Pity poor Peter Duesberg; even Medical Hypotheses has dissed him

Pity poor Peter Duesberg.

Back in the 1980s, he was on the top of the world, scientifically speaking. A brilliant virologist with an impressive record of accomplishment, publication, and funding, he seemed to be on a short track to an eventual Nobel Prize. Then something happened. The AIDS epidemic happened. Something about the AIDS epidemic led this excellent scientist in the late 1980s to fall directly into pseudoscience and crankery by latching onto and promoting the idea that HIV does not cause AIDS. Of course, at the time scientists didn’t yet know a lot about the virus and how it slowly destroyed the immune system. There was a lot of room for new knowledge. It might have been possible that something other than HIV was contributing to the development of AIDS. However, science and evidence accumulated. More importantly, in the 1990s, new antiretroviral drugs were developed. The success at prolonging the lives of HIV patients of drug cocktails designed to target HIV by different mechanisms and thus forestall the development of resistance represented the final evidence that HIV definitely caused AIDS. Scientists’ understanding of the virus had led for the first time to effective therapies–and in record time, a mere decade A deadly disease became a chronically manageable one.

None of this mattered to HIV/AIDS denialists. They continued to believe that it couldn’t possibly by HIV that cause the slow destruction of the immune system suffered by AIDS patients. They continued to insist that it must be some combination of pills, diseases spread by promiscuous sex, or other vague, unnamed factors. And Peter Duesberg was right there among them, destroying his own scientific career in the process. Oh, sure, he’s recently tried to resurrect it by pushing an interesting “everything old is new again” hypothesis for cancer causation, but even doing that he’s behaved like a crank by branding his hypothesis The One True Cause of Cancer and castigating other scientists for not immediately appreciating his brilliance.

About a week ago, for some reason that still escapes me, a whim took me and I decided to see what Duesberg was up to, scientifically speaking. So I did a quick PubMed on Peter Duesberg’s name, and I came across this abstract for a Medical Hypothesis article by Duesberg. My first reaction was to think was that Duesberg has really come down in the world if he’s actually publishing in Medical Hypotheses these days. My second reaction was laughter, and lots of it. Read the abstract and you will see why:

WITHDRAWN: HIV-AIDS hypothesis out of touch with South African AIDS – A new perspective.

Duesberg PH, Nicholson JM, Rasnick D, Fiala C, Bauer HH.
Department of Molecular and Cell Biology, Donner Laboratory, UC Berkeley, Berkeley, CA 94720, USA.

This Article-in-Press has been withdrawn pending the results of an investigation. The editorial policy of Medical Hypotheses makes it clear that the journal considers “radical, speculative, and non-mainstream scientific ideas”, and articles will only be acceptable if they are “coherent and clearly expressed.” However, we have received serious expressions of concern about the quality of this article, which contains highly controversial opinions about the causes of AIDS, opinions that could potentially be damaging to global public health. Concern has also been expressed that the article contains potentially libelous material. Given these important signals of concern, we judge it correct to investigate the circumstances in which this article came to be published online. When the investigation and review have been completed we will issue a further statement. Until that time, the article has been removed from all Elsevier databases. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.

Oh. My. God. Does it get any lower than having your article withdrawn by Medical Hypotheses?

Medical Hypotheses? The same crank journal that’s published utter pseudoscientific speculation by Mark Blaxill claiming that thimerosal in vaccines causes autism and similarly pseudoscientific idiocy by Mark and David Geier? The same journal that will publish virtually anything. It isn’t even a properly peer-reviewed journal

And Duesberg’s stuff was too crappy even for Medical Hypotheses.

He.

Hehehehehehe.

Hehehehehehahahahahahahahahahahaha.

Excuse me. I couldn’t help myself.

So what was the article that was so bad that even Medical Hypotheses decided to withdraw it? Leave it to an a website like this to explain it:

HIV-AIDS hypothesis out of touch with South African AIDS – A new perspective.

Med Hypotheses. 2009 Jul 18;

