§3. HIV and AIDS
Some scientists, including especially Peter Duesberg for several years, have challenged the hypothesis that "HIV is the cause of AIDS," and have provided some evidence for their challenge. In the past, I myself have sometimes used the expression "AIDS virus" in referring to HIV. In light of existing documentation, all such references should be amended to contain the qualification "alleged." At the time this essay is written, I do not regard the causal relationship between HIV and any disease as settled. I have seen considerable evidence that highly improper statistics concerning HIV and AIDS have been passed off as science, and that top members of the scientific establishment have carelessly, if not irresponsibly, joined the media in spreading misinformation about the nature of AIDS and its connection with HIV or its connection with the use (possibly repeated use) of certain drugs.
Specifically:
1. No scientific piece of evidence. Some scientists (including Peter Duesberg and Kary Mullis, independently), have pointed out that there is no scientific piece of evidence showing that HIV causes any disease. For instance Kary Mullis is quoted in an interview (California Monthly, September 1994 p. 20):
What happened was so simple I don't understand why it never happened to other people. In the late 1980s, I was working for several companies that were using PCR to detect HIV sequences. I would get into a situation where I'd have to write a little report on what was going on at one of the companies. And I would find myself in a position of having to write a sentence that said, "HIV is the probable cause of AIDS."
I figured there must be a standard reference or two I could use to back up that statement. So I just yelled across the room, "What's the reference for 'HIV is the cause of AIDS'"? Some guy said, "Oh you don't need a reference for that. Everybody knows that." And I said, "I think it should be footnoted. When you make a direct statement like that, you give a source. You say, "Here's how I know that's true.' I think it's good form."
So he said, "Why don't you cite this Centers for Communicable Diseases [CDC] report?" He gave it to me. It was a stupid little thing, without scientific merit; you might as well quote the New York Times. So I went to other people in the lab, and I started looking at the scientific literature, and I began to notice that nobody ever quoted a scientific paper to back up the notion that HIV causes AIDS.
Both Duesberg and Mullis have emphasized that the papers of Montagnier, Gallo or others do not provide any scientific justification that HIV causes a disease. They asked for such papers but none was forthcoming. In his California Monthly interview, Mullis tells how he began to think there was "something fishy" about the evasive answers he was getting to his questions. He tells about the way he confronted Montagnier in San Diego, after Montagnier had given a talk on AIDS. Mullis "noticed that Montagnier hadn't said one word about how come we ought to think HIV is the cause of AIDS." After the talk Mullis asked Montagnier directly for a scientific reference, and Montagnier admitted that none existed,
Duesberg wrote a letter dated 11 February 1993 to Harold Jaffe, Director of the HIV/AIDS Division at the CDC. In that letter, Duesberg asked: "Exactly which papers are now considered proof or, if there is no proof, the best support for the HIV-AIDS hypothesis?" Not a single specific paper was mentioned in Jaffe's reply. Jaffe only gave what he viewed as epidemiological evidence,
2. The case of chimpanzees. From 1983 to the late eighties, 150 chimpanzees were infected with HIV, but did not become sick as of 1994. This information was obtained by Duesberg directly from Jorg Eichberg, cf. Duesberg's article "AIDS acquired by drug consumption and other noncontagious risk factors," Journal of Pharmacology and Therapeutics [referred to as Pharmac. Ther,] Vol. 55 (1992), pp. 203 and 211. Like humans, chimpanzees are susceptible to HIV. The virus replicates in them and antibodies form against it exactly as in human beings.
[Added in proofs. On 31 January 1996 the New York Times headlined an article by Lawrence K. Altman (p. A8): "Human Virus Produces AIDS in a Chimpanzee." The headline was followed by the subhead: "An aberration or example of how chimps get AIDS?" This mixture of purportedly factual assertions and more cautious wording ran through the article, and reflects improper journalism. Lawrence K. Altman was reporting an announcement made at a meeting in Atlanta, by Dr. Francis J. Novembre of the Yerkes Regional Primate Research Center at Emory University. Two chimps were reported to have developed low CD4 cell counts after being inoculated with "H.I.V.-1, the main AIDS virus" more than a decade before. The only direct quote from an interview with Dr. Novembre was conditional, using "if" and "may" in the sentence: "So, if chimpanzees do develop AIDS, then protection from a vaccine may be more relevant now and may validate the chimpanzee for vaccine and therapeutic studies .... "
Other newspapers reported that one of the chimps developed diarrhea, e.g. the Washington Post, "Chimp Infected With AIDS for First Time," 31 January 1996, p. A3. But we all have had diarrhea at some time or another. The Washington Post reported that the chimp was "treated with antibiotics," that blood from this chimp was transfused to another one, and: 'The animal quickly lost CD4 cells and appears to be close to getting AIDS as well." So what does "AIDS" mean? No definition was given. We see here a typical example of garbled accounts about "AIDS" in the press.
