarter of 1993." source; CDC HIV/AIDS Surveillance Report
Since AIDS is not a disease, and there is no single universally accepted definition for AIDS, the conditions that are called AIDS vary from country to country. For example, Canada's Laboratory Centre for Disease Control (LCDC) does not recognize the American T cell count criteria for AIDS. This means that 182,200 American AIDS patients -- more than 25% of all people in the US, ever diagnosed with AIDS -- would not have AIDS if they were in Canada.
see: Vladimir L. Koliadin, (2) There has been no explosion of HIV infection in the United States Twelve years ago Newsweek warned that "by 1991 HIV, in all probability, will have spread to between 5 million and 10 million Americans" (AIDS: Grim Prospects, Newsweek, November 10, 1986.) That never happened. In fact, since that article appeared the CDC has continuously revised downward its estimate of the HIV-infected from 1.5 to 2 million Americans in the mid-1980s to a current low of 400,000 to 600,000. The numbers of U.S. AIDS cases in all groups have been phenomenally low for a country with a population of 260 million people. For example, the following AIDS cases, from outside the established "risk groups", were reported to the CDC for 1997:
- 26,783 African-Americans (down from 31,515 in 1993) Without trivializing the lives lost, these numbers aren't even blips on the radar screen of what the US should be experiencing from infectious-AIDS especially when compared to heart disease, cancer and past medical crises like the bubonic plague or the flu epidemic of 1918. Which brings us to the second truth: HIV has not behaved like any other sexually-transmissible, contagious virus. (3) Combination therapy with protease inhibitors was introduced too late and has failed too many patients to account for the AIDS drop. According to the Center for Disease Control and Prevention (CDC) HIV/AIDS Surveillance Report (Vol. 9, No. 2), AIDS cases and deaths for all ethnic groups, sexes, sexual orientations and ages peaked between 1993 and 1995 before the introduction of protease inhibitors and have since continued to steadily fall. CNN recently reported that only 10% of those "needing" new therapies are on them: "Fewer than 10 percent of infected Americans have access and are currently taking these new wonder drugs, let alone the access in developing countries." -James Curran, former Director of the CDC. With failure rates, depending on source, between 20%-65% for those on drugs, that leaves 3.5 to 8% reportedly benefiting from the "wonder" drugs. The final truth is that any attempt to explain away the decline in AIDS deaths as something attributable to combination therapy with protease inhibitors is anachronistic and contrary to what we know about these drugs. Protease inhibitors hit the market in 1996 - three years after the 'AIDS drop' began. An estimated 60,000 to 100,000 individuals started taking them. Medical studies confirmed that from the very start these drugs didn't work in about half of those people (ie: lower viral load or raise CD4 counts). Impossible dosing schedules caused compliance failures in a large percentage of the remaining patient population, many of whom then decided to quit therapy. Wicked adverse effects disfigured and damaged a majority of compliant patients who, like the ones that couldn't handle the dosing schedule, also decided to give up on the pills. This is real-world protease. Yet, the media, Departments of Public Health, and AIDS organizations now irrationally proclaim that protease inhibitors are somehow responsible for the reduction in AIDS deaths despite very few people properly taking them or experiencing clinical benefit and contrary studies (see below) that specifically warned against doing so. (4) Proponents of the HIV theory should have expected a dramatic reduction of AIDS cases and deaths because they reported new infections with HIV peaked and declined between 1979 and 1985.
