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The Hidden Face of HIV – Part 1
"Knowing is Beautiful"
http://gnn.tv/articles/article.php?id=1035

by Liam Scheff

As a journalist who writes about AIDS, I am endlessly amazed by the difference between the public and the private face of HIV; between what the public is told and what’s explained in the medical literature. The public face of HIV is well-known: HIV is a sexually transmitted virus that particularly preys on gay men, African Americans, drug users, and just about all of Africa, although we’re all at risk. We’re encouraged to be tested, because, as the MTV ads say, "knowing is beautiful." We also know that AIDS drugs are all that’s stopping the entire African continent from falling into the sea.

The medical literature spells it out differently – quite differently. The journals that review HIV tests, drugs and patients, as well as the instructional material from medical schools, the Centers for Disease Control (CDC) and HIV test manufacturers will agree with the public perception in the large print. But when you get past the titles, they’ll tell you, unabashedly, that HIV tests are not standardized; that they’re arbitrarily interpreted; that HIV is not required for AIDS; and finally, that the term HIV does not describe a single entity, but instead describes a collection of non-specific, cross-reactive cellular material.

That’s quite a difference.

The popular view of AIDS is held up by concerned people desperate to help the millions of Africans stricken with AIDS, the same disease that first afflicted young gay American men in the 1980s. The medical literature differs on this point. It says that that AIDS in Africa has always been diagnosed differently than AIDS in the US.

In 1985, The World Health Organization called a meeting in Bangui, the capital of the Central African Republic, to define African AIDS. The meeting was presided over by CDC official Joseph McCormick. He wrote about in his book "Level 4 Virus hunters of the CDC," saying, "If I could get everyone at the WHO meeting in Bangui to agree on a single, simple definition of what an AIDS case was in Africa, then, imperfect as the definition might be, we could actually start counting the cases..." The results – African AIDS would be defined by physical symptoms: fever, diarrhea, weight loss and coughing or itching. ("AIDS in Africa: an epidemiological paradigm." Science, 1986)

In Sub-Saharan African about 60 percent of the population lives and dies without safe drinking water, adequate food or basic sanitation. A September, 2003 report in the Ugandan Daily "New Vision" outlined the situation in Kampala, a city of approximately 1.3 million inhabitants, which, like most tropical countries, experiences seasonal flooding. The report describes "heaps of unclaimed garbage" among the crowded houses in the flood zones and "countless pools of water [that] provide a breeding ground for mosquitoes and create a dirty environment that favors cholera."

"[L]atrines are built above water streams. During rains the area residents usually open a hole to release feces from the latrines. The rain then washes away the feces to streams, from where the [area residents] fetch water. However, not many people have access to toilet facilities. Some defecate in polythene bags, which they throw into the stream." They call these, "flying toilets.’’

The state-run Ugandan National Water and Sewerage Corporation states that currently 55% of Kampala is provided with treated water, and only 8% with sewage reclamation.

Most rural villages are without any sanitary water source. People wash clothes, bathe and dump untreated waste up and downstream from where water is drawn. Watering holes are shared with animal populations, which drink, bathe, urinate and defecate at the water source. Unmanaged human waste pollutes water with infectious and often deadly bacteria. Stagnant water breeds mosquitoes, which bring malaria. Infectious diarrhea, dysentery, cholera, TB, malaria and famine are the top killers in Africa. But in 1985, they became AIDS.

The public service announcements that run on VH1 and MTV, informing us of the millions of infected, always fail to mention this. I don’t know what we’re supposed to do with the information that 40 million people are dying and nothing can be done. I wonder why we wouldn’t be interested in building wells and providing clean water and sewage systems for Africans. Given our great concern, it would seem foolish not to immediately begin the "clean water for Africa" campaign. But I’ve never heard such a thing mentioned.

The UN recommendations for Africa actually demand the opposite –"billions of dollars" taken out of "social funds, education and health projects, infrastructure [and] rural development" and "redirected" into sex education (UNAIDS, 1999). No clean water, but plenty of condoms.

