Test Ideas With Science, Not Scorn : Critics who insist that HIV doesn’t cause AIDS may be wrong, but their argument deserves checking.
Reports that AIDS patients are turning up with no sign of the human immunodeficiency virus, or HIV, in their bodies have thrown a monkey wrench into standard AIDS theory, and appear to signal at least partial, temporary vindication of Peter Duesberg, the virologist who says that HIV does not cause acquired immune deficiency syndrome.
The reports, made public last week at the International AIDS Conference in Amsterdam, have sent scientists scrambling for explanations. Since 1984, when then-Secretary of Health and Human Services Margaret Heckler announced, in a dramatic news conference, that the “cause” of AIDS--HIV--had been discovered and isolated, a mere three years after the disease was identified, humanity’s hopes for preventing and curing AIDS have rested with combatting the errant virus. So embedded in the world’s consciousness has the HIV-AIDS connection become that every controversy over clean needles, blood testing and condoms takes that connection for granted.
The majority of scientists believe that HIV does cause AIDS, and they may be right. The most recent reports may be merely the latest odd twist in the saga of an odd and baffling disease.
But the news from Amsterdam and other disturbing signs suggest otherwise. Troubling voices have arisen to challenge the federal Centers for Disease Control, the gatekeepers of the official theory of the cause of AIDS. The apostates claim that HIV is not the cause of AIDS and that the government is wasting its time and spending billions of dollars to combat a harmless virus. Furthermore, they contend, the medical Establishment is engaged in a conspiracy to silence critics (many of them with impeccable scientific credentials) who have the temerity to question the official CDC line.
Peter Duesberg, the unofficial leader of the revisionists, is a tenured virologist at UC Berkeley. Duesberg, 56, was an international star of virology long before anyone heard of AIDS. He was the first person, more than 20 years ago, to map the genetic structure of retroviruses. HIV is a retrovirus, inarguably the world’s most notorious.
Duesberg argues that HIV is a benign, garden-variety retrovirus, exactly like a thousand others he has studied over the decades, a notion directly in conflict with the axiom that HIV is the cause of AIDS.
In the annals of scientific controversy, few debates have been more clear-cut. Both sides cannot be right.
Conspiracy theorists are nothing new, and Americans, subject to years of fantastic theories ranging from who killed J.F.K. to whether the government is spreading crack in the inner cities, have understandably grown weary of unlikely conjecture and suspicious of those who would spread it. Yet the anti-HIV group has some persuasive arguments, and is steadily gathering enough support, among other scientists and public-policy experts, to suggest that the rest of us should listen.
The CDC argument is, in essence, a simple one. A new, virulent virus appears on the scene, is transmitted through bodily fluids, lies dormant in cells for years, then explodes with pathogenic violence, causing the collapse of the immune system and gradual deterioration and death by some two dozen nasty diseases. The evidence for this is all around us: in hospital wards filled with “high-risk group” members and in mounting statistics of morbidity and mortality around the globe.
Enter Duesberg. The first thing that must be said is that he is not just another conspiratorialist. Many of his anti-HIV arguments have the ring of common sense. Here are a few:
--As the latest reports state, not all cases of AIDS, even those occurring in high-risk groups like urban homosexuals, show signs of infection with HIV, thus violating the most fundamental postulate of infectious disease: If a person has the illness, his body must harbor the germ that causes it. The CDC has responded by changing its definition of AIDS, or by postulating the existence of at least one other as-yet unknown virus.
--There is nothing particularly new about AIDS, which, properly speaking, is not a disease at all, but rather a syndrome, arbitrarily defined as a long list of ancient diseases that are called AIDS only when HIV is present. Duesberg thus calls the definition of AIDS a tautology. Moreover, different people around the world who have been diagnosed with AIDS have entirely different symptoms. What other illness behaves like this?
--It is difficult to explain why some domestic partners of HIV-infected people never test positive for the virus, much less come down with the disease, despite having engaged in unprotected sex, often for years. On the other hand, a few individuals have contracted the disease through no known risk behavior.
--Even in cases of full-blown AIDS, where the patient is dying, the HIV virus, if it can be found at all, is present in the body in such minute quantities that it would appear impossible for it to have any negative health consequences. In other diseases caused by pathogens, great quantities of germs are almost always found in the body.
--Thousands, perhaps hundreds of thousands, of people who test positive for HIV have remained healthy for years, and there is little reason to believe that many of them will not live natural life spans and die of causes unrelated to AIDS. On the other hand, some people newly infected with HIV develop AIDS with incredible rapidity and die within days or weeks of diagnosis. Duesberg argues that long latency is associated with toxic causes, like cigarette smoking, rather than infective causes.
