Does HIV cause AIDS? -- Questions & Answers
HIV is the virus that attacks the immune systems and leaves the patient open to opportunistic infections. HIV is transmitted via blood to blood contact or sexual activity involving blood or semen.
While this is the standard acceptable definition for AIDS it has caused much controversy.
This is simply because there were politics involved in AIDS from the first day. Because AIDS originally attacked gay men, Haitians and IV drug users; many who saw AIDS not as a disease, but a punishment, welcomed it. Indeed we had the "bad" AIDS boys, the gay men and the druggies. We also had the "good" AIDS victims, the hemophiliacs and children.
Gay men realized that to get any fair and decent treatment they'd have to mobilize and fight for their fair share. In the meanwhile gay activists took things too far the other way denying homosexuals should even be responsible for their behaviour.
Who doubts HIV causes AIDS?
Peter Duesberg a respected professor of microbiology at the University of California - Berkley, began to question whether or not HIV was actually responsible for merely a co-factor or even just a harmless virus. Duesberg admits that the virus does exist but thinks it is a harmless virus. He has said that AIDS is caused by malnutrition, drug use (including poppers) and even the anti-viral drugs used to treat AIDS.
The Perth Group, a group of scientists in Australia claims that no one has actually isolated the virus. They claim therefore, if you can't even prove HIV exists, that it cannot cause AIDS.
These people, often lumped together in a group called denialists, maintain alternate theories about AIDS. They often criticize the government as trying to repress minorities or they accuse the drug companies of with holding a cure to make money. These alternatives appeal to people with HIV who are desperate for the hope that their condition is not always fatal.
Furthermore the drugs used to treat HIV, called antivirals are toxic and for most people cause a lot of problems and side effects. It is not uncommon for people using the antivirals to express that the treatment is worse than the illness.
But don't the alternatives make some sense?
No, the do not and they never do, IF you take the time to research them.
For instance if I say to you "Nothing can go faster than the speed of light," it is hard to imagine. It runs contrary to reason, after all why can't you go just a little fast than light. But if you spend the afternoon with a good physics book it becomes very clear.
What is the definition of AIDS?
This is a big problem and one that the denialists jump all over. This is problematic for people because there is no one single definition for AIDS, that all people agree on. People will say "How can you have AIDS in France but not have AIDS in the United States?" The ask "If it is a real disease, shouldn't the standard be the same all over the world?"
What people fail to understand it AIDS is not one disease it is a syndrome. All that means is that AIDS has a common set of symptoms. Not everyone will have all the symptoms. It's like saying if you have cold but don't have a headache with that cold, then it can't be a cold. Not all colds result in headaches. They also fail to understand people almost never die from HIV itself, they die from other diseases.These are called opportunistic illnesses. These other disease only happen because HIV weakens the immune system. If you had a properly functioning immune system you wouldn't be dead, because you would never have got the opportunistic diseases in the first place.
In 1982 no one knew what caused AIDS, all that was known was a set of two rare disease was showing up in young gay men. These diseases were not previous common in young men at all. They were Kaposi's sarcoma and PCP, a kind of pneumonia. However AIDS was never diagnosed unless all other factors for having those illnesses could be ruled out first.
As we began to learn more about AIDS and the virus HIV, the definition for AIDS was redefined. People took this as a sign of "well the medical establishment doesn't know what they are doing." Well they didn't know, no one knew.
What causes issues with the definitions? Why are they different?
The first issue is the circular logic. Having AIDS requires that the person have HIV. Without HIV there is no AIDS. Thus the definition assumes HIV causes AIDS.
Because of this circular logic for a while the Center For Disease Control (CDC) said they also have an alternative definition of AIDS. You need to have a consistent CD4+ count below 200 which cannot be explained any other way, such as chemotherapy, malnutrition or other immune disorders.
This alternate definition gave rise to the myth that many people with AIDS don't have the HIV virus. This was never right. As tests became more sensitive HIV was found on every person, or another reason, such as radiation was found to be the cause of the immune deficiency.
Last a problem occurred when some doctors begin to incorrectly diagnose people with AIDS who didn't have it. They did this because people with HIV are not eligible for government benefits. If you have AIDS you are eligible. Some people who take the HIV antivirals get sick enough so they can't work but the can't get benefits because they don't have AIDS. So some physicians will offer an AIDS diagnosis to help out their patients.