I have not seen any follow up, justifying the attribution of the chimps' illnesses to HIV, or reporting what happened eventually to the chimps. Were they given anti-HIV drugs besides antibiotics? There was also no report given on control groups. For instance, how many HIV-free chimps out of 150 develop a temporary (resp. severe, resp. fatal) case of low CD4 cell count or diarrhea in a decade? At what age? To my knowledge, as of September 1996, no scientific article has been published to take scientific responsibility for the story about the two sick chimps in 1996. Thus does superficial journalism substitute for scientific responsibility in affecting public opinion.]
3. What does HIV-positive mean? A difficulty lies in determining who is "HIV positive" and what HIV positivity means. The blood test for HIV does not determine directly the presence of the virus. At best it determines only having antibodies to the virus called HIV, and this blood test is not infallible.
Furthermore, Duesberg has brought to my attention scientific papers showing that antibodies to the influenza virus, tuberculosis bacillus, and leprosy bacillus have each been shown to give false HIV positive tests.(2) Such findings were also reported in the London Sunday Times ("Research disputes epidemic of AIDS," 2:2 May 1994, p. 24), where its science editor Neville Hodgkinson wrote:
An authoritative new study has uncovered powerful evidence that the 'AIDS test' is scientifically invalid, misleading millions into believing they are HIV positive when they are not infected with the virus.
The findings, published in the Journal of Infectious Diseases, provide practical evidence that HIV tests may be triggered by other factors, such as leprosy and tuberculosis. They have heightened concerns that the spread of Aids in Africa has been wildly exaggerated.
The discovery was made by a team headed by Dr. Max Essex of Harvard University's School of Public Health and a highly respected Aids expert. One of the originators of the hypothesis linking HIV with Aids, Essex was also a leading exponent of the theory that the virus originated in Africa.
Kary Mullis has also been quoted about HIV-positivity in the context of "African AIDS": "...They got some big numbers for HIV-positive people [in Africa] before they realized that antibodies to malaria--which everyone in Africa has--show up as 'HIV-positive' on tests." (Interview in the California Monthly, September 1994, p. 21)(3)
4. HIV-negatives with AIDS-defining diseases. There exist thousands of Americans who have AIDS-defining diseases but are HIV negative. It is quasi impossible to give proper statistics about how many thousands, partly because of the multiplicity of diseases used to define "AIDS," and also because of the lack of studies which would systematically report overall figures, either for individual diseases or all of them as a group.
5. HIV-positives without diseases. Conversely, there are hundreds of thousands who test HIV positive but have not developed AIDS-defining diseases. As noted by the magazine SPY (February 1993, p. 19), since 1985, the CDC has stated each year that there are approximately one million Americans who are HIV positive. The CDC figure remained constant from 1985 to 1993. But most of these people have not gotten sick with one of the diseases listed by CDC in defining AIDS. Responding to Duesberg's letter dated 11 February 1993, Harold Jaffe replied on 5 March 1993 that, of these one million, "approximately 900,000 have not developed one of the clinical conditions included in the 1987 AIDS case surveillance definition." So in 1993, the CDC was asserting that about 90% among HIV positives have not developed an AIDS-defining disease.
Jaffe's percentage figure is quite different from the figure attributed by the New York Times to the World Health Organization. The numbers game still goes on, as reported for instance in a New York Times article "Obstacle-Strewn Road to Rethinking the Numbers on AIDS" (1 March 1994, p. B8), by Lawrence K. Altman, M.D., who regularly writes on HIV and AIDS for the Times, and systematically calls HIV "the virus that causes AIDS." The article started: "Determining how many Americans are infected with the virus that causes AIDS is an imprecise science at best... it appears that the current estimate of one million will be lowered... For planning purposes, health officials need to know where and how many new cases of H.I.V., the virus that causes AIDS, are occurring." In his article, Altman gave a revised figure ranging from 600,000 to 800,000, and reported that the figures might go down further.
Note that the figure of 1 million "estimated cumulative HIV infections" in North America has also been given by the World Health Organization ("The HIV/AIDS Pandemic 1993 Overview," The WHO, June 1993). This figure and other WHO figures for Western Europe (500,000) and Sub-Saharan Africa (8 million) were reproduced in a table prominently displayed in the article "HIV: beyond reasonable doubt" (The New Scientist, 15 January 1994, p. 24).
Just what is "beyond reasonable doubt"? Considering the way some estimated numbers are now dropping radically, it follows that official figures from the CDC or WHO cannot be trusted. The figures these organizations put out add to the chaotic and unreliable mess which exists in lieu of information about HIV and various diseases.
