Re: Re: Re: Re: Re: Request for Peter Flegg and Outstanding 'Perth Group' Questions 26 November 2004
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Peter J Flegg,
Physician
Blackpool, UK FY3 8NR

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Re: Re: Re: Re: Re: Re: Request for Peter Flegg and Outstanding 'Perth Group' Questions

I welcome Mr Benvenuti’s “10 cents worth”, since he highlights several crucial issues.

Is it “dangerous” to question the prevailing view? In certain circumstances, very definitely, as many of his compatriots have discovered to their cost. HIV dissident views have been instrumental is moulding the policies of the South African government since Mbeki first encountered these on the internet, and therefore have been indirectly responsible for thousands of people being unable to obtain treatment and post-exposure prophylaxis each year, and have resulted in tens of thousands of cases of HIV infections in infants because mothers have been denied simple measures to prevent transmission.

Even in countries like the UK, I see instances where my own patients have been reluctant to continue with life-saving therapies because of influence by dissident sources. There have been several well-documented cases of “HIV-denial” resulting in mothers refusing to take measures to prevent their children becoming infected. Many internet dissident web sites promote views that HIV does not exist, that, that it is safe to have unprotected intercourse since condoms are dangerous and offer no protection against infection, or persuade people to stop treatment. There are many examples of this phenomenon(1). (I am somewhat reluctant to call attention to this, since the last time I mentioned this(2), the web site in question tried to bask in the glory of being cited in the BMJ as though this was some form of accolade, reminiscent of a school bully gleefully crowing about his enhanced peer status because he had been hauled before the headmaster). Another disturbing phenomenon is the active targeting by dissidents of many of the HIV web groups and discussion forums set up to help those with HIV, the usual tactics being to spam or mail bomb the sites in question until they are unable to continue to function(3). Dangerous, yes – which is why I will continue to debate these issues.

Is it wrong to question something? – Never, since this is the principle underpinning scientific progress. However, continued refusal to accept overwhelming evidence because it is contrary to one’s doctrine is not acceptable. Mr Benvenuti may be unaware that this debate often relates only to small areas of HIV science that the dissidents feel are the most fruitful to exploit, and vast areas of well established virology, epidemiology and clinical medicine that overwhelmingly show evidence for HIV are largely ignored. He mentions issues such as virus isolation, and asks why there are no EM pictures of HIV. With this statement he reveals that he has swallowed the dissident lie that such pictures do not exist. They do, and Nick Bennett and others have discussed this issue at length in the past. The facts are that dissidents simply refuse to accept that what they see is HIV, and quibble about the degree of contamination, or insist that they will only accept images obtained from blood but not other bodily fluids or tissue samples or culture specimens. Virology has moved on in the last half century, beyond the 1960s models of isolation that the Perth Group seem to have devised for themselves. Scientists can sequence and clone the virus, pick apart its genome and determine the function of all its genes (well, all apart from vpr). They can analyse the intricacies of its attachment and fusion to target cells and detail its replication cycle, develop designer drugs to successfully block target receptors and drugs to block replication enzymes, and demonstrate that these drugs work in vitro (and in vivo). They can study the molecular epidemiology and evolution of different strains of HIV and how these relate to other retroviruses such as SIV. They can detect HIV replication enzyme mutations and directly correlate the development of specific mutations to therapeutic failures and successes. I could go on, but fear my list would be incomplete, as I am not a virologist.

Dissidents insist that the virus does not exist, and assume thousands of scientists around the world spend their time playing with pixie dust in their laboratories. Until the Perth Group and others like Alexander Russell move past their mental block of isolation the dissidents will continue to think of HIV as pixie dust. I just wish the 40 million people currently living with HIV could be afforded the same luxury.

(1) http://groups.msn.com/dissident- action/general.msnw?action=get_message&mview=0&ID_Message=1992&LastModified=4675496267995554866

(2) http://bmj.bmjjournals.com/cgi/eletters/326/7387/495#52280, (2/3/04)

(3) http://groups.msn.com/dissident- action/actionboard.msnw?action=get_message&mview=0&ID_Message=1290&LastModified=4675481697489311365

Competing interests: None declared