Duesberg hypothesis 8309 222702882 2008-06-30T18:22:57Z Keepcalmandcarryon 7015792 text from broken link found in pub already referenced in article; also, this is all quoted from NIAID (rewrite?) The '''Duesberg hypothesis''' is the claim, associated with [[University of California, Berkeley]] professor [[Peter Duesberg]], that various non-infectious factors such as [[recreational drug|recreational]] and pharmaceutical drug use are the cause of [[AIDS]], and that [[HIV]] (human immunodeficiency virus) is a harmless [[passenger virus]]. The most prominent defenders of this hypothesis are Duesberg himself, [[biochemist]] and vitamin proponent [[David Rasnick]], and journalist [[Celia Farber]]. The majority of the [[scientific community]] considers that Duesberg's arguments are the result of [[cherry-picking]] predominantly outdated scientific data<ref>{{cite journal | author = Galea P, Chermann JC. | title = HIV as the cause of AIDS and associated diseases | journal = Genetica | volume = 104 | issue = 2 | pages = 133–142 | year = 1998 | pmid = 10220906 | doi = 10.1023/A:1003432603348}}</ref> and selectively ignoring evidence in favour of HIV's role in AIDS.<ref name="phenom">Cohen J. (1994) [http://www.sciencemag.org/feature/data/cohen/266-5191-1642a.pdf The Duesberg phenomenon]. ''Science'' '''266''', 1642-1644 PMID 7992043</ref> There is broad [[scientific consensus]] that the Duesberg hypothesis is incorrect, and that HIV is the cause of AIDS.<ref name="niaid">[http://www.niaid.nih.gov/Factsheets/evidhiv.htm National Institutes of Allergy and Infectious Disease Fact Sheet: The Evidence that HIV Causes AIDS]. Accessed via [[National Institutes of Health]] website on [[March 9]] [[2007]].</ref><ref name="cdcfacts">[http://www.cdc.gov/hiv/resources/factsheets/index.htm Fact Sheets on HIV/AIDS], from the [[Centers for Disease Control]]. Accessed [[March 9]] [[2007]].</ref><ref>[http://www.who.int/hiv/en/ World Health Organization HIV and AIDS Programme], from the [[World Health Organization]] website. Accessed [[March 9]] [[2007]].</ref> ==Role of legal and illegal drug use== Duesberg argues that there is a [[correlation|statistical correlation]] between trends in recreational drug use and trends in AIDS cases.<ref>{{cite journal |author=Duesberg P, Rasnick D |title=The AIDS dilemma: drug diseases blamed on a passenger virus |journal=Genetica |volume=104 |issue=2 |pages=85–132 |year=1998 |pmid=10220905 |doi=10.1023/A:1003405220186}}</ref> He argues that the [[AIDS epidemic|rapid increase of AIDS cases]] in the 1980s corresponds to a supposed epidemic of recreational drug use in the [[United States]] and Europe during the same time frame. These claims are not supported by [[epidemiology|epidemiologic data]]. Widespread recreational drug use preceded the onset of the AIDS epidemic.<ref>[http://www.niaid.nih.gov/Publications/hivaids/22.htm Trends in Drug Use and the AIDS Epidemic.] From the NIAID and [[National Institutes of Health]] website. Accessed [[24 October]] [[2006]].</ref> The reported increase in recreational drug sales and deaths during the 1980s was not reflected in absolute numbers of users; "the number of individuals aged 25 to 44 years reporting current use of marijuana, cocaine, inhalants, hallucinogens and cigarettes declined between 1974 and 1992, while the AIDS epidemic worsened".<ref>[http://www.niaid.nih.gov/Publications/hivaids/22.htm Trends in Drug Use and the AIDS Epidemic.] From the NIAID and [[National Institutes of Health]] website. Accessed [[01 May]] [[2008]].</ref> The average yearly increase in opioid-related deaths from 1990-2002 was nearly three times the yearly increase from 1979-1990, with the greatest increase in 2000-2002, yet AIDS cases and deaths fell dramatically during the mid-to-late-1990s.