6. Hemophiliacs. Questions have also arisen about AIDS being transmitted to hemophiliacs via blood transfusions. Such questions were raised for example in Peter Duesberg's letter to Harold Jaffe. Duesberg was careful about distinguishing HIV from diseases presumed to have been caused by HIV. He wrote:
It is frequently claimed that transfusion AIDS was eliminated by eliminating HIV from the nation's blood supply. Of course, screening for HIV did essentially eliminate the transmission of this virus by transfusions. But it did not affect the mortality and morbidity of recipients of transfusions. We must here distinguish between non-hemophiliacs and hemophiliacs...
(a) Non-hemophiliacs. Since all transfusion recipients, other than hemophiliacs, are already severely ill by the time they receive their transfusions, the mortality rates of HIV-positives and negatives provide the most objective statistics on the possible role of HIV as a cause of diseases. In the rare cases where such controlled studies have been done, the mortality has been the same for both groups...
(b) Hemophiliacs. The mortality of American hemophiliacs has actually decreased since 75% (some 15,000) of them were infected by HIV via transfusions received over a decade ago...As for the incidence of immunodeficiency in hemophiliacs with and without HIV, at least 16 controlled studies comparing these incidences have shown that immunodeflciency is independent of HIV, but depends on the lifetime dose of transfusions and factor VIII ....
See also Duesberg's comments on hemophiliacs in his Pharmac. Ther. paper, pp. 216-220, as well as an exchange concerning hemophiliacs at the AAAS meeting mentioned in §4 below.
Furthermore, among other places, a London Sunday Times editorial taking to task some of the establishment press for not reporting properly on the AIDS situation, had this to say about the case of hemophiliacs (12 December 1993): "Nature should also be discussing the remarkable story of the HIV positive hemophiliacs whose immune systems, after declining for many years in ways that were attributed to HIV, have recovered fully after they were switched to a new form of treatment for their blood-clotting disorder. There now seems no reason why they should not live a normal lifespan, regardless of their HIV status."
As for Kary Mullis, in his California Monthly interview, he said: "The IV-drug users are exchanging blood all the time, so they're getting everybody's diseases. This was true for hemophiliacs too before recombinant factor was available. If you're getting blood from lots of other people, you're getting a lot of organisms along with it."
7. Different diseases in different risk groups. In addition, Duesberg's letter to Jaffe pointed out that people in different risk groups in the United States come down with different "AIDS-defining" diseases. This phenomenon provides evidence that those diseases do not have a single cause, but different causes depending on different circumstances. For example, Duesberg wrote that among patients who have "AIDS-defining" diseases according to the CDC, "Kaposi's sarcoma is almost totally restricted to male homosexuals; tuberculosis is prevalent in intravenous drug users; microbial and fungal diseases, such as pneumonia and candidiasis, are practically the only AIDS defining diseases ever observed in recipients of transfusions; finally, until the most recent reclassficaion of diseases under the AIDS umbrella on January 1, 1993, bacterial infections were exclusively diagnosed in babies who were defined as having AIDS according to the CDC .... "
8. Differences with Africa. Differences exist not only internally within the United States, but also internationally. According to Duesberg ("The Last Word," Biotechnology Vol. 11, August 1993, p. 956), "since a clinical definition is used in Africa, statistics [about AIDS patients] from this continent are not biased against HIV-free AIDS..." Duesberg cites several specific studies about actual AIDS patients from Africa which show that approximately 50% of the diagnosed AIDS cases in these studies were HIV-antibody negative. Some of these patients suffered from diseases such as weight loss, diarrhea, chronic fever, tuberculosis, and neurological diseases. Statistics about AIDS patients in Africa also report equal distribution of AIDS among male and female. Some studies showed that HIV positivity did not precede but followed weight loss by several months and possibly years. Furthermore some diseases associated with specific risk groups in the U.S. have not always been diagnosed as part of the "AIDS epidemic" in Africa. For instance, the authors of one study wrote: "Since KS [Kaposi's Sarcoma] has long been endemic in Zaire, only patients with fulminant KS were included."(4)
Aside from all that, we recall that antibodies to malaria and other diseases prevalent in Africa show up as HIV-positive on tests. Hence the evidence suggests that whatever epidemic is taking place in Africa is due to causes different from those affecting the main risk groups in the U.S., such causes possibly involving malnutrition, poor sanitation, and other factors.
The article cited in footnote 4 evaluates critically the AIDS situation in Africa. In the abstract at the beginning of the article, one finds: "It is concluded that both acquired immune deficiency (AID) and the symptoms and diseases which constitute the clinical syndrome (S) are long standing in Africa, affect both sexes equally, and are caused, directly and indirectly, by factors other than HIV."