So can you prove HIV causes AIDS?
Well read this and you decide:
A German scientist in the 1800s put together a set of guidelines used to "prove" a germ caused an illness. Scientists knew that if they could prove Koch's guidelines that means HIV causes AIDS and these guidelines are referred to as "Koch's Postulates."
Here they are:
Koch 1: The germ must be found in every person with the disease.
Koch 2: The germ must be isolated from someone who has the disease and grown in pure culture.
Koch 3: The germ must cause the disease when introduced into a healthy person.
Koch 4: The germ must be re-isolated from the infected person.
So this guy Koch just made them up?
Correct, and this is another reason people have for denying HIV causes AIDS. They say since there is no real truth to the postulates, they can make up their own. Indeed the word postulate means something that is taken for itself with no further explination possible. For instance 1+1=2 is a postulate.
They Koch's guidelines are logical, but there was no reason he couldn't have come up with others. However even Koch realized his postulates had problems. Particularly troublesome was Koch's postulate number two. Viruses aren't life, but potential life. Viruses find a person or animal (called a host). Viruses invade a cell from that host and use the cell's DNA to reproduce. So now the cell reproduces a copy of the virus. As you can see a virus must be grown in a culture with another "cell" so by definition a virus will violate postulate number two.
Until the electron microscope was invented no one could see a virus. This caused some doctors to say viruses didn't exist. But even before the electron microscope, doctors knew something had to be causing illness, something smaller than bacteria. So some argument went on that all viruses didn't exist, until the elctron microscope was invented. We see a similar argument today with prions.
Does HIV satisfy postulate Koch 1?
(The germ must be found in every person with the disease.)
The Center For Disease Control in Atlanta has a definition of a condition called idiopathic CD4+ T-lymphocytopenia, or ICL for short. It says the patient must have a CD4+ cell count less than 300 on two separate occasions and no known cause for producing such a result, like radiation therapy. And have NO HIV antibodies or HIV virus detectable. This AIDS dissidents have said is basically a definition of AIDS minus the HIV virus.
The CDC published a study of ICL in the early 1990s reviewed all cases of ICL since the early 1980s. 47 people were said to have ICL. All these people later tested positive for HIV.
Subsequent studies have shown only 1 person with ICL that later on did not also test positive for HIV. And this person who tested negative was on therapy for cancer.
Thus HIV satisfies Koch postulate 1.
Only by giving a looser definition of AIDS can the alternative views produces any number of AIDS patients without HIV.
So what reason do the dissidents give for Koch Postulate 1?
The most common sited reason is the test gives false positives. One in particular Christine Johnson lists dozens of conditions she claims will return a false positive for an HIV antibody test. Some diseases such as malaria will produce a false result, not always but often enough to be a concern.
The issue of false positives is addressed by applying four separate tests, two for antibodies and two for the virus itself. Eventually everyone who developed AIDS tested positive for all four tests. A false positive would not likely consistently be false over so many tests.
Why do you say eventually test positive?
This is because each body is different and it can take up to six months to develop antibodies for HIV.
What about Koch Postulate 2?
(The germ must be isolated from someone who has the disease and grown in pure culture)
Getting past the issue that viruses depend on other cells to reproduce HIV does meet this condition.
HIV has been isolated in all bodily fluids, including blood, semen, tears, saliva, vaginal fluids, amniotic fluids, bone marrow, breast milk and saliva.
In the mid 1990s DNA testing was vastly improved by the ability to mass reproduce genetic sequences. This is why police can take a cell or two and look at it. Because they can essentially clone the one cell to get enough DNA to examine it.
So why does the Perth group say HIV has never been isolated?
The Perth group uses rigid standards that would not even allow the viruses for measles, small pox, influenza, mumps and yellow fever to be classed as a virus. Remember a virus only "lives" by hijacking another cell. So according to the Perth group that is wrong.
Even Peter Duesberg has tried to convince that the virus does exist to no avail.
Wait a minute I thought Duesberg said HIV doesn't cause AIDS?
He did say that, but Duesberg says the HIV virus exists, but claims HIV is a harmless virus. Now The Perth Group doesn't say that the virus doesn't exist, they just say no one yet has PROVED it exists.
So what does Perth say about the HIV test?
