Science / Medicine : THE AIDS DEBATE: Another View
The federal government is spending hundreds of millions of dollars fighting AIDS, channeling most of that money toward weapons against an organism called human immunodeficiency virus (HIV).
Most researchers accept that HIV causes the acquired immune deficiency syndrome, and the search is on for vaccines against the virus and for drugs against the disease.
But what if that basic assumption is wrong? What if researchers are concentrating on the wrong virus, or focusing only on a single virus when the disease is actually caused by a combination of agents? A small group of respected scientists is asking just that.
The two camps disagree not so much on the basic facts as on their interpretations.
The “dissidents” say that the AIDS Establishment, by closing the doors on unconventional theories, may actually be hampering the fight against the disease.
One leading dissident, UC Berkeley molecular biologist Peter H. Duesberg, believes that HIV is not the cause of AIDS--at least not the sole cause.
He thinks the virus may be an opportunistic organism that found a willing host in the AIDS patient who became sick from something else. That is, he believes HIV is the result of the disease, not the cause. Duesberg thinks the cause of AIDS has more to do with the life style of most of the AIDS patients, but he admits that he doesn’t know exactly what.
“It was wear and tear and exposure to a lot of things” that left victims vulnerable to the disease, Duesberg said. Many AIDS patients have used drugs including amphetamines, cocaine or heroin. “Only athletes could stand up to that,” he said.
Duesberg’s theory admittedly is controversial, but the notion that there may be something else other than--or in addition to--HIV that is responsible for AIDS should not be so lightly dismissed, says Albert Sabin, developer of the oral polio vaccine.
Sabin, now a National Institutes of Health consultant, says the scientific community is making a mistake by ignoring Duesberg. “I think the views of a person like Dr. Duesberg are terribly, terribly important,” he said, “and we must pay attention to them.”
Clearly, the “dissidents” are outnumbered, but that has not kept the dispute from getting pretty nasty.
Some of the dissidents call the federal Centers for Disease Control and the NIH “the AIDS Mafia.” Meanwhile, some AIDS researchers contacted for this story used such words as “kooks” and “nutty” to describe those holding contrary views; most refused to be quoted, even anonymously.
According to the popular theory, HIV, one of a class of viruses called retroviruses, attacks white blood cells called helper T-cells. The result is the destruction of the body’s immune system, leading most AIDS patients to die of otherwise rare infections and tumors.
HIV was identified as the cause of AIDS after an unseemly battle between American and French scientists over credit for its discovery. Once it became clear that the two groups had isolated essentially the same virus in some AIDS patients, all other paths of exploration were abandoned.
“There used to be some degree of competition only a couple of years ago,” said Duesberg.
For instance, early in the search for the cause of AIDS, some medical researchers indeed had suspected that other viruses may be responsible for the disease. But eventually, Duesberg said, those who didn’t accept HIV as the sole cause were simply “out-lobbied.”
As a result, for instance, a computerized search of the medical literature found that out of more than 600 papers on AIDS published in medical journals in the last three years, all but a few accepted HIV as the cause.
Duesberg does not perform AIDS research himself, but he is a member of the prestigious National Academy of Sciences and was a co-discoverer of oncogenes (genes that cause cancer). He also was the first to develop a genetic map of retroviruses.
Writing in the journal Cancer Research last March, Duesberg bluntly stated that “there is no evidence, besides its presence in a latent form, that (HIV) is necessary for AIDS.”
“If you find a microbe or a virus in a disease, that doesn’t prove it is the cause of the disease,” Duesberg added in a telephone interview.
For one thing, he noted, HIV violates two of the three hallowed laws of medicine, known as Koch’s Postulates.
Established 100 years ago by the German physician Robert Koch, the postulates state that before a microorganism can be blamed for causing a disease, three things must be true:
The microorganism must be found, either during the illness or after death, in every patient who has the disease.
It must cause the disease when it is injected into research animals, usually rodents or primates.
It must be not only isolated from the patient but also then grown in culture.
Every other microorganism identified as the cause of a disease has met all three of these conditions--except AIDS.
Duesberg says HIV fails on the first two of the Koch tests. According to his interpretation of the medical literature, the virus has been found in only 50% of AIDS patients; only antibodies have been found in virtually all AIDS patients. Also, no one has ever caused AIDS by injecting HIV into a primate or other experimental animal.
But one AIDS researcher, who refused to be quoted by name, said Duesberg was factually incorrect, that the virus has been found in virtually all patients.
Another researcher said the truth is somewhere in between. In many cases, doctors no longer look for the virus; if the patient has the antibodies and the symptoms, they assume that the patient has the AIDS virus. But in some cases, they have not found the AIDS virus in AIDS patients.
All that is clear is that the virus, for one reason or another, has not been found in every single AIDS patient, either at diagnosis or in post-mortem examinations.