I have, however, felt the push to get AIDS drugs to Africans. Drugs like AZT and Nevirapine, which are supposed to stop the spread of HIV, especially in pregnant women. AZT and Nevirapine also terminate life. The medical literature and warning labels list the side effects: blood cell destruction, birth defects, bone-marrow death, spontaneous abortion, organ failure, and fatal skin rot. The package inserts also state that the drugs don’t "stop HIV or prevent AIDS illnesses."

The companies that make these drugs take advantage of the public perception that HIV is measured in individual African AIDS patients, and that African AIDS - water-borne illness and poverty - can be cured by AZT and Nevirapine. That’s good capitalism, but it’s bad medicine.

Currently MTV, Black Entertainment Television and VH1 are running "Know HIV/AIDS"-sponsored advertisements of handsome young couples, black and white, touching, caressing, sensually, warming up to love-making. The camera moves over their bodies, hands, necks, mouth, back, legs and arms – and we see a small butterfly bandage over their inner elbows, where they’ve given blood for an HIV test. The announcer says, "Knowing is beautiful. Get tested."

A September, 2004 San Francisco Chronicle article considered the "beauty" of testing. It told the story of 59 year-old veteran Jim Malone, who’d been told in 1996 that he was HIV positive. His health was diagnosed as "very poor." He was classified as, "permanently disabled and unable to work or participate in any stressful situation whatsoever." Malone said, "When I wasn’t able to eat, when I was sick, my in-home health care nurse would say, ‘Well, Jim, it goes with your condition.’

In 2004, his doctor sent him a note to tell him he was actually negative. He had tested positive at one hospital, and negative at another. Nobody asked why the second test was more accurate than the first (that was the protocol at the Veteran’s Hospital). Having been falsely diagnosed and spending nearly a decade waiting, expecting to die, Malone said, "I would tell people to get not just one HIV test, but multiple tests. I would say test, test and retest."

In the article, AIDS experts assured the public that the story was "extraordinarily rare." But the medical literature differs significantly.

In 1985, at the beginning of HIV testing, it was known that "68% to 89% of all repeatedly reactive ELISA (HIV antibody) tests [were] likely to represent false positive results." (NEJM - New England Journal of Medicine. 312; 1985).

In 1992, the Lancet reported that for 66 true positives, there were 30,000 false positives. And in pregnant women, "there were 8,000 false positives for 6 confirmations." (Lancet. 339; 1992)

In September 2000, the Archives of Family Medicine stated that the more women we test, the greater "the proportion of false-positive and ambiguous (indeterminate) test results." (Archives of Family Medicine. Sept/Oct. 2000).

The tests described above are standard HIV tests, the kind promoted in the ads. Their technical name is ELISA or EIA (Enzyme-linked Immunosorbant Assay). They are antibody tests. The tests contain proteins that react with antibodies in your blood.

In the US, you’re tested with an ELISA first. If your blood reacts, you’ll be tested again, with another ELISA. Why is the second more accurate than the first? That’s just the protocol. If you have a reaction on the second ELISA, you’ll be confirmed with a third antibody test, called the Western Blot. But that’s here in America. In some countries, one ELISA is all you get.

It is precisely because HIV tests are antibody tests, that they produce so many false-positive results. All antibodies tend to cross-react. We produce antibodies all the time, in response to stress, malnutrition, illness, drug use, vaccination, foods we eat, a cut, a cold, even pregnancy. These antibodies are known to make HIV tests come up as positive.

The medical literature lists dozens of reasons for positive HIV test results: "transfusions, transplantation, or pregnancy, autoimmune disorders, malignancies, alcoholic liver disease, or for reasons that are unclear..."(Archives of Family Medicine. Sept/Oct. 2000).

"[H]uman or technical errors, other viruses and vaccines" (Infectious Disease Clinician of North America. 7; 1993)

"[L]iver diseases, parenteral substance abuse, hemodialysis, or vaccinations for hepatitis B, rabies, or influenza..." (Archives of Internal Medicine. August. 2000).