They say it isn't a test for HIV but a test for an antibody. When you put HIV in a culture with an HIV antibody the antibody will attack the virus. But that doesn't mean that that antibody is specific for that virus. If it is close enough it works. For instance you can have cowpox a mild disease and because the antibodies the body produces to fight cowpox, will also be effective against smallpox, because the illness are close enough.
So the Perth Group stand is that an antibody is proof of nothing.
What about the HIV test that test for the virus itself?
One test is for a protein and one for a viral envelope of the HIV virus. Since a virus depends on another cell to reproduce the Perth Group maintains it isn't properly isolated.
The Perth Group doesn't say AIDS does not exist but says the causal agent is not a virus. They don't attempt to explain "what" exactly cause AIDS, they are more concerned that HIV even exists.
OK what about the last two postulates?
(The germ must cause the disease when introduced into a healthy person.)
(The germ must be re-isolated from the infected person)
This is much harder to prove as you can see. Because AIDS is lethal you cannot do a proper study. We don't go around infecting people with lethal illness to prove a point.
But just because we don't do it on purpose doesn't mean it has never been done. It's been done three times in for sure.
There have been cases of lab technicians developing antibodies to HIV after getting accidentally stuck. We have examples of people exposing themselves to pure cloned HIV virus. None of these people fit any known risk group. The HIV was isolated using genetic sequencing, and was found to be identical to HIV now reproducing in their bodies.
Still three people isn't a lot and not everyone who got stuck has gone on to test positive for HIV. But we have other examples, by re-infecting chimps and monkeys they have developed "AIDS-like" conditions. In fact, in mice engineered to have a human immune system, HIV produces the same patterns of disease as in humans.
There have also been cases where people have been stuck but belonged to high risk groups, so they've been excluded. They have said they engaged in no risk behaviour. Though that isn't conclusive, it's a strong indication of transmitting the virus back to humans.
What other evidence do you have that HIV causes AIDS?
First there is the predictive power of the HIV test. At least 50% of all people, not on antivirals, develop full blown AIDS 10 years or sooner after getting tested. Only a handful remain alive more than 20 years.
Second HIV positive people have a rate of 1,000 times the person testing negative for HIV for diseases such as PCP and Kaposi's sarcoma
Third: In Thailand the death rate 50 times for HIV infected sex workers was over non infected sex workers.
Fourth: In Uganda testing has shown HIV positive people had a death rate at 16 times the rate of HIV negative persons.
Fifth: In the United Kingdom the death rate for AIDS in hemophiliacs declined by 11 times after blood was screened for the HIV virus. Today AIDS in hemophiliacs is rare.
Sixth: The rate of HIV infection for newborns has declined by 50% with introduction of anti-viral
Seventh: The rate of new HIV infection has gone up but the death rate for HIV has declined over the same period.
If AIDS was caused by a condition such as anal sex or malnutrition, how do you explain HIV negative drug users or malnourished HIV negative people that don't get AIDS.
If one continued to use the same statistics for the death rate of HIV positive people in 1994 it should've have amounted to an additional three million deaths. While certainly HIV is getting less deadly it's wouldn't' be three million.
HIV alone has been the single common factor for all AIDS victims.
But I've heard its lifestyle, drugs use and malnutrition that cause AIDS?
Those definitely play a part in how fast a person with HIV succumbs to AIDS but they are not the CAUSE of AIDS.
Dissidents have claimed recreational drugs, including heroin, cocaine, amphetamines and nitrite inhalants known as "poppers," cause AIDS. Malnutrition, and dirty drinking water are blamed for AIDS in Africa. Some groups also suggest semen, "immune overload", antibiotics, benzene, stress, or lack of sleep cause AIDS.
Clotting factors used in blood transfusions, and anti-HIV drugs such as AZT are also accused of causing AIDS. But now that the blood is screened for HIV the people getting transfusions virtually never get AIDS or test positive for HIV.
Peter Duesberg has claimed drug users get an "AIDS-like" condition but not AIDS itself. But Duesberg has never been definite about what is the difference between AIDS and "AIDS-like."
Certainly antivirals used to treat AIDS are toxic. In fact some are so toxic to certain people they can't be used. There is no doubt antivirals can cause issues but they aren't the CAUSE of AIDS.
