BOOK REVIEW:
Acquired Immune Deficiency Syndrome (AIDS) is more than just a disease.
It is alternately a symbol of uncaring government repression, a badge of
holiness or of disgrace, a symbol of the tragedy of liberation, a sign
that there is no God, a sign that there is an angry God. It has helped
change people's attitudes about prophylactics, sexuality and homosexuality
and forced many to question the mindset that almost epitomizes western
culture: the faith that we are able to control the natural world through
our will and technologies and bend it to our needs and desires.
More than anything else AIDS functions as a mental and social fault line.
Some say that we don't care enough about AIDS because its victims tend
to be from socially marginalized strata; others say that we concentrate
too many resources on it because its victims and their advocates are better
connected to the mass media and politics than those associated with more
widespread ailments such as cancer and heart disease. Though its status
as a fatal illness should command enough respect, in public discourse it
is somehow always more than just what it is; it has something to say about
our culture, our safety, our efficacy, our compassion, our politics, our
humanity.
"Silence=Death" goes the slogan, so it has become impossible
to avoid hearing about AIDS, even if the prophecy we've heard repeated
from newspaper op-ed pages and the Oprah Winfrey Show and public service
announcements for the past eight or so years hasn't yet come true and you
still don't personally know anyone suffering from it. Everyone seems to
think they know something about AIDS, perhaps everything they need to know.
Everyone has an opinion, even if that opinion is based on no more knowledge
than can be gleaned from a public health pamphlet advocating condom use.
The voices shouting in the echo chamber of AIDS debate occasionally drown
out rational discourse. But disguised by the hand wringing and hysteria
may be a story of single-minded government power pushing a bankrupt idea.
Rethinking AIDS by Robert Root-Bernstein, an Associate Professor
of Physiology at Michigan State University, is a heady and disturbing dose
of rational discourse that shakes to its core the establishment AIDS industry
of scientists, government, activists and the mass media. Root-Bernstein
tries to demonstrate that our current scientific and public health approach
to AIDS is fatally flawed; that the Human Immunodeficiency Virus (HIV),
commonly understood to be the cause of the range of diseases that we call
AIDS, may in fact be no more than a co-factor, if that.
Root-Bernstein is not alone in making such a claim. First and most famous
of the AIDS heretics is Berkeley molecular biologist Peter Duesberg, who
first challenged the notion that HIV causes AIDS in the peer-reviewed scientific
journal Cancer Research in March 1987. As a result Duesberg ended
up being informed by the National Institute of Health in October 1990 that
his "Outstanding Investigator Grant" would not be renewed after
it runs out in 1993. (The committee that made this decision had as members
the mother of one of the children of Robert Gallo, alleged discoverer of
HIV and someone who holds a patent on an HIV antibody test.) Duesberg has
become Gallo's bete noire; Gallo recently walked off the set while
being interviewed by ABC TV's Day One "news-magazine"
when they brought up Duesberg and he vowed he'd do everything in his power
to prevent them from giving Duesberg's ideas any publicity. But joining
the anti-establishment cause was Charles A. Thomas--a former Harvard biochemistry
professor--and a society he founded in 1991, the Group for the Scientific
Reappraisal of the HIV/AIDS Hypothesis, which counts among its over 40
members retrovirologists, epidemiologists and immunologists, all of whom
question the HIV dogma.
Because of the overriding sociological noise surrounding AIDS, it helps
to be fortified with some facts that go beyond the propaganda of the mass
media/government/activist axis. It's important to start with the basics:
What causes AIDS anyway? What is AIDS?
AIDS was first conceptualized in 1980-81 after doctors in Los Angeles,
San Francisco and New York began noticing many cases of Kaposi's sarcoma,
pneumocystis pneumonia, consistent low-grade fevers and a cornucopia of
unusual infections, protozoans, viruses and fungi in men aged 20-40 who
were suffering from immune suppression for no noticeable reason. Because
their common denominator was that they were sexually promiscuous young
gay men, many with histories of drug abuse, the syndrome was first called
GRID (gay-related immune deficiency). The search for a cause and a cure
was on.