"[U]npasteurized cows’ milk…Bovine exposure, or cross-reactivity with other human retroviruses" (Transfusion. 1988)

Even geography can do it:
"Inhabitants of certain regions may have cross-reactive antibodies to local prevalent non-HIV retroviruses" (Medicine International. 56; 1988).

The same is true for the confirmatory test – the Western Blot.
Causes of indeterminate Western Blots include: "lymphoma, multiple sclerosis, injection drug use, liver disease, or autoimmune disorders. Also, there appear to be healthy individuals with antibodies that cross-react...." (Archives of Internal Medicine. August. 2000).

"The Western Blot is not used as a screening tool because...it yields an unacceptably high percentage of indeterminate results." (Archives of Family Medicine. Sept/Oct 2000)

Pregnancy is consistently listed as a cause of positive test results, even by the test manufacturers. "[False positives can be caused by] prior pregnancy, blood transfusions... and other potential nonspecific reactions." (Vironostika HIV Test, 2003).

This is significant in Africa, because HIV estimates for African nations are drawn almost exclusively from testing done on groups of pregnant women.

In Zimbabwe this year, the rate of HIV infection among young women decreased remarkably, from 32.5 to 6 percent. A drop of 81% - overnight. UNICEF’s Swaziland representative, Dr. Alan Brody, told the press "The problems is that all the sero-surveillance data came from pregnant women, and estimates for other demographics was based on that." (PLUS News, August, 2004)

When these pregnant young women are tested, they’re often tested for other illnesses, like syphilis, at the same time. There’s no concern for cross-reactivity or false-positives in this group, and no repeat testing. One ELISA on one girl, and 32.5% of the population is suddenly HIV positive.

The June 20, 2004 Boston Globe reported that "the current estimate of 40 million people living with the AIDS virus worldwide is inflated by 25 percent to 50 percent."

They pointed out that HIV estimates for entire countries have, for over a decade, been taken from "blood samples from pregnant women at prenatal clinics."

But it’s not just HIV estimates that are created from testing pregnant women, it’s "AIDS deaths, AIDS orphans, numbers of people needing antiretroviral treatment, and the average life expectancy," all from that one test.

I’ve certainly never seen this in VH1 ad.

At present there are about 6 dozen reasons given in the literature why the tests come up positive. In fact, the medical literature states that there is simply no way of knowing if any HIV test is truly positive or negative:

"[F]alse-positive reactions have been observed with every single HIV-1 protein, recombinant or authentic." (Clinical Chemistry. 37; 1991). "Thus, it may be impossible to relate an antibody response specifically to HIV-1 infection." (Medicine International. 1988)

And even if you believe the reaction is not a false positive, "the test does not indicate whether the person currently harbors the virus." (Science. November, 1999).

The test manufacturers state that after the antibody reaction occurs, the tests have to be "interpreted." There is no strict or clear definition of HIV positive or negative. There’s just the antibody reaction. The reaction is colored by an enzyme, and read by a machine called a spectrophotometer.

The machine grades the reactions according to their strength (but not specificity), above and below a cut-off. If you test above the cut-off, you’re positive; if you test below it, you’re negative.
So what determines the all-important cut-off? From The CDC’s instructional material: "Establishing the cutoff value to define a positive test result from a negative one is somewhat arbitrary." (CDC-EIS "Screening For HIV," 2003 )

The University of Vermont Medical School agrees: "Where a cutoff is drawn to determine a diagnostic test result may be somewhat arbitrary….Where would the director of the Blood Bank who is screening donated blood for HIV antibody want to put the cut-off?...Where would an investigator enrolling high-risk patients in a clinical trial for an experimental, potentially toxic antiretroviral draw the cutoff?" (University of Vermont School of Medicine teaching module: Diagnostic Testing for HIV Infection)

A 1995 study comparing four major brands of HIV tests found that they all had different cut-off points, and as a result, gave different test results for the same sample: "[C]ut-off ratios do not correlate for any of the investigated ELISA pairs," and one brand’s cut-off point had "no predictive value" for any other. (INCQS-DSH, Brazil 1995).