<ref name="drugusepharmaco">{{cite journal |author=Paulozzi LJ, Budnitz DS, Yongli X |title=Increasing deaths from opioid analgesics in the United States |journal=Pharmacoepidemiology and Drug Safety |volume=15 |issue=9 |pages=618–27 |year=2006 |pmid=16862602 |doi=10.1002/pds.1276}}</ref> Duesberg's claim that recreational drug use, rather than HIV, was the cause of AIDS has been specifically examined and found to be false.<ref name="drugusenature">{{cite journal |author=Ascher MS, Sheppard HW, Winkelstein W, Vittinghoff E |title=Does drug use cause AIDS? |journal=Nature |volume=362 |issue=6416 |pages=103–4 |year=1993 |pmid=8095697 |doi=10.1038/362103a0}}</ref> Duesberg has also argued that [[nitrite inhalant]]s were the cause of the epidemic of [[Kaposi sarcoma]] (KS) in gay men. However, this argument has been described as an example of the [[fallacy]] of a [[lurking variable|statistical confounding effect]];<ref>{{cite journal |author=Morabia A |title=Poppers, Kaposi's sarcoma, and HIV infection: empirical example of a strong confounding effect? |journal=Prev Med |volume=24 |issue=1 |pages=90–5 |year=1995 |pmid=7661947 |doi=10.1006/pmed.1995.1014}}</ref> it is now known that [[Kaposi's sarcoma-associated herpesvirus|a herpesvirus]], potentiated by HIV, is responsible for AIDS-associated KS.<ref>{{cite journal |author=Kedes D, Operskalski E, Busch M, Kohn R, Flood J, Ganem D |title=The seroepidemiology of human herpesvirus 8 (Kaposi's sarcoma-associated herpesvirus): distribution of infection in KS risk groups and evidence for sexual transmission |journal=Nat Med |volume=2 |issue=8 |pages=918–24 |year=1996 |pmid=8705863 |doi=10.1038/nm0896-918}}</ref><ref>{{cite journal |author=Martin J, Ganem D, Osmond D, Page-Shafer K, Macrae D, Kedes D |title=Sexual transmission and the natural history of human herpesvirus 8 infection |journal=N Engl J Med |volume=338 |issue=14 |pages=948–54 |year=1998 |pmid=9521982 |doi=10.1056/NEJM199804023381403}}</ref> Moreover, in addition to recreational drugs, Duesberg argues that anti-HIV drugs such as [[zidovudine]] (AZT) can cause AIDS. Duesberg's claim that antiviral medication causes AIDS is regarded as disproven by the scientific community.<ref name="niaid"/> ===Scientific study and rejection of Duesberg's risk-AIDS hypothesis=== Several studies have specifically addressed Duesberg's claim that recreational drug abuse or [[sexual promiscuity]] were responsible for the manifestations of AIDS. An early study of his claims, published in ''[[Nature]]'' in 1993, found Duesberg's drug abuse-AIDS hypothesis to have "no basis in fact".<ref name="drugusenature"/> A large [[prospective study]] followed a group of 715 [[Homosexuality|homosexual]] men in the [[Vancouver, Canada]] area; approximately half were HIV-seropositive or became so during the follow-up period, and the remainder were HIV-seronegative. After more than 8 years of follow-up, despite similar rates of drug use, sexual contact, and other supposed risk factors in both groups, AIDS developed ''only in those patients'' who were HIV-seropositive. Similarly, [[CD4]] counts dropped in the patients who were HIV-infected, but remained stable in the HIV-negative patients, in spite of similar rates of risk behavior.<ref name="lancet1993"/> The authors concluded that "the risk-AIDS hypothesis... is clearly rejected by our data", and that "...The evidence supports the hypothesis that HIV-1 has an integral role in the CD4 depletion and progressive immune dysfunction that characterise AIDS."