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

It is not what we do not know that will cause us most harm; rather, it is WHAT WE KNOW TO BE TRUE but ISN'T, that will be our undoing. The earth is the center of the universe. Scurvy is a disease caused by a germ. HIV is the sole cause of AIDS. Well, it doesn't really fit. Nevertheless, there are some really smart people saying one thing, and a whole slew of professionals saying something else. If history is any indication then we should remain faithful to OBJECTIVE SCIENCE rather than BLATANT IGNORANCE, no matter how ridiculous it sounds.

I quite like the idea of a non-peer reviewed organ. If one good, controversial, piece of research gets through without being smothered at birth, then it will have been a success. As good as peer review is, its disadvantage is it can be a force for intellectual conformity. This is compounded by the situation we find ourselves in whereby our career-vectors are determined by the weight of papers published in 'good' journals.

There is no question here, pear review is necessary. Peer review is certainly not a perfect filter and that it lets mistakes through and sometimes blocks innovative new ideas. However, the new groundbreaking ideas are simply slowed down; they will eventually get through as the evidence builds. The problem is that without some sort of filter, there will be a flood of incorrrect ideas that get published. Perhaps 10% of the papers we now read are wrong in some respect, but that number could grow to 90% without any peer review at all. A 10% level is something that can be corrected by subsequent papers, but this will be impossible if the level gets too high.

Impact factor deals with this.

Most certainly not; impact factor just measures the populatity of articles according to citations. There many groups out there with strong ideas (e.g. alternative medicines , intelligent design) and with very large followings that would just love to publish in scientific journals. If they were able to start publishing their non-scientific ideas in journals, you can be certain that they would also get a lot of citations from each other.

Medical Hypotheses is based on an interesting model, which could be summed up as "anything goes." This model is also the basis for a form of scientific communication known as the science blog: immediate electronic publication, no peer review, no authorship requirements, minimal or no editing, and content decisions made by a single person. The two main differences are 1) Medical Hypotheses is currently published by a respected publishing house, Elsevier, and 2) unlike science blogs, Medical Hypotheses charges its contributors/commenters for publication, despite no good reason for these charges--there is no peer review process, which takes time and effort to coordinate, and from what I have read, no evidence even of competent copy editing.

Elsevier is under absolutely no obligation to publish a science blog, and especially not a science blog run by an admitted "agnostic" on HIV/AIDS.

Saying a paper in the Lancet shows that HIV treatment doesn't improve survival when it shows no such thing - as Duesberg's Medical Hypothesis paper does - is not expressing an "opinion." It's outrageous misrepresentation, I would characterize it as lying. I don't think "radical" is the right word for that. Duplicitous is more accurate.

Is Zoë Corbyn or any of the other journalists covering this story in a position to ask Charlton and the members of the Editorial Advisory Board to go on record regarding whether they think academic freedom extends to stating published papers say things they don't say? I think that is key to this whole debacle.

Regarding the two NM comments: You are claiming "outrageous interpretation" and pass judgment accordingly. But you don't provide the evidence for the misinterpretation – neither the Lancet paper nor our misquote of it.

This is the consequence of censorship and propaganda. A real scientific debate presents the evidence first and allows the reader to draw its conclusions.

Peter Duesberg

Elsevier: Good going; you need to get out of the business of printing tabloids. To Peter: You once stated that you were ready to be injected with HIV so that the whole world could see proof of your "theory". I recall you being rather shy when it came to the doing. May I suggest that it is high time you laid off the dope.

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?

Presumably there is no "censorship and propaganda" preventing Peter Duesberg from coming back and offering an explanation of what he wrote about that Lancet study in his Medical Hypotheses paper.

You have repeatedly, and publicly stated that you are willing to inject yourself with the HIV virus, in order to prove that it is harmless. It's time to stop the scribbling and assorted noise, and do the deed!

From http://en.wikipedia.org/wiki/Peter_Duesberg: "Two independent studies have concluded that the public health policies of Thabo Mbeki's government, shaped in part by Duesberg's writings and advice, were responsible for over 330,000 excess AIDS deaths and many preventable infections, including those of infants.[7][8]"

This is no laughing matter, Duesberg. Inject yourself now, as you have repeatedly offered to!

That statement explains your bone-headed approach: http://www.newsweek.com/id/217015/page/3

Before you can indict HIV for causing deaths, you have to prove that you can detect HIV, and that has not been proven for any of the tests:
Press Release: “A positive routine ‘HIV test’ is likely to be a false positive, scientist explains”, 2010/03/09
http://wp.me/p8Qhq-lP

Hello "MN",
I see, you made an effort to explain why the Abstract of the Lancet paper is incompatible with its contents. I wonder why Lancet-Elsevier "peer review" didn't catch that defect.

But how can we have a scientific debate, if you, under the cover of anonymity, combine your answers with threatening ad hominem attacks that I should be "kicked out" of the Academy of Sciences and of UC Berkeley, because I don't share your opinions?

Peter Duesberg

People are dying, so I really don't have time to engage you in nonsensical debates about whether we can detect HIV, whether it causes AIDS, etc. To Peter: surely you have been around the block long enough to know that peer review doesn't catch everything. NM has provided a reasonable account to justify his claims about your dishonesty. You should be able to make an objective response to those, regardless of how miffed you are at the suggestion that some of your associates ought to get rid of you. Well, are you going to do that, or will you keep ducking? Lastly, am still waiting for you to step up and be injected with a load of the "harmless" HIV. Just for the record, I agree with your colleague who has labelled you "an enabler of mass genocide". You have gone beyond the merely tragic hero-to-zero case. Time to give it a rest.

No, you are wrong Dr. Duesberg - the abstract is perfectly compatible with the paper if you take the time to read it and understand it. If all you are interested in is quote-mining it in order to try and convince people that HIV treatments don't work - which as far as I can discern is your intent - then it's a different matter.

To see the original comment from whence that explanation derived, follow The Guardian link. If you are not convinced of the explanation's veracity due to the opinions expressed in the concluding comments, email it to the lead author of the study and ask them. Better yet, read the paper and try and follow along. The supplemental web tables may help you, perhaps you should consider adding those to your website also?

Dr. Duesberg, what exactly is it that you feel deserves a scientific debate?
What questions do you now pose that have not been answered?
Jon Cohen at Science, the CDC, the NIH have all given you a fair hearing - despite your lack of any shred of evidence to support your claims. Extending old unsupported arguments from the 1980s to new epidemics does not make for a new argument.

The sad truth is you just like to argue. Anyone who has spent more than 5 minutes with you knows this. It is sport for you.

And that is why you infuriate AIDS scientists - who in fact are trying to save lives.

Just as Elsevier has worked to correct its mistake with Med Hypotheses, my hope is that the National Academy of Sciences, UC Berkeley, and VA Tech will realize that you and Henry (The Loch Ness Monster Hunter) Bauer are using their esteemed institutions to support a self indulgence that causes harm to public health. Post Tenure reviews and revoking life time appointments are necessary when credentialed scientists go off the deep end and cause harm to others.

http://en.wikipedia.org/wiki/Henry_H._Bauer

I will say no more, Dr. Nutjob.

Henry just proves the point of how academics can subscribe to deadly quackery. Posting links to yourself proves nothing other than a desperate need to look respectable when you look nothing more than desperate. Well done Henry. That is an own goal if ever there was one!

The argument that academia needs to employ some form of self regulation just became a lot stronger.

Med Hyp: Good riddance to a rubbish journal that only ever printed garbage from people who could never get was passes for their thinking (sic) anywhere half decent. Bruce Charlton deserves to lose his job.

Henry Bauer is a fool who can be safely ignored as nobody takes him seriously.

Peter Duesberg moans that he's been subject to an "ad hominem attack", as though criticism of him on a website was something that really awful and utterly horrible and unfair. Well, what's really unfair is that Duesberg has not been prosecuted for crimes against humanity over the 350000 South Africans who died as a result of the nonsense and junk science he fed into Mbeki's ear. Throwing Duesberg out of the National Academy and firing him from UC Berkeley are certainly necessary but they are absolutely not sufficient as punishment for the damage caused by his incompetent and, frankly, evil perversion of the scientific process. Duesberg betrayed science, just as Andrew Wakefield did. And yet he has never paid a significant price for what he did. That's a massive, massive shame that one day, perhaps will be rectified.