I’ve never heard of a person being asked where they would "want to put the cut-off" for determining their HIV test result, or if they felt that testing positive was a "somewhat arbitrary" experience.

In the UK, if you get through two ELISA tests, you’re positive. In America, you get a third and final test to confirm the first two. The test is called the Western Blot. It uses the same proteins, laid out differently. Same proteins, same nonspecific reactions. But this time it’s read as lines on a page, not a color change. Which lines are HIV positive? That depends on where you are, what lab you’re in and what kit they’re using.

The Mayo Clinic reported that "the Western blot method lacks standardization, is cumbersome, and is subjective in interpretation of banding patterns." (Mayo Clinic Procedural. 1988)

A 1988 study in the Journal of the American Medical Association reported that 19 different labs, testing one blood sample, got 19 different Western Blot results. (JAMA, 260, 1988)

A 1993 review in Bio/Technology reported that the FDA, the CDC/Department of Defense and the Red Cross all interpret WB’s differently, and further noted, "All the other major USA laboratories for HIV testing have their own criteria." (Bio/Technology, June 1993)

In the early 1990s, perhaps in response to growing discontent in the medical community with the lack of precision of the tests, Roche Laboratories introduced a new genetic test, called Viral Load, based on a technology called PCR. How good is the new genetic marvel?

An early review of the technology in the 1991 Journal of AIDS reported that "a true positive PCR test cannot be distinguished from a false positive." (J.AIDS, 1991)

A 1992 study "identified a disturbingly high rate of nonspecific positivity," saying 18% antibody-negative (under the cut-off) patients tested Viral Load positive. (J. AIDS, 1992)

A 2001 study showed that the tests gave wildly different results from a single blood sample, as well as different results with different test brands. (CDC MMWR. November 16, 2001)

A 2002 African study showed that Viral Load was high in patients who had intestinal worms, but went down when they were treated for the problem. The title of the article really said it all. "Treatment of Intestinal Worms Is Associated With Decreased HIV Plasma Viral Load." (J.AIDS, September, 2002)

Roche laboratories, the company that manufactures the PCR tests, puts this warning on the label:
"The AMPLICOR HIV-1 MONITOR Test….is not intended to be used as a screening test for HIV or as a diagnostic test to confirm the presence of HIV infection."

But that’s exactly how it is used – to convince pregnant mothers to take AZT and Nevirapine and to urge patients to start the drugs.

The medical literature adds something truly astounding to all of this. It says that reason HIV tests are so non-specific and need to be interpreted is because there is "no virologic gold standard" for HIV tests.

The meaning of this statement, from both the medical and social perspective, is profound. The "virologic gold standard" is the isolated virus that the doctors claim to be identifying, indirectly, with the test.

Antibody tests always have some cross-reaction, because antibodies aren’t specific. The way to validate a test is to go find the virus in the patient’s blood.

You take the blood, spin it in a centrifuge, and you end up with millions of little virus particles, which you can easily photograph under a microscope. You can disassemble the virus, measure the weight of its proteins, and map its genetic structure. That’s the virologic gold standard. And for some reason, HIV tests have none.

In 1986, JAMA reported that: "no established standard exists for identifying HTLV-III [HIV] infection in asymptomatic people." (JAMA. July 18, 1986)

In 1987, the New England Journal of Medicine stated that "The meaning of positive tests will depend on the joint [ELISA/WB] false positive rate. Because we lack a gold standard, we do not know what that rate is now. We cannot know what it will be in a large-scale screening program." ( Screening for HIV: can we afford the false positive rate?. NEJM. 1987)

Skip ahead to 1996; JAMA again reported: "the diagnosis of HIV infection in infants is particularly difficult because there is no reference or ‘gold standard’ test that determines unequivocally the true infection status of the patient. (JAMA. May, 1996)

In 1997, Abbott laboratories, the world leader in HIV test production stated: "At present there is no recognized standard for establishing the presence or absence of HIV antibody in human blood." (Abbot Laboratories HIV Elisa Test 1997)

In 2000 the Journal AIDS reported that "2.9% to 12.3%" of women in a study tested positive, "depending on the test used," but "since there is no established gold standard test, it is unclear which of these two proportions is the best estimate of the real prevalence rate…" (AIDS, 14; 2000).