<ref name="lancet1993">{{cite journal | author = Schechter M, Craib K, Gelmon K, Montaner J, Le T, O'Shaughnessy M | title = HIV-1 and the aetiology of AIDS. | journal = Lancet | volume = 341 | issue = 8846 | pages = 658–9 | year = 1993 | pmid = 8095571 | doi = 10.1016/0140-6736(93)90421-C}}</ref> Similarly, the Multicenter AIDS Cohort Study (MACS) and the Women's Interagency HIV Study (WIHS) — which between them observed more than 8,000 Americans — demonstrated that "...the presence of HIV infection is the only factor that is strongly and consistently associated with the conditions that define AIDS."<ref name="macs">[http://www3.niaid.nih.gov/news/focuson/hiv/resources/macs_and_wihs.htm MACS and WIHS Studies Provide Overwhelming Evidence That HIV Causes AIDS]. From the [[National Institute of Allergy and Infectious Diseases]]. Accessed [[March 9]] [[2007]].</ref> A 2008 study found that recreational drug use (including marijuana, cocaine, poppers and amphetamines) had no effect on [[CD4]] or [[CD8]] T-cell counts, providing further evidence against a role of recreational drugs as a cause of AIDS.<ref>{{cite journal |author=Chao C, Jacobson LP, Tashkin D, ''et al'' |title=Recreational drug use and T lymphocyte subpopulations in HIV-uninfected and HIV-infected men |journal=Drug Alcohol Depend |volume= 94|issue= |pages= 165|year=2008 |pmid=18180115 |doi=10.1016/j.drugalcdep.2007.11.010}}</ref> ==Current AIDS definitions== Duesberg argued in 1989 that a significant number of AIDS victims had died without proof of HIV infection.<ref>{{cite journal |author=Duesberg P |title=Human immunodeficiency virus and acquired immunodeficiency syndrome: correlation but not causation |journal=Proc Natl Acad Sci U S A |volume=86 |issue=3 |pages=755–64 |year=1989 |pmid=2644642 |doi=10.1073/pnas.86.3.755}}</ref> However, with the use of modern culture techniques and [[polymerase chain reaction]] testing, HIV can be demonstrated in virtually all patients with AIDS.<ref name="niaid"/> Since AIDS is now defined partially by the presence of HIV, Duesberg claims it is impossible by definition to offer evidence that AIDS doesn't require HIV. However, the first definitions of AIDS mentioned no cause and the first AIDS diagnoses were made before HIV was discovered. The addition of HIV positivity to surveillance criteria as an absolutely necessary condition for case reporting occurred only in 1993, after a scientific consensus was established that HIV caused AIDS<ref>[Centers for Disease Control and Prevention, ''Morbidity and Mortality Weekly Report,'' 31(37), 24 Sept. 1982] ''Update on Acquired Immunodeficiency Syndrome (AIDS), United States.''</ref><ref>[Centers for Disease Control and Prevention, ''Morbidity and Mortality Weekly Report,'' 34(25), 28 June 1985] ''Revision of the CDC Surveillance Case Definition of Acquired Immunodeficiency Syndrome for National Reporting, United States.''</ref><ref>[Centers for Disease Control and Prevention, ''Morbidity and Mortality Weekly Report,'' 36(S1), 14 August 1987] ''Revision of the CDC Surveillance Case Definition for Acquired Immunodeficiency Syndrome.''</ref><ref>[Centers for Disease Control and Prevention, ''Morbidity and Mortality Weekly Report,'' 41(RR-17), 18 December 1992] ''1993 Revised Classification System for HIV Infection and Expanded Surveillance Definition for AIDS Among Adolescents and Adults.''</ref> ==AIDS in Africa== According to the Duesberg hypothesis, AIDS is not found in Africa. What Duesberg calls "the myth of an African AIDS epidemic,"<ref name = "uirhmj">[Duesberg P "Inventing the AIDS Virus" Regnery, 1997. ISBN-10: 0895263998] Page 291.</ref> among people "he repeatedly refers to...as ''Schwartzes'',"<ref>[http://discovermagazine.com/2008/jun/15-aids-dissident-seeks-redemption-and-a-cure-for-cancer Discover Magazine feature on Duesberg.] Jeanne Linzer, Discover, 15 May 2008, ''AIDS "Dissident" Seeks Redemption...and a Cure for Cancer.'' Accessed 16 May 2008.