I love how Henry Bauer presents his own paper as proof of HIV tests being mostly false positive. Mr. Bauer, you are being dubious at best. If you are so certain of the validity of your paper, why not try and get it published somewhere other than JPandS? You know, like a real peer reviewed journal. Que Bauer's response: Peer Review is a Conspiracy.
JTD

This comment string so far, which features misleading analysis and personal insults from NM and Dr Truth in contradiction of Peter Duesberg, demonstrates the problem which publications such as Medical Hypotheses can help to ameliorate. These individuals are presumably the same champions of the flawed HIV=AIDS hypothesis, such as Richard Jefferys, typically financed by drug companies, who tried and failed to maintain this same incorrect interpretation of May et al Lancet 2006 at scienceguardian.com a while back.....Their analysis is based on statistical naivete and fails to take into account that the study was not a clinical trial but drew on different data bases whose inconsistencies must be adjusted to render them compatible. NM fails to understand this and does not make the requisite adjustments before converting raw numbers to percentages, as did the authors in reaching their conclusions. If he corrects his error he will find that Duesberg's account is perfectly correct, in fact is a direct quote from the authors. The viral load and other markers of virus control improved but the mortality did not. A very significant result suggesting the two are divorced.... Meanwhile their efforts on this thread remind us that defenders of the status quo in any field are capable of poor reasoning which can go unchecked if they are able to reserve all the platforms for themselves ie peer reviewed publications whose editors draw only on them for review and advice..... This is the serious problem inherent in the pusillanimous surrender of publishing executives at Elsevier to the self serving political attack of champions of HIV=AIDS on Medical Hypotheses, which apparently has now been successful in bringing it under their control.... All defenders of good science should be concerned with what is at stake here - the free speech, active outside review and publication of alternative hypothesis which guarantee good science. Otherwise we have the irresponsible naivete displayed here and on the other two earlier threads on this topic, which will mislead policymakers and the public, not to mention science publishers who do not seem to understand the intellectual issues in their business.

"Duesberg's account is perfectly correct,"

No, it is not. It's a quote-mine.

Can you explain the adjustments you're referring to? And how the dramatic fall in AIDS diagnoses during the second year people are on antiretrovirals can possibly be twisted to fit Duesberg's false claim that the drugs cause AIDS?

"The viral load and other markers of virus control improved but the mortality did not. "

The proportion of people achieving a viral load below 500 copies six months after starting treatment improved from 58% in 95/96 to 83% in 2002/3. The mortality rate after one year on treatment did not change significantly, it was 2.2% in 95/96 and 1.3% in 2002/3. The adjusted hazard ratio for mortality after one year on treatment didn't change significantly either (0.96 for 2002/3). Read the paper.

Mr. Kalichman, That is the last straw. I think it's about time for you to stay home, get a cat, and watch television for a while. It's evident that in the midst of your pontifications and drivel you don't possess the intestinal fortitude required to accept the simple facts of life that compel the rest of us to accept as a glorious free gift. Who is better than the good Professor Duesberg to give those poor test subjects a fighting chance against the whoremongering pharmaceutical companies? These companies are like prostitutes. We can't live with them and hope to God we won't ever have to live without them. As that dear, sweet lady Marcia Angell pointed out, we need them, they know it, they go to extraordinary lengths to
deceive us, but we depend upon them to provide us with effective cures and therapies. Do you think your mother is going to cook
something up in her kitchen and bring it to you on a tray? I don't think so. Who is going to serve as a test subject to be monitored for side effects? Can we count on you, Kalichman, or do you first need to travel down the yellow brick road and visit that crotchety old wizard to ask him for a token, or some other little trinket to inspire you? We won't hold our breath. Where will you be when we say, "Behold, the mouse lived, the rabbit lived, the dog lived, the monkey
lived, and now, Kalichman, it's your turn"? Are you going to come forward, drop your trousers, bend over, and take your injection like a real man? We won't hold our breath. We must have guinea pigs. And who is better to serve than a bunch of politically disenfranchised, self-pitying, martydom seeking minorities who've been brainwashed by the establishment to think that they are going to die anyway and therefore have nothing left to lose. Do you have a better suggestion? If not, then stay home, pet your pussy, watch television, and pay honor, respect, and gratitude to those who gave all because we didn't have the courage to do what they did.

To revisit the Duesberg et al quote from the withdrawn Medical Hypotheses paper which truthseeker claims is correct: "the Harvard study maintains that the ‘‘benefits” of these drugs ‘‘outweigh” their inevitable toxicity. 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.”" To start with a couple of basic misrepresentations, the Harvard study doesn't say toxicity is "inevitable" and the cohorts described in the Lancet paper do not only include people with AIDS. The more serious misrepresentation is that the Lancet paper neither shows nor claims that "treatment of AIDS patients with anti-viral drugs has ‘‘not translated into a decrease in mortality.”"

Also, and please pick up some milk on your way home from work. We ran out yesterday.

Let's be plain, for any onlookers, NM/Jefferys, so they can see where the foolishness lies as you drag yet another of your dead red herrings across the basic theme which is otherwise plain for all to see, unmuddied by this silliness. Which is that HIV does not = AIDS, and nothing shows it plainer than these studies which indicate that you may repress HIV as much as you please, but it will have no visible effect on patient mortality, evidently because of the drugs which maintain it, which Duesberg suspected from the beginning of this valid debate. In other words, the mortality rate doesn't change .because you and others are still busy peddling noxious drugs which kill off the most sensitive 1% or 2% of patients quite rapidly.... Let's read THE STUDY May et al Lancet 2006 again. It tells us what happened to patients in the first year of drug treatment, to each patient, according to whatever year they were started on said drugs. RESULT: There was great improvement in viral control and effectively nil in mortailty...... Dear me. You give drugs to someone, their virus get knocked down, and they still die at the same rate. What could be the interpretation of that one? What a very embarrassing result for the congregation of the church of HIV scientology. Give them drugs, get less virus, same death rate. Ouch! ......Yes, as the abstract stated, and Duesberg repeated, "INTERPRETATION: Virological response after starting HAART improved over calendar years, but such improvement has not translated into a decrease in mortality." After their first year of treatment, fewer died in later years of their treatment. You imagine this is because the drugs were working well after their initial disappointing non-effecf. How about, fewer died because the sensitive ones were already dead or dropped out, or their doses were lowered? Lohse amd other studies confirm this jump in mortality in the patient's first year of treatment, then that mortality drops only to the same level as before treatment. So here are the answers to your puzzlements: So your Point 1. Explain? Sure. Go to the paper at http://www.ncbi.nlm.nih.gov/pubmed/16890831 and read it line by line until you get to the words "hazard ratios". As the abstract states, "The primary endpoints were the hazard ratios for AIDS and for death from all causes in the first year of HAART, which were estimated using Cox regression." As you will recall Cox regression is a technique of multiple regression analysis used to to adjust for disparities in data between different groups..... Your point 2. Drugs tend to knock off the weakest at the same rate whichever year you start them. Your point 3. Repeat, your drugs achieve the same effect in year No 1 of treatment in 95/96 as in 2002/3, though higher AZT did in the sensitive ones a little more effectively than ARV.s.... For further understanding kindly revisit the discussion four years ago in which you (for surely it is you, Mr J) retired discomfited on scienceguardian.com...... And thank you for making our major THS point even clearer. Publications where all involved are not always wearing mauve, HIV=AIDS current paradigm spectacles are sorely needed if good science is to progress in this or any other field. The publishing executives at Elsevier need to stop cooperating with the self serving censors of any other analysis that proves their belief incorrect. They should leave Medical Hypotheses alone to do its job of reining in such censors, who cannot themselves think straight for fear of toppling their own platform.

I can see why you'd want to try and personalize this discussion, but you're not doing any better on that front than with the Lancet paper. The quote from the Duesberg et al withdrawn paper is: "treatment of AIDS patients with anti-viral drugs has ‘‘not translated into a decrease in mortality.”" To try and address the point that you seem to be trying o make, what exactly is your basis for believing that an increase in the proportion of people with viral loads below 500 copies six months after starting treatment from 58% in 95/96 to 83% in 2002/3 (the improved virological response being referred to in the quote you are mining) would impact the mortality rate at one year, which is 2.2% and 1.3%, respectively?