If we had a virologic gold standard, HIV testing would be easy and accurate. You could spin the patient’s blood in a centrifuge and find the particle. They don’t do this, and they’re saying privately, in the medical journals, that they can’t.

That’s why tests are determined through algorithms – above or below sliding cut-offs; estimated from pregnant girls, then projected and redacted overnight.

By repeating, again and again in the medical literature that there’s no virologic gold standard, the world’s top AIDS researchers are saying that what we’re calling HIV isn’t a single entity, but a collection of cross-reactive proteins and unidentified genetic material.

And we’re suddenly a very long way from the public face of HIV.

But the fact is, you don’t need to test HIV positive to be an AIDS patient. You don’t even have to be sick.

In 1993, the CDC added "Idiopathic CD4 Lymphocytopenia" to the AIDS category. What does it mean? Non-HIV AIDS.

In 1993, the CDC also made "no-illness AIDS" a category. If you tested positive, but weren’t sick, you could be given an AIDS diagnosis. By 1997, the healthy AIDS group accounted for 2/3rds of all US AIDS patients. (That’s also the last year they reported those numbers). (CDC Year-End Edition, 1997)

In Africa, HIV status is irrelevant. Even if you test negative, you can be called an AIDS patient:

From a study in Ghana: "Our attention is now focused on the considerably large number (59%) of the seronegative (HIV-negative) group who were clinically diagnosed as having AIDS. All the patients had three major signs: weight loss, prolonged diarrhea, and chronic fever." (Lancet. October,1992)

And from across Africa: "2215 out of 4383 (50.0%) African AIDS patients from Abidjan, Ivory Coast, Lusaka, Zambia, and Kinshasa, Zaire, were HIV-antibody negative." (British Medical Journal, 1991)

Non-HIV AIDS, HIV-negative AIDS, No Virologic Gold standard - terms never seen in an HIV ad.
But even if you do test "repeatedly" positive, the manufacturers say that "the risk of an asymptomatic [not sick] person developing AIDS or an AIDS-related condition is not known." (Abbott Laboratories HIV Test, 1997)

If commerce laws were applied equally, the "knowing is beautiful" ads for HIV testing would have to bear a disclaimer, just like cigarettes:

"Warning: This test will not tell you if you’re infected with a virus. It may confirm that you are pregnant or have used drugs or alcohol, or that you’ve been vaccinated; that you have a cold, liver disease, arthritis, or are stressed, poor, hungry or tired. Or that you’re African. It will not tell you if you’re going to live or die; in fact, we really don’t know what testing positive, or negative, means at all."

FOUR GRADE EVENT
Are AIDS drugs worse than the disease? Don't ask the people who make them.

By Celia Farber

After 20 years of hysteria, alarmism, misplaced recrimination and guilt, AIDS fatigue has beaten the newspaper-reading mind into a kind of blank. Citizens can't be faulted for not knowing how exactly to respond to last week's eruption of scandal from an NIH whistle-blower named Jonathan Fishbein, an AIDS researcher charged with overseeing clinical trials here and abroad. A reverberating language of bureaucracy and euphemism surrounds AIDS stories, making it impossible to know what has actually transpired. When people die from AIDS drugs, for instance, the word "death" is studiously avoided. I have seen medical articles documenting the fact that more people now die of toxicities from AIDS drugs than from the vanishingly opaque syndrome we once called AIDS. Death was referred to as a "grade four event," thus placing it eerily within the acceptable parameters of predictable phenomena in AIDS research—not as a failure, a crisis or even something to lament.

John Solomon broke the first in a series of stories in the Associated Press on Dec. 14. The lede read:

Weeks before President Bush announced a plan to protect African babies from AIDS, top US health officials warned that research in Uganda on a key drug was flawed and may have underreported severe reactions, including deaths, government documents show.