Authors: Duesberg PH, Nicholson JM, Rasnick D, Fiala C, Bauer HH

A recent study by Chigwedere et al., “Estimating the lost benefits of antiretroviral drug use in South Africa”, claims that during the period from 2000 to 2005 about 330,000 South African AIDS-deaths were caused by the Human Immunodeficiency Virus (HIV) per year that could have been prevented by available anti-HIV drugs. The study blamed those who question the hypothesis that HIV is the cause of AIDS, particularly former South African President Thabo Mbeki and one of us, for not preventing these deaths by anti-HIV treatments such as the DNA chain-terminator AZT and the HIV DNA inhibitor Nevirapine. Here we ask, (1) What evidence exists for the huge losses of South African lives from HIV claimed by the Chigwedere study? (2) What evidence exists that South Africans would have benefited from anti-HIV drugs? We found that vital statistics from South Africa reported only 1 “HIV-death” per 1000 HIV antibody-positives per year (or 12,000 per 12 million HIV antibody-positives) between 2000 and 2005, whereas Chigwedere et al. estimated losses of around 330,000 lives from HIV per year. Moreover, the US Census Bureau and South Africa reported that the South African population had increased by 3 million during the period from 2000 to 2005 instead of suffering losses, growing from 44.5 to 47.5 million, even though 25% to 30% were positive for antibodies against HIV. A similar discrepancy was found between claims for a reportedly devastating HIV epidemic in Uganda and a simultaneous massive growth of the Ugandan population. Likewise, the total Sub-Saharan population doubled from 400 millions in 1980 to 800 millions in 2007 during the African HIV epidemics. We conclude that the claims that HIV has caused huge losses of African lives are unconfirmed and that HIV is not sufficient or even necessary to cause the previously known diseases, now called AIDS in the presence of antibody against HIV. Further we call into question the claim that HIV antibody-positives would benefit from anti-HIV drugs, because these drugs are inevitably toxic and because there is as yet no proof that HIV causes AIDS.
PMID: 19619953 [PubMed – as supplied by publisher]

I was curious why this particular manuscript would have been withdrawn from Medical Hypotheses, given that it expresses the usual nonsensical “scientific opinions” that HIV isn’t enough to cause AIDS, that HIV doesn’t kill as many in Africa as estimated, and that anti-HIV drugs don’t work. Yada yada, same ol’, same ol’. What changed between the time that Medical Hypotheses (MH) accepted this article and decided to withdraw it? After all, MH has accepted and published all sorts of crap, from anti-vaccine pseudoscience to HIV/AIDS denialism, to all manner of crankery, including articles advocating masturbation as a treatment for nasal congestion and a horrible paper on “mongoloids.” It’s even published papers speculating that high heeled shoes are associated with schizophrenia. (Where was the Goddess when this happened?) Why would this one article be worse? Quite frankly, I was puzzled. at the time. Perhaps that’s why, after I first noticed this withdrawn MH paper a week ago and had meant to blog about it then, I let other things distract me and then totally forgot about it.

Until I saw Ben Goldacre’s column over the weekend entitled Medical Hypotheses fails the Aids test, which in turn led me to this detailed explanation on AIDSTruth.org entitled Elsevier retracts Duesberg’s AIDS Denialist article. After that, it all became clear. Basically, the slapdown administered to Duesberg and other HIV/AIDS denialists had its genesis in a study by Pride Chigwedere and coinvestigators at Harvard University, who estimated that delays in providing antiretroviral drugs in South Africa because of state-supported AIDS denialism (in which Duesberg played a prominent role in promoting) had caused over 300,000 deaths. In fact, the article mentioned Duesberg’s role in promoting HIV/AIDS denialism in South Africa. This is what happened:

AIDS denialist Peter Duesberg, whose influence on the disastrous South African government policies was mentioned in Chigwedere’s article, submitted a response to JAIDS that was co-authored by four others including Rasnick. After this article was rejected because of its poor academic quality, Duesberg et al. submitted it to a different journal, Medical Hypotheses. Two days later, the editor accepted the paper. Medical Hypotheses does not practice peer review, a process in which several scientists check a submitted academic paper for quality and suggest needed improvements over a period of weeks or months. The Duesberg et al. paper was accepted without such a review process, after inspection only by the editor of Medical Hypotheses.

Where have we seen this before? Articles rejected by real journals somehow have a way of finding their way into Medical Hypotheses? I’ve even witnessed it happen once, when a very cranky article was sent to me to be reviewed. I trashed it because it was so very, very bad that I had no choice. In essence it was nothing more than one long ad hominem attack with virtually no science or evidence. Guess what? About a year later, I saw a shorter version of the article, ironically cleaned up a bit of its worse offenses (maybe I did have an effect, after all), in–where else?–Medical Hypotheses. Duesberg was particularly crass, too, writing in the article:

A precursor of this paper was rejected by the Journal of AIDS, which published the Chigwedere et al. article, with political and ad hominem arguments but without offering even one reference for an incorrect number or statement of our paper (available on request).

Apparently I missed it, but HIV/AIDS denialists were crowing about this, just as anti-vaccinationists crowed about papers by Blaxill and Mark Geier making it into Medical Hypotheses and held them up as “evidence” that their ideas were making it into mainstream scientific journals, laboring under the delusion that this is a peer-reviewed journal or outright misrepresenting it as such.

