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(John P. Moore PhD)Tj
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(, Jeffrey T. Safrit PhD)Tj
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(1. Director Institute of Human Virology, University of Maryland Baltimo\
re )Tj
0 -1.2 TD
(2. Policy, Communications and Research Co-ordinator, Treatment Action C\
ampaign, South Africa )Tj
T*
(3. Gay Men's Health Crisis )Tj
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(4. Basic Science, Prevention & Vaccines Project, Treatment Action Group\
)Tj
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(5. Director of AIDS Research, Brigham and Women's Hospital, Associate P\
rofessor of Medicine, Harvard )Tj
1.39 -1.2 Td
(Medical School )Tj
-1.39 -1.2 Td
(6. Director of Communications, Marijuana Policy Project \(previously a \
health journalist who covered HIV/AIDS )Tj
1.39 -1.2 Td
(for AIDS Treatment News, Men's Healthand other publications\) )Tj
-1.39 -1.2 Td
(7. Professor of Microbiology and Immunology, Weill Medical College of C\
ornell University, New York )Tj
0 -1.2 TD
(8. Senior Programs Officer, Elizabeth Glaser Pediatric AIDS Foundation;\
Visiting Assistant Professor, )Tj
1.39 -1.2 Td
(Department of Pediatrics David Geffen School of Medicine, University of \
California, Los Angeles )Tj
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(Please send correspondence to Nathan Geffen at)Tj
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( )Tj
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(nathan@tac.org.za)Tj
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(This document describes the errors in Celia Farber's March 2006 article \
in Harper's Magazine, titled )Tj
/TT3 1 Tf
(Out of Control: )Tj
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(AIDS and the Corruption of Medical Science.)Tj
/TT0 1 Tf
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(Our primary concern is with rebutting Farber's misconceptions about HIV/\
AIDS and antiretrovirals \(ARVs\). We have )Tj
0 -1.2 TD
(not focused our attention on misleading or biased reporting that relate \
to the NIH; none of us is an NIH employee. )Tj
0 -1.2 TD
(We have also ignored the sections on Peter Duesberg\222s career problems\
, his rejected funding proposals, and how )Tj
T*
(he is \(or is not\) regarded by other cancer researchers nowadays; we ha\
ve no interest in Duesberg, other than to )Tj
T*
(note that he is not an AIDS researcher and has no practical experience i\
n studying HIV.)Tj
0 -2.889 TD
(Using a plethora of false, misleading, biased and unfair statements, Far\
ber attempts to cast scientific institutions and )Tj
0 -1.2 TD
(scientists as dishonest. But intellectual dishonesty is the norm for Far\
ber and other AIDS denialists including David )Tj
0 -1.2 TD
(Rasnick, Peter Duesberg, Kary Mullis and Harvey Bialy \226 all people sh\
e mentions favourably in her article. David )Tj
T*
(Rasnick works for a vitamin entrepeneur, Matthias Rath. They have conduc\
ted unauthorised experiments on people )Tj
T*
(with HIV in South Africa, convincing their subjects to take Rath's vitam\
in products in dangerously high doses, )Tj
T*
(instead of scientifically recognised treatments for AIDS. It has been al\
leged that some of their subjects have died )Tj
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(due to this experiment.)Tj
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( Farber implies financial motives permeate scientific research. Why does\
Farber not make )Tj
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(similar allegations against the AIDS denialists, many of whom are involv\
ed in the marketing of unproven alternative )Tj
0 -1.2 TD
(medicines?)Tj
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(HIV has been shown to be the cause of AIDS in numerous studies. ARVs hav\
e been shown to reduce death and )Tj
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(illness in people with HIV. They have also been shown to reduce mother-t\
o-child transmission \(MTCT\) of HIV. They )Tj
0 -1.2 TD
(often cause side-effects. On rare occasions these can be fatal, but deat\
h from HIV/AIDS is a far greater risk. The )Tj
T*
(evidence shows beyond doubt that the benefits of ARVs far outweigh their\
risks.)Tj
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(We present two tables below. The first is a list of errors in Celia Farb\
er's article in the March 2006 issue of Harper's. )Tj
0 -1.2 TD
(The list is possibly incomplete. All of these errors should have been fo\
und in the fact-checking process. The second )Tj
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(table contains some relevant points about the authorities Farber cites i\
n support of her views.)Tj
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(The first column contains the page and column number of the error in Far\
ber's article. If only one number is given, it )Tj
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(is the page.)Tj
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(Error Type Key)Tj
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(MISLEADING: Farber implies a false fact without stating it directly. The\
re are 16 such errors. )Tj
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(FALSE: Farber states a false fact. There are 25 such errors. )Tj
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(FAIRNESS: This denotes statements by Farber which are unfair, e.g. imply\
ing sinister motives with the flimsiest of )Tj
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(evidence. There are ten such errors. )Tj
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(BIAS: Farber neglects key facts which negate her theories. There are fiv\
e such errors.)Tj
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(There are 56 errors noted in the table.)Tj
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(TESTING: Related to HIV testing ARVs: Related to antiretrovirals )Tj
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(MTCT: Related to mother-to-child transmission prevention )Tj
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(The comments of Farber that are referred to are described in italics. Th\
en a description is given why Farber is wrong.)Tj
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(Farber states that pregnancy itself can cause a false positive result. )Tj
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)Tj
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(tests\) has a very small chance of giving a false positive, irrespective\
of )Tj
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(pregnancy status. Farber alleges that Hafford's HIV-test was carried out\
)Tj
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ter to )Tj
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(\(2001\).)Tj
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( For a more technical discussion see Coon \(2000\).)Tj
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r )Tj
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)Tj
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)Tj
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(and effective for treatment in the absence of pregnancy, in pregnant )Tj
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)Tj
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ne )Tj
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(In footnote one, Farber makes various false statements about )Tj
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(countries, have at least two different HIV antibody tests to confirm )Tj
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(they are HIV-positive, as part of the HIV testing protocol. HIV tests ar\
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(test indeterminate or negative. Even the risk of a single HIV ELISA )Tj
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)Tj
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)Tj
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(there are facilities in Africa which do not even have HIV tests \(one of\
)Tj
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(the cheapest components of the medical response to HIV\), our )Tj
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(knowledge of HIV in Africa is based on studies that have used HIV )Tj
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(We show later that numerous studies conducted in Africa have )Tj
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(Footnote 4 also states that AIDS happens to have the same )Tj
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)Tj
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(elderly and malnourished, are now common among HIV-infected )Tj
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(young and middle-aged people, including well-educated members of )Tj
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(the middle class." )Tj
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(25)Tj
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(Sewankambo, N)Tj
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(et al)Tj
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(. )Tj
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(AIDS. 2000 Oct 20;14\(15\):2391-400)Tj
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( is a study )Tj
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(of nearly 20,000 people, both HIV-positive and HIV-negative in a )Tj
0 -1.2 TD
(Ugandan district. People with HIV were much more likely to get sick or )Tj
0 -1.2 TD
(die. Furthermore death rates in civil servants and the better-educated )Tj
T*
(\(i.e. not the poor\) were higher than the general population. This was \
)Tj
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(associated with HIV infection.)Tj
ET
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(26)Tj
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(Statistics South Africa \(2005\) counted South African death certificate\
s )Tj
0 -1.2 TD
(between 1997 and 2002 and found a 57% increase in mortality \(only a )Tj
T*
(small portion can be accounted for by improved death registration and )Tj
T*
(population growth\). Critically, most of this increase is accounted for \
in )Tj
T*
(young adults, with the highest proportion of adult deaths in 2002 being \
)Tj
0 -1.2 TD
(30-39 year olds. Child mortality has also risen dramatically. This is )Tj
T*
(incompatible with poverty as the cause of AIDS, especially in a )Tj
T*
(country where living standards improved to some degree \(or at worst )Tj
0 -1.749 TD
(stayed the same\) during the period studied.)Tj
ET
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0 0 0.4 rg
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(27)Tj
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(Furthemore, some AIDS-related diseases, e.g. cryptococcal )Tj
0 -1.2 TD
(meningitis, are very rare in people without HIV, but very common in )Tj
T*
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(We provide further detail in the endnotes.)Tj
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(28)Tj
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(Footnote 4 further states that HIV tests are prohibitively )Tj
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(expensive in Africa.)Tj
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(HIV tests are widely available across Africa. They are not prohibitively\
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( )Tj
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(Footnote 4 further states "many diseases that are endemic to )Tj
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(Africa, such as malaria and TB, are known to give false )Tj
T*
(positives." Farber fails to supply a reference.)Tj
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(The risk of a false positive HIV test in Africa, as elsewhere, is very )Tj
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(small if the correct protocol is followed. Some HIV antibody tests have \
)Tj
T*
(been tested in Africa and found to be very accurate. These are the )Tj
0 -1.203 TD
(ones generally used. For example, the )Tj
/TT3 1 Tf
(Abbott Determine)Tj
/TT0 1 Tf
( rapid test )Tj
0 -1.2 TD
(used widely in South Africa has a specificity of at least 98% \(and in )Tj
T*
(some studies has achieved close to 100%\). When this test is )Tj
T*
(combined with a second rapid test or an ELISA test to determine HIV )Tj
T*
(status, the risk of a false positive is negligible. The contribution of \
TB )Tj
T*
(and malaria to false positives on today's tests is also negligible.)Tj
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(For examples of trials of HIV tests used in Africa and Brazil, see )Tj
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(et al.)Tj
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( Phili )Tj
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(et al.)Tj
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( \(2002\),)Tj