Whether you look at the numbers, percentages or the adjusted hazard ratio in that Lancet paper there's been a reduction in mortality in the most recent period, it's just not statistically significant because the numbers are so small (yet these are thousands of people taking the drugs Peter Duesberg says cause AIDS and death). The difference in the most recent period is even greater in the second year, and by the third year of follow up it's large enough to reach statistical significance (see the citation in the earlier comment). The prognostic significance of the viral load response to treatment is significant in these same cohorts, that's been reported separately: http://www.ncbi.nlm.nih.gov/pubmed/19779320. There's also an 84% drop in AIDS diagnoses in the second year of treatment in the most recent period, from 172 out of 2,421 people in the first year to just *27* out of a total of 2,249 people in the second year (the totals in that prior comment were wrong).

The only personalization of this discussion that is needed is in response to your lack of personal respect for a scientist whose social and scientific stature is higher than your own by several measures, including credentials and expertise, which has never been questioned except by the footsoldiers of the army defending the error that HIV=AIDS, which has been indefensible since it was kited by Robert Gallo in 1984, indefensible because it is in accord with neither laboratory nor epidemiological evidence, nor with any of the science of retroviruses that we have learned over several decades, despite enormous funding engendered by this claim, devoted to research based on this false premise, but none of it, absolutely none of it at all, let us note, dedicated to any experimental reexamination of its truth or falsity. For some reason it has proved impossible to gain any support for such research, even when supported by the editor of Science. Now why would that be, pray? Why when the belief is eviscerated at vast detailed length by the scientist who enjoyed the highest reputation in the field - let's note that Peter Duesberg's scientific papers have never been criticized by any scientist EXCEPT his reviews of HIV=AIDS, certainly not discovered to be based on false research, as have some of those by scientists who oppose him in this regard. And pray tell the audience why it is necessary for minor figures such as yourself to dedicate considerable amounts of time even on weekends to defending this sorry paradigm with claims of not understanding what is flawed in the defense of this paradigm? Do paradigms which are soundly based and demonstrated in leading journals ever show themselves in need of such amateur defense, mixed with personal disrespect for your betters? We ask merely for information, since we have some difficulty in thinking of any other possible reason than the obvious one, which is that its flaws are so many and so huge and so obvious even to lay thinkers that the leaders of the field know better than to attempt to defend them in the same peer reviewed journals that featured the damning reviews (eg Cancer Research and Proceedings of the National Academy), even though they maintained they would do so to the editors of the Proceedings.. Instead the defenses are confined to unscientific declarations of faith published as ads in the New York Times signed by anyone who could be scraped up, as emails revealed, or on the Web in unsigned statements by NIAID, ie nothing peer reviewed after the initial skirmish in Science was cut short without completing the exchange. Sorry if this seems ad hominem but the general point needs to be made, and your own disrespect for a fine scientist put down strongly..

The highly significant point also needs to be made time and time again until its sheer irresponsibility toward the public interest is made plain, that there has been no objective evaluation of the net benefit of the drugs you are so enamored with, NM., so enamored that you cannot see that "no decrease in mortality" means what it says. By that I mean specifically no clinical trials with placebo control groups since the last ones of AZT two decades ago, which showed the drug was worthless and dangerous in its own right...... Now why would that be, pray, when lives are at stake? Would you wish to take a drug which has never been shown to benefit its recipients more than a placebo? Which is otherwise known to be on balance rather noxious, so noxious that doctors can't long bear to prescribe it at full dose, and the pages advertising it are mostly listing the disgusting and potentially lethal side effects in small print? Because the researchers are so sure that since it interferes with the actions of HIV therefore it will benefit the patient, even though this and other studies failed to find such a benefit? Because you say so, when you don't understand the elementary facts about the design of the study and its analysis? ..... Surely you and I and any rational patient and doctor would prefer that if this is the case, that this crucial assumption HIV=AIDS is unproven, and contradicted by this study, the interpretation of the evidence accumulated in AIDS should be open to different arguments and conclusions, not shut out of prominent journals by the unwarranted assumption of naive editors and publishers that anything other than the mainstream interpretation of the great pile of accumulated evidence must be wrong? ..... We need Medical Hypotheses for just such a reason - the naivete of publishers and editors and others who should know better than to believe that conventional wisdom is always correct, when by definition it is not always correct, however long and widely entrenched. Otherwise science would make no progress except in minor matters..... But it is quite understandable why you should take advantage of this naivete in defending the status quo . What is not understandable is that the publishing executives at Elsevier of Medical Hypotheses should be taken in. Their naivete is in fact the strongest evidence that there is a real need for publications of this kind, another example being Cornell's arXiv.org. ......And by the way, Medical Hypotheses is not totally without review, as an early poster MStark3 implied with his phrase "anything goes". If you check you will find that everything underwent editorial review, and any substandard papers were disregarded...... Also, kindly note the abysmal lack of information shown by the Lancet review panel in failing to notice that the second paper withdrawn forcibly and not by its author Ruggiero was NOT a "denialist" paper, since it did not contradict the HIV=AIDS paradigm. ....Finally, again, NM you first try to muddy the waters with your own claim that the May et al paper didn't show the drugs were ineffective, and then shift ground to saying, Well, how does Duesberg explain that the drugs didn't seem to make people worse? ...... The answer is clear, as confirmed by the other papers that followed by Lohse etc. The drugs continued to do the same level of damage,. including death, that they had been before under AZT - ameliorated by the factors mentioned above, substitution of less noxious drugs, lower doses and drug holidays. All of these recognized the side effects of these useless medications which so concerned the patients' physicians that they couldn't in good conscience continue he full dose. Unlike you, they could not disregard the evidence.

I wasn't shifting ground, I was discussing the same issue I raised in the first place: Duesberg et al quote-mine and misrepresent a published paper in their Medical Hypotheses article, and I was hoping to clarify whether Charlton and the editorial board members who support him are in favor of allowing authors to do that in their journal.

@Truthseeker There have been hundreds of good studies showing that therapies with one or two reverse transcriptase inhibitors were of great short term benefit to individuals but could not prevent or eventual death from AIDS for the majority of patients, whereas the addition of a protease inhibitor to combination antiretroviral therapy did produce very good long-term results. From that point on (the beginning of the highly active antiretroviral therapy era) it would be highly unethical and illegal to include a placebo arm in any study, and only studies comparing one type of HAART against another, or comparing patients who start treatment earlier or later in disease progression were done. See for example: The Lancet Vol 373 April 18, 2009 pages 1352-1363 which analyzed data from 21,247 patients who were followed up during the era before the introduction of combination therapy and 24,444 patients who were followed up from the start of HAART treatment.

Figure 2 in this paper summarizes 15 placebo-controlled studies of AZT. http://www.bmj.com/cgi/content/full/324/7340/757 There were 558 cases of disease progression or death out of a total of 3439 placebo recipients.

@NM Yes, and there were 464 deaths or progressions in 4,490 people treated with AZT monotherapy (10.33% on AZT vs 16.23% on placebo). So all of those studies showed that AZT monotherapy was slightly better than placebo.
But to be able to compare that to the number of deaths or deisease progression in people treated with highly active antiretroviral therapies, we need to know the numbers per person/year of treatment and also what the definition of "progression" is in each study. Figure 9, for example compares double and triple therapy (2 drugs or 3 drugs taken at a time, none including a protease inhibitor) and shows 295 deaths or progression events out of 2,242 (13.16% for 2 drugs) which sounds like it is worse for 2 drugs than AZT monotherapy because the various studies were not all reporting a standard measurement such as deaths per person/year of treatment, and they also did not all enroll people with exactly the same starting criteria.

