HIV denial is fatal

The most convincing argument that the virus causes AIDS is that anti-retroviral medications are prolonging the lives of millions

Montreal Gazette Feb 10, 2011

How I wish that the opinion article "Junk science and AIDS" by Terry Michael (Gazette, Feb. 5) had begun: "Once upon a time there was a wicked journalist preying on sick and dying people ..." Instead, the article brought us a seemingly reputable journalist publishing a vitriolic and prejudiced rant exhorting Canadians to know that "there is not now and there never was a human immunodeficiency virus.".

Michael is wrong - as are the arguments he uses to deny that the human immunodeficiency virus (HIV) can cause the fatal destruction of the immune system that we call AIDS. Were his article to have been government-sponsored, people would in all likelihood be crying propaganda! It is incongruous and inexplicable that the executive director of what is claimed to be a prestigious and responsible U.S. journalism foundation could write such a misleading and harmful article.

I will not address the prejudiced, pejorative nomenclature Michael uses -such as "lucrative profits," "incestuous urban gay enclaves," "victims of a multi-billion dollar HIV-AIDS industry." Nor will I address his distorted presentation of the science and history of HIV/ AIDS with which he justifies his denial that HIV can cause fatal illness. Science establishes its truths through reproducible and peer-reviewed evidence, not by what politicians, journalists, or even individual scientists might "declare." The quality of science that explains the cause and disease mechanisms of HIV infection that lead to AIDS, and that underlies the development of highly effective anti-HIV treatments, resulted in a 2008 Nobel Prize being awarded to the two scientists who discovered HIV.

The biggest danger from Michael's article is that it might mislead people into failing to understand that HIV is a killer. Without treatment, almost everyone who is infected with HIV will eventually die from the infection. There is abundant evidence that HIV can be transmitted from infected mothers to their babies, through contaminated blood transfusions, by sexual intercourse from HIV-infected wives, husbands or gay partners, or by sharing bloody injection equipment.

Today, the most convincing argument that HIV causes AIDS is that anti-HIV medications -often called antiretrovirals or ARVs - are prolonging the lives of millions of HIV-infected people. The number of HIVinfected people progressing to the life-threatening immunodeficiency that is full-blown AIDS living in Canada or anywhere else has plummeted wherever these medications are being widely used. Blood is now safe thanks to HIV screening tests. Just as impressive is that babies are born uninfected when their mothers are effectively treated. And many of the millions who are taking ARVs are no longer dying or ill but, instead, are returning to work, having babies, and planning a long life.

As a physician and a researcher who has studied HIV infection and cared for HIV-infected adults for 30 years, I am very worried by the real danger that an article such as Michael's might persuade some infected people to forgo prevention that can protect their partners from being exposed to or infected by HIV. And, sadly, it might also persuade some people who are infected to forgo life-saving treatments.

Michael focuses on the case of American boxer Tommy Morrison, who is refusing to undergo HIV testing to be eligible to fight in Quebec. He describes a situation where the boxer's HIV test was initially reactive and he began ARV treatment. Those drugs are only used to treat people who are HIV-infected (i. e. they have reactive tests that are confirmed positive) and who are likely to benefit from being treated. Even if Morrison's subsequent tests became "negative" when being treated with ARVs -an extremely unusual result -he nonetheless remains infected. If Morrison was once found to be HIV positive and needed treatment, then, like everyone else who has been infected with HIV, his infection is a lifelong one, and he remains infected and potentially infectious. As a boxer, he would be a danger were he to be cut, because this could expose others to his HIV-carrying blood.

Morrison's denial is exactly the danger that this article is likely to exacerbate. It's essential that all HIV-infected people accept that they are infected and can, at times, be a potential danger to others. In contrast to Morrison and Michael, all of us, especially anyone who is HIV-infected, need to send a clear prevention message that will help to protect others, instead of one that denies HIV and that suggests being exposed to HIV is not dangerous. This is a universal response to HIV that we hope everyone -especially those who are infected -will understand and pass on.

Norbert Gilmore is professor of medicine (emeritus) at McGill University and a senior physician at the McGill University Health Centre.

Read more: http://www.montrealgazette.com/health/denial+fatal/4247661/story.html#ixzz1DTMSi5sv