It seemed to bear quick fruit. On April 23, 1984, Margaret Heckler, Secretary
of Health and Human Services for Ronald Reagan, proudly announced that
a U.S. doctor, Robert Gallo, had discovered the cause of AIDS: a retrovirus,
allegedly isolated as the Human Immunodeficiency Virus (HIV). She also
promised a vaccine by 1986.
Gallo's claim of discovery was only the beginning of the web of controversy,
confusion and possible fraud that would surround the conceptual romance
of HIV and AIDS. It turned out that the virus had already been discovered
a year earlier by a French scientist, Luc Montagnier of the Pasteur Institute.
Montagnier had sent Gallo the virus to examine. A dispute ensued over the
right to claim discovery and concomitant rights to patents on AIDS testing
kits that depend on looking for antibodies to this retrovirus. This fight
initially led to a compact between the French and American governments
that would split royalties and name Gallo and Montagnier "co-discoverers"
of HIV.
Bur recent revelations from the work of Chicago Tribune reporter
John Crewsden and an internal NIH investigation seem to indicate that Gallo
willfully attempted to steal credit for the HIV discovery and that one
of his early papers that purported to show how HIV causes AIDS, contained
"misrepresentations or falsifications." Gallo himself has admitted
that the virus used in developing his AIDS test was one of the ones sent
to him by the Pasteur Institute. The French are now suing for all past
and future royalties--which would amount to tens of millions of dollars--from
Gallo personally and from the U.S. government and for recognition of Montagnier
as sole discoverer of HIV.
Meanwhile, billions of dollars have been funneled by the U.S. government
pursuing Gallo's "HIV causes AIDS, alone and unaided" thesis.
But after nearly a decade, it has paid off with nothing. We still have
no vaccine. And we still don't know how a retrovirus is causing the array
of diverse ailments and infections that we have labeled AIDS. The problem
is that not one example of a retrovirus has ever been known to cause disease
in humans, since retroviruses parasitically require a living cell in order
to reproduce.
It is important to remember that AIDS is not a disease per se but a syndrome--a
catchall name for a situation in which massive immunosuppression leads
to the body's falling prey to a wide range of ailments, including pneumonia,
dementia, wasting disease, candidiasis, lymphoma, tuberculosis and various
sexually transmitted diseases such as herpes and Epstein-Barr Virus. These
diseases were around before HIV was isolated; they will be around even
if HIV were somehow eradicated. The"A" in AIDS stands for "acquired";
we diagnose massive immunosuppression as AIDS, supposedly, in the presence
of HIV antibodies and when there is no other apparent reason for the problems
of the immune system. But in around half of currently diagnosed AIDS patients,
HIV has not even been checked for, as Root-Bernstein's book exhaustively
demonstrates. I will return to this point later.
So how is HIV supposed to be doing its dirty work? According to the standard
theory, upon entering the body it infiltrates and kills T-helper cells,
a vital part of the immune system, by the billions. The precise mechanism
by which it does this is not yet known, as even HIV partisans admit; they
like to say that HIV is a "mysterious" virus. Without these mysteries
the multi-billion dollar government-financed industry surrounding HIV would
have little to do. On the subject of HIV's "mysteries," Kary
Mullis, the inventor of the polymerase chain reaction that has enabled
investigators to find viruses such as HIV, becomes caustic. "The mystery
of that damn virus has been generated by the $2 billion a year they spend
on it. You take any other virus and you spend $2 billion and you can make
up some great mysteries about it, too."
Over the past few years, Duesberg, the members of the Group for the Scientific
Reappraisal of the HIV/AIDS Hypothesis and now Root-Bernstein, have been
attempting to bring to public attention many anomalies that cast doubt
on the notion that HIV, mysterious or not, could possibly be responsible
for all the harms the standard paradigm claims.