The important point is that not only was Peter Duesberg perfectly correct in repeating the phrase from the abstract of May et al 2006 Lancet that ARVs achieved no decrease in mortality, but he was too kind, for in fact if you trouble to read the discussion you will see that a statistically significant worsening of condition of these more than 20,000 patients was observed..... "...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 one 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 progress might be related etc etc...".....The reasoning then wanders into various extrapolations of the eternal false premise that HIV is the cause of AIDS symptoms, rather than biting the bullet, grasping the nettle and risking excommunication by stating what any outside observer can see is the common sense and logical conclusion, which is that HIV has zero to do with AIDS symptoms except as a marker of various risk groups..... Now we have the same thing going on in this thread, the same absurd wriggling on the point of the same pin, as otherwise sane commentators struggle to hold to the same eternal false premise when they are faced with the blatantly conflicting evidence produced by this paper, which is signed by nearly two dense pages of researchers in the field, none of whom is able to rethink the premise either. This is known as confirmation bias, and is well known to group psychology...... Perhaps one should point out that the later paper dealing with the three year mark (E. Lanoy May et al JAIDS 2009) apparently referred to by NM actually demonstrates nothing comparable because it leaves out all the deaths in the first three years! (Some will view that remarkable manipulation as the HIV=AIDS version of three card monte)..... Also in the Lancet paper it appears the experience of patients up to the two years mark (Web table 3, additional to the main body of the paper) did not improve, contrary to the optimistic NM, who seems to count higher adjusted hazard ratios as an improvement, rather than a setback, and also appears to have subtracted AIDS events in table 4 from table 3, which is the wrong approach. ("Whether you look at the numbers, percentages or the adjusted hazard ratio in that Lancet paper there's been a reduction in mortality in the most recent period, it's just not statistically significant because the numbers are so small (yet these are thousands of people taking the drugs Peter Duesberg says cause AIDS and death). The difference in the most recent period is even greater in the second year, and by the third year of follow up it's large enough to reach statistical significance (see the citation in the earlier comment).".... But never mind, all this is not the point. It is a red herring of wrong trivial objection to Duesberg which detracts from the main point to be made. This is the great importance of having publications such as Medical Hypotheses and arXiv.og which can carry minority very expert opinion, independent of the group think of peer review and free of the repressive rule of the reigning paradigm which can then be questioned. Experts such as Duesberg, who are independent minded, like all great scientists, can reach a more sensible conclusion than their paradigm befuddled peers as to what a big jump in death rate and AIDS events in the first year of treatment with drugs which defeat HIV actually means. Any reader who cares to think for themselves can reach the same conclusion. If A is drugs, and B is HIV, and C is AIDS events, and A minus B equals C, as the Lancet study showed, then A=C.

@Truthseeker. There is no such paper as E. Lanoy May JAIDS 2009 but I did find some interesting papers with a PubMed search for "May[au] JAIDS 2009". I'll have to actually read the papers, before I can comment.

Even at the simplest level the Duesberg et al citation is a quote-mine, because the phrase they quote is not referring to "treatment of AIDS patients with anti-viral drugs" it's referring to the increased proportion of people with viral loads less than 500 copies in 2002/3 vs. 95/96. That is a fact which is not disputable, unfortunately for Duesberg, his co-authors, and truthseeker. And if they wanted to try and make something of the adjusted hazard ratios for AIDS diagnoses during the first year of treatment in 2002/3 vs. 1998, then they would have to say that they are talking about that comparison, not ""treatment of AIDS patients with anti-viral drugs" (and also not the mortality endpoint alone). The paper shows that the hazard ratio for AIDS has increased because of the increased proportion of people coinfected with TB (table 5) and the significance disappears after they adjust that: 1·15 (0·88–1·50). That's not an adjustment that truthseeker likes it seems. The adjusted hazard ratio for mortality in 2002/3 vs. 1998 is 0.96. The correct citation for the 3 year follow up is The Lancet, Volume 372, Issue 9635, Pages 293 - 299, 26 July 2008.

Perhaps truthseeker is right that the authors deserve criticism for writing a discussion of their results that is potentially confusing to people who deny that HIV causes AIDS. Given that they'd already documented the huge beneficial impact of treatment on mortality in their cohorts, I think it's understandable why this wouldn't be at the forefront of their minds. They could have mentioned that the differences they were talking about involved very low event rates during the first year of treatment (5% in 1998 vs. 6% in 2002/3) and they might also have mentioned that the fact that 17% of people still didn't achieve a viral load of less than 500 copies in 2002/3 might have been connected to the lack of an impact of the increased proportion of people with viral loads this low on outcomes at one year (why would an improvement in someone else's viral load response benefit the people most at risk, who still don't have that response?). They've documented in the same cohorts that the 6 month viral load is a predictor of the risk of progression after starting treatment, along with a lot of other factors that truthseeker would deny the importance of (like CD4 counts): http://journals.lww.com/aidsonline/Fulltext/2007/05310/Prognosis_of_HIV_1_infected_patients_up_to_5_years.12.aspx

A better URL: http://www.ncbi.nlm.nih.gov/pubmed/17502729

http://www.ncbi.nlm.nih.gov/pubmed/12853195
"...FINDINGS: The incidence of AIDS or death fell after September, 1998, by 8% per 6-month period (rate ratio 0.92, 95% CI 0.88-0.95, p<0.0001). When AIDS and death were analysed separately, the incidence of all deaths during the late-HAART era was significantly lower than that during the early-HAART era in patients whose latest CD4 count was 20 cells/microL or less (0.43, 0.35-0.53, p<0.0001), but at higher CD4 counts, did not differ between early-HAART and late-HAART. Incidence of AIDS was about 50% lower in late-HAART than in early-HAART, irrespective of latest CD4 count (p<0.0001)...."

http://www.ncbi.nlm.nih.gov/pubmed/16054937
"...
Low CD4 counts and increasing HIV-1 viral load were associated with increased probability of starting HAART. Overall hazard ratios were 0.14 (95% CI 0.07-0.29) for HAART compared with no treatment, and 0.49 (0.31-0.79) compared with dual therapy. Compared with no treatment, HAART became more beneficial with increasing time since initiation but was less beneficial for patients whose presumed mode of transmission was via intravenous drug use (hazard ratio 0.27, 0.12-0.61) than for other patients (0.08, 0.03-0.19).
..."

One more thing - the data in webtable 3 are cumulative i.e. there was a dramatic decline in event rates in the second year people were on treatment (9% total first year 12% total first+second year for 1995/6, 7% total first year 8% total first+second year for 2001, the most recent year with two year follow up when the paper was published).

@NM Yes, the studies all show that highly antiretroviral therapy made a DRAMATIC improvement in survival of HIV-infected people. But truthseker wants to believe Peter Duesberg is the expert, so I suspect we are wasting our time here.

Dr Duke, the PubMed number of the paper you state does not exist was given by NM above. Just copy it into PubMed. 19779320. The paper exists. It is AIDS. 2009 Oct 23;23(16):2199-208.Prognosis of patients treated with cART from 36 months after initiation, according to current and previous CD4 cell count and plasma HIV-1 RNA measurements. antiretroviral therapy cohort collaboration (ART-CC), Lanoy E, May M, Mocroft A, Phillip A, Justice A, Chêne G, Furrer H, Sterling T, Monforte AD, Force L, Gill J, Harris R, Hogg RS, Rockstroh J, Saag M, Khaykin P, de Wolf F, Sterne JA, Costagliola D. Sorry you are having difficulty......You and other readers should know that NM (aka Richard Jefferys, drug company financed activist) is merely playing his standard game here seen earlier at scienceguardian.com, where he typically tried to derail truthseeking by introducing irrelevant papers and misinterpreting them to boot until his game became so obvious that he was laughed out of court. Here he has tried the same thing including dragging in that paper and others, pretending they contradict Duesberg, and now again the Lancet paper issue 9635 pp 293-299, which as anyone who reads it can see does not serve his purposes, since the first second and third year results are not broken out there. His imagining that 0.96 in 2002/3 is better than 0.87 in 1998 when in fact it is worse (though not a statistically significant difference).does nothing to give his view credibility either......The simple picture that cannot be changed by these maneuvers is this. 20,000 HIV+ patients of whom about 15,000 were healthy (without AIDS symptoms) were given AIDS drugs and both deaths and AIDS events rose in their first year of treatment, and this response did not change over ten years, in fact, it somewhat worsened. This occurred even though the drugs successfully repressed HIV.

