Editing Duesberg hypothesis (section)

==Role of legal and illegal drug use==
Duesberg argues that there is a statistical [[correlation]] between trends in recreational drug use and trends in AIDS cases.<ref>{{cite journal |vauthors=Duesberg P, Rasnick D |title=The AIDS dilemma: drug diseases blamed on a passenger virus |journal=Genetica |volume=104 |issue=2 |pages=85–132 |year=1998 |pmid=10220905 |doi=10.1023/A:1003405220186|s2cid=30201649 }}</ref> He argues that the [[AIDS epidemic|epidemic]] of AIDS cases in the 1980s corresponds to a supposed epidemic of recreational drug use in the United States and Europe during the same time frame.

These claims are not supported by [[epidemiology|epidemiologic data]]. The average yearly increase in [[opioid]]-related deaths from 1990 to 2002 was nearly three times the yearly increase from 1979 to 1990, with the greatest increase in 2000–2002, yet AIDS cases and deaths fell dramatically during the mid-to-late-1990s.<ref name="drugusepharmaco">{{cite journal |vauthors=Paulozzi LJ, Budnitz DS, Yongli X |title=Increasing deaths from opioid analgesics in the United States |journal=Pharmacoepidemiology and Drug Safety |volume=15 |issue=9 |pages=618–27 |year=2006 |pmid=16862602 |doi=10.1002/pds.1276|s2cid=16121594 |url=https://zenodo.org/record/1229306 }}</ref> Duesberg's claim that recreational drug use, rather than HIV, was the cause of AIDS has been specifically examined and found to be false. Cohort studies have found that only HIV-positive drug users develop [[opportunistic infection]]s; HIV-negative drug users do not develop such infections, indicating that HIV rather than drug use is the cause of AIDS.<ref name="niaid"/><ref name="drugusenature">{{cite journal |vauthors=Ascher MS, Sheppard HW, Winkelstein W, Vittinghoff E |title=Does drug use cause AIDS? |journal=Nature |volume=362 |issue=6416 |pages=103–4 |year=1993 |pmid=8095697 |doi=10.1038/362103a0 |bibcode=1993Natur.362..103A|s2cid=42128974 }}</ref>

Duesberg has also argued that [[nitrite inhalant]]s were the cause of the epidemic of [[Kaposi sarcoma]] (KS) in gay men. However, this argument has been described as an example of the [[fallacy]] of a statistical [[confounding]] effect;<ref>{{cite journal |author=Morabia A |title=Poppers, Kaposi's sarcoma, and HIV infection: empirical example of a strong confounding effect? |journal=Prev Med |volume=24 |issue=1 |pages=90–5 |year=1995 |pmid=7661947 |doi=10.1006/pmed.1995.1014}}</ref> it is now known that [[Kaposi's sarcoma-associated herpesvirus|a herpesvirus]], potentiated by HIV, is responsible for AIDS-associated KS.<ref>{{cite journal |vauthors=Kedes D, Operskalski E, Busch M, Kohn R, Flood J, Ganem D |title=The seroepidemiology of human herpesvirus 8 (Kaposi's sarcoma-associated herpesvirus): distribution of infection in KS risk groups and evidence for sexual transmission |journal=Nat Med |volume=2 |issue=8 |pages=918–24 |year=1996 |pmid=8705863 |doi=10.1038/nm0896-918|s2cid=36556102 }}</ref><ref>{{cite journal |vauthors=Martin J, Ganem D, Osmond D, Page-Shafer K, Macrae D, Kedes D |title=Sexual transmission and the natural history of human herpesvirus 8 infection |journal=N Engl J Med |volume=338 |issue=14 |pages=948–54 |year=1998 |pmid=9521982 |doi=10.1056/NEJM199804023381403|doi-access=free }}</ref>