The other issue--that HIV has not caused AIDS in an experimental host--will remain unresolved. Usually, a virus known to cause a particular disease can be injected into a primate to cause the disease, thus providing scientists a convenient research model. Still, several diseases occur in humans but not in animals--smallpox, for example. With HIV presumed to be deadly, it would be unethical to test it on humans.
“We haven’t produced the illness in animals, but that doesn’t mean (HIV) doesn’t cause the disease in humans,” said Mervyn Silverman, former San Francisco health director and founder of the American Foundation for AIDS Research.
He said the fact that the virus has not been found in every case is less important than the fact that antibodies were found in nearly every case. “The finding of the antibodies to the virus in individuals correlates when we see the symptoms of AIDS. This doesn’t mean there’s not some fellow traveler (virus) causing the problem. We know (HIV) gets into cells and destroys them.”
Silverman doesn’t subscribe to Duesberg’s theory but thinks that even unconventional theories deserve exploration.
Duesberg believes that, even if HIV is the sole cause of AIDS, it acts as no other known virus has acted, a belief also subscribed to by nearly all AIDS researchers.
Scientists have found that the virus has taken over, at most, 0.01% of the T-cells in infected patients, an extremely small number. Even some patients who are dying of AIDS show little HIV infection and no active viruses.
Most disease-causing organisms invade many more cells, Duesberg said. If a virus can kill with as little cell invasion as HIV causes, he argued, the human race would not have lasted 3 million years.
Mainstream AIDS researchers say Duesberg is ignoring HIV’s invasion of cells other than the T-cells, which they believe contributes to the development of the disease. But they admit they cannot explain how.
“It’s very peculiar,” Duesberg said. “There is no precedent for such a behavior or such a situation in microbiology.”
Joseph Sonnebend, another dissident, is one of the discoverers of the natural virus-fighter interferon and a founder of the AIDS Medical Foundation in New York. Sonnebend was treating AIDS patients in the city’s homosexual community even before it was recognized as a separate disease.
Sonnebend believes that HIV may play a role in AIDS, but that of at least equal importance are environmental and behavioral factors.
Protests From Homosexuals
This theory has drawn sharp protests from homosexuals because it implies their life style may be partially responsible.
AIDS was recognized as a disease at the same time the homosexual community was undergoing sociological changes in the early 1970s, Sonnebend said. Large numbers of homosexual men were moving into big cities such as Los Angeles, New York and San Francisco, the places where the disease was first identified.
Additionally, he said, the “gay liberation” movement seemed to have produced considerable promiscuity on the part of some homosexuals, with a few men claiming thousands of sexual liaisons. Many practiced anal intercourse.
The physical trauma of anal sex and the barrage of semen in the rectum, compounded by promiscuous behavior, may have produced the disease identified as AIDS, Sonnebend said. (The mainstream view is that such behavior causes the spread of the disease, as opposed to causing the disease itself.)
Experiments on rabbits by Steven Witkin at the Cornell Medical Center in New York have shown that semen from healthy rabbits, injected anally, triggers the production of antibodies to the semen and suppresses the immune system. The result is similar to some of the symptoms of AIDS--implying that semen itself could, under certain conditions, have a role in depressing human immunity.
Additionally, the trauma of anal sex produces cuts and scrapes in the rectal tissue that could permit the easy passage of the semen and any organisms it was carrying into the body.
Other researchers said theories involving behavior ignore the fact that AIDS is rampant in Africa, among heterosexuals as well as homosexuals.
Sonnebend, however, thinks the syndrome is not new at all but has been described as other diseases throughout history, particularly in Africa. Nor does Sonnebend think AIDS is a single disease but rather a family of afflictions that have been hiding in malnutrition and tropical diseases.
“It’s been buried in all that stuff and we’ve never seen it,” he said.
“Europeans and Americans have gone to Africa for hundreds of years, have had sex, homosexual and heterosexual, and have gone home.” Many then suffered from unexplained pneumonia and other ailments that are part of the AIDS complex of diseases, he said.
Intravenous drug users, another high-risk group for AIDS in the United States, frequently suffer from malnutrition and live in poverty conditions.
But Silverman said HIV is “the only constant that we’ve seen in this disease.”
“I think it’s the best we’ve got to go with,” Silverman said. “Until somebody can demonstrate otherwise, we ought to pursue the most likely avenue.”
Why has there been so much resistance to alternative theories?
Duesberg said that many AIDS researchers cut their professional teeth in the early 1970s, when retroviruses were a popular field of study. Retroviruses, so called because their genetic material is RNA-based rather than DNA-based, were the target for President Richard M. Nixon’s vaunted “War on Cancer,” for instance. Duesberg also believes some researchers are hoping to win a Nobel Prize by finding an AIDS vaccine.
“Spending money on retrovirus research is great,” said Sonnebend, “but every avenue should be explored.”