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( Ferreira )Tj
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( \(2005\),)Tj
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( )Tj
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( \(2001\),)Tj
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( \(2004\))Tj
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(FALS)Tj
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(Footnote 4 states "The statistical picture of AIDS in Africa, )Tj
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(consequently, is a communal projection based on very rough )Tj
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(estimates of HIV positives culled from select and small samples, )Tj
T*
(which are extrapolated across the continent using computer )Tj
T*
(models and highly questionable assumptions.")Tj
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(\(1\) Statistical estimates are not extrapolated across the continent, b\
ut )Tj
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(on a per country basis.)Tj
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(\(2\) Large samples of people with HIV have been taken in a number of )Tj
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(countries including Kenya, Botswana, Uganda and South Africa.)Tj
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(\(3\) South Africa's HIV/AIDS surveillance is arguably better than most \
)Tj
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(industrialised countries, let alone developing countries. It comes from \
)Tj
T*
(annual antenatal surveys, two countrywide household surveys, )Tj
T*
(numerous small community surveys and death certificates. The most )Tj
T*
(widely used computer model used to determine the size of South )Tj
T*
(Africa's epidemic closely matches the prevalence calculated in the )Tj
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(latest countrywide household survey. See ASSA \(2005\))Tj
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( and )Tj
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(Shisana et al.)Tj
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( \(2005\).)Tj
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BT
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(35)Tj
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(\(4\) It is true that estimates of AIDS in most African countries are )Tj
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(imprecise, but there is evidence showing beyond reasonable doubt )Tj
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(that the African HIV epidemic is massive. For a detailed rebuttal of the\
)Tj
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(claim that HIV is not a serious epidemic in Africa see Geffen \(2004\).)Tj
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(Farber complains about the growth of clinical trials and claims )Tj
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(that everyone profits except the subjects. She also implies that )Tj
0 -1.2 TD
(only the poor and disadvantaged are used as subjects.)Tj
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(No reference is supplied to support the view that subjects on the )Tj
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(whole are not benefiting from clinical trials. Many well-off people )Tj
T*
(participate in clinical trials. The claim that most subjects of clinical\
)Tj
T*
(trials are put at greater risk than benefit is astonishing, and it certa\
inly )Tj
T*
(contradicts common sense. Not every clinical trial is conducted )Tj
T*
(perfectly, particularly from the perspective of record-keeping. Some )Tj
T*
(are poorly conducted, but the vast majority conform to strict, )Tj
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(internationally accepted ethical guidelines and benefit the study )Tj
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(Farber uses innuendo and rumours, from the perspective of )Tj
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(Jonathan Fishbein, to cast aspersions on HIVNET 012, )Tj
T*
(particularly on the honesty of its investigators. No concrete )Tj
T*
(evidence is supplied. Surely this is not acceptable journalism in )Tj
T*
(a magazine of Harpers' quality.)Tj
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(In actual fact, problems with HIVNET 012 were identified and made )Tj
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(public by NIAID long before Fishbein made an issue of them)Tj
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(. The )Tj
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(NIAID took steps to address these problems. The problems turned out )Tj
0 -1.2 TD
(to have no bearing on the scientific findings of HIVNET 012.)Tj
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(Bookkeeping errors should not be automatically equated with a lack of )Tj
0 -1.2 TD
(ethics or any problems of a more serious and significant nature. To )Tj
T*
(maintain clinical records in some developing countries \(especially very\
)Tj
0 -1.2 TD
(poor ones such as Uganda\) is not as simple as doing so in a leading )Tj
T*
(industrialised country clinical research centre for a variety of reasons\
)Tj
T*
(including financial ones and the shortage of fully trained clinical staf\
f. )Tj
T*
(This does not mean that clinical trials should not be conducted in )Tj
T*
(developing countries or that trials in such countries are necessarily )Tj
T*
(flawed, but there does need to be some understanding of the )Tj
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(circumstances that can apply.)Tj
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(Farber states that Canada rejected nevirapine twice on the )Tj
T*
(grounds that it did not show efficacy with respect to surrogate )Tj
T*
(markers. She says that the FDA nevertheless registered it.)Tj
/TT0 1 Tf
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(Nevirapine has been shown to be effective using surrogate markers of )Tj
0 -1.2 TD
(CD4 and viral load count. \(See the FDA package insert for details.\) )Tj
T*
(Also see the meta-analysis of nevirapine and efavirenz referred to )Tj
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(The study states that )Tj
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)Tj
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(They report )Tj
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(nevirapine among the mothers of either cohort. There were five )Tj
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)Tj
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(investigators to be possibly, but not likely, study drug related. This )Tj
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(Farber describes how the HIVNET 012 protocol was changed )Tj
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(implying this rendered its quality sub-optimal.)Tj
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(There is nothing unusual or inappropriate about changing a study )Tj
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(protocol if logistics or new scientific developments require it. If the \
)Tj
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(study protocol became unacceptable, it would be rejected for )Tj
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(publication. The results of HIVNET 012 were published in )Tj
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(a leading medical journal.)Tj
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(Farber appears not to know the difference between a phase II and )Tj
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(phase III trial, because HIVNET 012 was a randomized phase III trial. )Tj
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(It was not double-blind, because the drug administration procedures )Tj
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(Farber claims HIVNET 012 was not placebo-controlled.)Tj
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(This statement is true, but Farber fails to explain critical facts that \
)Tj
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(would allow readers to understand that the trial design was )Tj
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(appropriate and that the results are meaningful. A short-course AZT )Tj
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(regimen had been found in the PACTG 076 trial to be effective at )Tj
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(reducing MTCT. The AZT regimen used in HIVNET 012 was a subset )Tj
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(of the PACTG 076 regimen and therefore at least as good as placebo )Tj
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(\(but probably not as good as the regimen used in PACTG 076\). In the )Tj
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(AZT arm by the end of the of the study. It would have been unethical )Tj
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(could reduce MTCT.)Tj
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(Therefore simple logic shows this: \(1\) HIVNET 012 AZT regimen is )Tj
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(better than or equal to placebo. \(2\) HIVNET 012 nevirapine regimen is \
)Tj
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(better than HIVNET 012 AZT regimen. Therefore HIVNET 012 )Tj
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(nevirapine regimen is better than placebo.)Tj
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(For more details, see the Cochrane review of antiretroviral regimens )Tj
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(for reducing MTCT.)Tj
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(one short course AZT regimen that has been tested \(i.e. the one )Tj
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(dose nevirapine is a sub-optimal regimen for reducing MTCT, in )Tj
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(This page contains a highly biased account of the analysis of )Tj
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(HIVNET 012. So as not to labour each of)Tj
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(Farber's misrepresentations and omissions, the following should be )Tj
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(HIVNET 012 was imperfect. The NIH has been honest about this. )Tj
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(They state:)Tj
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("NIAID and NIH initiated several reviews and re-reviews of HIVNET )Tj
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(012. These reviews identified procedural flaws in the study that led )Tj
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(NIAID to implement improvements in the conduct of clinical research it )Tj
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(supports both in the United States and abroad. We understand that )Tj
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(certain previously recognized criticisms of the conduct of HIVNET 012 )Tj
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(have re-emerged, )Tj
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(but stress strongly that throughout multiple )Tj
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(reviews, the overall conclusions regarding the safety and )Tj
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(efficacy of single-dose nevirapine in this setting have remained )Tj
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(intact.")Tj
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( \(our emphasis\) They further state:)Tj
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(that there may have been thousands of underreported serious )Tj
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(adverse events in the HIVNET 012 study implies that those were due )Tj
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(to the drug nevirapine. This implication is absolutely false. )Tj
T*
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(adverse reactions related to nevira pine. The original published study )Tj
T*
(and the multiple subsequent reviews of the HIVNET 012 trial that have )Tj
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(carefully scrutinized its data have found only a very small number of )Tj
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(serious adverse reactions that potentially might be due to nevirapine." \
)Tj
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(See also NIAID \(2004\))Tj
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(The Institute of Medicine is part of the National Academy of Sciences. )Tj
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(One of the purposes of the academy is to act as an independent )Tj
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(reviewer of scientific issues. One could view it as the arbiter of )Tj