9. Destruction of T-cells? Even if patients have diseases unrelated to immunodeficiency, the HIV-AIDS hypothesis asserts that HIV affects the immune system in some fashion, for instance by destroying T-cells, thus making a person more liable to develop these other diseases. However the available evidence does not show that HIV destroys T-cells:
(a) There exist studies which show the existence of patients who test HIV-positive, who have diseases such as Kaposi's sarcoma, dementia, wasting disease, but who have a normal T-cell count, and have no immunodeficiency. There exist similar studies when the patients are HIV-negative. Duesberg gives examples of both in his article (Pharmac. Ther. p. 228, referring to half a dozen independent studies, listed in the bibliography). He concludes: "Thus, the assumption that all AIDS diseases are caused by immunodeficiency is erroneous."
(b) As for HIV killing T-cells in laboratory cultures, Duesberg draws attention to the fact that T-cells are notoriously difficult to maintain alive, whether infected with HIV or not. He gives scholarly references to the effect that they are not more difficult to maintain alive in the presence of HIV than in the absence of HIV (Pharmac. Ther. p. 229). In addition, HIV is mass produced for the HIV antibody blood test in permanently self reproducing T-cells, in many laboratories and companies.
10. A correlation between HIV and AIDS? Supporters of the hypothesis that "HIV is the cause of AIDS" (whatever this means) rely on what they see as a "correlation," that antibodies to the HIV virus are present in some (many? all?) people having AIDS (whatever AIDS means). However there are several reasons for reading whatever "correlation" exists with caution.
(a) I have already commented on the circularity of the CDC definition, which makes the correlation 100% if this definition is accepted; and on the problem of having meaningful statistics concerning the association of HIV with the multiple AIDS-defining diseases in the CDC list if a clinical definition is taken.
(b) Some people in the risk groups among which the actual disease is prevalent engage in practices whose effect is to increase the possibilities of passing on various viruses or microbes from one person to another, whether these are pathogenic or not. Among these viruses is HIV. Thus one explanation for the more extensive presence of HIV in risk groups lies in these practices. On the other hand, the spread of the HIV virus or other viruses in certain groups (for instance prostitutes) by itself does not necessarily correlate with this group being at high risk for AIDS-defining diseases. For instance, prostitutes who do get some AIDS-defining diseases on the whole are also found to engage in other practices besides sex, e.g. drug use. (See Duesberg's Pharmac. Ther. paper, p. 238.)
(c) Although there is a correlation of lung cancer with smoking, there is also a correlation of lung cancer with yellow fingers. This does not imply that yellow fingers cause lung cancer. Even when a "correlation of HIV with AIDS" is claimed, there may be another correlation which is even stronger, namely between certain diseases and the use of drugs of various sorts, ranging from recreational drugs such as "poppers" to purportedly HIV-inhibiting drugs such as AZT (see §4 and §5 below). It may simply be that HIV is an opportunistic virus which tends to be present when some diseases are present. Thus HIV would be merely a marker rather than a cause for whatever disease is involved.
A number of other points raise questions about the causal relationship between HIV and various diseases, but I merely wanted to give a sample here. Of course, none of the above points gives a conclusive answer as to what causes AIDS, or what does not cause AIDS in human beings, whatever AIDS is. I have no definitive answer. I merely question the line upheld up to now by the biomedical establishment, and repeated uncritically in the press, that "HIV is the virus that causes AIDS."
The improper reporting in the press reflects defective statements from many scientists who promote the establishment line about HIV being the cause of AIDS. That "HIV is the cause of AIDS" is taken as a postulate, and some scientists try to fit experimental data into this postulate, actually without success. Sometimes they hedge by speaking of "association" rather than "cause." Sometimes they state that they are still looking for "the enigmatic mechanism of the pathogenesis of HIV," which means they haven't found the way HIV causes any disease and are still looking. So how come they assert without qualification that "HIV is the cause of AIDS"?
§4. Some Revisionism
The "drug hypothesis." An alternative hypothesis concerning a possible cause of some AIDS-defining diseases is sometimes called the "drug hypothesis." Roughly speaking, this hypothesis asks whether drug use causes some of the diseases officially associated with AIDS, such as immunodeficiency and Kaposi's sarcoma. Various drugs could be involved, ranging from sex-enhancing recreational drugs such as amyl-nitrite ("poppers"), to cocaine or heroin, and also allegedly HIV-inhibiting drugs such as AZT. The time period and the cumulative effect may also be factors involved in the causation. The situation may be similar to prolonged use or abuse of alcohol causing cirrhosis of the liver, or smoking causing lung cancer.
Originally, in the early eighties, the drug hypothesis was among the first which occurred to scientists. It was abandoned, or overlooked, or disregarded by most establishment scientists in large part because of the Gallo-Montagnier controversy, and the Gallo press conference in 1984. It was never completely abandoned, even by some individuals in the CDC. For instance, as late as 1988, the National Institute on Drug Abuse (NIDA) published a monograph entitled "Health hazards of nitrite inhalants" dealing with many aspects of the toxicity of nitrite inhalants. Harry Haverkos, clinical director of AIDS research at NIDA, and co-editor of the above monograph, still supports having experiments made to test the nitrite-AIDS hypothesis. However, research on causes for "AIDS" other than HIV has been obstructed in various ways, including social and scientific pressure, and non-funding.
