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World Cup penalty goal scored against Gallo team

Toxic nevirapine probably worse than placebo in “preventing mother to child transmission of HIV”

TAC calls foul, gets red ticket themselves

Sorry, we were wrong earlier (Anti HIV campaigners winning on all fronts) in saying that the World Cup ReMatch between Gallo Team and Rethinking AIDS resulted in a 56-0 win for Rethinking AIDS, without a single kick at the RA goal in reply.

There has of course been one furious, failed attempt by the Gallo-TAC team to score a goal in overtime against the Rethinking AIDS team, after RA replied to the Gallo-TAC critique of the Harper’s March article, “Out of Control”, with an overwhelming, point by point rebuttal of their ’56 errors’ rebuttal.

The activist group TAC, Treatment Action Campaign, which makes it its business to promote US pharma drugs in South Africa with techniques including paid demonstrators, was especially anxious to dispute Celia Farber noting in Harpers a shocking truth: trials to date showed that nevirapine was a dangerous and useless drug, worse than nothing in reducing the rate at which mothers to be transmitted HIV to their babies.

That’s correct, taking nothing at all resulted in a MTCT (Mother to Child Transmission) rate of 12%, and taking the drug produced a rate of 13.1%!

In the quarrel which followed, the defenders of the faith in toxic but “life saving” drugs used the usual ploys to shortcircuit the arc lamp their opponents switched on – namely, disrespect, unwarranted claims and evasion.

Celia had written:

“The HIV transmission rate reported for nevirapine in the HIVNET 012 study was 13.1%. However, without antiviral treatments, mother-to-child transmission rates vary from 12% to 48%. The HIVNET 012 outcome is higher than the 12% transmission rate reported in a prospective study of 561 African women given no antiretroviral treatment.”

To this the Gallo-TAC team replied, in effect, What study?! We know of no study saying that! The rate for women who take no drug is 25%!:

Farber quotes Turner referring to a study of 561 people.

We are not sure what the 561 person study is that Turner refers to. No reference is supplied by Farber. We have given references above demonstrating that transmission is generally in the 25% region after a few months.

The Rethinking AIDS rebuttal numbered this point #30, and replied as follows, giving chapter and verse, ie the reference for Val Turner’s study:

Turner is referencing an African study published in 1998 that stated that “Presence of HIV-infection was assessed in 158 children [of HIV-positive mothers]…Overall, 19 children were diagnosed as HIV-infected [12%, even though there was no access to antiretroviral therapy or other interventions] ” (The study is) [1] # Ladner J et al. Chorioamnionitis and pregnancy outcome in HIV-infected African women. J Acquir Immune Defic Syndr. 1998 Jul 1; 18(3): 293-8.

Of course this reply was highly embarrassing for the Gallo/TAC team and they immediately poo-pooed the study as flawed.

Gallo team rejects study which authors stand by

The TAC’s attack on this study is carried here on the AIDSTruth.org web site, the new site begun after the Harpers piece to fire back at the HIV critics a compendium of misleading information to muddy the scene – in fact this site, which is apparently run by John Moore of Cornell on Cornell’s tab, is now the most comprehensive collection of misleading pardigm justification on the Web.

The TAC “the study is no good” claim appeared as a letter to Nature published online on May 24 2006, which says that the study was spoiled by the Rwanda war.

Of the children born to HIV-positive mothers, 158 were tested for HIV and 19 (12%, as Turner states) were found to be HIV-positive. Why were only 158 children assessed? The answer, conveniently ignored by the denialists, is that follow-up was interrupted by the events of the Rwandan civil war (J. Ladner et al. J. Acquir. Immun. Def. Syndr. Hum. Retrovirol. 18, 293–298; 1998). Given that this interruption was sufficiently lengthy for many HIV-positive children and their mothers to die of AIDS in the interim, the surviving sample of the initial cohort cannot be regarded as representative. The actual figure for HIV transmission was almost certainly much higher. Failing to acknowledge this important caveat to the study appears to us to be inconsistent with accepted academic standards.

