Recreational drug use is not the cause of AIDS

Yet more evidence has been added to the mountain of data weighing against Peter Duesberg's HIV/AIDS-related theories. Here, AIDS Truth reviews a new study (Chao, C., et al., Recreational Drug Use and T lymphocyte subpopulations in HIV-uninfected and HIV-infected men, Drug Alchol Depend (2008), doi: 10.1016/j.drugalcdep.2007.11.010).

In a study recently published on-line and scheduled for final publication later this year in the 'Journal of Drug and Alcohol Dependence', Multi-Center AIDS Cohort (MACS) investigators from UCLA, Johns Hopkins University, Northwestern University, and the University of Pittsburgh report that the use of various recreational drugs-including poppers, cocaine, amphetamines and marijuana-has no clinically significant effect on blood levels of CD4 and CD8 T lymphocytes. This finding holds true both in the presence and absence of HIV-1 infection. Similar results have been reported for several drugs in the past, but the study by Chao et al. is a particularly important addition because of its large sample size and statistical rigor, and because it controls for several confounding variables. Its conclusions underscore why Peter Duesberg has no credibility in the field of retrovirology nowadays: he destroyed his reputation in serious scientific circles by promoting an unproven, and now disproven, theory that AIDS is caused by drug abuse, not a retrovirus.

Because Duesberg was unwilling to accept that other members of his peer group of retrovirologists had made a major scientific discovery with important implications for public health (see here) that HIV-1 caused AIDS, he proposed an alternative hypothesis. Duesberg's original notion was that taking amyl nitrite inhalants ("poppers") is sufficient to cause the immunodeficiency associated with AIDS. He later extended this to almost
any recreational drug.

Quite simply, Chao et al. have proven, yet again, that Duesberg was wrong.

Chao et al. state: "...we did not find any clinically meaningful adverse associations between use of marijuana, cocaine, poppers, or amphetamines and any of the four outcomes examined" (CD4 and CD8 absolute numbers and CD4 and CD8 percentages).

Figure 1 from: Chao, C., et al., Recreational Drug Use and T lymphocyte subpopulations in HIV-uninfected and HIV-infected men, Drug Alchol Depend (2008), doi: 10.1016/j.drugalcdep.2007.11.010 Upper lines are uninfected men, lower lines are infected men. Solid lines represent baseline drug users, while dashed lines represent those who did not use drugs at baseline.

Duesberg and his fellow HIV/AIDS denialists will no doubt attempt to dismiss these new data, just as they have objected to previous studies. However, the paper by Chao et al. addresses several of the denialists' standard counter-arguments.

Denialist argument: The men with CD4 decline probably had a longer or more intense history of drug use. No, according to Chao et al., "(b)aseline substance use was also not associated with a faster decline in CD4 cell count and percentage, or a steeper increase in CD8 cell count and percentage." Furthermore, using drugs more or less frequently had no clinically significant effect on the parameters examined (see Table 2 in Chao et al.).

Denialist argument: But these authors are looking at different populations. The men with who took drugs died earlier, so they didn't have a chance for as much follow-up. That skewed the results. Although this problem may have been relevant to some earlier studies, Chao et al. avoid it by analyzing only incident infections: "...we only included incident HIV seroconverters, thereby avoiding any systemic differences in duration of infection between those who used recreational drugs and those who did not..."

Denialist argument: The CD4 decline must have been due to antiretroviral therapy, or the combination of antiviral and recreational drugs. This is not true. According to Chao et al., the "use of single or combination antiretroviral therapy" was addressed as a potential confounding, in addition to "age, race, education, tobacco smoking, alcohol use, number of male sexual partners, receptive anal intercourse (yes vs. no), follow-up time, and lifetime history of sexually transmitted infections". Adjusting for these factors, HIV causes CD4 cell declines; drug use does not.

Denialist argument: The study participants are lying. This foolish, conspiratorial "argument" is a standard denialist fall-back position: When the truth is inconvenient, make out that those telling it are lying. Duesberg did exactly this when the poster-boy for his theory died. Raphael Lombardo was HIV-1 infected and sought to control his infection with healthy living, exercise, and avoiding drugs. Duesberg included Lombardo in his notorious book, "Inventing the AIDS Virus," as evidence that HIV-1 is harmless and that drugs cause AIDS. When Lombardo died of AIDS, Duesberg had no recourse but to accuse Lombardo-publicly and to his grieving family-of lying. His family, who knew the dead man far better than Duesberg ever did, resent this accusation.

When the thousands of MACS cohort members are involved, as in the study by Chao et al., the 'liar argument' becomes absurd. For the study to be based on lies, two things would have to be true. First, the non-drug-using participants who experienced a decline in CD4 counts were lying: they were actually drug users. Second, the drug-using participants who did not experience a CD4 decline were also lying: they were not actually drug users. Under what circumstances could both groups by lying? Why would the propensity to lie be segregated by CD4 count?

There has never been any credible scientific evidence to support Duesberg's theories about AIDS. During the early 1980s (before Duesberg proposed his drugs-AIDS connection), many clinicians and scientists recognized that while some AIDS patients had a history of drug use, this could not, by itself, explain the immunodeficiency observed in AIDS. Nor could it explain the spread of AIDS, as the epidemiology strongly suggested an infectious agent was involved. In other words, theories about substance abuse causing AIDS had been generally disregarded as erroneous even before the discovery of HIV-1. Duesberg's theory was dead on arrival; he was both wrong on the science and behind the times, failing to take note of the successes of his scientific peers.

The scientific invalidity of Duesberg's hypothesis was hammered home throughout the next 20 years. In the Introduction to their paper, Chao et al. review some of that pertinent literature on drug use and lymphocyte subpopulations. They note that while some results have conflicted, their own conclusions are consistent with most of the existing literature. Chao et al. are also careful to include some words of caution: although poppers and other recreational drugs do not cause the profound quantitative changes of CD4+ and CD8+ T-lymphocyte subsets observed in HIV-1-infected patients, it remains possible that these cells are affected qualitatively by drugs. Presenting caveats is honest science.

AIDSTruth congratulates the MACS investigators on their important contribution to our understanding of AIDS. If his denialist position were science-based, Duesberg would now retract his theory that drug abuse causes AIDS. However, as he is driven not by any respect for science and the truth, but by jealousy over the success of other scientists we accept that this is unlikely to happen.