In 1993-1994, there was some evidence of a revisionist movement which surfaced sporadically, partly on TV, partly in some of the non-mainstream press in the United States, and in other places. Thus some of the media started reporting questions raised by some scientists about the role of HIV in causing "AIDS." The year 1994 especially saw a continuing evolution in thinking about HIV, and what is regarded as appropriate for mainstream publications. I shall list some examples of media reports of the revisionist movement.
Peter Duesberg. In the last decade, Peter Duesberg has been one of those who have continued to raise questions about the drug hypothesis seriously. For decades he had been in high standing with NIH and had been continuously funded, receiving "outstanding investigator" grants. After he spoke out clearly challenging the dogma about HIV being "the cause of AIDS," and supporting the drug hypothesis, he lost his grants.
In 1992 he applied to the Department of Public Health for funding for experiments to test the drug hypothesis on animals (for instance, "feed poppers to mice" as he once said in picturesque language).
Duesberg's application was supported by the editor of Science, Daniel Koshland, who wrote to the Study Section of the National Institute on Drug Abuse to urge the funding (26 August 1993), stating in part: "As an observer, I have in the past been critical of Duesberg for not suggesting experiments to resolve this controversy. However, he has now answered my call with a proposal to test the role of nitrite inhalants as a co-factor in AIDS... Duesberg's proposal is a specific, workable one that will be done in collaboration with an inhalation toxicologist at the University of Califomia, Davis. I believe this research would add much to our understanding of AIDS, and I have told Duesberg that I would consider such data important material for readers of Science if it develops appropriately." In fact, Koshland iterated his support for funding Duesberg's experiments a year later, in a letter dated 24 August 1994.
Duesberg was not funded. He received a notice stating (13 December 1993): "The Initial Review Group (IRG) has recommended that NO FURTHER CONSIDERATION BE GIVEN TO THIS APPLICATION. [Capital letters in the original] Applications so designated cannot be funded in their current form; therefore they are not routinely scheduled for second-level review by the National Advisory Council/Board..." (See my essay "To fund or not to fund..." for details.) Science did not report on the situation, despite the interest expressed by its editor.
A meeting sponsored by NIDA; report in Biotechnology. On 23 and 24 May 1994, the National Institute on Drug Abuse (NIDA, Rockville MD) sponsored a meeting on the toxic effects of nitrite inhalants. This meeting was not covered by Science and the New York Times, for example. The 12 August 1994 issue of Biotechnology reported on this meeting under the headline: "NIH reconsiders nitrites' link to AIDS." A displayed conclusion of the article stated: "A consensus is developing that the connection between nitrites and AIDS goes beyond their promoting of HIV transmission and that understanding nitrite toxicity should be a priority of AIDS research."
The article, by John Lauritsen, stated among other things:
Meeting participants were divided into those whose primary interest is in studying nitrite inhalants as an important risk factor for AIDS, because their use encourages transmission of HIV via unsafe sex, and into those who think that the mutagenic and carcinogenic nitrites function more directly, either causing AIDS alone or acting as co-factors of HIV. Both sides were supported by strong epidemiological correlations between nitrite use by male homosexuals and AIDS. For example, according to Jay Paul of the University of California at San Francisco, the highest risk for AIDS involves the use of poppers and four other drugs. And Lisa Jacobson of Johns Hopkins University (Baltimore, MD) reported that 60-70 percent of the several thousand gay men at risk for AIDS who participate in the Multicenter AIDS Cohort Study (MACS) have used nitrites.
In addition, those favoring a more direct role of nitrites in AIDS pointed to data from the MACS showing that HIV-negatives had, on average, 25 months of nitrite use, HIV-positives had 60 months of nitrite use, and AIDS patients had over 65 months of nitrite use--an apparent dose-response relation. When asked whether there was even one gay AIDS case in the cohort who had not used drugs, a somewhat-surprised Jacobson replied, "I have never looked at the data in this way."
Jacobson's answer documents the extent to which researchers have shut-out questions which did not fit into the establishment dogma about HIV being the virus that causes AIDS, to the exclusion of other hypotheses in general, and the drug hypothesis in particular.
Lauritsen's article in Biotechnology also reported several other studies linking nitrites to AIDS, notably:
Harry Haverkos, acting director for clinical research at NIDA and chairman of the meeting, extended his original observations on the role of poppers in gay AIDS and reported an essentially exclusive correlation between nitrite use and gay KS [Kaposi's Sarcoma]. The hypothesis of Harold Jaffe of the CDCP [Centers for Disease Control and Prevention] that an "unknown infectious agent" is the cause of KS could not be reconciled with Haverkos' evidence that there was not a single confirmed case of KS from blood transfusions, which often contain infectious agents.