How does Duesberg explain AIDS? The body’s immune system is worn down, he asserts, by the ingestion of street drugs (including crack, amphetamines and inhalant “poppers”), which open the individual to a host of infections, including HIV. (In Africa, Duesberg says, African people are simply dying of ancient indigenous diseases, such as “slim disease.” Infants in the West with AIDS, he says, are largely in utero victims of their mothers’ drug use.) More frighteningly, Duesberg calls AZT, one of only a handful of American drugs approved for AIDS treatment, “a virulent immunosuppressive” that is itself causing healthy HIV carriers to develop full-blown AIDS. It is instructive to note that Duesberg does not implicate any kind of sexual practice, including anal intercourse, as a factor in AIDS. If the disease is not caused by a bug, then sexual practices cannot be part of its etiology (although they may be associated with other serious diseases).
What has been the response of the medical community, and particularly the CDC and its sister organization, the National Institutes of Health, to Duesberg? In 1990, Duesberg’s seven-year, open-ended, $1.5-million grant from the National Cancer Institute, an NIH agency heavily involved in HIV research, was not renewed, because (said the letter informing him of its cancellation) Duesberg had strayed into “non-scientific issues” in his investigation of non-HIV causes of AIDS. This, despite the fact that the grant had charged Duesberg to “venture into new territory” and “ask creative questions.”
Duesberg says he finds it virtually impossible to get published in the professional literature any more. Bad blood has arisen between Duesberg and leaders of the government’s fight against AIDS. Dr. Robert Gallo, once Duesberg’s close friend and colleague, and the putative co-discoverer of HIV (along with Dr. Luc Montagnier of the Institute Pasteur in Paris), has ridiculed Duesberg in print and has refused to attend meetings at which he was speaking. Dr. Anthony Fauci, coordinator of AIDS research at NIH, has publicly accused Duesberg of spreading “absolute and total nonsense.” Dr. David Baltimore, a leading AIDS researcher, has called Duesberg “irresponsible and pernicious.”
Duesberg gives as good as he gets. The truth could be determined by appropriate experiments, he says, but no one in the scientific Establishment has the guts to conduct them, particularly those who have climbed aboard the multibillion-dollar HIV funding wagon.
Ironically, Montagnier, whose name, along with Gallo’s, is ineluctably linked to HIV, recently stated that HIV in itself is probably necessary, but not sufficient, to cause the disease. Some co-factor, Montagnier reasons, may exist, which would explain some of the anomalies of AIDS.
And the defection from HIV continues. Research late last year, reported in the respected British journal Nature, suggests that AIDS may be an autoimmune disease, like arthritis, rather than an infectious illness. In an editorial reporting on that research, Nature editor John Maddox, saying that “something strange is afoot,” concluded, “Duesberg will be saying, ‘I told you so.’ ” He later added, “I feel sorry that Nature has not done more to give (Duesberg’s) view prominence.”
It would seem apparent that there are now three legitimately contending theories regarding the cause of AIDS: the official CDC theory (that HIV alone causes AIDS), the Montagnier co-factor theory and Duesberg’s (that street drugs cause AIDS, and HIV is irrelevant).
Three conflicting theories, 10 years into a devastating pandemic, are not acceptable. The problem is not merely that a scientific house divided against itself is less likely to come up with real cures and preventions or to persuade funding agencies to support research. The real problem is that, as the mixed message is disseminated by an eager media (as the Amsterdam reports were), the public becomes more and more confused. Getting average citizens to properly understand AIDS has always been one of the most difficult fronts on which to fight the disease, in may ways as hard as the battle on the medical front itself. The spectacle of scientists quarreling among themselves does not make it easier. The dispute has created a maddening paradox. If Duesberg is correct, then those who believe the CDC’s theory will use clean needles while shooting up drugs that destroy their immune systems, and will enjoy “safe” sex with condoms even as they inhale poppers, thus committing suicide. On the other hand, if the CDC is right, then those who pick up on a version of Duesberg’s message and thereby conclude that sex does not transmit AIDS are equally damned.
If there is even a remote chance that Duesberg is correct--and the latest reports increase that possibility--then the powers that be must leap into action. Future historians have got to record that when the time came, the late 20th Century’s scientists, after a wrong turn or two, accurately made clear, and cured, whatever it was that caused hundreds of thousands of people to die.
TOMORROW: What are we to make of the AIDS debate. By Dr. Russell Maulitz.