Denial on so many levels. "the first second and third year results are not broken out there." The three year follow up is specifically referenced if you read the paper. Where is your explanation of why Duesberg's quote mine isn't a quote mine, and your concession that webtable 3 does reflect cumulative data, thus showing that events declined in the second year of treatment, and this decline was greater in 2002/3 to 95/6? Won't be forthcoming I suspect. The adjusted hazard ratio in 1998 was 1, because that is the comparison year.

"both deaths and AIDS events rose in their first year of treatment" - the capacity of these people to lie through their teeth is shocking. the 2006 Lancet paper contains no data on the death and AIDS event rate in the cohorts prior to treatment, that data was published previously and just cited by Dr. Duke: "Overall hazard ratios were 0.14 (95% CI 0.07-0.29) for HAART compared with no treatment, and 0.49 (0.31-0.79) compared with dual therapy." Since truthseeker seems proud of his mastery of hazard ratios, perhaps he can explain what a hazard ratio of 0.14 means compared to no treatment, and whether that hazard ratio is consistent with his claim that "both deaths and AIDS events rose" after treatment initiation in these cohorts.

It is not relevant to the main issue here of rescuing the editor and Medical Hypotheses from venal science politics and from a publisher ignorant of their essential contribution to truth seeking in science to continue responding to the inane attempted quibbles of NM and Duke in the matter of the 2006 Lancet paper that Duesberg quoted accurately and their unceasing production of other papers to confuse the issue like some game of Whack-A-Mole from a Chevy Chase movie..... Therefore it is time to close this discussion of their false argumentation by stating clearly again that...... 1. Peter Duesberg quoted the 2006 Lancet paper accurately verbatim that first year of treatment with AIDS drugs in the HAART era from 95/96 showed no improvement in mortality thru 02/03...... 2. He did not even discuss AIDS events, which "worsened" over the time period as the paper states..... 3. The fact that fewer people die in later years of treatment reflects the amelioration of drug treatment (lower doses, holidays, introduction of less noxious drugs) and the sturdiness of survivors ( the very weakest die in the first six months of treatment or drop out) - NOT the irrational view that the drugs that kill off quite a few in the first six months of treatment suddenly turn beneficial...... 4. The drugs do no good despite repressing the virus successfully, which is the aim of medication...... 5. The Lohse study (Ann Intern Med 2007:146:87-95) confirmed (see Table 3 second half - no HAART AND no AZT treatment - 2000-2005) that in their years prior to treatment patients survived as well as they did under treatment in the 2nd 3rd and 4th years of treatment but that there was a more than doubling of deaths in the first year of their treatment ( Please read carefully and see that this is so (22 to 43 per thousand per year), Duke and NM, and do not send up any more clay pigeons in this regard)...... 6 The ability of patients to survive HAART after the first year of their treatment is aided by the antibiotic effects of specific HAART drugs (NRT's including AZT) which have been demonstrated in several studies. This is one reason why the toughest patients manage to go on living as well as they did before treatment. Sooner or later however they succumb from drug abuse, malnutrition, corticosteroids like cortisone and other various risks of life style, and other illnesses, half of them from AIDS drug induced non AIDS condition liver damage etc, according to the steady rate of AIDS deaths in the US (15,000 or more a year). Whatever they die from they are put under the AIDS umbrella......7. It is necessary to know the difference between crude percentages and adjusted hazard ratios before trying to reinterpret studies and believe they show these drugs are beneficial after all, when this international study of Lancet 2006 and others showed they are unable to prevent a worsening of patients conditions, and are sometimes even the last fatal straw in the first year of treatment...... 8. The incessant activity of activists paid by drug companies should be countered by pointing out they are nothing but red herring fishmongers trying to distract attention from the obvious. They are the true "denialists", denying that 22 years of accumulated evidence shows that HIV as cause of AIDS symptoms is a non starter in any informed and intelligent reader's book...... In sum, publications like Medical Hypotheses are the last bastion of good science in this respect, because they are NOT ruled by the gatekeepers of the conventional wisdom, and their fellow travelers such as NM. The public interest is at stake. Otherwise policymakers will continue to be misled by one sided and self serving scientists following internal science politics, not good science carefully reviewed.

"Peter Duesberg quoted the 2006 Lancet paper accurately verbatim that first year of treatment with AIDS drugs in the HAART era from 95/96 showed no improvement in mortality thru 02/03." No, for the umpteenth time, the quote was NOT referring to "treatment of AIDS patients with anti-viral drugs" as Duesberg et al wrote, or "that first year of treatment with AIDS drugs in the HAART era from 95/96" as you just wrote, it was referring to the increased proportion of people with viral loads less than 500 copies after six months of treatment (58% in 95/96 vs. 83% in 2002/3).

Perhaps Elvesier will leave Charlton in charge and just change the name of the journal to The Journal of Outrageous Misrepresentation (JOM). If that happens, I suggest you submit you commentary on the Lohse study, truthseeker.

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

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

The paper: "Virological response after starting HAART improved over calendar years, but such improvement"... Duesberg et al: "treatment of AIDS patients with anti-viral drugs..."

"In other words, AIDS drugs result in patient deterioration over time even though HIV is repressed" Another blatant lie, with the specific goal of misleading people about the effectiveness of treatment for a potentially life-threatening disease. How is "deterioration over time" compatible with an 84% drop in AIDS diagnoses in the second year of treatment, to just 27 events out of over 2000 people? And as has been pointed out repeatedly, the cohort data does not show that it's people with suppressed viral loads that are experiencing disease progression, but the opposite. The misrepresentation is shameless, and endless.

@NM You have to ignore all the data, which all contradicts Duesberg's "hypothesis" that AIDS is caused by drugs. The fact that this hypothesis has been disproven by dozens of studies is not relevant for denial. The whole point of AIDS denial is to deny that HIV has been isolated, deny that the virus exists, deny that the virus causes CD4+ T-cell depletion, deny that medical doctors and virologists have direct experience treating patients and watching them recover, etc...
But the story here is about the Medical Hypotheses journal, and not about Duesberg's disproven "hypothesis". The Medical Hypotheses journal had published dozens of other useless papers and invited scrutiny of its practices even before Duesberg's latest AIDS denial paper was accepted.

Truly, NM, your performance is beginning to be quite instructive, but not in the way you imagine. Now that readers can see for themselves that your red herring is fish dead for several days, and stinks accordingly, you are reduce to truly witless challenges such as "how is deterioration over time compatible with an 84% drop in AIDS diagnoses" etc etc. If you don't understand that you don't understand anything, it must be said..... (the more sensitive die in the first six months or year of treatment, dear Sir, as we have repeatedly told you, or begin to suffer drug induced AIDS events, and so their noxious drug regimen is reduced accordingly by their kind physicians who can see in front of their eyes the revolting side effects caused by these useless medications - main effects, in fact, given the irrelevance of HIV to causing any symptoms of any kind except your own contradictions of science and reality - THAT is why, sorry you cannot see it as so many other people can)..... By the way, you are aware, I hope, of the difference between what happens to AIDS patients in a group over time and what happens to each individual patient over time, when different patients are started at different times on HAART? And you are aware that in the 2009 paper all the dead patients were removed from the figures before the drugs were accorded their supposed victory? Your comments bring this understanding into question......And Dr Duke, please stop making statements in direct contradiction of the medical evidence in peer reviewed papers. Faith does not a hypothesis sustain, data does, or explodes it, as in this case...... Which is why we need Medical Hypotheses, and for you to stop imagining that Duesberg's paper is incorrect,. even though you are plainly shown that it is not..... What are quite useless and misleading are your own statements that the drugs have achieved improved health for HIV+ patients, contrary to the evidence in these and many other papers, which provide overwhelming evidence they do not, and your misleading implication that Duesberg has ever denied HIV exists, which he has not, and your fatuous belief that doctors who have treated patients have "watched them recover", without understanding that the papers you have not read well demonstrate that the fewer and weaker anti-HIV drugs HIV+ patients imbibe, the better they fare...... All this has been thrashed out in detail on scienceguardian.com from whence you and your ilk have been forced to retreat and give up this endless evasive defense of a very silly paradigm which flies in the face of all evidence it has produced in research which already assumes it is true..... All any reader has to do is to read the latest post on scienceguardian.com, Luc Montagnier punctures World AIDS Day balloon, and the comments which follow, where your and NM's silliness was repressed with reason and fact and evidence from the papers of the established researchers in HIV=AIDS - not with hot air faith based claims and calumny and lack of respect for your betters suich as Peter Duesberg which your paradigm defense squad normally trades in, as evidenced in the three threads on this topic here at THE, this one and the previous two in January and February, where you were also chased off..... So yes, the true issue you are diverting all of us from here is the great contribution made by Medical Hypotheses over the years to good science, free of the [pseudo religious beliefs of those who treat current paradigms as articles of faith inviolable and as enduringly true and unreformable as the Muslims believe their Koran....... Medical Hypotheses should live on in its original form. David Horrobin its founder was a very distinguished mind who wrote a very fine editorial introducing and justifying Medical Hypotheses when he founded it which should be read by all scientists and their publishers. See medicalhypotheses.blogspot.com/2009/12/david-horrobins-inaugural-editorial. David Horrobin was a very fine intellect and all who are interested in good science instead of the journeyman plodding of almost all HIV=AIDS research and its defenders should read that editorial, and compare the quality of its thinking with the comments of HIV=AIDS defenders in this thread.