SPIN. Celia Farber wrote a number of articles on the developing AIDS revisionism in the magazine SPIN, for instance "AIDS--WORDS FROM THE FRONT," 10 January 1994, p. 71, where she reported:
In 1993, we witnessed a dizzying spectacle of collapsing certainties and quick political repositioning around the subject of AIDS ....
This year, however, the editor of Science [Daniel Koshland] wrote a letter to the National Institute of Drug Abuse, requesting that Duesberg be funded to test his drug hypothesis.
The mainstream [U.S.] press has remained largely oblivious to the HIV debate, and the progressive liberal press (Village Voice, etc.) strictly shrill, anti-debate, and ill-informed as ever. Yet major network television proved to be surprisingly progressive in 1993. In March, ABC aired a groundbreaking half hour segment on the program Day One, on which they interviewed Duesberg, Dr. Joseph Sonnabend, Dr. Robert Root-Bernstein, Walter Gilbert, and other HIV skeptics. Gallo threw an on-camera tantrum, storming off the set when asked about Duesberg, fuming that the reporters were doing a "grave disservice to the American public."
The article goes on:
But perhaps the single most important event of 1993 was the release of the much awaited Concorde trial, which showed that AZT does not prolong life or improve health in people who are HIV-positive but still healthy.
(5) Former AZT" supporters leaped from the sinking ship .... The Group for the Scientific Reappraisal of the HIV/AIDS Hypothesis had a 1,000 percent increase in signatures following the release of the Concorde results .... In October, one of the group's long-standing members became a Nobel Laureate in chemistry: Dr. Kary Mullis, inventor of the gene-amplification technique Polymerase Chain Reaction (PCR). PCR is one of the main biological tools used in AIDS research. But a fact that is virtually never reported is that Mullis is an HIV skeptic. In 1991, speaking on the record for the first time, Mullis told SPIN, "PCR made it easier to see that certain people are infected with HIV, and some of those people came down with symptoms of AIDS. But that doesn't begin even, to answer the question, "Does HIV cause it?"
Celia Farber published an interview with Kary Mullis in the 4 July 1994 issue of SPIN, from which I quote.
Our talk focused on AIDS. Though Mullis has not been particularly vocal about his HIV skepticism, his convictions have not, to his credit, been muddled or softened by his recent success and mainstream acceptability. He seems to revel in his newly acquired power. "They can't pooh-pooh me now, because of who I am," he says with a chuckle---and by all accounts, he's using that power effectively...(6)
When ABC's Nightline approached Mullis about participating in a documentary on himself, he instead urged them to focus their attention on the HIV debate. "That's a much more important story," he told the producers, who up to that point had never acknowledged the controversy. In the end, Nighline ran a two-part series, the first on Kary Mullis, the second on the HIV debate. Mullis was hired by ABC for a two-week period, to act as their scientific consultant and direct them to sources. The show was superb, and represented a historic turning point, possibly even the end of the seven-year media blackout on the HIV debate...
Celia Farber also mentioned the hypothesis that Kary Mullis has concerning the breakdown of the immune system in some of the risk groups: "Kary Mullis hypothesizes that AIDS is not caused by any single organism, but by prolonged exposure to an overwhelming number of distinct organisms, which individually may be harmless."
Harry Haverkos. In November 1994, SPIN published a four-page article on Harry Haverkos, who was chairman of the NIDA meeting. I quote from this article:
Surrounded by stacks of medical journals in his cramped office, Haverkos gives four main reasons why he links KS with nitrite use. First, there is the statistical connection. Repeated use of poppers and incidence of KS have been confined to gay men. "About 96 percent of Kaposi's cases occur in gay men, who make up 65 percent of all AIDS cases," he says. Twice as many whites as blacks use poppers--and twice as many get KS ....
Second, there is the lack of a firm HIV connection to KS. No cases of KS have been reported among blood-transfusion recipients where the blood donor himself later developed the cancer ....
The third reason Haverkos suspects a nitrite connection to KS is that the disease is caused by an abnormal growth of blood vessels, and nitrites act on blood vessels ....
Finally, Haverkos says, "The KS lesions are most common on the face, nose, and chest. If you're inhaling vapors, that is where you will have the highest concentrations." Put those points together, he says, and "you don't have to be a rocket scientist to see that there is some logic to the hypothesis."