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(scientific disputes of this nature, analogous to the way in which the US\
)Tj
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(Farber or any of the AIDS denialists as well as the Associated Press )Tj
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(journalist Farber refers to, the IOM extensively examined the )Tj
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("Based on its review, the committee finds no reason to retract the )Tj
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(publications or alter the conclusions of the HIVNET 012 study. The )Tj
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(committee concludes that data and findings reported in )Tj
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(Guay et al)Tj
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(. )Tj
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(\(1999\) and )Tj
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(Short-course nevirapine has been tested in the South African )Tj
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(Intrapartum Nevirapine Trial, a much bigger trial than HIVNET 012. )Tj
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(Short-course nevirapine has been used extensively in operational )Tj
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(settings, e.g. Ayouba )Tj
/TT1 1 Tf
(et al.)Tj
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( \(2003\).)Tj
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( From a safety perspective, not a )Tj
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(single life-threatening event has been recorded due to short-course )Tj
0 -1.2 TD
(nevirapine. From an efficacy perspective, results have been mixed; )Tj
0 -1.2 TD
(some cohorts have done well, others less well than expected. There is )Tj
T*
(no cohort however that has reported worse results than would be )Tj
T*
(expected with placebo including the Ghent study referred to by )Tj
T*
(Farber. In the absence of any intervention, the rate of MTCT varies )Tj
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(but is seldom less than 25% after a few months in a breast-feeding )Tj
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(population,)Tj
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(In many cases in the developing world the benefit of ARVs for )Tj
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(reducing MTCT at the time of delivery is undone by the later )Tj
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(transmission of HIV through breast-milk. Resolving this additional )Tj
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(mode of transmission is a complex scientific, operational and social )Tj
T*
(undertaking. However, in wealthy countries, paediatric epidemics )Tj
0 -1.2 TD
(have been virtually eliminated through a combination of long-course )Tj
T*
(ARV treatments, caesarian sections and formula-feeding. There are )Tj
T*
(also success stories in the developing world, including the Cameroon )Tj
T*
(study cited above, an MSF site in Cape Town, South Africa, a hospital )Tj
T*
(in Johannesburg, South Africa \(which found a 9% transmission rate in )Tj
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(an operational setting, much lower than would be achieved with )Tj
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(placebo\) and the Ugandan site where HIVNET 012 was conducted.)Tj
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(Farber states that the fact that some of the HIVNET 012 )Tj
0 -1.2 TD
(participants were on a vitamin A trial negates data associated )Tj
T*
(with them.)Tj
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(If vitamin A supplements were actually effective at reducing MTCT, )Tj
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(Farber's statement would be true. However several studies of whether )Tj
T*
(vitamin A supplements reduces MTCT have been conducted. They all )Tj
T*
(found that vitamin A supplementation does not differ from placebo. )Tj
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(See the Cochrane review \(2006\))Tj
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( on this. It is possible that vitamin A )Tj
-15.507 -1.2 Td
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(recent Zimbabwean study demonstrates.)Tj
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(Farber says that the terms of the IOM study were skewed from )Tj
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(the start because the IOM would not look at issues of )Tj
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(Investigating misconduct is not the role of the IOM and it was not )Tj
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(asked to do so in this case either. The IOM was asked to examine )Tj
T*
(scientific issues. It concluded that the science underlying the HIVNET )Tj
0 -1.2 TD
(012 was sound. It also found that the trial largely conformed to )Tj
0 -1.2 TD
(internationally accepted ethical standards. Issues of misconduct are )Tj
T*
(investigated by the NIH\222s Office of Research Integrity and/or by the \
)Tj
T*
(Department of Health and Human Services\222 Office of the Inspector )Tj
T*
(General, if they are justified. We are not aware that any such )Tj
0 -1.2 TD
(investigations have been initiated.)Tj
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(Farber points out that six of the nine IOM members were NIH )Tj
T*
(grantees. The innuendo is therefore they covered up for the NIH.)Tj
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(This is an astounding implied accusation that the magazine should not )Tj
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(have permitted without evidence. In effect, Farber impugns the )Tj
T*
(reputation of the six IOM members without offering any evidence that )Tj
T*
(their findings were incorrect or that the implied bias was in any way )Tj
T*
(real. It would be hard to find nine distinguished US scientists in the )Tj
T*
(field of HIV research who do not receive NIH grants, given the role of )Tj
T*
(the NIH as a funding agency. Furthermore, does Farber wish to )Tj
T*
(suggest that the three non-NIH funded IOM members colluded in this )Tj
T*
(suggested cover-up?)Tj
/TT1 1 Tf
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(Farber states that the " 'multiple studies' line is a familiar tactic )Tj
T*
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T*
(addressed, and that is HIVNET 012.")Tj
/TT0 1 Tf
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(On the contrary, the fact that short-course nevirapine has been )Tj
0 -1.2 TD
(demonstrated to be effective in other clinical studies as well as in )Tj
0 -1.2 TD
(operational settings is relevant.)Tj
/TT1 1 Tf
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(Farber quotes Valendar Turner's letter which makes the same )Tj
T*
(misrepresentation about nevirapine not being tested against )Tj
T*
(placebo discussed above.)Tj
/TT0 1 Tf
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(As explained above nevirapine clearly performed better than placebo, )Tj
0 -1.2 TD
(despite Turner\222s allegations. Of note is that Turner is a prominent )Tj
T*
(AIDS denialist in his own right, so is scarcely an objective reviewer of\
)Tj
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(the trial data.)Tj
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(Farber quotes Turner referring to a study of 561 people.)Tj
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(We are not sure what the 561 person study is that Turner refers to. No )Tj
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(reference is supplied by Farber. We have given references above )Tj
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T*
(few months.)Tj
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(Farber's reference to women with higher levels of vitamin A )Tj
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(See above for evidence that vitamin A supplementation is not effective )Tj
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(the body.)Tj
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(Farber describes the AZT study that resulted in FDA approval as )Tj
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(a phase II study but that was actually presented as a double-)Tj
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(blind, placebo controlled study.)Tj
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(The AZT study referred to was a double-blind placebo controlled )Tj
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(phase III study, known as BW 002.)Tj
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(Incidentally, it was for the treatment of HIV, not for the prevention of\
)Tj
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(MTCT. Farber does not make this clear. Other studies demonstrated )Tj
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(Farber states that the "AZT study was unblinded almost )Tj
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(immediately because of the severe toxicity of the drug. Members )Tj
T*
(of the control group began to acquire AZT independently or from )Tj
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(other study participants.")Tj
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(Farber cannot have it both ways. If the BW 002 study became )Tj
0 -1.2 TD
(unblinded because of AZT's toxicity, then control group members )Tj
T*
(would surely not have wished to acquire AZT. If the study became )Tj
T*
(unblinded because AZT tasted differently to placebo, then perhaps )Tj
T*
(control group members might have tried to acquire it.)Tj
0 -2.267 TD
(But here again, Farber makes a series of old AIDS denialist )Tj
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(allegations that the results of BW 002 are invalid because of )Tj
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(irregularities in the trial. In effect, Farber asks readers to take the \
side )Tj
T*
(of a journalist who does not believe that HIV causes AIDS, John )Tj
T*
(Lauritsen, against the considerably more expert opinion of the FDA )Tj
T*
(panel that approved AZT. A number of points need to be made about )Tj
T*
(this:)Tj
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(\(1\) All the trial participants were symptomatic of AIDS or what was )Tj
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(called AIDS Related Complex at the time. One out of 145 AZT )Tj
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(recipients died on the trial. Nineteen out of 137 placebo recipients )Tj
T*
(died. Furthermore the AZT recipients had fewer opportunistic )Tj
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(infections and scored higher on quality of life measurements. This )Tj
T*
(cannot be explained by chance and demonstrated the efficacy of AZT. )Tj
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(\(2\) If as is alleged by the AIDS denialists some subjects became )Tj
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(unblinded with the consequence that placebo subjects took AZT, then )Tj
T*
(the results of the trial actually underestimate the efficacy of AZT and \
)Tj
0 -1.2 TD
(the AIDS denialist case is hoisted by its own petard. This is because if\
)Tj
0 -1.2 TD
(AZT was more dangerous than placebo, then there should have been )Tj
T*
(more than just one death on the AZT arm. If the allegation of )Tj
T*
(unblinding is true, then the only logical conclusion is that the number \
)Tj
T*
(of placebo deaths was fewer than should have been the case, )Tj
0 -1.2 TD
(because some of the placebo subjects were given extra life-)Tj
T*
(expectancy by taking AZT. There is simply no logical way for AIDS )Tj
T*
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)Tj
T*
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(\(3\) BW 002 was not the only placebo-controlled study that )Tj
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(\(4\) Fifteen AZT versus placebo studies have been conducted. Not one )Tj
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(\(5\) Several uncontrolled studies have shown that AZT increases life-)Tj
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(\(6\) The BW 002 trial that Farber refers to in the main text involved )Tj
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(Footnote 11 states that AZT is a DNA chain terminator and kills )Tj
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(\(Postulate one\) Studies have found HIV in almost every case where a )Tj
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(\(Postulate two\) HIV can be isolated from AIDS patients and grown in )Tj
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(\(Postulate three\) Most people with HIV experience immune system )Tj
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(Furthermore, there are well-documented cases of workers developing )Tj
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)Tj
