Tuesday, September 28, 2010

How AIDS Denialism Can Kill You Part II: Accountability and Liability for Spreading Medical Disinformation

"with Nessies and psychic phenomena and UFOs and the like, there are many evident gaps in empirical knowledge, so there exists the possibility (somewhere in the “unknown unknown” *) that future observations could provide satisfactory understanding of the empirical data. As concerns extrasensory perception, there’s even a plausible analogy in the phenomenon of quantum entanglement at the sub-microscopic level. With HIV/AIDS, there’s no such hope, because data in hand have already disproved decisively the notion that HIV causes AIDS" Dr. Henry Bauer


AIDS Deniers tell you not to bother getting tested for HIV and if you have tested positive to avoid taking HIV treatments. Christine Maggiore, Brian Carter, Michael Geiger and others share their life experiences hoping to persuade you to join their fragile bubble. These private citizens are free to say what they want regardless of whether it places you in the same peril that they have chosen for themselves.

But the accountability is different for professional denialists. AIDS Denialists who can call themselves ‘Doctor’ can be easily mistaken for medical doctors. Dr. Peter Duesberg, for example, does not have a medical degree, has never conducted research with humans and has never seen a single patient. When Dr. Duesberg says that HIV is harmless people are apt to listen with deadly consequence.



Dr. Henry Bauer is a ‘Science’ Professor at Virginal Tech University who claims that HIV does not cause AIDS. Dr. Bauer bases his false and irresponsible conclusion on his misguided use of epidemiology, ignorance of basic epidemiological concepts, and insatiable need for attention in the hope of making up for a life of obscurity. Dr. Bauer is now stooping to offer faulty medical advice, such as this posted at his blog,

UPDATE: Men living with HIV/AIDS in South Florida are dying less thanks to anti-HIV medications. AIDS denialism is the toxic poison.

Official: Antiretrovirals maybe not the best treatment

“Updated HIV guidelines emphasise primary care need of patients”

“While improvements in antiretroviral therapy have improved the prognosis for many HIV patients, data from recent studies suggest those living with HIV are at higher risk for developing common health problems, such as heart disease, diabetes or cancer”

— but those are not “common” for adults in prime middle age, which is the age at which HAART-treated individuals are dying from heart failure, kidney failure, liver failure, and certain cancers [“AIDS” deaths: owing to antiretroviral drugs or to lack of antiretroviral treatment?, 2 October 2008; NIH Treatment Guidelines, 3 November 2008].
“Baseline urinalysis and calculated creatinine clearance should be considered, especially in black patients, because of an increased risk of HIV-associated nephropathy”

— “HIV-associated nephropathy” is actually iatrogenic, drug-induced nephropathy occurring in “HIV-positive” people who are on HAART; which is admitted, but only indirectly:
“Urinalysis and calculated creatinine clearance should also be performed prior to initiating treatment with drugs such as tenofovir or indinavir, which have the potential for nephrotoxicity”




— “potential” for nephrotoxicity sounds much less alarming than a straightforward description as nephrotoxic.
“Emphasis should be placed on the importance of adherence to care rather than focusing solely on adherence to medications”



— because HAART itself can cause a variety of ailments.

Dr. Bauer misuses the point




Henry Bauer is wrong when he says that HIV treatments cause heart problems, kidney disease, and cancer. What doctors say is that people with existing heart and kidney disease need special monitoring when they start HIV treatments. Certain medications in various doses may carry added risks for these patients, requiring adjustments. Henry Bauer ignores the context and cherry picks sentences to misconstrue their meaning when he concludes that “because HAART itself can cause a variety of ailments.”

HIV treatments do not cause kidney disease. HIV-associated nephropathy results from direct HIV inflammation of kidney cells. Other kidney conditions that affect people with HIV/AIDS include IgA nephropathy which occurs when antibodies are trapped in the areas of the kidney where filtering occurs. Kidney functioning can also be affected by T-cell abnormalities and abnormal blood proteins associated with HIV infection.




People with HIV-associated nephropathy rapidly progress to end-stage kidney disease when their HIV infection is left untreated. People with kidney disease who are on HIV treatments and stop taking their HIV treatments, as Dr. Bauer suggests, will likely experience permanent kidney failure within months. Dr. Bauer’s incompetent interpretation of HIV treatment guidelines ignores the fact that HIV-associated nephropathy has nothing to do with HIV treatment toxicity, and HIV treatments have been a major factor in reducing incidence of HIV-associated nephropathy.

Are people with HIV infection at increased risk for cancer?
Yes.
Our immune system protects us from tumor growth and HIV disables the immune system. People on HIV treatments are living longer with suppressed immune systems, allowing more time to develop cancer. There are also HIV co-occurring conditions that cause cancer, such as hepatitis B and C viruses that cause liver cancer and humanpapilloma virus (HPV) that can cause anal, penile, and cervical cancers.
Is there a link between HIV treatments and cancer?
No.




Responsibility, accountability, and liability




There is no question that Dr. Bauer should be held accountable for what he is saying. Following Dr. Bauer’s bad advice can hasten HIV disease and cause death.




Who else is accountable?




Is Dr. Bauer’s family responsible? If Grandpa is fondling kids in the neighborhood, family members would be responsible for stopping him. If the Old Guy is telling people with HIV infection to stop taking their life saving medications, should his family stop him?
Are colleagues who just ignore the nutty professor down the hall accountable? I recently spoke with one of Dr. Bauer’s colleagues and he had no clue what Henry was up to. Now that he is aware of Henry’s antics, should his colleague be held responsible for taking action? Professional ethics of intervening with an impaired colleague seem relevant here.



Are Dr. Bauer’s Department Head and Dean accountable? Department Heads and Deans should be aware of what their faculty members are doing. And what about Virginia Tech University? Is Henry Bauer using State resources to maintain his Internet presence and spread misinformation about AIDS?
Aside from his own Geriatric Care, Henry Bauer has no medical experience. He is a Pseudoscientist’s Pseudoscientist who should be stripped of his Internet privileges at his University as well as the Roanoke Senior Center.




Dr. Bauer has convinced himself that he is correct about HIV not causing AIDS. He is now treading in waters even more dangerous than Loch Ness by offering medical advice. Henry Bauer offering medical advice through the misinterpretation of treatment guidelines is akin to my telling you the best spots to find Nessies in the Loch. I think it best for Henry to stick with what he knows best, Nessies, Aura’s, and Aliens, and leave HIV treatments to the experts.




Note: The ideas for the How AIDS Denialism Can Kill You posts came from a reader of this blog who also follows discussions on AIDS Denialism blogs. I appreciate the suggestions.

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