"Editor says no to peer review for controversial journal" http://www.nature.com/news/2010/100318/full/news.2010.132.html And Charlton continues to behave as if his actions were somehow noble: "It has now been shown that no editor, no journal, is any longer free to publish dissenting views such as those of Duesberg. This is something new to science, indeed it is not science at all — as science was done in its golden age." - How does blatant quote-mining and misrepresentation of the published work of other scientists get transformed into "dissenting views" in Charlton's mind? Was quote-mining part of a golden age of science that the rest of us missed?

Here is an excerpt from that editorial which all should note is very much concerned with the biological sciences and their great defect, where poor thinking is rampant, as on this thread, because thinking of any kind is not much published, and thus wrong ideas flourish too long................................................

Ideas in biomedical science: reasons for the foundation of Medical Hypotheses................................................................................................

David F. Horrobin, (1939–2003) Founder and first editor of Medical Hypotheses.........................................................

Adapted from the inaugural editorial which appeared in the first issue of Medical Hypotheses (1975) 1(1), 1–2. Re-published in the first issue edited by Bruce G Charlton - Medical Hypotheses, Volume 62, Issue 1, January 2004, Pages 3-4 ..............................................................


It is at least arguable that too much biomedical research is published rather than too little. Why then start a new journal?..........................................................................

Scientific progress depends on the existence of creative tension between ideas and observations. An observation is made which cries out for explanation. A hypothesis is proposed to account for this observation. The hypothesis is tested by making more observations which almost invariably require the abandonment of some part of the hypothesis. A new hypothesis is proposed. And so on…................................................................................

The physical and chemical sciences long ago recognized that observations are not superior to hypotheses in generating scientific progress nor are hypotheses superior to observations. Both are necessary. While the ideal research worker may be one who is equally able to generate hypotheses and to test them experimentally, these sciences also recognized that such paragons are very rare indeed. Most scientists are much better at either one or the other activity. In physico-chemical fields this is fully accepted and the contributions of both theoretical and experimental scientists are recognized...............................

In contrast, in the biomedical sciences there seems to me much ignorance of the way in which scientific advance actually occurs. Physical scientists often dismiss biology and medicine as backward and the biologists quite legitimately react by pointing out that they are usually dealing with much more complex phenomena. But I have a suspicion that there is some truth in what the physical scientists say and that biology and medicine are backward because they have relied almost exclusively on observation. They have failed to recognize adequately that observation is always more effective when disciplined and channelled by hypothesis...................................

Many journals will occasionally publish a theoretical paper from a scientist with an outstanding reputation but will not consider similar papers from relative unknowns. The rule that is almost universally applied biology and medicine is that ideas can be presented or criticized only by those with a record of experimental work in a field. Even then they must be kept strictly to the discussion sections of papers and their presentation must usually be rigorously curtailed because ignorant and pedantic referees and editors object to ‘unjustified speculation’ and complain that the discussion ‘goes beyond the observed facts’. It is hardly surprising that the best physicists and chemists find medicine and biology primitive and unsophisticated.......................................................

The situation seems to be to be a tragedy. It leads to a total misrepresentation of the way in which science actually takes place. In 10,000 years time, a historian who had access only to the journals would be unable to build up anything like an accurate picture of what biomedical scientists actually do. This would not matter unduly but what does matter is that many scientists and most students also fail to understand how scientific advance actually occurs. As a result of this antipathy to theory the rate of progress is slowed because there is neither free presentation of new ideas nor open criticism of old ones. Outdated concepts can persist for prolonged periods because the evidence against them is scattered through hundreds of papers and no one is allowed to gather it together in one article to mount a sustained attack........................................

The refusal to accept the equal importance of ideas and observations leads to inefficiency. Most scientists now active in the biomedical field are competent observers whose ability to generate ideas is either naturally absent or has been stultified by the prevailing philosophy. As a result they spend their time in making more and more detailed observations of the same sorts of phenomena. In contrast, a few have far more ideas than they could possibly investigate but their potential contribution is largely nullified because they are allowed to publish only in those areas where they have done experimental or clinical work. If only these differences of ability and emphasis could be accepted and recognized then the people with ideas (who may often be inept experimenters) could generate a steady flow of new concepts which might rejuvenate the work of those whose primary skill is in observation........for remainder see url page quoted in previous comment.....

"It has now been shown that no editor, no journal, is any longer free to publish dissenting views such as those of Duesberg. This is something new to science, indeed it is not science at all — as science was done in its golden age."....As it happens, Bruce Chalrton's quote is exactly right, though NM tries to convert it into some kind of graffiti. It deserves to be graven in stone, so that NM can contemplate it for the many hours it will take for him to understand it, apparently, since he says he does not understand it is a noble thought, which it is. Clearly he should read Horrobin's editorial above, in full, and contemplate that. For his attempt to represent this Duesberg reference as somehow a “quote mine” and misleading to readers is precisely what Horrobin was referring to when he said "Most scientists now active in the biomedical field are competent observers whose ability to generate ideas is either naturally absent or has been stultified by the prevailing philosophy.". .....What NM's "quote-mine" phrase and accompanying resistance to obvious truths betrays is the desperate lengths to which brains befuddled with an inviolable premise (in this case that drugs must be helping patients, not damaging them, since they defeat HIV and HIV causes AIDS symptoms) suffer from confirmation bias, whereby anything which conflicts with the idee fixe is rendered invisible to the mind.....The comments of NM and Drs Truth and Duke above show precisely why the existence of Medical Hypotheses is very much needed to allow contributions to science from people who do not suffer from this syndrome, which is incompatible with good science.....There is no doubt that science as practiced before the modern era was a "golden age" and Bruce Charlton is quite right to say so, when the newly vast influence of great amounts of money and prestige, and the whole system of peer reviewed funding for costly research, means only that second rate minds flourish, because their ideas are in accord with their group, and are never allowed to break free and make a theoretical advance, even experimentally.

"Virological response after starting HAART" (as defined by proportion of people with viral loads less than 500 copies after six months) is not the same thing as "treatment of AIDS patients with anti-viral drugs." That is an issue of basic reading comprehension, before you even get to the data.

@NM Don't confuse a lack of reading comprehension with deliberate lying. Duesberg and "truthseeker" are both intelligent enough to know that they are telling lies, aimed at confusing HIV-seropositive people into their world of denial, and an earlier than necessary death.

For one clear example, Peter Duesberg's science career involved studying highly pathogenic tumor-inducing viruses including Avian Sarcoma Viruses and Murine Leukemia Viruses. Yet, on a recent (Jan 19, 2010) radio show ( http://direct.media.katherinealbrecht.com/archives/1001/20100119_Tue_Albrecht2.mp3 ) he claims that all retroviruses are harmless and never cause cancer or other disease outside the lab. Isolation of a transformation-defective deletion mutant of Moloney murine sarcoma virus.
Evans LH, Duesberg PH. J Virol. 1982 Feb;41(2):735-43.PMID: 7077752 Peter Duesberg knows very well that Avian retroviruses continue to cause millions of dollars of losses in the poultry industry, and that lentiviruses likewise cause millions of dollars of losses for sheep, goat (Visna viruses and related), and horse (Equine infectious anemia virus) farmers around the world. Less attention is paid to deaths of wild mice from murine retroviruses, because they are not of economic importance to humans.