Here’s the whole letter:

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Correspondence

Nature 441, 406 (25 May 2006) | doi:10.1038/441406c; Published online 24 May 2006

HIV denialists ignore large gap in the study they cite

Nathan Geffen (1), Nicoli Nattrass (2) and Glenda Gray (3)

1. Treatment Action Campaign, 34 Main Road, Muizenberg 7945, South Africa

2. AIDS and Society Research Unit, University of Cape Town, Private Bag, Rondebosch 7701, Cape Town, South Africa

3. Perinatal HIV Research Unit, University of Witwatersrand, PO Box 114, Diepkloof 1864, South Africa

Sir:

Valendar Turner, in Correspondence (“HIV drug remains unproven without placebo trial” Nature 435, 137; 2005), argues that there is no evidence for antiretrovirals reducing the transmission of HIV from mother to child. He points out that HIV transmission in people taking the antiretroviral drug nevirapine was 13.1% in the HIVNET 012 study in Uganda, whereas only 12% of women in a Rwandan study were found to have transmitted HIV to their babies in the absence of antiretroviral treatment.

Despite a rebuttal in Correspondence by the authors of the Ugandan study, Brooks Jackson and Thomas Fleming (“A drug is effective if better than a harmless control” Nature 434, 1067; 2005), Turner’s letter continues to be cited by AIDS denialists (for example, C. Farber Harper’s Magazine 37–52; March 2006).

The Rwandan study referred to by Turner enrolled 561 pregnant women, of whom 286 were HIV-positive. Of the children born to HIV-positive mothers, 158 were tested for HIV and 19 (12%, as Turner states) were found to be HIV-positive. Why were only 158 children assessed? The answer, conveniently ignored by the denialists, is that follow-up was interrupted by the events of the Rwandan civil war (J. Ladner et al. J. Acquir. Immun. Def. Syndr. Hum. Retrovirol. 18, 293–298; 1998). Given that this interruption was sufficiently lengthy for many HIV-positive children and their mothers to die of AIDS in the interim, the surviving sample of the initial cohort cannot be regarded as representative. The actual figure for HIV transmission was almost certainly much higher. Failing to acknowledge this important caveat to the study appears to us to be inconsistent with accepted academic standards.

“Inconsistent with accepted academic standards”? In other words, Turner was cheating. He was being misleading in not acknowledging that the study, which said that giving nevirapine to reduce the transmission of HIV from mother to baby (13.1 %) was worse than doing nothing (only 12%), was flawed. He is accused of being underhand, concealing a qualifying factor which spoiled the study, and made the rate much lower than it probably was.

Accusers cry cheat, yet evade response

The qualifying factor was the Rwanda war, which prevented timely followup, and in the delay many of the mothers and children in the study who were HIV positive died “of AIDS”, at least in the imagination of Nathan Geffen of TAC and his colleagues. They suggest that the number of mothers who passed HIV to their children was higher than counted when the data was finally collected. And they accuse the “denialists” of ignoring this factor and failing to observe “accepted academic standards”. In other words, of being cheats.

However, the critic attacked in the letter, Dr. Valendar Turner, responded effectively to this calumny at the Perth Group web site. He responded there because the Gallo team now stated that they would not “engage in any public or private debate with AIDS denialists” ie tried to weasel out of any rejoinder by imposing a shutdown on the exchange. He responded there also because the text is actually a letter he wrote to Nature, which was summarily rejected.

The reasons for the rejection are known only to the editors of that journal, whose record on HIV?AIDS is already a grand embarrassment to its reputation among the cognoscenti. Perhaps it was because it was a little circuitous in style. Turner could have been more straightforward, and left out two apt quotations by Bacon and Galileo, but one imagines he was stung by the false accusation of cheating:

Francis Bacon observed “The human understanding is not composed of dry light, but is subject to influence from the will and the emotions, a fact that creates fanciful knowledge: man prefers to believe what he wants to be true”.

As Galileo famously observed, consensus is not the way of science.

These are good quotes, of course, and applicable to the entire body of HIV?AIDS knowledge, as far as the HIV critics are concerned.

