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CLINICAL REVIEW: Michael W Adler ABC of AIDS: Development of the epidemic BMJ 2001; 322: 1226-1229 [Full text]

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HISTORY OF AIDS

Daniel H Duffy   (18 May 2001)

Misuse of the AIDS epidemic to promote male circumcision

George Hill   (20 May 2001)

HIV may not be the cause of AIDS

Thomas Brunoski   (24 May 2001)

The "epidemic" has been around for much longer.

T F Sandeman   (5 June 2001)

HISTORY OF AIDS 18 May 2001
Daniel H Duffy, Family doctor Geneva, Ohio, USA Send response to journal: Re: HISTORY OF AIDS	Napoleon said, "history is an agreed upon set of lies." AIDS was originally called GRIDS - Gay Related Infectious Disease. Initially, AIDS was seen as a failure of the immune system most often seen in cancer patients as a result of chemotherapy although a rare case would pop up here and there brought about by contact with other various environmental poisons. GRIDS was caused by the use of recreational drugs amongst two groups of homosexuals in, (La, Cal and NYC, NY)and was an embarrassing mistake since an infectious disease cannot show bias. The mistake of attempting to connect an immune system failure with an "infectious" organism was caused by three factors: 1. Politics 2. scientific reductionist medicine reduced to the absurd 3. lack of common sense 1. Just as FMD and Mad Cow are not infectious diseases, neither is AIDS. (check your history, and failing that, contact Abigail Wood in Manchester, she'll set you straight - if you can learn the facts on FMD and Mad Cow, that might bring you to a true, fact-based understanding of the AIDS myth) 2. HIV has nothing to do with AIDS. 3. AIDS is not a transmissable disease - not even by blood transfusion as was demonstrated all across this country several years ago by a courageous fellow in possession of both MD and PhD degrees. Peter Duesberg has presented the proper analysis of AIDS in his book Inventing The AIDS Virus. No vested interest
Misuse of the AIDS epidemic to promote male circumcision 20 May 2001
George Hill, Retired Send response to journal: Re: Misuse of the AIDS epidemic to promote male circumcision	To the Editor:        An interesting sidelight of the development of the AIDS epidemic currently being reviewed1 is the use of the AIDS epidemic by advocates of male circumcision to promote their favorite cause. The promotion started in the 1980s when Aaron J Fink, M.D., a now deceased California urologist who once wrote a book that ardently promoted male circumcision, started to write letters to set out his hypothesis, founded only in his ardour for male circumcision, that male circumcision could prevent HIV transmission.2, 3        Other circumcision advocates soon picked up on this tactic and more than 40 studies have been carried out in Africa with the apparent intent of "proving" that male circumcision somehow prevents the transmission of HIV. The studies are noted for "the lack of attention given to potential confounding factors, which could be related to both circumcision status and risk of sexually transmitted infections, such as sexual behaviour or differences in hygienic practices, or differential use of specific health facilities."4        The pet theory of the circumcision advocates was dashed when Robert S. Van Howe, M.D., F.A.A.P, an expert in statistical analysis, carried out a statistical meta-analysis of all existing studies.5 The meta-analysis found that circumcised men have a somewhat greater chance of contracting HIV infection,4 even though, as noted above, those studies seem to have been designed to produce a particular outcome.       Notwithstanding the findings of de Vincenzi & Mertens, and Van Howe, the circumcision advocates continue to publish opinion pieces to promote their pet theory.6        More recently, the Rakai Project reports that viral load and genital ulcer disease are the primary factors that influence the transmission of HIV between discordant couples in Uganda.7 The Rakai Project also reports that risk of transmission was not significantly affected by the circumcision status of HIV positive male partners."7       In spite of this new evidence of the lack of efficacy of male circumcision in preventing the transmission of HIV, the promotion of male circumcision as a preventive measure is unlikely to cease, since most of the circumcision promoters seem to be circumcised males. There is evidence that the psychological effects of genital alteration drive some circumcised males to misuse the medical literature to justify their personal genital alteration and loss of erogenous tissue.9 Such males are unlikely to be reached by the evidence, because they may be subjectively responding to their internal needs rather than objectively assessing the evidence, so the promotion of male circumcision and the controversy generated by these efforts seems likely to continue. George Hill Port Allen, Louisiana, 70767 USA References Adler MW. Development of the epidemic. BMJ 2001;322:1226-1229. Fink AJ. A possible explanation for heterosexual male infection with AIDS N Engl J Med 1986;315:1167. Fink AJ. Newborn circumcision: a long-term strategy for AIDS prevention. J R Soc Med 1989;82(11):695. de Vincenzi I, Mertens T. Male circumcision: a role in HIV prevention? AIDS 1994;8(2): 153-160. Van Howe RS. Circumcision and HIV infection: review of the literature and meta-analysis. Int J STD AIDS 1999;10:8-16. Szabo R, Short RV. How does male circumcision protect against HIV infection? BMJ 2000;320:1592-1594. Gray RH, Wawer MJ, Brookmeyer R, et al. Probability of HIV-1 transmission per coital act in monogamous, heterosexual, HIV-1-discordant couples in Rakai, Uganda. Lancet 2001; 357: 1149-53. Goldman R. The psychological impact of circumcision. BJU Int 1999;83 Suppl. 1:93-103. Taylor JR, Lockwood AP, Taylor AJ. The prepuce: specialized mucosa of the penis and its loss to circumcision. Br J Urol 1996;77:291-295.