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(Of note is that, in extremely rare cases, HIV-infected people die of )Tj
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(68)Tj
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(If Duesberg has made this astonishing finding, he should be able to )Tj
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T*
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(As explained previously and in more detail later, numerous studies )Tj
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)Tj
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(demonstrate that mortality and morbidity is much higher in people with )Tj
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(Farber writes: "In fact, most AIDS patients have no active HIV in )Tj
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(their systems, because the virus has been neutralized by )Tj
T*
(antibodies.")Tj
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(PCR tests demonstrate that HIV is active in people with HIV )Tj
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(antibodies.)Tj
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(Most of the HIV in the body is located within solid lymphoid tissues, )Tj
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(where it is transmitted by cell-to-cell spread. Antibodies are unable to\
)Tj
T*
(interfere efficiently with this process. Furthermore, whenever effective\
)Tj
T*
(neutralizing antibodies are generated within the body, HIV responds )Tj
T*
(by mutating to generate resistant variants that are unaffected by these \
)Tj
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(antibodies.)Tj
ET
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BT
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(69)Tj
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(HIV)Tj
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(Farber states "HIV can be isolated only by 'reactivating' latent )Tj
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(copies of the virus, and then only with extraordinary difficulty." )Tj
T*
(She supplies no reference.)Tj
/TT1 1 Tf
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(This is false. Virus isolates are routinely made in clinical and basic )Tj
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(research laboratories. It is true that more virus is produced by )Tj
T*
(reactivating latent cells, but this is not what Farber is saying.)Tj
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(49; 3)Tj
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(HIV)Tj
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(Farber states "With all other viral diseases, by the way, the )Tj
T*
(presence of antibodies signals immunity from the disease. Why )Tj
T*
(this is not the case with HIV has never been demonstrated.")Tj
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(The presence of antibodies all too often does not signify immunity )Tj
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(from disease \(e.g. herpes zoster, herpes simplex, hepatitis C, )Tj
T*
(hepatitis B, dengue - all of these viruses can cause disease in the )Tj
T*
(presence of virus-specific antibodies\). HIV is a retrovirus and as such\
)Tj
T*
(it integrates upon infection. Antibodies specific to a retrovirus almost\
)Tj
T*
(always means the patient is infected and the levels of antibody usually \
)Tj
T*
(correlate to some extent with the level of virus replication. We present\
)Tj
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(more detail in an endnote.)Tj
ET
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(70)Tj
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(Farber writes "Viral load, one of the clinical markers for HIV, is )Tj
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(not a measurement of actual, live virus in the body, but the )Tj
T*
(amplified fragments of DNA left over from an infection that has )Tj
T*
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(This is nonsense. First, viral load assays do not measure DNA, they )Tj
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(measure HIV's content of RNA genomes \(HIV is an RNA-containing, )Tj
T*
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T*
(signals from plasma viral load assays are proportional to the infectious\
)Tj
T*
(virus content of plasma.)Tj
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(In numerous studies monitoring cohorts of HIV patients, viral load )Tj
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(increases with time.)Tj
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(71)Tj
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( How is this possible if all that is left over are )Tj
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(Koch's third and fourth postulates. She gives no reference.)Tj
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(HIV as the cause of AIDS does meets all four of Koch's postulates as )Tj
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(has been shown above.)Tj
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(50; 1)Tj
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(through the population, but HIV does not.)Tj
/TT1 1 Tf
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(HIV is primarily sexually transmitted and sexually transmitted )Tj
0 -1.2 TD
(infections do not spread randomly through the population. Sexually )Tj
T*
(transmitted infections consistently target people who have more )Tj
T*
(partners, use condoms less frequently, and visit sex workers.)Tj
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( )Tj
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(50; 1)Tj
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(MISLEADING)Tj
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(HIV)Tj
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(Footnote 13 contains multiple scientific errors and perpetuates )Tj
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(several misconceptions about HIV and AIDS that are commonly )Tj
T*
(listed on AIDS denialist web sites.)Tj
/TT1 1 Tf
0 -2.29 TD
(Farber writes "It has been claimed that HIV somehow causes cell )Tj
0 -1.2 TD
(death even when it is not present by remote programmed 'suicidal' )Tj
T*
(mechanisms.")Tj
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(It is difficult to discern what Farber is trying to say here, because as\
)Tj
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(written, the sentence makes no scientific sense whatsoever. Perhaps )Tj
0 -1.2 TD
(the most plausible interpretation of Farber's train of thought is that s\
he )Tj
T*
(is alluding to the death of CD4+ T-cells by a mechanism known as )Tj
T*
(apoptosis \(sometimes called "programmed cell death"\) during HIV )Tj
T*
(infection. The underlying science here is complex, and specialist )Tj
T*
(reviews on viral pathogenesis should be consulted for a fuller )Tj
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(picture.)Tj
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(72)Tj
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(,)Tj
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0 0 0.4 rg
BT
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(,)Tj
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( We provide a detailed explanation as an endnote.)Tj
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(Farber states in footnote 13 "Some researchers claim that HIV )Tj
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(exploits special receptors on human T-cells that, due to a )Tj
T*
(hypothetical genetic mutation, many 'Caucasian Europeans' lack, )Tj
T*
(but many Africans have. What's interesting is that many gay men )Tj
T*
(also seem to possess these mysterious receptors, as do )Tj
T*
(intravenous drug users and transfusion recipients.")Tj
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(Again, these sentences betray Farber's ignorance of a substantial )Tj
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(body of scientific information. As we explain in a detailed endnote)Tj
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(, a )Tj
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(fraction of Caucasians have genetic predispositions which render )Tj
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(them less likely to contract HIV \(not immune\) or more likely to )Tj
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(progress slowly. However, the vast majority of Caucasians have no )Tj
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(known genetic predisposition that makes them less likely to contract )Tj
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(Farber further states in footnote 13 "It is claimed that although )Tj
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(HIV does not kill the laboratory T-cells used to manufacture AIDS )Tj
T*
(tests, it does kill T-cells in the human body, even though it )Tj
T*
(infects only a very small proportion of them, typically an average )Tj
0 -1.2 TD
(of 0.1 percent.")Tj
/TT1 1 Tf
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(There are three inaccuracies in this sentence. First, HIV does kill T-)Tj
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(cells in the laboratory, as was recorded in the very earliest papers on \
)Tj
T*
(the isolation of HIV dating from 1983-1984. Second, "laboratory T-)Tj
T*
(cells" have not been used to "manufacture AIDS tests" for many years )Tj
T*
(now \(the technology has evolved well beyond the early methods of the )Tj
T*
(mid-1980's which were based on the production of inactivated HIV )Tj
T*
(particles in permanent T-cell lines that had been carefully selected for\
)Tj
T*
(relative resistance to the cell-killing effects of HIV\). Third, HIV doe\
s )Tj
T*
(directly kill, or otherwise cause the death of a substantial fraction of\
)Tj
T*
(the total CD4+ T-cell complement of the body.)Tj
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(Farber is presumably alluding to measurements of the HIV infection )Tj
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(status of CD4+ T-cells present in the bloodstream, which constitute )Tj
T*
(only a small proportion of the total amount of these cells present in th\
e )Tj
T*
(body as a whole. Most CD4+ T-cells cells are, in fact, located in solid \
)Tj
T*
(lymphoid tissues, particularly in the gut-associated lymphoid tissue. )Tj
T*
(The loss of CD4+ T-cells from such tissues upon HIV infection is rapid )Tj
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(in rate and substantial in extent.)Tj
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(Farber further states in footnote 13 that "HIV does not sicken or )Tj
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(kill chimpanzees.")Tj
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(It is true that HIV replicates inefficiently in chimpanzees, to a much )Tj
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(lower level than it does in humans so it usually does not cause )Tj
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(disease. However, there are recorded examples of HIV causing )Tj
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(immunodeficiency in these animals.)Tj
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(78)Tj
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(,)Tj
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(79)Tj
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(Many agents which cause disease in man are unable to cause )Tj
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(disease in a host of other species because they fail to infect, or infec\
t )Tj
T*
(poorly, or produce a different response. HIV has probably been in the )Tj
T*
(chimpanzee population for a very long time. Therefore it is plausible )Tj
T*
(that natural selection has rendered it less harmful.)Tj
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(We note the presumably unintended irony in Farber's closing )Tj
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(sentence in this footnote: )Tj
/TT3 1 Tf
("Seldom do journalists insist on good hard )Tj
T*
(evidence for these assertions.")Tj
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( In fact, most professional science )Tj
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(writers do exactly that. Perhaps Farber will take the trouble to do so i\
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(Farber proceeds from column 2 to the end of column 3 to )Tj
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(postulate other causes of AIDS and makes various statements )Tj
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(about the demographics of AIDS. No sources are cited for her )Tj
T*
(ponderings. This is a particularly poorly researched and fact-)Tj
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(checked part of the article.)Tj
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(Not a single credible peer-reviewed article published in a credible )Tj
