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Implement peer review or resign, controversial journal’s editor told

Ultimatum spells end for Medical Hypotheses in its current form. Zoë Corbyn reports

The editor of the journal Medical Hypotheses has been given until 15 March either to implement changes to adopt a traditional peer-review system, or to resign.

He has also been told that even if he stays with the journal, his contract will not be renewed at the end of the year.

As Times Higher Education reported in January, publisher Elsevier is attempting to rein in its unorthodox journal, which publishes papers on the basis of how interesting or radical they are rather than using peer review, after it published a paper last July that denied the link between HIV and Aids.

The article prompted an outcry from Aids researchers, leading Elsevier to propose changes to both introduce peer review and exclude papers on certain controversial topics.

But Elsevier’s plans have been vehemently opposed by the journal’s editor, Bruce Charlton, its editorial advisory board and a large number of Medical Hypotheses’ authors, who have mounted a campaign to save the journal, believing it offers an important outlet for radical ideas.

Professor Charlton said: “Elsevier is asking me either to resign immediately, or else immediately to begin implementing changes that it has unilaterally and irrationally demanded. But my conscience will not allow me… I cannot do either of these things.”

The news comes as two controversial papers on the Aids virus that had been retracted from the journal following the outcry are “permanently withdrawn” after they failed to pass the test of peer review.

The papers in question are “HIV-AIDS hypothesis out of touch with South African AIDS: A new perspective” by Peter Duesberg, professor of molecular and cell biology at the University of California, Berkeley, and a paper published the same month, “AIDS denialism at the ministry of health” by Marco Ruggiero, professor of molecular biology at the University of Florence.

Both papers are being permanently withdrawn from the scientific record, even though the Ruggiero paper does not deny the link between HIV and Aids, but argues that the Italian Ministry of Health seemed not to believe that HIV is the “sole cause” of the Aids virus.

The papers were both rejected unanimously by five anonymous reviewers in a process managed by The Lancet, another Elsevier journal.

But Professor Charlton said he rejected both the process and outcome of this assessment, and accused Elsevier of running a “show trial” and making a “gross mistake”.

“I do not acknowledge the validity of deleting these papers from the scientific literature,” said the professor of theoretical medicine at the University of Buckingham.

“I do not acknowledge the validity of the Elsevier process of reviewing these papers, nor do I consider the referees’ reports relevant to the criteria I use in selecting papers.”

He added that it was “ludicrous” that the Ruggiero paper, which he said was “the opposite of an HIV denialist paper”, had been bracketed with the Duesberg paper.

He said that “since this gross mistake has not been acknowledged”, the evaluation process had not been rigorous enough.

Professor Ruggiero said he believed his paper was “condemned from the very beginning” of the process, “probably because of the word ‘denialism’ in the title”.

Elsevier declined to comment on the developments, saying it was engaged in a “private discussion” with the editor about the future of the journal.

It has previously said that the Duesberg paper contained opinions “that could potentially be damaging to global public health”.

zoe.corbyn@tsleducation.com

Readers' comments (3)

  • Dr. Duesberg, in your withdrawn paper you wrote:

    "the Harvard study maintains that the ‘‘benefits” of these drugs ‘‘outweigh” their inevitable toxicity (1). But, contrary to these claims hundreds of American and British researchers jointly published a collaborative analysis in The Lancet in 2006 concluding that treatment of AIDS patients with anti-viral drugs has ‘‘not translated into a decrease in mortality” (30).

    (30) May MT, Sterne JA, Costagliola D, Sabin CA, Phillips AN, Justice AC, et al. HIV treatment response and prognosis in Europe and North America in the ?rst decade of highly active antiretroviral therapy: a collaborative analysis. Lancet 2006;368:451–8.

    - In case you failed to read beyond the abstract, here is an explanation of what the study actually showed:

    The lack of a "decrease in mortality" that is being referred to in that quote involves a comparison of mortality AFTER JUST ONE YEAR ON TREATMENT among people who started treatment in 95/96 compared to people who started in 2002/3.

    Mortality after one year of treatment in 95/96 was 2.2% (27 deaths out of a cohort of 1,232 people) and in 2002/3 it was 1.3% (25 deaths out of a cohort of 1,932 people). This is not a statistically significant difference. BUT IT IS NOT A COMPARISON OF TREATMENT vs. NO TREATMENT.

    The study also included measurement of HIV viral load six months after starting treatment, and the proportion of people with viral loads less than 500 copies at this timepoint increased from 58% in 95/96 to 83% in 2002/3. Given that there is still a significant proportion of people who did not achieve a viral load this low in the more recent period (17%) and given that mortality after one year of treatment was much lower than this (1.3%) it is not particularly surprising that this overall improvement in virological response "has not translated into a decrease in mortality" AFTER JUST ONE YEAR ON TREATMENT.

    What would be expected based on the published literature is that the improvement in virological response in the more recent period would lead to better long-term outcomes. And indeed this is the case. The Lancet paper includes a supplemental table with two-year follow up; far fewer people get diagnosed with AIDS or die in their second year on treatment and the differences between 95/96 and 2001 (the most recent period with two-year follow-up available) get wider: 2 year mortality in 95/96 is 4.3% vs. 2.5% in 2001.