HIV may not be the cause of AIDS 24 May 2001
Thomas Brunoski, Private practice Private office Send response to journal: Re: HIV may not be the cause of AIDS	Dear Editor: There’s something wrong with the AIDS discussion, and nobody in the BMJ is saying it. Read quickly through “ABC of AIDS: Development of the epidemic.” Does something strike you as odd? Take a glance at the table of “AIDS defining conditions.” What jumps off the page with these lists? Put simply, they are a diverse hodge-podge of illnesses, ranging from invasive cervical cancer and sarcoma, lymphoma, candidiasis, herpes infections, interstitial pneumonia, etc, etc. What you see is a long list of individual illnesses, each of which have been examined and treated for years as the individual illnesses they are, not one syndrome. Now, in some magical fashion, all these disparate conditions are being said to result from a single viral infection? A virus so low-grade that its presence cannot be detected except by amplification techniques? A viral load that is so low by comparison to any other known viral infection that it does not exceed the threshold of disease, except in the somewhat fanciful AIDS kingdom? And even more astonishing, this array of devastating diseases can be triggered “without laboratory evidence of HIV infection”!! In other words, we are meant to believe that we have a virus so amazing in its potency and intelligence as to be the sole cause of a virtual textbook of pathology -- and it doesn’t even have to be there to do it!! In the court of science it is impolite to speak against the reigning dictum. The courtiers who do so might be out of a job. But there are some in the AIDS kingdom who have said that the emperor isn’t wearing any clothes, that HIV is not the cause of AIDS, and that AIDS medications are not the cause for clinical improvement in treated patients. My impression is that they are right. AIDS does not behave like an infection. It does behave like an immune dysfunction, and there are many possible causes of disordered immunity, which can be found in essentially all patients with AIDS. In other words, there are explanations for the immune deficiency of AIDS that are far more plausible and scientifically grounded than the theory of an all-powerful and often invisible virus. There is a very interesting article on this view of AIDS available on the internet. It was written by the American alternative health journalist and radio announcer Gary Null. Mr. Null has had the opportunity to interview a wide range of prominent scientists, gay activists and physicians on this subject, and these people make a compelling case that AIDS is not caused by a virus, but by a number of other identifiable factors. Whether or not you believe in the HIV virus, you will probably be interested to see what a growing number of well- informed and expert people are saying on the subject. For those interested, go to www.garynull.com and click on “search,” then under “A” you’ll find the article, “AIDS: A second opinion.” There appears to be a credo of silence on this subject, even though dissenters’ opinions first appeared in Science magazine nearly ten years ago. But AIDS is now a global issue. If HIV may be a fiction, shouldn’t there be active and open discussion on the subject? I write this letter to express my own views, but also in the hope that it may stimulate others to read further and uncritically examine the broader issue of what actually causes AIDS. Sincerely, Thomas Brunoski, M.D., M.S. Westport, CT USA
The "epidemic" has been around for much longer. 5 June 2001
T F Sandeman, Retired Radiation Oncologist home Send response to journal: Re: The "epidemic" has been around for much longer.	EDITOR- In May 1966 the Robert Fowler Scholarship of the Anti-Cancer Council of Victoria enabled me to visit Mulago Hospital and Makarere University in Kampala Uganda. The main reason for the visit was to assess the current status of viral induced human malignancy of which the most exciting aspect then was Burkitt's Lymphoma. During ward rounds and discussions with Denis Wright, Michael Hutt and Professor Pulvertaft in the Pathology Department, my attention was drawn to the high incidence of Kaposi's sarcoma in African natives. Epidemiologically they seemed to originate in only a few localities and theories as to a viral aetiology with possibly an insect vector (Simulium Damnosum) were raised. As AIDS infection precedes the appearance of Kaposi's sarcoma by several years it would seem to me that the date given for the start of the epidemic in Sub-Saharan Africa as the "late 1970s" is about 20 years too late. In view of the turmoil that has ensued in Uganda since, it is unlikely that decent records will have survived but someone might have rescued some data from the wreckage. T.F.Sandeman retired radiation oncologist 67 Park Drive, Parkville, Victoria 3052, Australia sandeman@alphalink.com.au