</ref> exists for several reasons, including: *The need, according to Duesberg, of the CDC, the WHO, and other health organizations to justify their existences, resulting in their "manufacturing contagious plagues out of noninfectious medical conditions."<ref>[Duesberg P "Inventing the AIDS Virus" Regnery, 1997. ISBN-10: 0895263998] Page 137.</ref> *Media sensationalism, with stories that "helped shape the Western impression of an AIDS problem out of control," resulting in high levels of funding.<ref name = "uirhmj"/> *Willing participation in deception by local doctors who wish to take advantage of this aid money: "African doctors themselves participate in building the myth of the AIDS pandemic."<ref>[Duesberg P "Inventing the AIDS Virus" Regnery, 1997. ISBN-10: 0895263998] Pages 290-1.</ref> *Confusion or incompetence on the part of African doctors: "Many common Third World diseases are confused with AIDS even if they are not part of its official definition."<ref>[Duesberg P "Inventing the AIDS Virus" Regnery, 1997. ISBN-10: 0895263998] Page 293.</ref> Duesberg states that African AIDS cases are "a collection of long-established, indigenous diseases, such as chronic fevers, weight loss, alias “slim disease”, diarrhea and tuberculosis"<ref name="DuesbergJBiosci">{{cite journal |author=Duesberg P, Koehnlein C, Rasnick D |title=The chemical bases of the various AIDS epidemics: recreational drugs, anti-viral chemotherapy and malnutrition |journal=J Biosci |volume=28 |issue=4 |pages=383–412 |year=2003 |pmid=12799487 |doi=10.1007/BF02705115}}</ref> that result from malnutrition and poor sanitation. African AIDS cases, though, have increased in the last three decades as HIV's prevalence has increased<ref>Boerma JT, Nunn AJ, Whitworth JA. (1998) Mortality impact of the AIDS epidemic: evidence from community studies in less developed countries. ''AIDS'' '''12 Suppl 1''', S3-14 PMID 9677185</ref> but as malnutrition percentages<ref>[http://www.ony.unu.edu/unu-africa/presentations/pinstrup-andersen-watson.ppt#27 Figure of malnutrition percentage decreases] Accessed 02 May 2008.</ref> and poor sanitation have declined in many African regions.<ref>[http://www.wateraid.org/documents/giving_sanitation_the_green_light.pdf]Accessed 02 May 2008.</ref> In addition, while HIV and AIDS are more prevalent in urban than in rural settings in Africa,<ref>[http://data.unaids.org/pub/GlobalReport/2006/2006GlobalReportSlide008.ppt#8 "HIV prevalence (%) by gender and urban/rural residence, selected sub-Saharan African countries, 2001-2005] From UNAIDS Joint United Nations Programme on HIV/AIDS. Accessed 02 May 2008.</ref> malnutrition and poor sanitation are found more commonly in rural than in urban settings.<ref>{{cite journal |author=Fotso JC |title=Urban-rural differentials in child malnutrition: trends and socioeconomic correlates in sub-Saharan Africa |journal=Health Place |volume=13 |issue=1 |pages=205–23 |year=2006 |pmid=16563851 |doi=10.1016/j.healthplace.2006.01.004}}</ref> According to Duesberg, common diseases are easily misdiagnosed as AIDS in Africa because "the diagnosis of African AIDS is arbitrary" and does not include HIV testing.<ref name="DuesbergJBiosci"/> A definition of AIDS agreed upon in 1985 by the [[World Health Organization]] in [[Bangui]] did not require a positive HIV test, but since 1985, many African countries have added positive HIV tests to the Bangui criteria for AIDS or changed their definitions to match those of the U.S. [[Centers for Disease Control]].<ref>[http://www.who.int/hiv/strategic/en/use_aids_def.xls] From the [[World Health Organization]] Accessed 01 May, 2008.</ref> One of the reasons for using more HIV tests despite their expense is that, rather than overestimating AIDS as Duesberg suggests, the Bangui definition alone excluded nearly half of African AIDS patients."