Opposition to the HIV thesis is not monolithic. There are strong differences
in emphasis between Duesberg, who until this book was the best-known of
the AIDS heretics and Root-Bernstein. Duesberg asserts that HIV is completely
harmless and even offers to be publicly injected with it under controlled
testing circumstances; Root-Bernstein holds open the possibility that HIV
has some role to play in immunosuppression. Duesberg places the entirety
of AIDS causation on drug abuse; Root-Bernstein entertains a more nuanced,
multifactorial hypothesis.
But the question of what does cause AIDS is secondary to establishing doubt
that HIV is the sole explanation. It is not necessarily incumbent on one
questioning HIV's role to counter with a fully worked-out alternative explanation.
And there are many reasons to doubt HIV's role as the sole necessary and
sufficient cause of AIDS. Though it is supposedly killing T-helper cells
by the billions, HIV is rarely detectable in large quantities in the bodies
of those allegedly dying of its effects. What we call "the AIDS test"
does not test for the presence of HIV itself--it tests for the presence
of antibodies against HIV, which generally is a sign that the body has
been exposed to and beaten off, the infection. This is the same principle
behind vaccination, in which you are injected with an attenuated form of
a virus in order to engender an antibody response that will keep you safe
from that virus thereafter. The virus itself is very difficult to find,
generally detectable in no more that 1 out of 10,000 T-cells, hardly a
large enough presence to be doing the damage it is alleged to do.
Since the mechanism by which HIV is supposedly killing T-cells is still
uncertain, the HIV hypothesis is based largely on correlation assumptions
that are both factually and rationally weak. HIV is often (though by no
means always) found where AIDS is found; and Gallo claims that the syndrome
only appears after HIV appears; that there is no AIDS where there is no
HIV.
This view is associated with the thesis that HIV is a dread new microbe,
the same notion that has led some to aver that it must be the result of
some biological warfare experiment gone awry (or fiendishly created to
wipe out "undesirables"). Root-Bernstein lays to rest the notion
that either AIDS or HIV is new to the world as of the late seventies and
early eighties. Through painstaking reading of the extant literature, he
has discovered many case histories dating back over the last century of
people dying of a mysterious overload of opportunistic diseases such as
Kaposi's sarcoma, pneumocystis pneumonia, candida infections and cytomegalovirus,
all of which are now associated with AIDS. And HIV has been found in frozen
blood samples dating back at least to 1959. Thus, the notion that HIV and
AIDS burst on the scene together in the late '70s is without foundation.
Once this is realized, the tenuousness of the official HIV hypothesis becomes
more and more apparent. The alleged "latency period" of the virus,
another unusual attribute of HIV is repeatedly extended as people known
to have HIV continue to live longer and longer. In 1986, it was assumed
to be less than two years, by the beginning of 1992 it was between 10 and
15 years. No advances in knowledge of how HIV is doing its allegedly murderous
work triggered these revisions, merely the observation that people continue
to live healthily with HIV. Could this possibly indicate that HIV is not
necessarily fatal, that a diagnosis of "HIV positive" need not
be a death sentence, need not scare you into consuming AZT (the current
FDA approved AIDS drug that is a known cell killer and immune suppressor)?
Or will the "latency period" continue to stretch on infinitely
in protection of the "HIV is the sole necessary and sufficient cause
of AIDS" thesis that so many careers and reputations (including that
of the U.S. government) depend on?
AIDS epidemiology also casts doubt on its status as a sexually transmitted
single-cause microbe. In addition to anecdotal cases such as Marc Christian,
Rock Hudson's lover who survived an estimated 600 unprotected sexual encounters
with the dying Hudson without contracting either HIV or any illness, there
is the simple fact that, despite a decade of activist and right-wing scare
tactics, AIDS has never turned into the predicted plague breaking out of
the initial risk groups of homosexuals, hemophiliacs and drug abusers.
The official Centers for Disease Control estimate that the prevalence of
HIV in the U.S. population has remained steady since 1985; around one million.