Malnutrition is known to cause immune problems but in areas of low HIV presence and malnutrition or starvation the immune problems in no way resemble the same immune problems as found in those areas with HIV.
What about AIDS in Africa?
The biggest problem is that the data is so unreliable and it's not a random sample. Therefore any statistic that comes out of Africa must be viewed as an "educated guess."
Africa does not have the ability to do proper testing on a wide scale. What they do is look for small groups and then properly test them. Then apply that group to a larger population. But because the group chosen is often not representative of the larger area it is not an accurate statistic, but rather only shows a trend.
Also because AIDS, in Africa, is diagnosed on the basis of symptoms and not HIV testing for antibodies, it may not be reflective. The disease may be worse or better.
How could it be worse?
Well let's take TB is for example. Because the TB strain in Africa, is very aggressive the people die off quickly and the death is attributed to TB. It may be really due to TB caused by AIDS. So people may be dying off and the deaths not attributed to the appropriate thing. Of course it can just as easily go the other way.
What evidence is there for AIDS in Africa?
First: Southern Africa and Western Africa have similar amounts of poverty and migrant workers and the rates in Southern Africa are much higher for HIV. If poverty was a factor you'd see it wherever poor people are.
Second: A rebound of disease like TB and KS has occurred in areas where the diseases were well controlled. And unlike the rise of Malaria due to overuse of anti-malarial drugs, no other common link can be found.
Third: In the 1980s the death rate for adults where HIV is now prevalent had gone up sharply where in African countries with a low HIV rate their death rate remained static.
Fourth: The death rates have overwhelmingly been with urban poor and urban young people under 30.
Fifth: In some rural Southern African communities the orphan rate is soaring and the children cannot be cared for. This is something previously unknown at any time in Africa. Even during the Ebola crisis of the late 1970s Africa was known as the "place where people take care of each other." Now there are countries with so many orphans they can't cope.
As you can see none of this "proves" HIV causes AIDS is in Africa, it gives a strong signal to the fact a germ and not malnutrition or lifestyle is causing HIV.
So is there any argument that HIV does not cause AIDS you might give credence to?
The best argument is one put forth slowly by Peter Duesberg. Over the years he has gone from saying HIV doesn't cause AIDS, to there's no proof HIV causes AIDS, to his present statement on HIV. Duesberg now states HIV is only ONE factor. Even Robert Gallo the "co-discover" of HIV has said we probably would do well to look for a co-factor for AIDS.
What do you mean co-factor?
In other words the current "best" alternative theory is that HIV doesn't alone cause AIDS. You must have something else beside HIV to get AIDS.
In other words they may say poppers won't cause AIDS and HIV won't cause AIDS, but if you use the two together you get AIDS. Or HIV won't give you AIDS, but maybe AIDS and another undiscovered virus would give you AIDS.
Shouldn't it be easy to find another virus?
Not if you're not looking for it. It could be a harmless virus that is already in most people.
For instance, let's suppose the herpes virus-1, which causes cold sores, is a cofactor with HIV. It is not but let's pretend it is. Since 90% of the population has had a cold sore you may need to look for a virus that nearly everyone already has and is basically harmless.
One of the most common things looked at is the HHV6 or HHV7 virus. This is a herpes virus that causes Roseola, mild fever and rash. It is seen most often in children and can be so mild that people don't know they've had it.
But every once in awhile it has been observed the herpes virus 6 (or herpes virus 7) will go wild and cause a serious illness or even death.
Researchers note that in HIV positive people these herpes virus (6 and 7) go nuts and kill of immune cells. But this is only beginning to be researched. A lot of people have this virus and are unaware of it. So it's one place to look for a co-factor to HIV causing AIDS. HHV6 is also thought to play a role in MS as well. Again the research on it has just started.
Why are people so quick to pick up on alternate theories?
Partly because the science used for HIV has been sloppy. And it's political. Look at the court battles for who discovered the virus. Medicine and patents have meant big grant dollars. This leads people to believe they are not a concern, only the money is.
And partly because HIV is lethal so you can't properly test people. Usually what they do is infect people or animals with a virus and some people without a virus and neither the doctors nor the patients know. Then they see how the disease progresses. This is called a double blind study. It is the gold standard for testing.
And lastly because the attitude of government agencies is so bad, that when they go wrong they scruff off their error instead of accepting it.