<ref>{{cite journal |author=Diaz T, De Cock K, et al. |title=New strategies for HIV surveillance in resource-constrained settings: an overview |journal=AIDS |volume=19 |issue=Suppl2 |pages=S1–S8 |year=2005 |pmid=15930836 |doi=10.1097/01.aids.0000172871.80723.3e}}</ref> Duesberg notes that diseases associated with AIDS differ between African and Western populations, concluding that the causes of immunodeficiency must be different. [[Tuberculosis]] is much more commonly diagnosed among AIDS patients in Africa than in Western countries, while [[Pneumocystis pneumonia|PCP]] conforms to the opposite pattern.<ref>Cohen J. (2000) Is AIDS in Africa a distinct disease? ''Science'' '''288(5474)''', 2153-5 PMID 10896593</ref> Tuberculosis, though, had higher prevalence in Africa than in the West before the spread of HIV. In Africa and the United States, HIV has spurred a similar percentage increase in tuberculosis cases.<ref>{{cite journal |author=Corbett EL, Watt CJ, et al. |title=The growing burden of tuberculosis: global trends and interactions with the HIV epidemic |journal=Arch Intern Med |volume=163 |issue=9 |pages=1009–21 |year=2003 |pmid=12742798 |doi=10.1001/archinte.163.9.1009}}</ref> PCP may be underestimated in Africa: since machinery "required for accurate testing is relatively rare in many resource-poor areas, including large parts of Africa, PCP is likely to be underdiagnosed in Africa. Consistent with this hypothesis, studies that report the highest rates of PCP in Africa are those that use the most advanced diagnostic methods"<ref>[http://www.aidstruth.org/science-sold-out.pdf Science Outsold? Correcting the Falsehoods of "Science Sold Out: Does HIV Really Cause AIDS?"] Page 15. Accessed 01 May 2008.</ref> Duesberg also claims that [[Kaposi's Sarcoma]] is "exclusively diagnosed in male homosexual risk groups using nitrite inhalants and other psychoactive drugs as aphrodisiacs",<ref name="DuesbergJBiosci"/> but the cancer is fairly common among heterosexuals in some parts of Africa,<ref>[Chokunonga E, Levy LM, Bassett MT, Borok MZ, Mauchaza BG, Chirenje MZ, Parkin DM. (1999) Aids and cancer in Africa: the evolving epidemic in Zimbabwe. ''AIDS'' '''13(18)''', 2583-8 PMID 10630528]</ref> and is found in heterosexuals in the United States as well.<ref>{{cite journal |author=Hiatt KM, Nelson AM, et al. |title=Classic Kaposi Sarcoma in the United States over the last two decades: A clinicopathologic and molecular study of 438 non-HIV-related Kaposi Sarcoma patients with comparison to HIV-related Kaposi Sarcoma |journal=Modern Pathology |volume=21 |issue=5 |pages=572–82 |year=2008 |pmid=18376387 |doi=10.1038/modpathol.2008.15}}</ref> Because reported AIDS cases in Africa and other parts of the developing world include a larger proportion of people who do not belong to Duesberg's preferred risk groups of drug addicts and male homosexuals,<ref>[http://hivinsite.ucsf.edu/global?page=cr09-00-00 Sub-Saharan Africa] From HIV InSite at the University of California, San Francisco. Accessed 02 May 2008.</ref> Duesberg writes on his website that "There are no risk groups in Africa, like drug addicts and homosexuals," However, many studies have addressed the issue of risk groups in Africa and concluded that the risk of AIDS is not equally distributed.<ref>{{cite journal |author=Wade AS, Kane CT, et al. |title=HIV infection and sexually transmitted infections among men who have sex with men in Senegal |journal=AIDS |volume=19 |issue=18 |pages=2133–40 |year=2005 |pmid=16284463 |doi=10.1097/01.aids.0000194128.97640.07}} One recent article on AIDS and men who have sex with men (MSM).</ref><ref>{{cite journal |author=Beyrer C |title=HIV epidemiology update and transmission factors: risks and risk contexts--16th International AIDS Conference epidemiology plenary |journal=Clin Infect Dis |volume=44 |issue=7 |pages=981–7 |year=2007 |doi=10.1086/512371 |unused_data=|17342654}} A recent article on various risk groups and risk factors in Africa.