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(scientific journal since 1990 offers any support for what she says here.\
)Tj
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(Instead of a complete point-by-point explanation, some critical )Tj
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(comments are offered:)Tj
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(\(1\) HIV does affect the heterosexual population in the US, not just ga\
y )Tj
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(men.)Tj
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(80)Tj
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( The US population in which HIV infection is now spreading )Tj
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(most rapidly is African-American women. Poverty \(where untreated )Tj
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(sexually transmitted infections, lack of prevention knowledge, lack of )Tj
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(power of women to negotiate condom use, increased frequency of )Tj
T*
(transactional sex are more likely than in wealthier populations\), )Tj
T*
(unprotected anal sex \(due to greater risk of abrasions\), blood )Tj
T*
(transfusions, intravenous needle reuse and exposure to multiple )Tj
T*
(partners. All increase risk of HIV transmission and explain the )Tj
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(demographic aspects of the disease with which Farber fumbles.)Tj
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(\(2\) In contrast to Farber's implication that proposed causes of AIDS )Tj
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(other than HIV have not been tested, they have \226 in great depth. )Tj
T*
(These studies have found that in the absence of HIV none of )Tj
T*
(recreational drug use, poverty, malnutrition and homosexuality can )Tj
T*
(predict the onset of AIDS. Footnote 14 is consequently false too. )Tj
T*
(There is no evidence that recreational drug use is the cause of AIDS. )Tj
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(We quote an NIAID rebuttal to this myth:)Tj
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("[I]n a prospectively studied cohort in Vancouver, 715 homosexual )Tj
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(men were followed for a median of 8.6 years. Among 365 HIV-positive )Tj
T*
(individuals, 136 developed AIDS. No AIDS-defining illnesses occurred )Tj
T*
(among 350 seronegative men despite the fact that these men )Tj
T*
(reported appreciable use of inhalable nitrites \("poppers"\) and other )Tj
T*
(recreational drugs, and frequent receptive anal intercourse)Tj
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( \(Schechter )Tj
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(et al)Tj
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(. )Tj
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(Lancet. 1993 Mar 13;341\(8846\):658-9)Tj
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(Other studies show that among homosexual men and injection-drug )Tj
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(users, the specific immune deficit that leads to AIDS - a progressive )Tj
T*
(and sustained loss of CD4+ T cells - is extremely rare in the absence )Tj
T*
(of other immunosuppressive conditions. For example, in the )Tj
T*
(Multicenter AIDS Cohort Study, more than 22,000 T-cell )Tj
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(determinations in 2,713 HIV-seronegative homosexual men revealed )Tj
T*
(only one individual with a CD4+ T-cell count persistently lower than )Tj
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(300 cells/mm)Tj
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( of blood, and this individual was receiving )Tj
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(immunosuppressive therapy \(Vermund )Tj
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(et al)Tj
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(. )Tj
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(N Engl J Med. 1993 Feb )Tj
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(In a survey of 229 HIV-seronegative injection-drug users in New York )Tj
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(City, mean CD4+ T-cell counts of the group were consistently more )Tj
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(than 1,000 cells/mm)Tj
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(3)Tj
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( of blood. Only two individuals had two CD4+ T-)Tj
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( of blood, one of whom died )Tj
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(of death)Tj
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(J Acquir Immune Defic Syndr. 1993 Jul;6)Tj
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(The use of some recreational drugs, such as metamphetamines, can )Tj
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(place individuals at greater risk of acquiring HIV infection by lowering\
)Tj
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(inhibitions and increasing the probability of engaging in, e.g., unsafe \
)Tj
T*
(sexual practices. This does not mean that "drugs cause AIDS.")Tj
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(\(3\) Farber's claim that researchers have failed to demonstrate a )Tj
0 -1.2 TD
(higher incidence of AIDS in people with HIV is false. See the above )Tj
T*
(studies. There are many more. Here is a further tiny sample of such )Tj
T*
(studies, including some from Africa:)Tj
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(\(i\) The Multicenter AIDS Cohort Study \(MACS\) and the Women's )Tj
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(Interagency HIV Study \(WIHS\) consisted of 8,000 participants in the )Tj
T*
(US. It demonstrated that participants with HIV were approximately )Tj
T*
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(\(ii\) A one-year South African study of 1,792 HIV-positive and 2,970 )Tj
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(HIV-negative gold miners found that miners with HIV were nearly )Tj
T*
(three times more likely to be hospitalised and nine times more likely to\
)Tj
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(die than HIV-negative ones.)Tj
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(83)Tj
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(\(iii\) Researchers at Chris Hani Baragwanath Hospital in Johannesburg )Tj
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(looked at deaths of HIV-positive and HIV-negative children between )Tj
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(1992 and 1996. They found that deaths increased among HIV-positive )Tj
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(\(iv\) A study in Uganda of nearly 20,000 people found that HIV-positive\
)Tj
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(people had a death rate more than twenty times higher than HIV-)Tj
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(negative people.)Tj
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(Incidentally, in this study, educated people and civil )Tj
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(servants were more likely to die, which is inconsistent with poverty )Tj
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(being the cause of AIDS \(though it certainly is an exacerbating factor\)\
.)Tj
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(\(v\) In Cote d\222Ivoire, HIV-positive people with TB were 15 times mor\
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(likely to die within six months than HIV-negative people with TB.)Tj
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(86)Tj
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(\(vi\) A study in Rwanda found that death was 21 times higher for HIV-)Tj
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(87)Tj
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(\(vii\) A study of pregnant women at King Edward Hospital in Durban, )Tj
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(South Africa found that those with HIV had a ten times higher rate of )Tj
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(turberculosis than those without.)Tj
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(\(viii\) A study of over 6,000 people with haemophilia in the United )Tj
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(Kingdom found that those with HIV had a much higher death rate. The )Tj
T*
(death rate amongst HIV-negative haemophiliacs stayed stable during )Tj
0 -1.2 TD
(the analysis period \(1977 to 1991\). The death rate amongst )Tj
0 -1.2 TD
(haemophiliacs who contracted HIV rose dramatically from 1984 to the )Tj
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(end of the study period.)Tj
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(This disproves Farber's assertion that no )Tj
-11.563 -1.2 Td
(studies have been carried out to determine if haemophiliacs infected )Tj
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(with HIV die sooner than those not infected.)Tj
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(\(ix\) As explained by the NIH )Tj
/TT2 1 Tf
("Similar data have emerged from the )Tj
0 -1.203 TD
(Multicenter Hemophilia Cohort Study. Among 1,028 hemophiliacs )Tj
0 -1.2 TD
(followed for a median of 10.3 years, HIV-infected individuals \(n=321\) \
)Tj
T*
(were 11 times more likely to die than HIV-negative subjects \(n=707\), )Tj
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(with the dose of Factor VIII having no effect on survival in either grou\
p)Tj
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( )Tj
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(\(Goedert. )Tj
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(Lancet. 1995 Nov 25;346\(8987\):1425-6)Tj
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(90)Tj
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1.112 -0.576 Td
( Factor VIII is )Tj
-24.122 -1.405 Td
(Duesberg's proposal for higher mortality in haemophiliacs with HIV. )Tj
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(This study debunked this notion. See Cohen \(1994\))Tj
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(91)Tj
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( for a more )Tj
-23.902 -1.2 Td
(detailed discussion.)Tj
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(For further examples showing more illness and death among people )Tj
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(with HIV, see NIAID \(2003\).)Tj
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(25)Tj
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( A diligent search on Medline will elicit )Tj
-13.172 -1.2 Td
(even more examples.)Tj
0 -2.267 TD
(\(4\) Farber provides no reference for her claim that HIV is a harmless \
)Tj
0 -1.2 TD
(passenger virus. The claim is false and disproven by the evidence )Tj
T*
(presented in this document.)Tj
0 -2.267 TD
(\(5\) Farber provides no reference for her claim that HIV is primarily )Tj
0 -1.2 TD
(spread from mother-to-child. The claim is false. Most HIV transmission )Tj
T*
(is through heterosexual sex.)Tj
0 -2.267 TD
(\(6\) In footnote 14 Farber claims that the majority of Kaposi's sarcoma\
)Tj
0 -1.2 TD
(patients are heavy users of nitrate inhalers. She gives no reference. )Tj
T*
(Assuming she's right, if a sizeable minority are not, then nitrate )Tj
T*
(inhalers cannot be the cause of Kaposi's sarcoma.)Tj
0 -2.267 TD
(Once infected with HIV, recreational drug use and poverty are factors )Tj
0 -1.2 TD
(in the progression of HIV to AIDS, but HIV progresses to AIDS in )Tj
T*
(sufficiently large numbers of well-off people who do not use )Tj
T*
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(Our present-day understanding of HIV and AIDS results from the )Tj
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(efforts of thousands of scientists publishing tens of thousands of )Tj
T*
(studies over 25 years. No other disease in history has been studied in )Tj
T*
(this depth. It would require the exposure of an unprecedented )Tj
T*
(conspiracy or duping for the scientific consensus on HIV as the cause )Tj
T*
(of AIDS and the benefits of ARVs to be overturned. This is absurdly )Tj
T*
(implausible. ARVs are probably more studied than any other class of )Tj
T*
(drugs. Comparing HIV science to the history of scurvy is misleading )Tj
T*
(and silly. Furthermore, the link between vitamin C and scurvy was )Tj
T*
(definitively discovered in the 1930s, at the onset of the modern era of \
)Tj
T*
(medical research. Scientific method in medicine has developed )Tj
T*
(dramatically since then. Furthermore, Farber provides no reference for )Tj
T*
(those proposing citrus fruit as a remedy for scurvy being dismissed as )Tj
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(flat-earthers. Although scurvy was not properly understood until the )Tj