It is certainly true that anyone who confuses "Virological response after starting HAART" (as defined by proportion of people with viral loads less than 500 copies after six months)" with "treatment of AIDS patients with anti-viral drugs." should sit at your feet, NM, since you are apparently ahead of them at least in that. Perhaps Dr Duke could sit by repeating "Dr Duesberg's views are vetted by intense hostile peer review at the highest level - Cancer Research and Proceedings of the National Academy - and have not been challenged in the same journals for 21 years, whereas my views on comment threads are not peer reviewed and are challenged and dispensed with as soon as I utter them, which is upsetting, so I will repeat them even louder."

Duesberg and critics agree: hemophilia is the best test. Cohen J.
Science. 1994 Dec 9;266(5191):1645-6. PMID: 7992044 And how did that work out? Did Peter Duesberg defend Bayer in the Ricky Ray class action lawsuit? How many hemophiliacs died from contaminated blood products in the early to mid 1990s?

Perhaps that should be lengthened to, "I will repeat them even louder, and appeal to journalists who write biased and poorly thought out articles premised on the supposition that Duesberg or any other theoretical critic of the mainstream ideology in HIV/AIDS must be wrong by definition." Dr Duke, it behooves you to reread some of this material without the mauve spectacles of "there is no sense in any alternative interpretation to HIV=AIDS" perched on your nose, so that your mind will be free to accept and examine the research without prejudice and on its real merits, including the evidence that in fact hemophiliacs as it turned out did not suffer from HIV at all, but from other factors, and that none of the data offered even a shred of confirmation for the fear that they were or would be killed by HIV, much to the baffled surprise of those who credited this baseless danger.

@Truthseeker I'm just asking for evidence, data, and things like that, rather than lies. Anyone can say that all retroviruses are harmless or that a sleeping on a magnet cures cancer. Telling lies about medical issues like that is all legal. But providing data or evidence that a magnet can cure cure cancer, or that ALV subtype J does not kill whole flocks of chickens is another matter.

Actually, telling lies in some places is legal, and in others it is illegal. For example, in a court of law in the USA and many other countries it is illegal to tell lies. So, for example, it would Duesberg could have faced perjury charges if he lied to defend the Bayer corporation during the Ricky Ray lawsuit. The South African Presidential AIDS Advisory Panel was apparently set up without any rules about evidence, truth, or procedures to be followed.

But the difficulty, Dr Duke, is that there is an overwhelming amount of evidence wherever you look, after twenty six years of well financed research based on your fond premise, and it is clear that you are familiar with it, as is NM, but prefer to overlook its real meaning and cherry pick papers for points which you feel are exceptions to the rule that HIV never does show any sign of causing AIDS symptoms, but always the real cause of the symptoms complained of by AIDS patients is obviously some other cause of a conventional nature, and very often the drugs the patient has taken before he is revealed to be HIV positive, or those given him as medication subsequently. This is demonstrated by the fact that symptoms that are NOT on the CDC list of AIDS symptoms per se such as liver or kidney damage are reckoned the cause of death even in HIV+ people (half of current AIDS deaths in the US, in fact). But since persons such as yourself who obviously have the best interests of patients at heart are incapable of conceiving that anything but HIV is the cause of AIDS symptoms, you cannot imagine that any alternative interpretation can be true, and your thinking is not permitted to go beyond resolute and unremitting rationalization of the many inconsistencies and paradoxes unexplained after 26 years of the reign of the paradigm, to which so many billions of research dollars have been dedicated........ In the age of Copernicus the adherents of Ptolemy concocted an intricate scheme by which the orbits of the sun and stars around the earth could be predicted without changing their basic belief in the sun going around the Earth, (still shared by one fifth of Americans, by the way), just as you and your paradigm defending and promoting colleagues manage to rationalize the myriad problems with the HIV=AIDS paradigm by embroidering your explanations in ever stranger patterns. But the Ptolelmaic defenses broke down whenever any reviewer examined the alternative with an open mind for the reason that heliocentricity resolved the difficulties Ptolemy supporters had in wrestling their theory around the evidence, just as the hypothesis that HIV does not cause AIDS resolves all the difficulties and unexplained pproblems of the HIV=AIDS hypothesis, which include the basic and most central concepts, such as the fact that tests have to be for HIV antibodies because there is so little HIV in the body after the immune system rejects it, so little in fact that PCR has to be used to confirm its presence, by multiplying it vastly, and antibodies are not transmissible by definition and do not cause disease, also by definition, and so on and so on..... Any reader of the newspaper who still has a functioning brain must ask why he/she has to accept a disease effectively homosexual in the West and heterosexual in Africa and further East, and there has been no answer for that one for two decades and still isn't. The truth is that the paradigm is prima facie absurd and no intelligent person has any excuse for swallowing it, except the remarkable capacity of large groups to unify the thinking of their members and armor it against any outside critique, a phenomenon best exemplified by religions. It is for this reason that your pleas for evidence to help you change your mind is not worth taking up, even though you are obviously a well informed, intelligent and sincere individual with a great sense of social responsibility, and deserving of great respect.

@Truthseeker There is no such thing as the "HIV = AIDS paradigm", it's just something that a lot of AIDS denialists talk about. HIV is a virus, a group of viruses actually, including groups and subtypes of HIV-1 and HIV-2. AIDS is a syndrome characterized by a specific deficiency in the immune system, a decline is CD4+ T-cells while CD8+ and B-cell counts remain in near normal numbers. Infection with HIV-1 or HIV-2 results in decline in CD4+ T-cells over time for the majority of infected people.

@truthseeker. If antiretroviral drugs cause AIDS, how do you explain results like these:
"Death rates significantly decreased between 1994 and 2000, from 7.2 to 0.8 per 100 person-years, and remained relatively stable through 2006."
Declines in mortality rates and changes in causes of death in HIV-1-infected children during the HAART era. Brady MT, Oleske JM, Williams PL, Elgie C, Mofenson LM, Dankner WM, Van Dyke RB; Pediatric AIDS Clinical Trials Group219/219C Team. J Acquir Immune Defic Syndr. 2010 Jan 1;53(1):86-94.PMID: 20035164

@Dr Duke if as you write "infection with HIV-1 or HIV-2 results in decline in CD4+ T-cells over time for the majority of infected people" perhaps you would care to indicate how this process works, why it hasn't been explained by anybody else in 26 years, and why it doesn't occur straight away in otherwise healthy people, why it always correlates with other disease causing factors and not with HIV+itivity, except insofar as HIV+itivity results in noxious medication, why Africans who receive decent nourishment recover their health without medication, why mothers who breast feed pass on HIV to their children far LESS often than those that bottle feed with formula, why Kaposi's sarcoma the key indication of AIDS in the 80s is no longer said to be caused by HIV, why there is virtually no HIV to transmit in an HIV positive person, why there is no explanation for how HIV might cause CD4 cells to dwindle after 26 years, why there has never been a heterosexual AIDS epidemic in the US or Europe, why there is virtually no active HIV in the CD4 cells of any AIDS patient however ill, and no inactive HIV either, why HIV+ people who are drug free last as long as anybody else, why there have been no placebo controlled clinical trials of HAART drugs when there were such trials of AZT, and why those with AZT produced results showing AZT ensured a worse outcome, why all those who support HIV=AIDS strongly are funded for it, why all those who question HIV are not funded for anything at all by the NIH because their colleagues won't support their grants, especially not in research to check whether HIV does in fact cause AIDS and whether the drugs do in fact do any good, why HIV=AIDS has to be supported in Web threads by diversionary red herrings when the main points made against it are unanswerable, why HIV acts as a vaccine against itself as acknowledged by Dr Fauci in agreeing that it actually initially stimulates CD4 production, why we we need to fund the vain hunt for an AIDS vaccine when that is so, why all those who defend HIV=AIDS rush to shut down any platform they find such as Medical Hypotheses rather than answer their critics' points, why you ask such a question as in your last comment about HIV+ children faring better under HAART over the years from 1996 when that is the year long enough after AZT was reduced to make the change felt, and when it was partially replaced by the increasingly less noxious ARVs and the study was done by people who use HIV=AIDS as a premise, as do all researchers of HIV in AIDS, and why I should look at the study concerned when every single point you have produced so far has been a dead red herring, and most people have better things to do in life than exist on a diet of bad herring? But I will if you insist and first answer the questions above.