... Haverkos believes the government's unofficial position today is that HIV may not be involved in KS, but whatever is, is transmitted sexually; the unwritten rule of public health seems to be that infectious disease always trumps toxicology. Haverkos argues: "If somebody could find me five white women with Kaposi's who did not use nitrites, between the ages of 18 and 45, sexually linked to a man with Kaposi's--just five couples--that would take me back. But we're 13 years into this epidemic, and I have not seen such cases reported. If this was a sexually transmitted agent, there ought to be a handful of women like that."
Once again, one finds such analyses from a "lone crusader at the National Institutes of Health" (as SPIN calls Haverkos) in SPIN, but not in Science or the New York Times, or the other major scientific or main-stream newspaper and magazines.
Aside from chairing the NIDA meeting, being a co-editor of the NIDA monograph on nitrite inhalants mentioned previously, and airing his views in SPIN, Haverkos is also the author and co-author of several articles over more than a decade, such as "What causes Kaposi's Sarcoma? Inquiring Epidemiologists Want to Know," co-authored with Peter Drotman (Epidemiology, May 1992 Vol. 3 No. 3, pp. 191-193, ). This article stated three hypotheses concerning causes of KS: "(1) a particular strain of HIV causes Kaposi's sarcoma; (2) another infectious agent acts as a co-factor; and (3) a non-biological environmental agent acts as co-factor [of HIV]." The article immediately stated that "the first hypothesis has been disproved .... " However, the article also discarded the possibility that some factors may be independent of HIV by calling the other two "co-factors." Asking whether something is a co-factor of HIV prejudices the question in one direction. One can see this by reordering the question. Asking whether HIV is a co-factor of nitrite inhalants, in the absence of definite confirmation that they cause KS, would prejudice the question in the other direction, implicitly granting that nitrite inhalants are a factor. With either formulation, the use of the expression "co-factor" is prejudicial to an impartial investigation of possible causes of KS.
Since KS is endemic in some countries of Africa, and nitrite inhalants are not a cause in that country, it follows that nitrite inhalants are certainly not a necessary cause of KS, although there is evidence that they are sufficient, taken in sufficiently strong doses over a sufficiently long period of time. Haverkos himself is one of those who have emphasized this evidence, as reported in SPIN and in the Epidemiology article. In this article, the authors also state that "the epidemic pattern of Kaposi's sarcoma in the industrialized nations does not fit that of any other sexually transmitted disease. All the others tend to be prominent in minority racial/ethnic groups, particularly urban blacks and Hispanics, whereas epidemic Kaposi's sarcoma tends to occur in middle-class whites." In addition, it is relevant to note here that clinical symptoms of Kaposi's sarcoma in Africa and in the gay groups in the United States have been reported to be different, for instance with respect to the location of the lesions.
Given the current state of knowledge, it is illegitimate to discard a priori the possibility of factors for KS independent of HIV. The Drotman-Haverkos article gave no reason for having done so, or for having prejudiced investigations and discourse about possibly independent causes for KS in the direction of "co-factors" of HIV. In their article, they mention "six large cohort or case-control studies." Subsequently, they do not make clear whether these studies considered and tested for the possibility of factors such as nitrite inhalants to be independent of HIV, or if it was assumed automatically that they are "co-factors" of HIV. The Drotman-Haverkos article legitimately criticized some of the questionnaires used in these studies, in a way which makes them appear partly incompetent or sloppy, but the reader was given no information:
- to determine if these studies implicitly assumed that HIV is a cause of KS;
- to determine if these studies tested whether HIV occurs as a marker, or whether it is a cause;
- to determine if these studies were designed to test whether KS occurs independently of HIV antibodies positivity, or to what extent.
London Sunday Times. Perhaps the most spectacular revisionist event was the publication of a series of articles in fall 1993 by the London Sunday Times, which also quoted Kary Mullis in the Sunday Times editorial (12 December 1993}: "The HIV theory, the way it is being applied, is unfalsifiable and therefore useless as a medical hypothesis... If there is evidence out there that HIV causes AIDS, there should be some scientific documents which either singly or collectively demonstrate that fact, at least with a high probability. There is no such document."
The Sunday Times series of articles was virulently attacked by some of the medical and scientific establishment, especially in editorials by Nature's editor John Maddox, such as the one of 9 December 1993. The Sunday Times science editor Neville Hodgkinson replied equally vigorously on 12 December 1993. His reply began:
The Sunday Times has been subjected to a wave of extraordinary attacks in recent weeks over its attempts to widen discussion of one of the most crucial medical and scientific issues of our time, the cause of AIDS.
A growing body of evidence suggest that when the medical and scientific communities rallied in 1984 behind a call to arms against the Human Immunodeficiency Virus (HIV) as the purported cause of a terrible new syndrome afflicting homosexuals and drug-users, they may have picked the wrong target.
This sensational possibility, now being contemplated by numerous doctors, scientists and others intimately concerned with the fight against the disease, deserves the widest possible examination and debate. Yet it has been largely ignored by the British media and suppressed almost entirely in the United States.