Mitchell Katz of San Francisco Department of Public Health spells it out to San Francisco Mayor Willie Brown: MAYOR BROWN: Let me ask Dr. Katz. Mitch, Michael [Pasquarelli] read a paragraph from an article written by you. Is it true that there is a conclusion reached by you in preparation of this article, that the reduction in the number of deaths would have occurred even without the protease inhibitors? MITCH KATZ: Absolutely. We've been very clear about that. San Francisco mounted very successful prevention campaigns in the early eighties, and those campaigns were successful in dropping the number of seroconversions dramatically. Since it takes about ten years, on average, from seroconverting to AIDS and about twelve years, on average, from seroconversion to death. [..] On those averages, you would expect that about ten to twelve years after the reductions in new infections, you would see a reduction in AIDS cases and a reduction in deaths, and that's absolutely true. MICHAEL BELLEFOUNTAINE: Mayor, I'd like to point out, with all due respect, in that very same article, his very own statistics state that in San Francisco new cases of HIV infection peaked in 1982 with 7,000 cases and have gone down 1,000 cases every year since then. So, number one, that obviously isn't the behavior of an epidemic. And number two, 1982 was too early for any safe sex information or anything to hit the streets. And the fact that it declined to 6,000 by 1983 would make us think that the epidemic either burned itself out in 1982 or never truly existed. And I feel that again the science and the rhetoric have got to catch up. I believe that you may be intentionally being mislead because he should readily admit that in 1982 these cases peaked at 7,000 and that was too early for any type of prevention campaign.
Source: AIDS Dissidents Meet San Francisco Mayor Willie Brown
January 16, 1999
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Sources:
"Spin City" & Decreases in AIDS Deaths According to Shalala in the 10/8/98 NYT: "This reflects the tremendous power of the new combination drug therapies, the enormous effort to get the drugs to people and the huge federal effort to pay for these drugs." Interestingly, AIDS deaths peaked in 1994 at 47,636; dropped to 43,115 in 1995; 31,130 in 1996; and 16,685 in 1997 (Source: National Center for Health Statistics) And, nobody expected the AIDS death to drop so much. And, they are worried that new infections are not decreasing. Yet, there is no mention that decreased HIV infection rates in young, white men were recently published by the NCI's Rosenberg & Biggar (1998): "In contrast, declines in HIV incidence in young white men were so profound that HIV prevalence in this group declined by about 50 percent between 1988 and 1993, in both persons aged 20 years and persons aged 25 years. Occurring at a time of high overall HIV prevalence, this decline marks a notable prevention success." (JAMA 1998, 279:1894-1899). Yet, as concerns the recent decreases in San Francisco AIDS deaths ascribed to HAART*, Lemp et al. (1997) explain: "Both our projected model and our observed model indicate a peak and decline in AIDS incidence. Recent national reports have also demonstrated a decrease in AIDS incidence and mortality among gay and bisexual men. Much of this decline is being attributed to the effect of therapy. Although combination antiretroviral therapy with protease inhibitors clearly improves survival, our analysis shows that San Francisco would have experienced a significant decline in AIDS cases, due to the decrease in HIV seroconversions, even if combination antiretroviral therapy had not been developed." (J Acquir Immune Defic Syndr Hum Retrovirol 1997, 16(3):182-189.) In the United States, Australia, and Germany, new infection rates peaked during 1983 to 1985 and markedly declined in subsequent years thus accounting for the decreases in AIDS deaths attributed to HAART during the period 1996 to 1998 (Stat Med 1994, 13:1975-1990; J Acquir Immune Defic Syndr 1994, 7:74-78; J Acquir Immune Defic Syndr 1993, 6 Suppl 1:S1-S4; Clin Infect Dis 1993, Suppl 1:S219-S223; Science 1991, 253:37-42). Considering the huge federal funding of the antiviral drugs, is it any wonder that they now have to show benefits. I'm sure that NIH/NIAID is well aware of the present political fiat/spin concerning attributing decreased AIDS deaths to drugs and not to decreased new infections in the mid-eighties. One year ago, in the 9/12/97 San Francisco Chronicle (p. A1), Staff Writer Sabin Russell wrote: "Fauci also attributed the declining death rate to the dramatic shift toward safer sex that occurred in the mid-1980s, which sharply reduced the infection rate among gay men. Because it can take more than 10 years for an HIV infection to develop into AIDS, the decreased death rate was, in effect, predicted more than a decade ago by successful prevention efforts." How things change in just one year at NIAID! Presently, as concerns the drugs, Fauci says: "We now have the ammunition and already made a major positive impact on HIV-infected individuals when it comes to longevity and quality of life." AIDS is politics not science & NIAID is the best!
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