War made no difference

Anyhow Turner pointed out that the rejoinder they had filed against his condemnation of Nevirapine didn’t work. Even if it did, he said he didn’t just choose one paper, but looked at all the papers on Mother to Child Transmission (MTCT), including all the papers which claim to show Nevirapine reduced transmission of HIV to the infant, and the results were very embarrassing indeed for Nivirapine enthusiasts.

I did not choose one paper. Our group [1] has critically analysed all the papers which claim to prove mother to child transmission (any omissions are inadvertent), as well as the studies which claim that nevirapine and AZT decrease mother to child transmission (HIVNET 012 and the ACTG 076)…

… it is understandable that perinatologist Glenda Gray and her HIV protagonist colleagues (Nature 441: 406; 2006) are uncomfortable with the data published by Ladner et al that the mother to child HIV transmission rate in African women and children given no antiretroviral treatment is 1% less than that reported from the administration of nevirapine in the HIVNET 012. Or half as much as those given AZT in the same study.

To overcome this problem Gray and her colleagues state that had the Ladner et al data not been interrupted by a civil war the transmission rate “would almost certainly [have been] much higher”. However, Ladner et al do not claim their results were invalidated by the Rwandan civil war and if Gray and her colleagues are able to divine a “much higher” transmission rate then how “much higher”? If 25%, over double that reported by Ladner et al, they are still left with the problem that no antiretroviral therapy is as effective as the “harmless” AZT treatment given in HIVNET 012.

How does Gray and her colleagues know the transmission rate would not have remained at 12%? Or would not have been “much lower” (even lower that the 10.5% reported in the subgroup of mothers free from chorioamnionitis)? Gray and her colleagues are engaging in speculation and cannot possibly know what might have occurred.

In other words, the people who did the study do not think their data was affected by the war, and even if it was, and their 12% was in fact as high as 25%, so Nevirapine reduced the rate from 25% to 13.1%, that still would not be as good as AZT, the other dangerous drug tested in Africa.

In point of fact, Turner continued,

How does Gray and her colleagues know the transmission rate would not have remained at 12%? Or would not have been “much lower” (even lower that the 10.5% reported in the subgroup of mothers free from chorioamnionitis)? Gray and her colleagues are engaging in speculation and cannot possibly know what might have occurred.

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Response by Valendar F Turner to Geffen and Bergman

June 15th 2006

This is a response to an article posted on June 4th at AIDSTruth.org by Nathan Geffen and Jeanne Bergman. The article is at http://www.aidstruth.org/denying-rwandan-genocide.php. Those who maintain this site state “We will not Engage in any public or private debate with AIDS denialists”. Hence my response is posted at the Perth Group website.

Nathan Geffen and Jeanne Bergman say of me “He looked for and found an article…”. I did not choose one paper. Our group [1] has critically analysed all the papers which claim to prove mother to child transmission (any omissions are inadvertent), as well as the studies which claim that nevirapine and AZT decrease mother to child transmission (HIVNET 012 and the ACTG 076). If these authors want to know more about this they must read our monograph [2] as well as view our presentation on the HIVNET 012 study [3]. After they have completed this task we would welcome their scientific criticism. As far as the Ladner paper is concerned, here is the response I sent to Nature which was promptly rejected without explanation.