</ref>. In addition, AIDS in Africa largely kills sexually active working-age adults.<ref>Nunn AJ, Mulder DW, Kamali A, Ruberantwari A, Kengeya-Kayondo J-F, Whitworth J. (1997) Mortality associated with HIV-1 infection over five years in a rural Ugandan population: cohort study. ''BMJ'' '''315''', 767-771 PMID 9345167</ref><ref>Borgdorff MW, Barongo LR, Klokke AH, Newell JN, Senkoro KP, Velema JP, Gabone RM. (1995) HIV-1 incidence and HIV-1 associated mortality in a cohort of urban factory workers in Tanzania. ''Genitourin Med.'' '''71''', 212-215 PMID 7590710</ref> ==Duesberg's offer to infect himself== [[Robert Gallo]] suggested that Duesberg infect himself with HIV if he insisted on maintaining his stance that HIV is harmless. Duesberg claims that he would do so, but that he would need the approval of the U.S. [[National Institutes of Health]] and the university that employs him to work with HIV. Critics regard this as a stunt, because the NIH cannot ethically give "approval" for a person to knowingly infect themselves with HIV.{{Fact|date=April 2008}} ==Duesberg claims that retroviruses like HIV must be harmless to survive== Peter Duesberg argues that [[retroviruses]] like HIV must be harmless to survive: they do not kill cells and they do not cause cancer, he maintains. Duesberg writes, "retroviruses do not kill cells because they depend on viable cells for the replication of their RNA from viral DNA integrated into cellular DNA."<ref name="DuesbergJBiosci"/> However, Duesberg elsewhere states that "the typical virus reproduces by entering a living cell and commandeering the cell's resources in order to make new virus particles, a process that ends with the disintegration of the dead cell."<ref>[Duesberg P "Inventing the AIDS Virus" Regnery, 1997. ISBN-10: 0895263998] Page 90.</ref> Duesberg also rejects the involvement of retroviruses and other viruses in [[cancer]]. To him, virus-associated cancers are "freak accidents of nature" that do not warrant research programs such as the [[War on Cancer]]. Duesberg rejects a role in cancer for numerous viruses, including [[leukemia]] viruses, [[Epstein-Barr Virus]], [[Human Papilloma Virus]], [[Hepatitis B]], [[Feline Leukemia Virus]], and [[Human T-lymphotropic virus]].<ref name="inventing">Duesberg P "Inventing the AIDS Virus" Regnery, 1997. ISBN-10: 0895263998</ref> Duesberg claims that the supposedly innocuous nature of all retroviruses is supported by what he considers to be their normal mode of proliferation: infection from mother to child ''in utero''. Duesberg does not suggest that HIV is an [[endogenous retrovirus]], a virus integrated into the [[germ line]] and genetically heritable: {{Quotation|...[a mother] provides her child with a nine-month continuous exposure to her blood and therefore has at least a 50 percent chance of passing HIV to the baby.<ref name="inventing"/>}} ==Scientific response to the Duesberg hypothesis== The current [[scientific consensus|consensus]] in the [[scientific community]] is that the Duesberg hypothesis has been refuted by a large and growing mass of evidence showing that causation of AIDS by HIV is clear, that virus numbers in the blood correlate with disease progression, that a plausible mechanism for HIV's action has been proposed, and that anti-HIV medication decreases [[mortality rate|mortality]] and [[opportunistic infection]] in people with AIDS.<ref name="niaid"/> In the [[December 9]] [[1994]] issue of ''[[Science (journal)|Science]]'' (Vol. 266, No. 5191),<ref name="phenom" /> Duesberg's methods and claims were evaluated. The authors concluded that: * it is abundantly evident that HIV causes disease and death in [[hemophiliac]]s, a group generally lacking Duesberg's proposed risk factors.