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It is interesting how a study about the relationship between a disease "HIV infection", and infant mortality, avoids the obvious problem of actually recording and testing for what actually happened. One could have also tested mothers for any of the following endemic diseases, and found a connection between them and infant mortality.
Typhoid fever
Malaria
Hepatitis A
Hepatitis E
Meningococcal meningitis,
Crimean-Congo hemorrhagic fever,
Plague,
Yellow fever
Lassa fever
Japanese Encephalitis
African Trypanosomiasis
Dengue fever
Schistosomiasis,
Leptospirosis
All those, and more, are endemic problems for mothers and babies in the region the study used.
Firstly, Robinson, I think it would be pretty apparent if any of the mothers actually suffered from something like typhoid or meningitis.
Your statement is tantamount to me saying "I don't believe Study X showed influenza mortality, because the study authors have not specifically told us whether the study group also had galloping monkey disease."
Give us a break - the illnesses you mention are quite evident clinically, with the exception of malaria, which can exist at low parasitaemic levels and actually does affect the outcome of pregnancy in those affected, and schistosomiasis, which does not.
Secondly, I am rather disappointed that you of all people should spout out a list of diseases you claim to be "endemic" in Zimbabwe without checking your facts. I thought higher of you.
Most of the diseases you mention are not endemic in Zimbabwe, and some do not occur there at all. I think you also need to double check the definitions of "endemic" and "epidemic". Because an infection has been reported in a country, or it has had an outbreak of disease, that does not mean it is "endemic". Perhaps your sources of information on this one are off beam.
[Thirdly, I'll let you into a little secret-
I lived in Zimbabwe for nearly 30 years, in several regions of the country. I also worked there in a medical capacity. You
don't have to believe me, but I did, and I think I do know what I am talking about on this one.]
But what is most odd, is the number of HIV+ mothers who gave birth to HIV- babies. And that late stage HIV/AIDS was linked to infant mortality, when they didn't have HIV. Lets be clear on this, mothers HIV status effected the chance of baby being dead in the first two years of life.
What does that mean?
Having an HIV positive mother did affect the child's chances of survival (but not nearly as much as actually being infected with HIV)
Couple of possible reasons - Firstly, the mothers with HIV are likelier to be less able to care for their children if they are ill themselves. Secondly, those with HIV are very poor at producing specific antibodies (HIV causing a polyclonal expansion and rises in nonspecific antibodies), so materal transfer of passive immunity covering a number of important infections of infancy will be very poor (rendering infants more prone to infections such as measles -which is endemic) .
So everybody agrees it is a good study. It would have been a lot better if they had tested everybody involved, for all factors that effect infant mortality, but that would have cost a lot of money.
Now why are we even talking about a study like this? Because there isn't any study showing HIV kills you, by producing AIDS, which is fatal. It has never been done.
I find that odd.
It hasn't been done because animal studies couldn't be done. It hasn't been done with HIV populations either. I find this hard to swallow. You would think that a Pandemic of this proportion, the worst ever known to mankind, would have some basic scientific experiments done.
Every time this issue arises, the same problem shows up. Where is the basic experiment? Where are the peer reviewed studies? Where is the most basic research?
We are talking about this study because it happens to be the one that KellyB cited to show Dubya that HIV is not a nice thing to have. Since then, this study has been the topic of several detailed posts. It is only one study, and does not claim to show cause and effect directly. There are plenty of other studies in the scientific domain that look at different aspects of HIV, including animal studies and basic science - all peer reviewed. They are out there, waiting for you to criticise them all!
I find it strange that for every study under discussion here there is a reversion to the old denialist cant of "You can't believe this study because it did not prove the underlying premise which it naturally assumes". No doubt a study on seasonal changes in wheat production in Oregon would be criticised for assuming the earth spins on its axis and rotates around the sun without also displaying documented proof of this within the paper.
So for a simple study showing that HIV infection in infants correlates with a massive rise in mortality, the study is criticised because the authors did not prove HIV causes AIDS, or because the study took place in a developing country, or that it was not quadruple blinded, or they did not say exactly what the kids died from, or a hospital administrator assigned causes of death (conspiracy!!), or they did not control for galloping yellow-spot disease in the mothers, or they did not control for germanium exposure from inhaled aircraft contrails, yada, yada.
The study merely says what it states on the box. It contributes a tiny piece of the massive jigsaw of evidence that has been assembled into showing unequivocally that HIV is bad news.
The strategy of denialists like Dubya has been to question everything. Fair enough, that is how science progresses. But the questioning is not "skeptical" but trivialistic in nature. So when Dubya questions that HIV causes CD4 decline, a paper showing several mechanisms by which HIV causes CD4 loss in vitro and in vivo is criticised because science hasn't been able to supply to the last decimal point the definitive mechanism for this effect. Who would expect it to? We don't know everything yet about the mode of HIV pathogenesis. Different models of this are still being proposed, debated and being reformed. This is how science progresses, but when one hypothesis is revised, people like Dubya scream "See! you might have got it wrong! therefore HIV doesn't cause AIDS!"
It can be very wearying.
The debate with denialists is like arguing with someone who believes that powered heavier than air flight is impossible. All the "evidence" is interpreted differently. Reliance is placed on quotes from people 100 years ago saying flight was impossible. Video evidence is "faked". A plane pointed out in the sky is "a bird". The pilot's testimony of a flight cannot be trusted because he's "employed by the airline". Passengers are in on the conspiracy. Offers to take the denialist up on a plane are rejected because of silly excuses, and so on. Sometimes it's that obvious, it really is. But to a lay observer, the denialist claims can appear to have merit. Occasionally they do -there is plenty that is still unknown about the subject of HIV, plenty wrong with its politics, its funding etc that we all could find a lot of common ground in discussing.
But the denialists style of debate forces us all to assume polarised positions on every issue. If an orthodox scientist says something that questions accepted dogma, or even something like innacurate UNAIDS statistics, he is immediately championed as a "rethinker" and risks getting placed on the denialists' "List of the 30 Scientists Who Question AIDS". Twice in recent memory, orthodox scientists have had to publicly restate their views to try and reject the denialist reinterpretation of their work. Once I told the Perth Group that my own past work on immunity in drug users would qualify me to be placed on their list. AFAIK I am not on it (but I'd better check again to make sure!)