So the government has missed on a disease before?
Yes, they totally screwed up the West Nile virus. Here's how. West Nile virus is spread by mosquitoes and was found only in Africa. Usually viruses spread bit by bit covering all the land consecutively as it goes. Even so the West Nile virus only causes illness in about 20% of people that get it.
In 1999 in New York City people began to get sick. They were hospitalized and some died. The doctors were baffled. Eventually they said it was St Louis encephalitis, a brain illness that caused the death. The city of New York immediately put out measure to spray for mosquitoes. At the news conference one of the reporters asked if the St Louis encephalitis had anything to do with the crows dying all over the city. The doctors said no.
No one thought much of this except a researcher. She immediately found some dead crows and went to the zoo where see found other birds were dying. She was a researcher with an excellent background and thought, this must be West Nile virus, known to kill birds.
She then tried to get the Center For Disease Control and the National Institutes of Heath to test the birds, both to her to get lost. When she begged them to test the birds they said they aren't vets. And she was well known to both agencies too.
But she had an old acquaintance at USAMRID (the U.S. Army Medical Research Institute of Infectious Diseases). It was, at the time, the only other place in the United States with the ability to test for West Nile virus.
It came back confirmed it was West Nile virus not St Louis encephalitis. Because she was insistent and had connections she was able to convince the CDC and the NIH they were wrong.
It was fortunate that the spraying of mosquitoes; for St Louis encephalitis is exactly what you do for West Nile virus, so further problems were avoided.
When asked why they didn't check it out the CDC wrote it off to they can't check up on every "crackpot." But this was missing the point totally. This lady wasn't just "anyone;" she was a respected researcher; they SHOULD have listened to.
The CDC could not accept the virus skipped directly from Africa to North America but it did.
A similar situation occurred when a lung illness broke out in northwest New Mexico. Because the leading candidate was a hantavirus, which was never previously known to cause lung problems. So the virus was at, first ignored. It was only at the insistence of Native American tribal leaders that the CDC discovered this hantavirus did cause breathing issues.
So as you can see, because of government indifference and "know it all" attitudes a lot of people are willing to easily accept a conspiracy theory or think the government is lying.
What don't we know about HIV?
The biggest issue we have facing us is we really don't know why AIDS has become such a mainstream disease in Africa but remains a disease of gay men and IV drug users in North America and Europe.
A plausible explanation is the rate of other sexually transmitted diseases (not including HIV) is similar in North America and Europe to that of Africa. So it appears that HIV still has yet to find a way into the general population.
Additionally Africans tend to have more diseases and more HIV in their blood this may effect the transmission rate.
We also have to consider that right after infection the viral loads of HIV are very high, and thus more likely to be transmitted efficiently.
It is worth noting that even though Africans, have the same number of heterosexual partners that heterosexuals do in Western nations, the Africans have them concurrently (at the same time). While Americans and Europeans have partners one relationship at a time.
Complicating this all the more is that Africans do not have access to even sub-standard healthcare. Also lack of education and culture and religious differences mean less than 1% of all Africans know their HIV status. Many women have issues trying to bring their culture and safe sex together. They feel even if they know about safe sex and how not to get HIV they do not know how to prevent it.
That said, the concentration of infectious disease in a specific group of people isn't unheard of. Hepatitis-c is transmitted by blood and confined by in large to IV drug users.
And statistics appear to show a very slow trend to HIV getting in the general population of Western nations. But the heterosexual transmission of HIV is dwarfed as the gay populations in the West, which now show an increase of new HIV cases.
We also don't know exactly how HIV causes AIDS. To be sure it kills the cells of the immune system but when HIV is present it also appears to be "stopping" but not "killing" the immune system
Well doesn't it seem then that AIDS in America and AIDS in Africa are different diseases?
Yes but the differences are only superficial. For instance an opposum looks similar to a raccoon, or woodchuck, but it is much more closer related to a kangaroo than either a raccoon or woodchuck.
Of course ignorance about precisely how something happens is not proof that it does not happen.
HIV Myth Rebuttal
MYTH: HIV antibody testing is unreliable.
FACT: Testing for HIV exceeds the medical standards for other antibody tests for other diseases; double blind studies of testing for HIV antibodies exceeds 99.8% accuracy.