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( century the surgeon general of the British )Tj
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(East India Company suggested using fresh food including oranges, )Tj
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(But Farber is also highly selective. She fails to mention the successes \
)Tj
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T*
(numerous infections treated by penicillin, treatments for diabetes, )Tj
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(cardiovascular disease, cancer, etc. These treatments have had a )Tj
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(Footnote 16 refers to the reappraising petition with its )Tj
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(It appears that Farber is referring to one of two petitions on the )Tj
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(virusmyth website \(we assume this because Farber, as usual, does )Tj
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(not supply references\). Farber is a signatory to one of these petitions\
)Tj
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(a fact that indicates she had prejudged views before writing the )Tj
T*
(Harper's piece. The petition texts are vague. They have been open for )Tj
T*
(signing for years. It is not clear how to remove one's name from them )Tj
T*
(if one wishes to do so. It is difficult to verify which of them are )Tj
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(By contrast, the Durban Declaration was signed by approximately )Tj
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(Farber states "Duesberg thinks that up to 75 percent of AIDS )Tj
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T*
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T*
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T*
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vitamin )Tj
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(diabetes, asthma and many other serious diseases. Rath also claims that \
all )Tj
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he )Tj
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(Farber refers to a nutritional study being conducted by Rasnick in South\
Africa. )Tj
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(Here are the facts on this disgraceful unethical debacle: Rath and Rasni\
ck )Tj
T*
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ived no )Tj
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Vs and )Tj
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llegations )Tj
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nd )Tj
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f the )Tj
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uld )Tj
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. )Tj
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(What she fails to mention is that he has a wide range of odd beliefs. He\
does )Tj
T*
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0 -1.2 TD
(by aliens and is partial to astrology. Entertaining perhaps, but if you'\
re going to )Tj
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blished )Tj
0 -1.2 TD
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0 -2.267 TD
(Farber also fails to point out that his new cancer hypothesis is also co\
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(pseudo-science by most cancer scientists. Farber is also wrong about )Tj
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(Duesberg being the youngest member ever elected to the National Academy \
)Tj
T*
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(There were many younger than 50, even at the time Duesberg was elected.)Tj
0 -2.267 TD
(Farber further claims that the National Cancer Institute \(NCI\) "refuse\
s" to fund )Tj
0 -1.2 TD
(Duesberg. The NCI relies on peer review groups that score grants. If his\
)Tj
T*
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o fund him. )Tj
T*
(So the implication that the institution has blackballed him from funding\
is both )Tj
T*
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t )Tj
T*
(applications, and if peers deem it worthy, he'll receive funding.)Tj
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(Farber points out that Bialy is the founding scientific editor of Nature\
)Tj
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(Biotechnology. He no longer holds any position with Nature.)Tj
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(NIAID publicly revealed the problems with the HIVNET 012 study long befo\
re )Tj
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(Fishbein was hired. His original complaint was about recertifying the st\
udy site, )Tj
T*
(and it somehow mutated into concerns about efficacy and safety of the )Tj
0 -1.2 TD
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dence )Tj
0 -1.2 TD
(that undermines HIVNET 012's scientific results \(e.g. an unrecorded sid\
e )Tj
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(Fishbein, Farber writes, "supported Luzar in a sexual harassment claim )Tj
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(3 March 2006: First public version. Sent to Harper's. )Tj
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("Nevirapine remains an important antiretroviral medicine whose benefits \
outweigh its risks." )Tj
0 -1.2 TD
(\(b\) Modified Bruce Mirken affiliation. )Tj
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(5-25 March: references standardised and typing errors corrected. Thank y\
ou to Sister Mary Elizabeth of )Tj
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(Phillips et al. \(1997\) )Tj
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(A trial comparing nucleoside monotherapy with combination therapy in HIV\
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(et al.)Tj
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( \(2004\) )Tj
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( )Tj
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( )Tj
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q
21 0 0 22 113.9049988 646.7741089 cm
/Im0 Do
Q
134.905 653.904 m
181.784 653.904 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 134.905 655.5241 Tm
(Full-Text)Tj
0 0 0.2 rg
/TT1 1 Tf
(]\). These peturbations are not mirrored in chronic malnutrition, malari\
a, parasitic )Tj
-8.759 -1.634 Td
(infections and other common African illnesses. The only condition associ\
ated with similar immunological )Tj
0 -1.203 TD
(perturbations is HIV-2 infection \(Sousa AE, et al. )Tj
/TT2 1 Tf
(CD4 T cell depletion is linked directly to immune activation in )Tj
0 -1.203 TD
(the pathogenesis of HIV-1 and HIV-2 but only indirectly to the viral loa\
d.)Tj
/TT1 1 Tf
( )Tj
ET
395.92 608.449 m
591.625 608.449 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 395.92 610.0688 Tm
(J Immunol. 2002 Sep 15;169\(6\):3400-)Tj
ET
36.37 589.022 m
42.625 589.022 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 590.6418 Tm
(6)Tj
0 0 0.2 rg
/TT1 1 Tf
( [)Tj
ET
q
21 0 0 22 48.8800049 581.8918304 cm
/Im0 Do
Q
69.88 589.022 m
116.759 589.022 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 69.88 590.6418 Tm
(Full-Text)Tj
0 0 0.2 rg
/TT1 1 Tf
(]\).)Tj
ET
18.86 565.949 m
31.37 565.949 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 567.5688 Tm
(29)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Sauer G )Tj
/TT2 1 Tf
(et al.)Tj
/TT1 1 Tf
(, )Tj
/TT2 1 Tf
(Evaluation of the abbott determine HIV-1/2 rapid assay using samples fro\
m the Western Cape )Tj
0 -1.203 TD
(region.)Tj
/TT1 1 Tf
( South Africa. )Tj
/TT2 1 Tf
(Int Conf AIDS)Tj
/TT1 1 Tf
( 2000 Jul 9-14; 13:\()Tj
ET
307.135 552.066 m
437.174 552.066 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 307.135 553.6865 Tm
(abstract no. MoPeA2091)Tj
0 0 0.2 rg
/TT1 1 Tf
(\))Tj
ET
18.86 531.566 m
31.37 531.566 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 533.1865 Tm
(30)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Phili R )Tj
/TT2 1 Tf
(et al.)Tj
/TT1 1 Tf
( \(2002\) )Tj
/TT2 1 Tf
(Evaluation of a rapid human immunodeficiency virus test at two community\
clinics in )Tj
T*
(Kwazulu-Natal.)Tj
/TT1 1 Tf
( )Tj
ET
115.143 517.684 m
305.211 517.684 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 115.1425 519.3042 Tm
(S Afr Med J. 2002 Oct;92\(10\):818-21)Tj
ET
18.86 497.184 m
31.37 497.184 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 498.8042 Tm
(31)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Ferreira )Tj
/TT2 1 Tf
(et al.)Tj
/TT1 1 Tf
( \(2005\) )Tj
/TT2 1 Tf
(Evaluation of rapid tests for anti-HIV detection in Brazil.)Tj
/TT1 1 Tf
( )Tj
ET
420.276 496.841 m
587.834 496.841 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 420.2762 498.4606 Tm
(AIDS. 2005 Oct;19 Suppl 4:S70-)Tj
ET
36.37 481.341 m
42.625 481.341 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 482.9606 Tm
(5)Tj
ET
18.86 460.841 m
31.37 460.841 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 462.4606 Tm
(32)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Koblavi-D\350me S. \(2001\) )Tj
/TT2 1 Tf
(Sensitivity and Specificity of Human Immunodeficiency Virus Rapid Serolo\
gic Assays )Tj
T*
(and Testing Algorithms in an Antenatal Clinic in Abidjan, Ivory Coast.)Tj
/TT1 1 Tf
( )Tj
ET
382.139 446.958 m
584.706 446.958 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 382.1387 448.5783 Tm
(J Clin Microbiol. 2001 May;39\(5\):1808-)Tj
ET
36.37 427.531 m
48.88 427.531 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 429.1514 Tm
(12)Tj
0 0 0.2 rg
/TT1 1 Tf
( [)Tj
ET
q
21 0 0 22 55.1349945 420.4013824 cm
/Im0 Do
Q
76.135 427.531 m
123.014 427.531 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 76.135 429.1514 Tm
(Full-Text)Tj
0 0 0.2 rg
/TT1 1 Tf
(])Tj
ET
18.86 404.458 m
31.37 404.458 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 406.0783 Tm
(33)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Foglia et al. \(2004\) )Tj
/TT2 1 Tf
(Use of rapid and conventional testing technologies for human immunodefic\
iency virus type )Tj
T*
(1 serologic screening in a rural Kenyan reference laboratory.)Tj
/TT1 1 Tf
( )Tj
ET
340.874 390.576 m
540.303 390.576 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 340.8737 392.1961 Tm
(Clin Microbiol. 2004 Aug;42\(8\):3850-2)Tj
0 0 0.2 rg
/TT1 1 Tf
(. )Tj
-27.067 -1.727 Td
([)Tj
ET
q
21 0 0 22 39.4974976 364.0191193 cm
/Im0 Do
Q
60.497 371.149 m
107.376 371.149 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 60.4975 372.7691 Tm
(Full-Text)Tj
0 0 0.2 rg
/TT1 1 Tf
(])Tj
ET
18.86 348.076 m
31.37 348.076 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 349.6961 Tm
(34)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(ASSA. \(2005\) )Tj
/TT2 1 Tf
(ASSA 2003.)Tj
/TT1 1 Tf
( \(The model's spreadsheets can be downloaded from )Tj
ET
437.466 347.732 m
528.13 347.732 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 437.4662 349.3524 Tm
(www.assa.org.za)Tj
0 0 0.2 rg
/TT1 1 Tf
(.\))Tj
ET
18.86 327.232 m
31.37 327.232 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 328.8524 Tm
(35)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Shisana O. )Tj
/TT2 1 Tf
(et al.)Tj
/TT1 1 Tf
( \(2005\) )Tj
/TT2 1 Tf
(South African National HIV Prevalence, HIV Incidence, Behaviour and Comm\
unication )Tj
T*
(Survey 2005.)Tj
ET
18.86 295.194 m
31.37 295.194 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 296.8138 Tm
(36)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Geffen N. \(2004\) )Tj
/TT2 1 Tf
(Rian Malan Spreads Confusion about AIDS Statistics.)Tj
/TT1 1 Tf
( )Tj
ET
394.03 294.85 m
510.299 294.85 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 394.03 296.4702 Tm
(http://www.tac.org.za/)Tj
ET
36.37 279.045 m
222.715 279.045 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 280.6652 Tm
(newsletter/2004/ns20_01_2004.htm)Tj
0 0 0.2 rg
/TT1 1 Tf
(. Last accessed 2006/03/01.)Tj
ET
18.86 258.545 m
31.37 258.545 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 260.1652 Tm
(37)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(NIAID \(2002\). )Tj
/TT2 1 Tf
(Review of HIVNET 012.)Tj
/TT1 1 Tf
( )Tj
ET
230.185 258.202 m
520.93 258.202 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 230.185 259.8216 Tm
(http://www3 . niaid . nih .gov/news/newsreleases/2002/)Tj
ET
36.37 242.397 m
129.542 242.397 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 244.0166 Tm
(review_hivnet012)Tj
0 0 0.2 rg
/TT1 1 Tf
(.)Tj
ET
18.86 221.897 m
31.37 221.897 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 223.5166 Tm
(38)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.118 Td
(Torre )Tj
/TT2 1 Tf
(et al.)Tj
/TT1 1 Tf
( \(2001\), )Tj
/TT2 1 Tf
(supra)Tj
/TT1 1 Tf
( Note 5.)Tj
ET
18.86 201.397 m
31.37 201.397 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 203.0166 Tm
(39)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Musoke P. )Tj
/TT2 1 Tf
(et al.)Tj
/TT1 1 Tf
( \(1999\) )Tj
/TT2 1 Tf
(A phase I/II study of the safety and pharmacokinetics of nevirapine in H\