The story held many shocking revelations, but was quickly spun upside-down and inside-out by the AIDS spin machine, which can take any horror and reduce it to banality, keeping the strict focus off of government malfeasance. What Fishbein disclosed was that NIH AIDS research chief Edmund Tramont had airbrushed and cooked damning clinical data from a large experimental trial in Uganda that tested a drug called Nevirapine against AZT, in pregnant HIV-antibody-positive women, intended to reduce HIV transmission. Tramont had censored reports of thousands of toxic reactions to the drug, and "at least 14 deaths," concealing from the White House the truth about the drug, just before Bush rolled out his $500 million plan to push Nevirapine across Africa.

Additional data not widely reported in the media revealed that there were 16 more deaths in babies on Nevirapine, bringing the total to 30, and 38 babies died on AZT (the other arm of the study). The ominous data coincided with findings from an aborted study in South Africa in the late 1990s (stopped due to toxicities and deaths); it was disturbing enough that the drug's manufacturer, Boehringer Ingelheim, withdrew its application to have the FDA approve the drug for use in pregnant women in all Western nations, including the U.S.

In 2000, the FDA put out a black-box label on the drug (which is approved for use in HIV-positive adults as part of a "cocktail therapy"), warning that it could cause fatal kidney damage and a syndrome that causes the flesh to blister and peel as though burned.

This is the drug that countless campaigners—spanning the political spectrum from George Bush to Bono—wish to give all Africans "free access" to. South African President Thabo Mbeki has been savagely pilloried for attempting to stop the drug's distribution to black South Africans. South African lawyer and journalist Anthony Brink's scathing report "The Trouble With Nevirapine" documented the long-known "problems" with the drug. The report was widely read by South Africa's leadership, and is the source of furious debate between black South Africans and the mostly white-run media, which still ridicules all criticism of U.S.-imported AIDS drugs and protocols as being a symptom of not caring about AIDS victims.

Nevirapine is a cheap drug, believed to reduce the transmission of HIV antibodies from mother to child if given before and during birth, despite there being no reliable data to prove that Nevirapine "drastically reduce[s]" transmission." (On average, in women who are well nourished, about eight percent of babies born to HIV-positive mothers with no intervention wind up HIV-antibody-positive; of these, disease progression is not tied to HIV status but rather to the overall health of the mother.) Wild claims about reduction in transmission are based on outdated, flawed research and ignore critical facts. In Africa, for instance, the test used to detect for HIV antibodies cross-reacts with the very proteins of pregnancy, meaning the women may not be true positives to begin with. Furthermore, every baby carries ghost antibodies from its mother for up to 18 months, which it eventually sheds, so all data about HIV status prior to that window of time is useless—but consistently cited anyway.

Nevirapine is a non-nucleoside reverse transcriptase inhibitor—a class of drug designed in the hopes of being less toxic than AZT. This isn't asking much, since AZT is chemotherapy that simply terminates DNA synthesis.

"Of all the AIDS drugs, Nevirapine is the most acutely toxic," explained Dr. Dave Rasnick, a fierce critic of the government's AIDS research agenda, and a former drug developer. "It shows its toxic effects quickly. It has been documented in the medical literature for years that a single dose of Nevirapine can kill a person. People don't normally drop dead from taking a protease inhibitor, but that is what happens with Nevirapine. The rationale for this stuff is just as bizarre as it could be."

He continued: "Liver toxicity is the leading cause of death of HIV-positive people in America and Europe in the cocktail era."

Some months ago, I asked Rasnick to send me documentation of this seemingly unfathomable statement, which he did. The statement is in line with interviews I did with healthcare workers back in 2000, who reported that many more people are hospitalized from the effects of the AIDS drugs than from any of the 30-odd symptoms that originally constituted the definition of AIDS (i.e., a disintegration of the immune system).

This would seem to be a p.r. problem for the AIDS industry. But as we learned from the spin that followed the Fishbein revelations, death by AIDS drugs is not viewed as something that should get in the way of a well-intentioned research agenda—either in the West or in Africa.

The high dudgeon, when it came, was directed not at the NIH for experimenting to lethal effect on pregnant Ugandan mothers, cooking and deleting data, stating openly that African research can't be held to the same standards as Western research, or any of the other disturbing things that came out of Tramontgate.