1. http://www.theperthgroup.com

2. http://www.theperthgroup.com/MONOGRAPH/MTCTMay2005.pdf

3. http://www.theperthgroup.com/PRESENTATIONS/nevppsn1.ppt

SOOTHSAYING PLAYS NO PART IN A SCIENTIFIC DEBATE

Francis Bacon observed “The human understanding is not composed of dry light, but is subject to influence from the will and the emotions, a fact that creates fanciful knowledge: man prefers to believe what he wants to be true”. Hence it is understandable that perinatologist Glenda Gray and her HIV protagonist colleagues (Nature 441: 406; 2006) are uncomfortable with the data published by Ladner et al that the mother to child HIV transmission rate in African women and children given no antiretroviral treatment is 1% less than that reported from the administration of nevirapine in the HIVNET 012. Or half as much as those given AZT in the same study. To overcome this problem Gray and her colleagues state that had the Ladner et al data not been interrupted by a civil war the transmission rate “would almost certainly [have been] much higher”. However, Ladner et al do not claim their results were invalidated by the Rwandan civil war and if Gray and her colleagues are able to divine a “much higher” transmission rate then how “much higher”? If 25%, over double that reported by Ladner et al, they are still left with the problem that no antiretroviral therapy is as effective as the “harmless” AZT treatment given in HIVNET 012. How does Gray and her colleagues know the transmission rate would not have remained at 12%? Or would not have been “much lower” (even lower that the 10.5% reported in the subgroup of mothers free from chorioamnionitis)? Gray and her colleagues are engaging in speculation and cannot possibly know what might have occurred.

Gray and her HIV/AIDS activist colleagues also claim I have been rebutted by Brooks Jackson and Fleming (Nature 434, 1067; 2005). However, these authors do no more than document the consensus of four institutions and assert a placebo can be substituted by the “harmless” drug AZT. As reported in the Johns Hopkins Medical News,1 this consensus frustrated Brooks Jackson’s plans and ran contrary to his own reported reasons for including a placebo arm in his HIVNET study. As Galileo famously observed, consensus is not the way of science.

Gray and her colleagues state I have not followed “accepted academic standards”. In this light perhaps they might contemplate the scientific basis of their clinical practice. HIV infection and the HIV theory of AIDS is predicated on the fact that cultures of tissues of AIDS patients contain a number of proteins that react with antibodies present in AIDS patient sera. Gray and others interpret these data as proof that (a) the proteins are those of a unique retrovirus; (b) the antibodies in question are specifically induced by such a virus. If this is an example of “accepted academic standards” then the path to enlightenment lies far from academia.

1. Swingle, A. B. The pathologist who struck gold. Hopkins Medical News Spring/Summer 2001 (2001).

www.hopkinsmedicine.org/hmn/S01/feature.html

Valendar F Turner

The Perth Group

More papers show drug may be worse than nothing

So Turner is sticking with the Ladner study, since its authors say it is valid, and he says he has more papers casting doubt on whether nevirapine is any better than no drug at all for mothers to be, to prevent MTCT.

There were even more additional papers that Robert Houston found, and which he forwarded to Rethinking AIDS to clinch Turner’s rebuttal by showing that the rate of transmission of HIV at birth without any drug at all was as low as 7.2%! This was the rate found by Harvard researchers in Tanzania among 838 HIV positive mothers between 1995 and 2003 in a study that was designed to assess vitamins supplements in this area of concern.

In HIVNET 012 in Uganda, the rate for nevirapine was 8.2 % at birth and 11.9 % at 6 weeks. In Tanzania, the 6 week rate for placebos was 11.1%! In South Africa, the 3 month rate for women receiving no drug was 14.6%, hardly any higher than the 13.1 % for nevirapine at 3 months. In Kenya, the 3 month rate for nevirapine was 18.1%, not much better than the 21.7% before intervention.

When the dust settled, it was clear that nevirapine, designed and now licensed for preventing mother to child transmission of HIV, makes very little difference if any improvement at all in MTCT, and may even prove worse than placebo.

The sum total of the anecdotal report of the nevirapine death in Harper’s and all the studies in this discussion is that nevirapine has been proven only to kill the mother if the dose is too high, without doing any better than placebo in preventing HIV transmission, and possibly a lot worse.

Babies deserve better: Vitamins

What the Gallo group ignores is that without a placebo group in a trial it cannot show whether any treatment is better than placebo. But if the Harvard Tanzania trial was compromised by the testing of Vitamin supplements, the better results obtained surely suggest that vitamins should be preferred over toxic drugs which are less effective. And they have other benefits, of course, which drugs aimed specifically at HIV do not have.

As the Rethinking AIDS group concluded, “it is shocking that less effective toxic drugs are preferred over cheap and non-toxic vitamins, which also have other benefits.”

But vitamins, of course, are not patentable.

Final score: Gallo team, 0, Rethinking AIDS, 56.

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