MYTH: HIV cannot be the cause of AIDS because researchers are unable to explain precisely how HIV destroys the immune system.
FACT: Although a great deal about AIDS remains to be seen, science understands quite a deal about what causes the immune system to fail. Long before science understood about rabies, smallpox and other viral illness, they knew how to treat them. Adequate testing simply cannot be done to the same standards of other medical tests to the virus's lethality.
Most infectious agents are known to science long before their precise mechanism is found out. The disease-causing mechanisms in many diseases, including tuberculosis and hepatitis-B, are poorly understood. By that reasoning would lead to the conclusion that M. tuberculosis is not the cause of tuberculosis or that hepatitis B virus is not a cause of liver disease.
MYTH: AZT and other antiretroviral drugs, not HIV, cause AIDS.
FACT: Long before AZT was used to treat patients people died of AIDS. Long before other antivirals were developed people died of AIDS. This fact is simply overlooked.
People often fail to understand AZT and other Antivirals are toxic to the body, this is well understood. It is also understood in some people their effects are not well tolerated. In fact since the time from exposure to HIV to development and death from AIDS can be over 10 years, for some people to use the antivirals would do them more harm.
To use antivirals or not and quality of life, while on them, is strictly a personal issue between the patient and the doctor.
MYTH: Behavioral factors such as recreational drug use and multiple sexual partners account for AIDS.
FACT: This overlooks the fact hemophiliacs have gotten AIDS and babies are born and suffer from AIDS. There are many homosexuals that have gotten AIDS without using recreational drugs. There are documented people of getting HIV infection and AIDS from accidental needle sticks.
Furthermore there are far too many homosexuals that engage in the identical sexual acts with poppers, drug use and multiple partners who simply do not have HIV and AIDS.
MYTH: AIDS among transfusion recipients is due to underlying diseases that necessitated the transfusion, rather than to HIV.
FACT: This completely ignores the fact that after widespread screening of blood came into practice the rate of AIDS in transfusions is near zero now. Nothing else changed so what happened? If it were the underlying illness AIDS should still be there.
MYTH: The distribution of AIDS cases casts doubt on HIV as the cause. Viruses are not gender-specific, yet only a small proportion of AIDS cases are among women.
FACT: Incorrect, once you factor out male homosexuals you find similar rates of infection for non-IV drug users. If anything the statistic slightly skews higher for women, which is consistent because women are "passive" in intercourse. This also is consistent with the "passive" homosexual partner getting HIV more.
The HIV virus affects homosexual men simply because their sexual behaviour is exactly the easiest way for the virus to reproduce. This is why non-IV drug using, lesbians have an almost non-existent rate for HIV or AIDS.
MYTH: HIV cannot be the cause of AIDS because the body develops a vigorous antibody response to the virus.
FACT: Response to a virus by antibody often can predict the severity of an illness but is no means a total preventative. Furthermore antibodies and viruses exist in the body in other diseases. Herpes simply "hides" in the nervous system where the immune system can't get it, poking its head out occasionally to give you a cold sore. Sometimes 3 year sometimes no cold sores for thirty years.
MYTH: HIV is not the cause of AIDS because many individuals with HIV have not developed AIDS.
FACT: AIDS is a new illness with a relatively long time of incubation. Simply we don't know if everyone who has HIV will get the disease. Some may be carriers. As of now there is no way to know.
Other factors such as strain of HIV, over all health of an individual and nutritional facts may play roles.
Hepatitis-B can be deadly, but in a few people it mild and still others have no sign of devastation to the liver. But for a majority hepatitis-B is problematic.
Similarly not all smokers will develop lung cancer. An overwhelming number will develop a cancer eventually but by no means all. And other may be likely to develop cancer but die from other things long before this happens.
MYTH: The spectrum of AIDS-related infections seen in different populations proves that AIDS is actually many diseases not caused by HIV.
FACT: AIDS is a "Syndrome" and properly understanding this means that HIV doesn't kill you but suppresses the immune system. This allow diseases that normally would be "suppressed by your immune system" to not be suppressed.
You get ill from those illnesses not HIV. Very few people are directly ill from the HIV virus but rather the opportunistic diseases that take "advantage" of a weakened immune system. HIV weakens the system. Think of it like this: In a back robbery, HIV is like the guy who knocks out the bank guards so the other crooks can rob the bank.