(And only about 3 percent a year of these on average go on to develop symptoms
of AIDS.) The much-hyped epidemic didn't happen. For a supposedly infectious
virus, HIV shows an almost human preference for certain types of people
and for males over females. For example, over 90 percent of AIDS cases
in the U.S. are male, though in Africa the sexual distribution is almost
even. What is in the nature of this microbe to make it sexually selective
depending on what continent it is on? According To Root-Bernstein it is
not the microbe but the nature of the differing immunosuppressive hazards
in the two continents' populations that makes the difference.
The lack of massive heterosexual spread through prostitutes is crucial
in showing that AIDS is not a standard sexually transmittable disease.
Root-Bernstein cites many studies showing that no significant increase
in HIV seropositivity (showing antibodies for HIV) among non-drug abusing
prostitutes can be found in any major Western city. A study in the American
Journal of Public Health concluded that "HIV infection in non-drug
using prostitutes tends to be low or absent, implying that sexual activity
alone does not place them at high risk, while prostitutes who use intravenous
drugs are far more likely to be infected with HIV." Prostitutes in
this study do evince the normal range of known sexually transmitted diseases.
And for a sexually-transmitted disease, HIV is rarely detectable in semen.
"In all studies...less than a third of the infected men had any HIV
present in the semen and then generally less than one virus genome per
milliliter of semen, or perhaps one or two dozen virus-infected cells per
ejaculate, on average. Approximately the same number of viruses are excreted
in the saliva of HIV infected individuals and in vaginal secretions. This
amount of HIV is considered to be incapable of transmitting disease,"
Root-Bernstein says (p.34).
Another blow to the notion of HIV's power to kill is [the fact that] though
there are over "6,000 verified cases of health care workers reporting
subcutaneous exposure to HIV-infected blood or tissue as a result of needle-stick
injuries, surgical cuts, broken glass and so forth...only a few dozen health
care workers are known to have become seropositive during the entire decade
of the 1980s in the United States" (p.44). Compare this to hepatitis,
a typical infectious disease, which causes about 15,000 accidental infections
among health care professionals a year. Clearly, the notion of the single
infectious killer retrovirus bringing down the healthy is impossible.
What does Root-Bernstein hypothesize is suddenly causing widespread immune
collapse among so many people? No new killer microbe is necessary, he asserts
and he makes his case painstakingly; this book's thoroughness does not
necessarily make for fun or easy reading. Through case study after case
study, medical citation after medical citation, he shows that the major
risk groups for AIDS all have multiple immunosuppressive behaviors or risks
that do not require the hypothesis of a single new cause. Multiple blood
exposure to semen; the internal damage caused by anal sex and sex practices
such as "fisting" which expanded greatly throughout the gay community
in the 1970s and '80s; multiple blood transfusions; anesthetics and surgery;
the overuse of antibiotics, opiates and nitrate drugs; severe malnutrition
and exposure to infections such as cytomegalovirus and various sexually
transmitted diseases, which are just as present in AIDS patients as HIV;
all of these are known to be immunosuppressive or to expose the body to
the risk of the multiple concurrent infections that characterize AIDS.
Root-Bernstein documents these assertions at copious and almost tiresome
length, but it is important to show the reader that there are many possible
common factors among those dying of immune suppression that are unfortunately
being ignored in the rush to judgment on HIV. The studies that could help
prove or disprove Root-Bernstein's theories are not being done, particularly
his rather complicated, but compelling, explanation of how certain combinations
of opportunistic infections that are as common in AIDS patients as HIV
may lead to an autoimmune reaction in which the body's immune system turns
on itself.
While this book can be understood by a lay reader, it does not condescend.
It requires of readers a demanding level of thought about the workings
of the immune system and the ability to remember the results of copious
numbers of medical case studies.
Root-Bernstein makes a compelling case against continuing to channel funding
for research on this disease on the assumption that HIV is the sole necessary
and sufficient cause of AIDS. So how did we get to this state? Why are
so many spending so much money on a wrong path?