IV-1-infected )Tj
0 -1.522 TD
(pregnant Ugandan women and their neonates \(HIVNET 006\).)Tj
/TT1 1 Tf
( )Tj
ET
345.273 183.931 m
504.708 183.931 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 345.2725 185.551 Tm
(AIDS. 1999 Mar 11;13\(4\):479-8)Tj
0 0 0.2 rg
/TT1 1 Tf
(. [)Tj
ET
q
21 0 0 22 514.0899963 176.8010406 cm
/Im0 Do
Q
535.09 183.931 m
581.969 183.931 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 535.09 185.551 Tm
(Full-Text)Tj
0 0 0.2 rg
/TT1 1 Tf
(])Tj
ET
18.86 160.858 m
31.37 160.858 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 162.478 Tm
(40)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.116 Td
(Ibid.)Tj
ET
18.86 140.358 m
31.37 140.358 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 141.978 Tm
(41)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Guay LA. )Tj
/TT2 1 Tf
(et al.)Tj
/TT1 1 Tf
( \(1999\) )Tj
/TT2 1 Tf
(Intrapartum and neonatal single-dose nevirapine compared with zidovudine\
for )Tj
0 -1.203 TD
(prevention of mother-to-child transmission of HIV-1 in Kampala, Uganda: \
HIVNET 012 randomised trial.)Tj
/TT1 1 Tf
( )Tj
ET
36.37 112.976 m
237.092 112.976 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 114.5957 Tm
(Lancet. 1999 Sep 4;354\(9181\):795-802)Tj
0 0 0.2 rg
/TT1 1 Tf
(.)Tj
ET
18.86 92.476 m
31.37 92.476 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 94.0957 Tm
(42)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Brocklehurst P. )Tj
/TT2 1 Tf
(et al.)Tj
/TT1 1 Tf
( \(2006\) )Tj
/TT2 1 Tf
(Antiretrovirals for reducing the risk of mother-to-child transmission of\
HIV infection.)Tj
/TT1 1 Tf
( )Tj
0 -1.2 TD
(The Cochrane Database of Systematic Reviews. )Tj
ET
281.462 78.632 m
554.68 78.632 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 281.4625 80.2521 Tm
(http://www.cochrane.org/reviews/en/ab003510.html)Tj
0 0 0.2 rg
/TT1 1 Tf
(. Last )Tj
-21.786 -1.405 Td
(accessed 2006/03/02.)Tj
ET
EMC
/Artifact <>BDC
Q
BT
/T1_0 1 Tf
9 0 0 9 18 7.17 Tm
(http://ww2.aegis.org/files/tac/2006/errorsinfarberarticle.html \(31 of 3\
5\)5/8/2006 14:41:09)Tj
ET
EMC
endstream
endobj
765 0 obj<>stream
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0 0 0 rg
0 i
BT
/T1_0 1 Tf
0 Tc 0 Tw 0 Ts 100 Tz 0 Tr 9 0 0 9 18 780.17 Tm
(http://ww2.aegis.org/files/tac/2006/errorsinfarberarticle.html)Tj
ET
EMC
/Article <>BDC
q
0 18 612 756 re
W* n
0 0 0.4 RG
0.54 w 10 M 0 j 0 J []0 d
18.86 752.057 m
31.37 752.057 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 753.6769 Tm
(43)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Public Health Service Task Force. \(2005\) )Tj
/TT2 1 Tf
(Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-)Tj
0 -1.203 TD
(Infected Women for Maternal Health and Interventions to Reduce Perinatal\
HIV-1 Transmission in the United )Tj
0 -1.2 TD
(States.)Tj
/TT1 1 Tf
( )Tj
ET
74.519 724.675 m
350.178 724.675 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 74.5188 726.2947 Tm
(http://aidsinfo.nih.gov/ContentFiles/PerinatalGL.pdf)Tj
0 0 0.2 rg
/TT1 1 Tf
(. Last accessed 2006/03/01.)Tj
ET
18.86 704.175 m
31.37 704.175 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 705.7947 Tm
(44)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(NIAID. \(2005\) )Tj
/TT2 1 Tf
(Questions and Answers: The HIVNET 012 Study and the Safety and Effective\
ness of Nevirapine )Tj
0 -1.203 TD
(in Preventing Mother-to-InfantTransmission of HIV.)Tj
/TT1 1 Tf
( )Tj
ET
292.712 690.292 m
567.82 690.292 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 292.7125 691.9124 Tm
(http://www3.niaid.nih.gov/news/newsreleases/2005/)Tj
ET
36.37 674.487 m
125.144 674.487 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 676.1074 Tm
(hivnet012qa.htm)Tj
0 0 0.2 rg
/TT1 1 Tf
(. Last accessed 2006/03/02.)Tj
ET
18.86 653.987 m
31.37 653.987 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 655.6074 Tm
(45)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(NIAID. \(2004\) )Tj
/TT2 1 Tf
(The HIVNET 012 Study and the Safety and Effectiveness of Nevirapine in P\
reventing Mother-to-)Tj
T*
(Infant Transmission of HIV.)Tj
/TT1 1 Tf
( )Tj
ET
175.173 640.105 m
525.925 640.105 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 175.1725 641.7252 Tm
(http://www3.niaid.nih.gov/news/newsreleases/2004/hivnet012.htm)Tj
0 0 0.2 rg
/TT1 1 Tf
( Last )Tj
-12.338 -1.405 Td
(accessed 2006/03/02.)Tj
ET
18.86 606.105 m
31.37 606.105 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 607.7252 Tm
(46)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(IOM \(2005\) )Tj
/TT2 1 Tf
(Review of the HIVNET 012 Perinatal HIV Prevention Study.)Tj
/TT1 1 Tf
( )Tj
ET
395.268 605.762 m
509.027 605.762 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 395.2675 607.3815 Tm
(http://www.iom.edu/?)Tj
ET
36.37 589.957 m
146.429 589.957 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 591.5766 Tm
(id=26287&redirect=0)Tj
0 0 0.2 rg
/TT1 1 Tf
(. Last accessed 2006/03/02.)Tj
ET
18.86 569.457 m
31.37 569.457 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 571.0766 Tm
(47)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Moodley D. )Tj
/TT2 1 Tf
(et al.)Tj
/TT1 1 Tf
( \(2002\) )Tj
/TT2 1 Tf
(A Multicenter Randomized Controlled Trial of Nevirapine Versus a Combina\
tion of )Tj
T*
(Zidovudine and Lamivudine to ReduceIntrapartum and Early Postpartum Moth\
er-to-Child Transmission of )Tj
0 -1.2 TD
(Human Immunodeficiency Virus Type 1.)Tj
/TT1 1 Tf
( )Tj
ET
238.938 542.074 m
437.77 542.074 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 238.9375 543.6943 Tm
(J Infect Dis. 2003 Mar 1;187\(5\):725-35)Tj
0 0 0.2 rg
/TT1 1 Tf
(. [)Tj
ET
447.152 542.074 m
494.031 542.074 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 447.1525 543.6943 Tm
(Full-Text)Tj
0 0 0.2 rg
/TT1 1 Tf
(])Tj
ET
18.86 521.574 m
31.37 521.574 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 523.1943 Tm
(48)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Lallemant M. )Tj
/TT2 1 Tf
(et al.)Tj
/TT1 1 Tf
( \(2004\) )Tj
/TT2 1 Tf
(Single-dose perinatal nevirapine plus standard zidovudine to prevent mot\
her-to-child )Tj
0 -1.522 TD
(transmission of HIV-1 in Thailand.)Tj
/TT1 1 Tf
( )Tj
ET
208.304 504.109 m
420.265 504.109 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 208.3038 505.7287 Tm
(N Engl J Med. 2004 Jul 15;351\(3\):217-28)Tj
0 0 0.2 rg
/TT1 1 Tf
(. [)Tj
ET
q
21 0 0 22 429.6475067 496.978714 cm
/Im0 Do
Q
450.648 504.109 m
497.526 504.109 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 450.6475 505.7287 Tm
(Full-Text)Tj
0 0 0.2 rg
/TT1 1 Tf
(])Tj
ET
18.86 481.036 m
31.37 481.036 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 482.6557 Tm
(49)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Ayouba A )Tj
/TT2 1 Tf
(et al.)Tj
/TT1 1 Tf
( \(2003\) Low rate of mother-to-child transmission of HIV-1 after nevira\
pine intervention in a pilot )Tj
0 -1.2 TD
(public health program in Yaounde, Cameroon. )Tj
ET
269.605 467.192 m
560.327 467.192 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 269.605 468.812 Tm
(J Acquir Immune Defic Syndr. 2003 Nov 1;34\(3\):274-80)Tj
0 0 0.2 rg
/TT1 1 Tf
(.)Tj
ET
18.86 446.692 m
31.37 446.692 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 448.312 Tm
(50)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Wiktor SZ. )Tj
/TT2 1 Tf
(et al.)Tj
/TT1 1 Tf
( \(1999\) )Tj
/TT2 1 Tf
(Short-course oral zidovudine for prevention of mother-to-child transmiss\
ion of HIV-1 in )Tj
0 -1.203 TD
(Abidjan, Cote d'Ivoire: a randomised trial.)Tj
/TT1 1 Tf
( )Tj
ET
244.855 432.81 m
432.438 432.81 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 244.855 434.4298 Tm
(Lancet. 1999 Mar 6;353\(9155\):781-5)Tj
ET
18.86 412.31 m
31.37 412.31 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 413.9298 Tm
(51)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Connor EM. )Tj
/TT2 1 Tf
(et al)Tj
/TT1 1 Tf
(. \(1994\) )Tj
/TT2 1 Tf
(Reduction of maternal-infant transmission of human immunodeficiency viru\
s type 1 )Tj
T*
(with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol\
076 Study Group.)Tj
/TT1 1 Tf
( )Tj
ET
486.539 398.427 m
591.58 398.427 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 486.5388 400.0475 Tm
(N Engl J Med. 1994 )Tj
ET
36.37 382.623 m
154.54 382.623 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 384.2425 Tm
(Nov 3;331\(18\):1173-80)Tj
0 0 0.2 rg
/TT1 1 Tf
(.)Tj
ET
18.86 362.123 m
31.37 362.123 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 363.7425 Tm
(52)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Wiysonge CS \(2006\) )Tj
/TT2 1 Tf
(Vitamin A supplementation for reducing the risk of mother-to-child trans\
mission of HIV )Tj
T*
(infection.)Tj
/TT1 1 Tf
( The Cochrane Database of Systematic Reviews.)Tj
ET
18.86 330.045 m
31.37 330.045 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 331.6652 Tm
(53)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Humphrey JH. \(2006\) )Tj
/TT2 1 Tf
(Effects of a Single Large Dose of Vitamin A, Given during the Postpartum\
Period to HIV-)Tj
T*
(Positive Women and Their Infants, on Child HIV Infection, HIV-Free Survi\
val, and Mortality.)Tj
/TT1 1 Tf
( )Tj
ET
492.164 316.163 m
586.585 316.163 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 492.1638 317.7829 Tm
(J Infect Dis. 2006 )Tj
ET
36.37 300.358 m
147.036 300.358 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 301.978 Tm
(Mar 15;193\(6\):860-71)Tj
0 0 0.2 rg
/TT1 1 Tf
(.)Tj
ET
18.86 279.858 m
31.37 279.858 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 281.478 Tm
(54)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Fischl MA. )Tj
/TT2 1 Tf
(et al.)Tj
/TT1 1 Tf
( \(1987\) )Tj
/TT2 1 Tf
(The efficacy of azidothymidine \(AZT\) in the treatment of patients with\
AIDS and AIDS-)Tj
T*
(related complex. A double-blind, placebo-controlled trial.)Tj
/TT1 1 Tf
( )Tj
ET
319.611 265.976 m
531.572 265.976 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 319.6113 267.5957 Tm
(N Engl J Med. 1987 Jul 23;317\(4\):185-91)Tj
0 0 0.2 rg
/TT1 1 Tf
(.)Tj
ET
18.86 245.476 m
31.37 245.476 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 247.0957 Tm
(55)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(NIAID. \(1995\) )Tj
/TT2 1 Tf
(AZT and AIDS.)Tj
/TT1 1 Tf
( )Tj
ET
187.053 245.132 m
467.74 245.132 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 187.0525 246.7521 Tm
(http://www.niaid.nih.gov/publications/hivaids/23.htm)Tj
0 0 0.2 rg
/TT1 1 Tf
(. Last accessed )Tj
-13.394 -1.405 Td
(2006/03/01.)Tj
ET
18.86 211.132 m
31.37 211.132 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 212.7521 Tm
(56)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.027 Td
(Some AIDS denialists have misrepresented the Concorde study to show that\
AZT is more dangerous than )Tj
T*
(placebo. But the Concorde study did not show this. Ref: NIAID. \(1995\) \
)Tj
/TT2 1 Tf
(The relationship between the Human )Tj
0 -1.203 TD
(Immunodeficiency Virus and the Acquired Immune Syndrome.)Tj
/TT1 1 Tf
( )Tj
ET
348.366 183.75 m
593.425 183.75 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 348.3663 185.3698 Tm
(http://www.niaid.nih.gov/Publications/hivaids/)Tj
ET
36.37 167.945 m
72.629 167.945 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 169.5649 Tm
(all.htm)Tj
0 0 0.2 rg
/TT1 1 Tf
(. Last accessed 2006/03/02.)Tj
ET
18.86 147.445 m
31.37 147.445 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 149.0649 Tm
(57)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.116 Td
(Ibid.)Tj
ET
18.86 126.945 m
31.37 126.945 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 128.5649 Tm
(58)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(NIH \(2006\). )Tj
/TT2 1 Tf
(International HIV/AIDS Trial Finds Continuous Antiretro viral Therapy Su\
perior to Episodic )Tj
0 -1.203 TD
(Therapy.)Tj
/TT1 1 Tf
( )Tj
ET
83.89 113.063 m
343.956 113.063 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 83.89 114.6826 Tm
(http://www.nih.gov/news/pr/jan2006/niaid-18.htm)Tj
0 0 0.2 rg
/TT1 1 Tf
(. Last accessed 2006/03/01.)Tj
ET
18.86 92.563 m
31.37 92.563 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 94.1826 Tm
(59)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Kahn JO. )Tj
/TT2 1 Tf
(et al.)Tj
/TT1 1 Tf
( \(1992\) )Tj
/TT2 1 Tf
(A controlled trial comparing continued zidovudine with didanosine in hum\
an )Tj
T*
(immunodeficiency virus infection. The NIAID AIDS Clinical Trials Group.)Tj
/TT1 1 Tf
( )Tj
ET
397.09 78.68 m
562.15 78.68 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 397.09 80.3003 Tm
(N Engl J Med. 1992 Aug 27;327)Tj
ET
36.37 62.875 m
82.63 62.875 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 64.4954 Tm
(\(9\):581-7)Tj
0 0 0.2 rg
/TT1 1 Tf
(.)Tj
ET
EMC
/Artifact <>BDC
Q
BT
/T1_0 1 Tf
9 0 0 9 18 7.17 Tm
(http://ww2.aegis.org/files/tac/2006/errorsinfarberarticle.html \(32 of 3\
5\)5/8/2006 14:41:09)Tj
ET
EMC
endstream
endobj
766 0 obj<>stream
/Artifact <>BDC
0 0 0 rg
0 i
BT
/T1_0 1 Tf
0 Tc 0 Tw 0 Ts 100 Tz 0 Tr 9 0 0 9 18 780.17 Tm
(http://ww2.aegis.org/files/tac/2006/errorsinfarberarticle.html)Tj
ET
EMC
/Article <>BDC
q
0 18 612 756 re
W* n
0 0 0.4 RG
0.54 w 10 M 0 j 0 J []0 d
18.86 752.057 m