The ire was aimed at the Associated Press and its reporters for spreading alarm about Nevirapine in Africa, which raised "fears that many women there will stop taking the drug."

The New York Times led the Orwellian spin, in a December 21 article by Donald McNeil Jr. The lede went right to the heart of the matter: The dyspepsia of activists and public health experts.

A series of articles critical of past trials of an important AIDS drug has created a furor in Africa, causing many public health experts to worry that some countries will stop using the drug, which prevents mothers from infecting their babies with the virus that causes AIDS.

It went on: "On Friday, The National Institutes of Health for Allergy and Infectious Diseases, an arm of the National Institutes of Health, sharply criticized the articles, saying, 'It is conceivable that thousands of babies will become infected with HIV and die if single-dose Nevirapine for mother-to-infant HIV prevention is withheld because of misinformation.'"

Misinformation? The AP stories were specifically about the transmogrification of information into misinformation that Tramont engineered for his White House report. He cooked data. He deleted information about toxic reactions and death. In what kind of inverted universe is this not a gross violation of the entire premise of science and medicine?

Nature soon followed suit. From an article dated December 23, this dizzying opener:

Scientists and patient advocates this week united to defend an HIV treatment against allegations that a key clinical trial was flawed. A doctor from Global Strategis for HIV Prevention was quoted: 'This is the most successful therapy in the entire AIDS epidemic. It should not be attacked.'

"We are now living in a time of psychotic science, or abnormal science as I call it," said former New York Native publisher Chuck Ortleb, who was boycotted by the activist group ACT UP for publishing scathing critiques of AZT in the 1980s—a drug that was later proven to shorten rather than lengthen life. "That's why there are no controls in AIDS science, no dissent, why it's all science by press release. These self-appointed AIDS czars pretending to speak for the gay community, pretending to be revolutionaries, pretending to be anti-government when in fact they've always worked hand in hand with the government."

In recent years, Ortleb has turned to writing satirical novels, plays and a soon-to-be-released film called The Last Lovers on Earth, which is centered on a future dystopia in which AIDS research has been so successful that all gay men are dead.

"With their logic," Ortleb says, "this risk-benefit analysis, it doesn't matter if people die on the drugs, because they died so that the rest of the world could be saved."

His most recent send-up is a fictional press release for a new medical group called "Doctors Without Borders, Brains or Ethics," and focuses on protecting the AIDS establishment from criticism, "before the infection of skepticism spreads."

Let us not forget that Nevirapine is a drug that was pulled by its own manufacturer from use in the West, after an investment of many millions of dollars. It remains banned for use in pregnant first-world women.

Still, the NIH is using it on American women, in experimental trials you never heard about—until now. Alongside the revelations about the Ugandan trial, the AP stories brought to light that Joyce Ann Hafford, a 33-year-old, perfectly healthy, eight-months pregnant HIV-positive woman from Tennessee died from liver failure in an NIH trial testing Nevirapine. Her liver counts had been way off for days, and still doctors didn't take her off the drug.

The doctors told her family, naturally, that she had died of AIDS. The trouble is, cocktail-drug deaths are easily distinguished from AIDS deaths. This was not the case with AZT, a drug that simply decimated the immune system. Cocktail deaths are caused primarily by liver toxicity, heart attacks and strokes—from the effects of the drugs on the body's fat metabolism.

Hafford's death crystallizes the raging conflict between the establishment point of view that HIV is deadly and drugs save lives and the "denialist" or dissident point of view that HIV is not deadly at all by itself, but AIDS drugs are. Hafford had no so-called AIDS symptoms; she was simply HIV positive. She also had an older healthy child, which suggests that HIV may not be as lethal as advertised. By refusing to lament her death, or even the scores of Ugandan deaths, and instead attacking the messenger, the AIDS establishment has shown itself to be lost, with a broken compass, on the map of medicinal ethics.

Once it becomes acceptable to kill patients in experimental clinical trials and cover it up, without