There is a historical parallel. Years of time and effort were wasted searching
for a "single cause" for cancer, which is now understood to be
a multifactorial ailment. Again with AIDS it was assumed that this seemingly
new phenomenon must have a single, somewhat new cause--despite the fact
that all that is new about it is its prevalence. Root-Bernstein blames
this, in America, on a massive sociological explosion of risk behaviors
involving sex and drug practices and new attention to the health risks
of hemophiliacs and recipients of blood transfusions. He blames the phenomenon,
in Africa, on ancient problems of malnutrition, poor sanitation and the
modern spread of sexually transmitted diseases. But a retrovirologist like
Robert Gallo (who had earlier claimed that a retrovirus he discovered was
causing a form of leukemia) fought for the importance of his retrovirus
turf and managed to get the weight of the federal government and its research
grant monopoly behind him. At that point, the fate of alternative approaches
was sealed.
Don't expect this book to cause public breakthroughs any time soon. Though
it is well-reasoned, thorough, calm and professional, it is certain to
be attacked with invective and a refusal to respond point by point, the
fate that Duesberg has suffered for the last six years. Root-Bernstein
claims that many of his colleagues privately agree with him but refuse
to say so publicly in fear of losing their funding as well. The emotional
energy of AIDS activists who see continued massive government funding as
their only hope--and who consider anyone who isn't getting with the prevailing
program to have blood on his hands--combined with the cultural weight of
"official" explanations promulgated relentlessly in every part
of our culture, produces a powerful backlash against heretics.
Even journalists who write about AIDS heretics are not immune from reprisals.
One writer for the Miami Herald was fired for criticizing AZT after
a letter-writing attack from Martin Delaney, director of Project Inform,
an AIDS activist group. Project Inform--which is funded by Burroughs-Wellcome,
the developers of AZT whose sales depend on the HIV hypothesis--makes a
practice of attacking the reputations and jobs of journalists who publicize
questions about the hypothesis. Delaney circulated a six-page diatribe
containing personal attacks on the AIDS heretics, accusing Spin's
Celia Farber of spreading misinformation and of being a threat to public
health. He even argued that she should be prohibited from writing about
the subject.
From the beginning the HIV thesis was marinated in fraud and possible professional
and pecuniary gain. It appears to be based only on a correlational and
epidemiological pattern that ignores other possible explanations. Its importance
has expanded beyond the possible wasting of money; if Duesberg and Root-Bernstein
are on the right track, then the cries of some radical gay activists are
right: the government's promotion of "cures" like AZT and programs
such as needle giveaways is claiming lives and ignoring real risks of immunosuppression.
Government's dominance of science can only be expected to lead to results
like this. Instead of letting a thousand flowers bloom, the government
has poured tons of manure on one superficially lovely scientific flower
festooned with possibly fatal thorns.
But the diagnosis is not totally bleak: more and more people are beginning
to question the orthodoxy. If you look hard enough, you can find the heretical
thought even in the press: an article by Duesberg in the Summer 1990 issue
of Policy Review, an article or two by iconoclastic right-wing journalist
Tom Bethell in National Review and the American Spectator
and most of all the writings of the indefatigable Celia Farber of Spin.
A floodgate is beginning to burst, especially after this summer's conference
in which many doctors came forward to discuss cases that were obviously
AIDS but in whom no trace of HIV could be found by even the most sophisticated
methods. I have seen the anti-HIV thesis discussed more on TV and in magazines
in the last six months than in the prior six years. Even HIV's actual discoverer,
Luc Montagnier, now admits that cofactors must be involved. (He hypothesizes
a form of bacteria called mycoplasma as a possible culprit.)
Anyone who cares about AIDS, is interested in a curious intellectual adventure,
or wants more evidence of how centralization of power and responsibility
undermines a flourishing intellectual climate and a healthy culture--healthy
in many senses--should read this demanding, often shocking and important
book. *
Reviewed by Brian Doherty
Source: Liberty August 1993