Truthseeker, I'm concerned that you may be expending so much of your energy and intellect (which you obviously possess in great abundance) fighting this academic skirmish, that you're losing focus on the larger war here. Big Pharma can easily, easily, easily recruit thousands of NMs and Dr. Dukes for every Truthseeker that pops up. Regardless of how much is or is not known about retroviruses, please consider: when AIDS first appeared on the scene, everyone
was scared as hell, nobody knew what we were dealing with and everyone was running around like rats on a sinking ship screaming, "What is this thing? Are we in danger? Where are the experts? Who is going to save us?" . Certainly, Truthseeker, you don't believe that after all this world leaders would go before
television cameras and declare, "Okay folks, nothing to worry about, everyone can go home now. It was just Bruno and his friends in New York and San Francisco having sex and snortin' poppers". The public outrage that would have followed would have been just as intense as the fright that preceded it. The successful maintenance and mobilization of an enormously vast biomedical/pharmcaceutical/research/clinical trials infrastructure and
manufacturing industry as well as traditional health-care infrastructure has many requirements that depend upon scientific facts , most of which are not known at the time a real epidemic emerges. Big Pharma is one hard-to-swallow son of a bitch, he's got a war-chest that's second-to-none , and he's got world leaders in a death grip. Does Fauci and Gallo trouble us? Yes, but that's
irrelevant. These guys have a crucial role to play in this drama. Any rational person can understand yours and Duesberg's position. If I were HIV+, would I follow Duesberg's advice? Hell yes. But that's not the point. The point is this: the current HIV=Disease paradigm is not keeping 7 billion people on the planet from trying to get it. For God's sake, most of them can't even read.

"The world today has 6.8 billion people. That's heading up to about
nine billion. Now if we do a really great job on new vaccines, health
care, reproductive health services, we could lower that [number of 9 billion] by perhaps 10 or 15 percent". - Bill Gates (March, 2010)


"For indeed the days are coming in which they will say, 'Blessed are the barren, wombs that never bore, and breasts which never nursed!' - Jesus of Nazareth (a long, long time ago)

@ WashDC well, sure, attempting to stop the juggernaut is like putting a rose in front of a steamroller, but the purpose here is top speak up for Peter Duesberg (who has saved a few lives among the dwindling number of rational people on the planet, which one should cheer, don't you think, especially since he sacrificed some research to do so, research which went unfunded because of his truthtelling, research which kight have been very productive in the cause of science and the public intrest, perhaps taking a giant step towards solving cancer). There is something revolting about a fine scientist of exceptionally clear intellect and integrity writing a paper defending himself against obtuse calumny and setting the scientific record straight after it has been corrupted yet again by miscreants, and having it accepted for publication and published by an editor who appreciated its merit and held back the baying hounds of self serving hostility only to have them run around the back door and scare scientifically ignorant publishers into taking it down, and that then justified by a panel which was clearly nothing but a kangaroo court that failed to examine the case long enough to understand that the other paper was not even a "denialist" paper. It is a rank breach of social trust and scientific etiquette, and intellectual justice.

"Do not give what is holy to the dogs; nor cast your pearls before
swine, lest they trample them under their feet, and turn and tear you
in pieces" -Jesus of Nazareth (a long, long time ago)

@Truthseeker: Your stunning intellect shines like a beacon in this wasteland of scientific ineptitude. You and Peter Duesberg are clearly modern day Galileo's who can see clearly that without the rampant drug abuse of the flaming homosexual lifestyle, or starvation in Africa, AIDS would not exist. It is clear that all those who claim to have studied the epidemiology of AIDS were simply paid off by big pharma as part of the global conspiracy to defraud the world. Thanks for letting shouting from the rooftop of this globally read forum. I am sure that now that you have exposed the scam, AIDS will end tomorrow.

I apologize FP if I have given you the impression that this is a facile conspiracy theory drawn from the more adolescent postings on the Web. I wouldn't waste your time with such insults to your intelligence. What it is is a description of how very large groups can be misled into adopting a scientific premise too quickily, never questioning it since, and the political pressures which have prevented it being questioned. There is a certain Catch 22 here which leads every idea once endorsed by the leaders and spread among followers to be ever more strongly rooted, an assumption which by its very acceptance and universality become inviolable, not through any conspiracy (though there is a tacit agreement among the leaders of a field to disapprove of any challenge and prevent it finding a platform very easily) but through simple social psychology. As soon as any paradigm becomes a premise of research then all the research as in the case of HIV/AIDS seems to prove it, but this is an illusion. In the case of HIV/AIDS the logic also allows much more rationalization of evidence which conflicts with it than would be normal, because the ideology has HIV bringing down the immune system, and all the symptoms other than the CD4 reduction are indirect results of that, and therefore can include almost any symptom of almost any illness a defective immune system allows. It is quite remarkable how lucky this claim has been in this respect. It is almost impossible to say any disease is not the result of AIDS. Luckily they haven't been able to work out how liver and kidney damage could result from HIV, so we know they are from the drugs themselves. Half of AIDS patients in the US die of these symptoms, which are not caused by HIV as far as the scheme has been worked out so far. Sooner or later however we will probably learn some fanastic way HIV is in fact the cause.

"He who walks in darkness does not know where he is going"-Jesus

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2/3 cup flour
2/3 cup finely chopped walnuts
2/3 cup pack light brown sugar
5 tablespoons unsalted butter, melted
1 teaspoon ground cinnamon
1/4 teaspoon salt

@WASHDC The survival of MH is a serious issue in science, as is the abuse of Peter Duesberg, a fine scientist, whose work was ignorantly censored, and I hope that your last post is not meant to suggest otherwise.

Truthseeker, I absolutely understand the seriousness of the issues
you mention. HIV/AIDS has been classified by world governments
as a serious threat to global security. Censorship by world governments is likewise a cause for serious concern. However, any rational and intelligent person also knows that private citizens simply cannot be given access to all records of what transpires in the secret corridors of world powers. At some point the individual must make an informed decision about the trustworthiness of the chosen leaders by drawing upon his intellect, faith, and a multitiude of life experiences. Is there a better way? In my humble opinion, our Creator intended for us to have freedom and joy. He also gave us a brain and expects us to use it. How else can we summon
the courage and reason to answer questions that have profound implications for our lives and our planet, such as : Is it morally acceptable to perpetrate a falsehood at the point of a gun when to do otherwise would place global security in jeopardy? Is the risk of an emerging pandemic killing hundreds of millions so high that it justifies the creation of a Virus=DeadlyDisease paradigm to deal with it? Are all countries properly equipped? Is the Virus=DeadlyDisease paradigm merely a dress rehearsal for an even more serious pandemic: human overpopulation? Are we equipped to deal with it? How? Do we install a similar paradigm to cope, such as GlobalWarming=PlanetDestruction to deal with it? Do we perpetrate another falsehood when to do otherwise would place global security at an even higher risk? How does a world leader, after winning the hearts and souls of his people, stand before the cheering crowds and declare, "You people must be sterilized", and how will he make it back to his hotel room safely? Truthseeker, these are just a miniscule fraction of the questions before us. There are no simple answers. But in spite of this horrible, horrible backdrop, I genuinely believe that humankind will,
ultimately, draw upon its intellect, courage, experience, faith and most of all its love for each other and for God's world to find the right answers and meet these challenges. And I hope, Truthseeker, that you will not be offended by those of us who decide to keep our sense of humour and joy in the process. As for the brilliant scientist Peter Duesberg, he is and will always be a hero in the hearts and minds of people who realize how important it is to keep looking, keep questioning, and keep seeking the truth.