Be that as it may, what this incident led me to was a long overdue effort by scientists to do something that should have been done a long time ago. For some reason that has always eluded me, ever since I first discovered the land of woo that is Medical Hypotheses, this journal is indexed with MEDLINE and shows up on PubMed searches. It goes against a lot of what MEDLINE claims to be its standards for indexing a journal or even the very functions of MEDLINE. Based on the co-optation of Medical Hypotheses by HIV/AIDS denialists to their cause, a number of academics, authors, and researchers have written a letter to Donald A. B. Lindberg, M.D. Director, National Library of Medicine Betsy L. Humphreys Deputy Director, National Library of Medicine Sheldon Kotzin Associate Director, Library Operations Library Selection Technical Review Committee calling for Medical Hypotheses to be delisted from MEDLINE, concluding:

We, the undersigned, respectfully request that the journal Medical Hypotheses be reviewed for MEDLINE deselection at the earliest convenience of the Literature Selection Technical Review Committee. Medical Hypotheses does not appear to meet the standards for MEDLINE listing as established by the National Library of Medicine, and recent publications in the journal are inconsistent with the stated missions of the National Library of Medicine and the National Institutes of Health.

According to the AIDSTruth.org website, he NLM responded that it would review the journal in October of 2009.

My thought upon reading this is: What took them so long? My other thought was this; If one of the reasons Elsevier removed Duesberg’s article and another article by an HIV/AIDS denialist was because they potentially “endangered public health,” why the hell hasn’t Medical Hypotheses been called out in the same way for publishing anti-vaccine articles. The Blaxill article, whose coauthors included founders of the anti-vaccine group SAFEMINDS, and the Geier article both became tools of the anti-vaccine movement in their propaganda war to convince the world that vaccines cause autism. The were arguably just as much “threats to public health” as either of these articles by HIV/AIDS denialists.

The problem with Medical Hypotheses, of course, is that it is a crank journal masquerading as a real, peer-reviewed journal. Indeed, cranks of all stripes take advantage of the confusion and lack of understanding most non-scientists have over what does and does not constitute a peer-reviewed journal to represent articles in Medical Hypotheses as though they come from a reputable scientific source. “Look!” they proclaim, “science really is taking us seriously!” Even some scientists get taken in, because many scientists and physicians are unaware that this isn’t a peer-reviewed journal, mainly because it’s indexed in MEDLINE. Indeed, its editor, Bruce G. Charlton, showed up in the comments of Bad Science to proclaim:

As the editor I am ‘agnostic’ about the truth or correctness of the papers chosen for publication in Medical Hypotheses, so I make no comment on that aspect of the AIDS papers.

Instead I aim to decide what ought to be published according to the criteria applied by Medical Hypotheses – which can be seen here – http://www.elsevier.com/locate/mehy .
Clearly these two AIDS papers ought to have been published by the journal’s evaluation criteria, and the reaction since they were accepted shows exactly why it was right that they were accepted to be published.

Instead of working within the scientific process, for example by submitting a reasoned rebuttal to Medical Hypotheses of the kind which we always publish, the authors who are trying to destroy Medical Hypotheses wrote to the _publisher_ of the journal and succeeded in getting these papers suppressed and deleted from the records.

These authors then wrote to try and de-list Medical Hypotheses from Medline, an act that would exclude the journal from the mainstream scientific communication network in which – at present – it plays a significant role (significant, that is, according to objective data on impact factor, citations and downloads).

Cry me a river. You made your bed. Now lie in it.

Mr. Charlton’s statement, gentle reader, is better evidence than I could ever give to explain why Medical Hypotheses has no part being listed on MEDLINE. I have no problem with a magazine or journal that publishes speculative science, however irresponsible. There should be a role for such a journal, where scientists and physicians can let their minds wander and see what comes of it. What I do have a problem with is that journal’s editor thinking it has some sort of right to be listed in MEDLINE, abusing that listing to publish irresponsible articles by HIV/AIDS denialists, and then crying persecution when his irresponsible publication policies lead to calls to delist his journal from MEDLINE. Indeed, Charlton’s response tells me that he relies on the patina of respectability that his MEDLINE listing provides as part of the marketing of his journal. Worse, the only time he appears to try to disabuse anyone of the notion that Medical Hypotheses is a peer-reviewed journal is by occasionally showing up in the comments of a critical blog post like this to opine that, really, you shouldn’t take this stuff so seriously because it’s all highly speculative, and, oh, it’s “editorially reviewed” rather than peer-reviewed–which, he promises, is really, truly just as good.

I wonder if they need any more signatories to the letter. Or maybe those of us who regularly combat the anti-vaccine movement should draft a letter of my own before the NLM reconsiders the status of Medical Hypotheses in October. I’d say we should go after JPANDS next, but it’s never been listed by MEDLINE. In the meantime, I’ll enjoy the spectacle of the arch-HIV/AIDS denialist being thoroughly slapped down by, of all things, Elsevier, which hasn’t exactly been a paragon of responsibility before. Truly, when your work in Medical Hypotheses is so bad that even Elsevier feels obligated to slap you down, all that’s left is Whale.to.