<ref>Cohen J. (1994a) [http://www.sciencemag.org/feature/data/cohen/266-5191-1645a.pdf Duesberg and critics agree: Hemophilia is the best test]. ''Science'' '''266''', 1645-1646 PMID 7992044</ref><ref name="niaid"/> * HIV fulfills [[Koch's postulates]], which are one set of criteria for demonstrating a causal relationship between a microbe and a disease.<ref>Cohen J. (1994b) [http://www.sciencemag.org/feature/data/cohen/266-5191-1647.pdf Fulfilling Koch's postulates]. ''Science'' '''266''', 1647 PMID 7992045</ref><ref>{{cite journal |author=Harden V |title=Koch's postulates and the etiology of AIDS: an historical perspective |journal=Hist Philos Life Sci |volume=14 |issue=2 |pages=249–69 |year=1992 |pmid=1342726}} [http://www.history.nih.gov/NIHInOwnWords/assets/media/pdf/publications/Koch_Postulate.pdf Full text available] from [[National Institutes of Health]] website.</ref> * the AIDS epidemic in [[Thailand]] cited by Duesberg as confirmation of his hypothesis is in fact evidence of the role of HIV in AIDS.<ref>Cohen J. (1994c) [http://www.sciencemag.org/feature/data/cohen/266-5191-1647.pdf The epidemic in Thailand]. ''Science'' '''266''', 1647 PMID 7992046</ref> * According to researchers who conducted large-scale studies of AZT, the drug does not cause AIDS. Furthermore, researchers acknowledged that recreational drugs do cause immune abnormalities, though not the type of immunodeficiency seen in AIDS.<ref>Cohen J. (1994d) [http://www.sciencemag.org/feature/data/cohen/266-5191-1648a.pdf Could drugs, rather than a virus be the cause of AIDS?] ''Science'' '''266''', 1648-1649 PMID 7992047</ref> ===Effectiveness of antiretroviral medication=== The vast majority of people with AIDS have never received antiretroviral drugs, including those in developed countries prior to the licensure of [[AZT]] ([[zidovudine]]) in 1987, and people in developing countries today where very few individuals have access to these medications.<ref>[http://www.unaids.org/html/pub/publications/fact-sheets04/fs_treatment_en_pdf.pdf UNAIDS, 2003].</ref> The NIAID reports that, "In the mid-1980s, clinical trials enrolling patients with AIDS found that AZT given as single-drug therapy conferred a modest survival advantage compared to placebo. Among HIV-infected patients who had not yet developed AIDS, placebo-controlled trials found that AZT given as single-drug therapy delayed, for a year or two, the onset of AIDS-related illnesses. Significantly, long-term follow-up of these trials did not show a prolonged benefit of AZT, but also did not indicate that the drug increased disease progression or mortality. The lack of excess AIDS cases and death in the AZT arms of these placebo-controlled trials effectively counters the argument that AZT causes AIDS. Subsequent clinical trials found that patients receiving two-drug combinations had up to 50 percent improvements in time to progression to AIDS and in survival when compared to people receiving single-drug therapy. In more recent years, three-drug combination therapies have produced another 50 to 80 percent improvement in progression to AIDS and in survival when compared to two-drug regimens in clinical trials."<ref>[http://www.hivatis.org/guidelines/adult/AA_040705.pdf HHS, 2005]</ref> "Use of potent anti-HIV combination therapies has contributed to dramatic reductions in the incidence of AIDS and AIDS-related deaths in populations where these drugs are widely available, an effect which clearly would not be seen if antiretroviral drugs caused AIDS."