Moreover, in addition to recreational drugs, Duesberg argues that anti-HIV drugs such as [[zidovudine]] (AZT) can cause AIDS. Duesberg's claim that antiviral medication causes AIDS is regarded as disproven within the scientific community. Placebo-controlled studies have found that AZT as a single agent produces modest and short-lived improvements in survival and delays the development of opportunistic infections; it certainly did not cause AIDS, which develops in both treated and untreated study patients. With the subsequent development of [[Protease inhibitor (pharmacology)|protease inhibitor]]s and [[highly active antiretroviral therapy]], numerous studies have documented the fact that anti-HIV drugs prevent the development of AIDS and substantially prolong survival, further disproving the claim that these drugs "cause" AIDS.<ref name="niaid"/>

===Scientific study and rejection of Duesberg's risk-AIDS hypothesis===
Several studies have specifically addressed Duesberg's claim that recreational drug abuse or [[sexual promiscuity]] were responsible for the manifestations of AIDS. An early study of his claims, published in ''[[Nature (journal)|Nature]]'' in 1993, found Duesberg's drug abuse-AIDS hypothesis to have "no basis in fact."<ref name="drugusenature"/>

A large [[prospective study]] followed a group of 715 [[Homosexuality|homosexual]] men in the Vancouver, Canada, area; approximately half were HIV-[[seropositive]] or became so during the follow-up period, and the remainder were HIV-seronegative. After more than eight years of follow-up, despite similar rates of drug use, sexual contact, and other supposed risk factors in both groups, only the HIV-positive group suffered from [[opportunistic infection]]s. Similarly, [[CD4]] counts dropped in the patients who were HIV-infected, but remained stable in the HIV-negative patients, despite similar rates of risk behavior.<ref name="lancet1993"/> The authors concluded that "the risk-AIDS hypothesis ... is clearly rejected by our data," and that "the evidence supports the hypothesis that HIV-1 has an integral role in the CD4 depletion and progressive immune dysfunction that characterise AIDS."<ref name="lancet1993">{{cite journal |vauthors=Schechter M, Craib K, Gelmon K, Montaner J, Le T, O'Shaughnessy M | title = HIV-1 and the aetiology of AIDS. | journal = Lancet | volume = 341 | issue = 8846 | pages = 658–9 | year = 1993 | pmid = 8095571 | doi = 10.1016/0140-6736(93)90421-C| s2cid = 23141531 }}</ref>

Similarly, the [[Multicenter AIDS Cohort Study]] (MACS) and the [[Women's Interagency HIV Study]] (WIHS)—which between them observed more than 8,000 Americans—demonstrated that "the presence of HIV infection is the only factor that is strongly and consistently associated with the conditions that define AIDS."<ref name="macs">[http://www3.niaid.nih.gov/news/focuson/hiv/resources/macs_and_wihs.htm MACS and WIHS Studies Provide Overwhelming Evidence That HIV Causes AIDS] {{Webarchive|url=https://web.archive.org/web/20061004002832/http://www3.niaid.nih.gov/news/focuson/hiv/resources/macs_and_wihs.htm |date=4 October 2006 }}. From the [[National Institute of Allergy and Infectious Diseases]]. Retrieved 9 March 2007.</ref> A 2008 study found that recreational drug use (including [[cannabis (drug)|cannabis]], [[cocaine]], [[poppers]], and [[amphetamines]]) had no effect on [[CD4]] or [[CD8]] T-cell counts, providing further evidence against a role of recreational drugs as a cause of AIDS.<ref>{{cite journal |author=Chao C |title=Recreational drug use and T lymphocyte subpopulations in HIV-uninfected and HIV-infected men |journal=Drug Alcohol Depend |volume= 94|issue= 1–3|pages= 165–171|year=2008 |pmid=18180115 |doi=10.1016/j.drugalcdep.2007.11.010 |pmc=2691391 |author2=Jacobson LP |author3=Tashkin D |last4=Martínez-Maza |first4=Otoniel |last5=Roth |first5=Michael D. |last6=Margolick |first6=Joseph B. |last7=Chmiel |first7=Joan S. |last8=Rinaldo |first8=Charles |last9=Zhang |first9=Zuo-Feng|display-authors=3 }}</ref>