    In 2008, the same authors published three year follow up for the same cohorts: The Lancet, Volume 372, Issue 9635, Pages 293 - 299, 26 July 2008

    "Findings: 18 587, 13 914, and 10 854 eligible patients initiated combination antiretroviral therapy in 1996—99, 2000—02, and 2003—05, respectively. 2056 (4·7%) deaths were observed during the study period, with crude mortality rates decreasing from 16·3 deaths per 1000 person-years in 1996—99 to 10·0 deaths per 1000 person-years in 2003—05."

    This reduction in mortality in the more recent period is significant.

    These papers also show that the rate of AIDS events in the second year people are on treatment is much lower than the first e.g. for the 1,232 people who started treatment in 95/96 the difference was 103 AIDS events in the first year and 32 in the second. For 1,932 people who started treatment in 2001 the difference was 172 AIDS events in the first year versus 27 in the second.

    And yet Duesberg still argues that HIV treatment causes AIDS, and tries to cite these data in support of that argument. I think it's time he was kicked out of the National Academy of Sciences and UC Berkley for bringing both institutions into disrepute.

    http://www.guardian.co.uk/commentisfree/2009/sep/12/bad-science-peer-review-goldacre?showallcomments=true#CommentKey:63866b4b-cab5-4464-9fc2-7724b2e26df8

    Perhaps you can now explain yourself?

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  • Duesberg: best to just use you name; we all know that standard bullshit that you have to dish out.

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  • NM having run out of clay pigeons, he is apparently reduced to schoolboy taunts and tossing up part of a clay pigeon that was blown out of the air before. Here for the benefit of readers and our apparently scientifically illiterate company are the quotes concerned. Perhaps they can find the discrepancy that NM refers to.....In DUESBERG, from HIV-AIDS hypothesis out of touch with South African AIDS – A new perspective - Peter H. Duesberg, Joshua M. Nicholson, David Rasnick, Christian Fiala, Henry H. Bauer a paper accepted by Medical Hypotheses on June 11 2009, p5: “Aware of some of these life threatening toxicities of anti-HIV drugs, the Harvard study maintains that the ‘‘bene?ts” of these drugs ‘‘outweigh” their inevitable toxicity [1]. But, contrary to these claims hundreds of American and British researchers jointly published a collaborative analysis in The Lancet in 2006 concluding that treatment of AIDS patients with anti-viral drugs has ‘‘not translated into a decrease in mortality” (30).....(30) refers to (30) May MT, Sterne JA, Costagliola D, Sabin CA, Phillips AN, Justice AC, et al. HIV treatment response and prognosis in Europe and North America in the ?rst decade of highly active antiretroviral therapy: a collaborative analysis. Lancet 2006;368:451–8” a metastudy of 22, 217 HIV+ patients in 12 cohort studies either side of the Atlantic by hundreds of researchers. The summary of that study reads as follows, and justifies Duesberg's reference perfectly..... ///////SUMMARY ….BACKGROUND Highly active antiretroviral therapy (HAART) for the treatment of HIV infection was introduced a decade ago. We aimed to examine trends in the characteristics of patients starting HAART in Europe and North America, and their treatment response and short-term prognosis. …..METHODS We analysed data from 22 217 treatment-naive HIV-1-infected adults who had started HAART and were followed up in one of 12 cohort studies. The probability of reaching 500 or less HIV-1 RNA copies per mL by 6 months, and the change in CD4 cell counts, were analysed for patients starting HAART in 1995–96, 1997, 1998, 1999, 2000, 2001, and 2002–03. The primary endpoints were the hazard ratios for AIDS and for death from all causes in the ?rst year of HAART, which were estimated using Cox regression.....RESULTS The proportion of heterosexually infected patients increased from 20% in 1995–96 to 47% in 2002–03, and the proportion of women from 16% to 32%. The median CD4 cell count when starting HAART increased from 170 cells per µL in 1995–96 to 269 cells per µL in 1998 but then decreased to around 200 cells per µL. In 1995–96, 58% achieved HIV-1 RNA of 500 copies per mL or less by 6 months compared with 83% in 2002–03. Compared with 1998, adjusted hazard ratios for AIDS were 1·07 (95% CI 0·84–1·36) in 1995–96 and 1·35 (1·06–1·71) in 2002–03. Corresponding ?gures for death were 0·87 (0·56–1·36) and 0·96 (0·61–1·51)......INTERPRETATION Virological response after starting HAART improved over calendar years, but such improvement has not translated into a decrease in mortality.”..... Readers may compare the quote from Peter Duesberg with this Interpretation and decide for themselves if they can see anything misleading in his paragraph......As we have also pointed out above what Duesberg did not trouble to note also was the following from the Discussion later on: DISCUSSION: The results of this collaborative study, which involved 12 prospective cohorts and over 20 000 patients with HIV-1 from Europe and North America, show that the virological response after starting HAART has improved steadily since 1996. However, there was no corresponding decrease in the rates of AIDS, or death, up to 1 year of follow-up. Conversely, there was some evidence for an increase in the rate of AIDS in the most recent period..... “The discrepancy between the clear improvement we recorded for virological response and the apparently worsening rates of clinical progression might be related to.....” etc.. In other words, AIDS drugs result in patient deterioration over time even though HIV is repressed

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