<ref name="niaid"/><ref>Palella FJ Jr, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, Aschman DJ, Holmberg SD. (1998) Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. ''N. Engl. J. Med.'' '''338''', 853-860 PMID 9516219</ref><ref>Mocroft A, Vella S, Benfield TL, Chiesi A, Miller V, Gargalianos P, d'Arminio Monforte A, Yust I, Bruun JN, Phillips AN, Lundgren JD. (1998) Changing patterns of mortality across Europe in patients infected with HIV-1. EuroSIDA Study Group. ''Lancet'' '''352''', 1725-1730 PMID 9848347</ref><ref>Mocroft A, Katlama C, Johnson AM, Pradier C, Antunes F, Mulcahy F, Chiesi A, Phillips AN, Kirk O, Lundgren JD. (2000) AIDS across Europe, 1994-98: the EuroSIDA study. ''Lancet'' '''356''', 291-296 PMID 11071184</ref><ref>Vittinghoff E, Scheer S, O'Malley P, Colfax G, Holmberg SD, Buchbinder SP. (1999) Combination antiretroviral therapy and recent declines in AIDS incidence and mortality. ''J. Infect. Dis.'' '''179''', 717-720 PMID 9952385</ref><ref>Detels R, Munoz A, McFarlane G, Kingsley LA, Margolick JB, Giorgi J, Schrager LK, Phair JP. (1998) Effectiveness of potent antiretroviral therapy on time to AIDS and death in men with known HIV infection duration. Multicenter AIDS Cohort Study Investigators. ''JAMA'' '''280''', 1497-1503 PMID 9809730</ref><ref>de Martino M, Tovo PA, Balducci M, Galli L, Gabiano C, Rezza G, Pezzotti P. (2000) Reduction in mortality with availability of antiretroviral therapy for children with perinatal HIV-1 infection. Italian Register for HIV Infection in Children and the Italian National AIDS Registry. ''JAMA'' '''284''', 190-197 PMID 10889592</ref><ref>Hogg RS, Yip B, Kully C, Craib KJ, O'Shaughnessy MV, Schechter MT, Montaner JS. (1999) Improved survival among HIV-infected patients after initiation of triple-drug antiretroviral regimens. ''CMAJ'' '''160''', 659-665 PMID 10102000</ref><ref>Schwarcz SK, Hsu LC, Vittinghoff E, Katz MH. (2000) Impact of protease inhibitors and other antiretroviral treatments on acquired immunodeficiency syndrome survival in San Francisco, California, 1987-1996. ''Am J Epidem'' '''152''', 178-185 PMID 10909955</ref><ref>Kaplan JE, Hanson D, Dworkin MS, Frederick T, Bertolli J, Lindegren ML, Holmberg S, Jones JL. (2000) Epidemiology of human immunodeficiency virus-associated opportunistic infections in the United States in the era of highly active antiretroviral therapy. ''Clin Infect Dis.'' '''Suppl 1''', S5-14 PMID 10770911</ref><ref>McNaghten AD, Hanson DL, Jones JL, Dworkin MS, Ward JW. (1999) Effects of antiretroviral therapy and opportunistic illness primary chemoprophylaxis on survival after AIDS diagnosis. Adult/Adolescent Spectrum of Disease Group. ''AIDS'' '''13''', 1687-1695 PMID 10509570</ref> ===Opponents claim that nearly all HIV-positive people will develop AIDS=== Duesberg claims as support for his idea that many drug-free HIV+ people have not yet developed AIDS; HIV/AIDS scientists note that many drug-free HIV+ people have developed AIDS, and that, in the absence of medical treatment or rare genetic factors postulated to delay disease progression, it is very likely that nearly all HIV+ people will eventually develop AIDS. Scientists also note that HIV-negative drug users do not suffer from immune system collapse. ==See also== * [[AIDS denialism]] ==References== {{reflist|2}} == External links == * [http://www.duesberg.com/ Peter Duesberg's website] *[http://www.niaid.nih.gov/factsheets/evidhiv.htm The Evidence That HIV Causes AIDS]: from the [[National Institute of Allergy and Infectious Diseases]] *[http://www.niaid.nih.gov/factsheets/howhiv.htm How HIV Causes AIDS]: [[National Institutes of Health]] fact sheet. *[http://www.history.nih.gov/NIHInOwnWords/assets/media/pdf/publications/Koch_Postulate.pdf Koch's Postulates and the Etiology of AIDS: An Historical Perspective]. {{AIDS}} [[Category:AIDS origin hypotheses]] [[Category:AIDS denialism]] [[Category:Pseudoscience]] [[fr:Hypothèse de Duesberg]] [[pt:Hipótese de Duesberg]]