31.37 752.057 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 753.6769 Tm
(60)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Darbyshire J. )Tj
/TT2 1 Tf
(et al.)Tj
/TT1 1 Tf
( \(2005\) )Tj
/TT2 1 Tf
(Zidovudine \(AZT\) versus AZT plus didanosine \(ddI\) versus AZT plus za\
lcitabine )Tj
0 -1.203 TD
(\(ddC\) in HIV infected adults.)Tj
/TT1 1 Tf
( )Tj
ET
180.179 738.175 m
502.188 738.175 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 180.1788 739.7947 Tm
(The Cochrane Database of Systematic Reviews 2006 Issue 1)Tj
ET
18.86 717.675 m
31.37 717.675 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 719.2947 Tm
(61)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(FDA. \(1996\) )Tj
/TT2 1 Tf
(FDA grants accelerated approval to third protease inhibitor to treat HIV\
.)Tj
/TT1 1 Tf
( )Tj
ET
458.425 717.331 m
585.314 717.331 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 458.425 718.951 Tm
(http://www.fda.gov/bbs/)Tj
ET
36.37 701.526 m
193.904 701.526 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 703.1461 Tm
(topics/NEWS/NEW00528.html)Tj
0 0 0.2 rg
/TT1 1 Tf
(. Last accessed 2006/03/01.)Tj
ET
18.86 681.026 m
31.37 681.026 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 682.6461 Tm
(62)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Furman PA. )Tj
/TT2 1 Tf
(et al.)Tj
/TT1 1 Tf
( \(1988\) )Tj
/TT2 1 Tf
(Spectrum of antiviral activity and mechanism of action of zidovudine. An\
overview.)Tj
/TT1 1 Tf
( )Tj
ET
36.37 667.182 m
238.307 667.182 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 668.8025 Tm
(Am J Med. 1988 Aug 29;85\(2A\):176-81)Tj
0 0 0.2 rg
/TT1 1 Tf
(.)Tj
ET
18.86 646.682 m
31.37 646.682 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 648.3025 Tm
(63)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.027 Td
(AZT stops the conversion of viral RNA to DNA by acting as an analog of t\
he DNA-component, thymidine. )Tj
0 -1.2 TD
(Unlike thymidine, once AZT is added into a nascent DNA chain, that chain\
cannot be further lengthened, which )Tj
0 -1.2 TD
(is the basis for AZT's antiviral activity. The process of HIV reverse tr\
anscription is more sensitive to AZT than is )Tj
0 -1.2 TD
(the process of copying the cell's own DNA during cell division; the reas\
on is that the HIV reverse transcriptase )Tj
T*
(enzyme incorporates AZT with a 10-fold preference over thymidine, wherea\
s the host cell DNA-copying )Tj
T*
(enzymes preferentially incorporats thymidine by a comparable margin. The\
result is that AZT relatively )Tj
T*
(selectively inhibits viral DNA synthesis. There is, therefore, a useful,\
albeit small, "Therapeutic Index" for AZT )Tj
0 -1.2 TD
(use, both in cell culture systems and in humans. Understanding the conce\
pt of the Therapeutic Index is )Tj
T*
(important: It is the ratio between the concentration at which a drug has\
a beneficial effect and that at which it )Tj
T*
(has a toxic effect. Ideally, this ratio should be as high as possible, a\
llowing the greatest possible margin of )Tj
T*
(safety. Every chemical can be toxic - water, salt, anything - if enough \
of it is administered to a human. The skill )Tj
T*
(is to find the dose that is effective but safe enough to use.)Tj
ET
18.86 479.682 m
31.37 479.682 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 481.3025 Tm
(64)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(NIAID. \(2004\) )Tj
/TT2 1 Tf
(How HIV causes AIDS.)Tj
/TT1 1 Tf
( )Tj
ET
227.057 479.339 m
490.859 479.339 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 227.0575 480.9589 Tm
(http://www. niaid. nih .gov/factsheets/howhiv.htm)Tj
0 0 0.2 rg
/TT1 1 Tf
(. Last accessed )Tj
-16.95 -1.405 Td
(2006/03/01.)Tj
ET
18.86 445.339 m
31.37 445.339 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 446.9589 Tm
(65)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(NIAID \(1995\) )Tj
/TT2 1 Tf
(Koch's Postulates Fulfilled: The Relationship Between the Human Immunode\
ficiency Virus and )Tj
0 -1.203 TD
(the Acquired Immunodeficiency Syndrome.)Tj
/TT1 1 Tf
( )Tj
ET
253.956 431.457 m
471.52 431.457 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 253.9563 433.0766 Tm
(http://www.aegis.org/factshts/niaid/1995/)Tj
ET
36.37 415.652 m
227.699 415.652 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 417.2717 Tm
(niaid95_fact_sheet_hivaids_12.html)Tj
0 0 0.2 rg
/TT1 1 Tf
(. Last accessed 2006/03/01.)Tj
ET
18.86 395.152 m
31.37 395.152 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 396.7717 Tm
(66)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Osmond,DH. \(1998\) )Tj
/TT2 1 Tf
(Epidemiology of Disease Progression in HIV.)Tj
/TT1 1 Tf
( HIV InSite Knowledge Base Chapter May )Tj
0 -1.2 TD
(1998. )Tj
ET
67.645 381.308 m
356.792 381.308 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 67.645 382.928 Tm
(http://hivinsite.ucsf.edu/InSite?page=kb-03-01-04#S3X)Tj
0 0 0.2 rg
/TT1 1 Tf
(. Last accessed 2006/03/01.)Tj
ET
18.86 360.808 m
31.37 360.808 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 362.428 Tm
(67)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.118 Td
(NIAID. \(2003\), )Tj
/TT2 1 Tf
(supra)Tj
/TT1 1 Tf
(, Note 25.)Tj
ET
18.86 340.308 m
31.37 340.308 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 341.928 Tm
(68)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Montagnier L. \(1997\) )Tj
/TT2 1 Tf
(Human immunodeficiency virus infection and AIDS in a person with negativ\
e serology.)Tj
/TT1 1 Tf
( )Tj
ET
575.965 339.964 m
585.348 339.964 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 575.965 341.5844 Tm
(J )Tj
ET
36.37 324.159 m
209.553 324.159 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 325.7795 Tm
(Infect Dis. 1997 Apr;175\(4\):955-9)Tj
0 0 0.2 rg
/TT1 1 Tf
(.)Tj
ET
18.86 303.659 m
31.37 303.659 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 305.2795 Tm
(69)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Richman DD )Tj
/TT2 1 Tf
(et al.)Tj
/TT1 1 Tf
( \(2003\) )Tj
/TT2 1 Tf
(Rapid evolution of the neutralizing antibody response to HIV type 1 infe\
ction.)Tj
/TT1 1 Tf
( )Tj
ET
550.36 303.316 m
578.496 303.316 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 550.36 304.9359 Tm
(Proc )Tj
ET
36.37 283.889 m
279.584 283.889 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 285.5089 Tm
(Natl Acad Sci U S A. 2003 Apr 1;100\(7\):4144-9)Tj
0 0 0.2 rg
/TT1 1 Tf
(. [)Tj
ET
q
21 0 0 22 288.9662476 276.7588959 cm
/Im0 Do
Q
309.966 283.889 m
356.845 283.889 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 309.9662 285.5089 Tm
(Full-Text)Tj
0 0 0.2 rg
/TT1 1 Tf
(])Tj
ET
18.86 260.816 m
31.37 260.816 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 262.4359 Tm
(70)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.027 Td
(The reason why HIV antibodies do not confer immunity from disease has be\
en demonstrated. Farber may be )Tj
T*
(confusing binding and neutralizing antibodies. Many antibodies to viral \
proteins lack antiviral activity; they are )Tj
0 -1.2 TD
(raised against viral proteins, they often bind efficiently to dissociate\
d viral proteins or fragments of these )Tj
0 -1.2 TD
(proteins \(which is why they register in diagnostic assays\), but they a\
re unable to bind to intact virus particles )Tj
T*
(and inhibit their replication. Virus-neutralizing antibodies, on the oth\
er hand, do possess antiviral activity, with )Tj
T*
(the caveats noted in the text. Among the very many publications on these\
basic immunology topics are: )Tj
0 -1.1 TD
( )Tj
0 -1.103 TD
(Hangartner L et al. \(2006\) )Tj
/TT2 1 Tf
(Anti viral antibody responses: the two extremes of a wide spectrum.)Tj
/TT1 1 Tf
( )Tj
ET
507.824 168.222 m
552.835 168.222 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 507.8237 169.8422 Tm
(Nat Rev )Tj
ET
36.37 152.722 m
200.17 152.722 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 154.3422 Tm
(Immunol. 2006 Mar;6\(3\):231-43)Tj
0 0 0.2 rg
/TT1 1 Tf
( )Tj
0 -1.408 TD
(Burton DR. \(2002\) )Tj
/TT2 1 Tf
(Antibodies, viruses and vaccines.)Tj
/TT1 1 Tf
( )Tj
ET
300.227 136.879 m
509.669 136.879 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 300.2275 138.4986 Tm
(Nat Rev Immunol. 2002 Sep;2\(9\):706-13)Tj
0 0 0.2 rg
/TT1 1 Tf
( )Tj
-23.454 -1.408 Td
(Parren PWHI. \(2001\) )Tj
/TT2 1 Tf
(The antiviral activity of antibodies in vitro and in vivo.)Tj
/TT1 1 Tf
( )Tj
ET
409.634 121.035 m
573.445 121.035 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 409.6337 122.655 Tm
(Adv Immunol. 2001;77:195-262)Tj
0 0 0.2 rg
/TT1 1 Tf
(.)Tj
ET
18.86 100.535 m
31.37 100.535 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 102.155 Tm
(71)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(NIAID \(1995\). )Tj
/TT2 1 Tf
(Course of HIV infection.)Tj
/TT1 1 Tf
( )Tj
ET
230.196 100.191 m
504.629 100.191 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 230.1962 101.8114 Tm
(http://www.niaid.nih.gov/publications/hivaids/9.htm)Tj
0 0 0.2 rg
/TT1 1 Tf
(. Last accessed )Tj
-17.229 -1.405 Td
(2006/03/01.)Tj
ET
18.86 66.191 m
31.37 66.191 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 67.8114 Tm
(72)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Brenchley JM. )Tj
/TT2 1 Tf
(et al.)Tj
/TT1 1 Tf
( \(2006\) )Tj
/TT2 1 Tf
(HIV disease: fallout from a mucosal catastrophe?)Tj
/TT1 1 Tf
( )Tj
ET
422.155 65.848 m
554.691 65.848 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 422.155 67.4678 Tm
(Nat Immunol. 2006 Mar;7)Tj
ET
36.37 50.043 m
82.63 50.043 l
S
BT
/TT0 1 Tf
11.25 0 0 11.25 36.37 51.6628 Tm
(\(3\):235-9)Tj
0 0 0.2 rg
/TT1 1 Tf
(.)Tj
ET
EMC
/Artifact <>BDC
Q
BT
/T1_0 1 Tf
9 0 0 9 18 7.17 Tm
(http://ww2.aegis.org/files/tac/2006/errorsinfarberarticle.html \(33 of 3\
5\)5/8/2006 14:41:09)Tj
ET
EMC
endstream
endobj
767 0 obj<>stream
/Artifact <>BDC
0 0 0 rg
0 i
BT
/T1_0 1 Tf
0 Tc 0 Tw 0 Ts 100 Tz 0 Tr 9 0 0 9 18 780.17 Tm
(http://ww2.aegis.org/files/tac/2006/errorsinfarberarticle.html)Tj
ET
EMC
/Article <>BDC
q
0 18 612 756 re
W* n
0 0 0.4 RG
0.54 w 10 M 0 j 0 J []0 d
18.86 752.057 m
31.37 752.057 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
11.25 0 0 11.25 18.86 753.6769 Tm
(73)Tj
0 0 0.2 rg
/TT1 1 Tf
1.556 -0.031 Td
(Haase AT. \(2005\) )Tj
/TT2 1 Tf
(Perils at mucosal front lines for HIV and SIV and their hosts.)Tj
/TT1 1 Tf
( )Tj
ET
430.289 751.713 m
585.336 751.713 l
S
0 0 0.4 rg
BT
/TT0 1 Tf
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(et al.)Tj
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( \(2003\) )Tj
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(T cell dynamics in HIV-1 infection.)Tj
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( )Tj
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0 -1.2 TD
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0 -1.2 TD
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death of the activated cells. Because )Tj
T*
(HIV is not eliminated from the body by the immune response, the chronic \
and persistent immune activation )Tj
T*
(over a multi-year period contributes substantially to the gradual erosio\
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T*
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T*
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T*
(as the extent of immune activation and the degree of cell death both dec\
line when HIV replication is inhibited )Tj
T*
(by the use of antiretroviral therapy. It should be noted that the natura\
l function of the CD4+ T-helper cell is to )Tj
T*
(coordinate and regulate acquired immune responses to pathogens, includin\
g of course HIV itself. The loss of )Tj
T*
(this critical component of the immune system seriously compromises the d\
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T*
(efficient humoral \(antibody-mediated\) and cellular \(cell-mediated\) i\
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T*
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gene\) therefore have a reduced )Tj
T*
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T*
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0 -1.2 TD
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T*
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T*
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T*
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T*
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ormal CCR5 alleles because the lower )Tj
T*
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less efficiently. The CCR5-delta32 )Tj
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(mutant allele arose spontaneously in the human genome several thousand y\
ears ago, most probably in )Tj
T*
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T*
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T*
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T*
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n\) and in populations that have bred )Tj
T*
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T*
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T*
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T*
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