The Sunday Times also wrote: "We look forward to seeing Nature open its pages to the views of this distinguished scientist [Kary Mullis], who received the [Nobel] prize for a genetic test now used worldwide by AIDS researchers."
The New York Times is among the newspapers which has not given examination and debate for the above "sensational possibility." However, it did report the existence of the controversy between the Sunday Times and Nature in the article "British Paper and Science Journal Clash on AIDS," even though it did not report the substance of the documentation presented either by the Sunday Times or its critics.(7)
Hodgkinson in his articles had pointed to some instances when Maddox did not publish pieces going against the hypothesis that HIV is the AIDS virus. On one occasion when Maddox did not publish such a piece, his position was summarized as follows ("Has Duesberg a right of reply?," editorial in Nature 363, 13 May 1993, p. 109): 'The truth is that a person's 'right of reply' may conflict with a journal's obligations to its readers to provide them with authentic information. Whatever Duesberg's friends say,(8) the right of reply must be modulated by its content."
Furthermore, Maddox accused the Sunday Times of "selective reporting of the evidence" (among other things). However, at a time when Nature itself refused to print certain articles questioning the HIV causality of AIDS, Hodgkinson stated: "Despite distortions and inaccuracies, the [Nature] editorial deserves a wider audience than Nature's, both in the interests of open debate and because of the insight it gives into the mind of the journal's editor. So we reprint it in full below, with Maddox's permission, though he requested £200 [about $300] for the privilege."
A subsequent issue of the London Sunday Times (3 April 1994) headlined: "These scientists are among hundreds now challenging the accepted view on Aids. But the establishment won't let them be heard." Below the photographs of ten scientists, accompanied by brief quotes from each, the Sunday Times science editor Neville Hodgkinson wrote:
...Scientists, too, have to be careful not to rock the HIV boat, which carries jobs, reputations, and huge research funds. Despite the pressure, a large and growing network of highly-qualified 'dissidents' has become established worldwide over the past two years. They not only challenge the HIV hypothesis, but have 'come out' publicly about their concerns. More than 450 have put their names to a letter demanding a reappraisal of the conventional view, arguing that the HIV hypothesis is at best unproven, at worst discredited..."
Most of the names are American-based, but overall the list spans 23 countries.
It is the tip of an iceberg of dissent. The group's newsletter has a mailing list of more than 2,000...
Signatories of the reappraisal letter are united in wanting a change in direction; they differ in the extent to which they reject the HIV theory.
Some, like Dr. Charles Thomas, a molecular biologist and former Harvard professor of biochemistry, say it is complete nonsense...
Others, like Dr. Lawrence Bradford, a biology professor in Atchison, Kansas, and Dr. Roger Cunningham, a microbiologist and director of the center for immunology at the State University of New York at Buffalo, think the virus could be one factor among many, but maintain an unbiased reassessment is urgently needed.
"Unfortunately," Cunningham says, "an AIDS 'establishment' seems to have formed that intends to discourage challenges to the dogma on one side and often insists on following discredited ideas on the other."
... Most of the signatories, such as Dr. Henk Loman, professor of biophysical chemistry at the Free University in Amsterdam, deplore the neglect of non-HIV lines of research...
Many of the scientists believe the fight against AIDS was derailed by a flaw in reasoning over HIV in which "the hypothesis itself got incorporated in the definition of AIDS." as Dr. Kary Mullis, winner of last year's Nobel prize for chemistry, puts it. When people fall sick and HIV is present or thought to be present, it is called AIDS; when HIV is not present, it is called something else...
Thus did the Sunday Times keep informing its readers of the existence of a dissident group.
Root-Bernstein in The Scientist. On 4 April 1994 The Scientist printed an article by Robert Root-Bernstein entitled "Agenda for U.S. AIDS Research Is Due For A Complete Overhaul." The article started on the front page and extended over three pages inside the journal. Among other things, Root-Bernstein asserted:
An example of something we thought we knew, but did not, is that the human immunodeficiency virus (HIV) is the direct cause of T-cell killing in AIDS. Even such formerly stalwart proponents of this notion as Anthony Fauci and Robert Gallo now admit that this is not the case. Virtually all HIV research is now focused on finding "indirect" mechanisms by which HIV may cause immune suppression.
We also thought we knew that HIV alone is sufficient to cause AIDS. But such researchers as Luc Montagnier, Shyh-Ching Lo, Joseph Sonnabend, and many others--including me--now believe that co-factors are necessary and, therefore, that HIV by itself cannot cause AIDS.
We used to think we knew that everyone is at equal risk for HIV and AIDS, and that a heterosexual epidemic was inevitable. But the epidemiology of AIDS has yet to prove consistent with that view...
We thought we knew that people in all AIDS risk groups proceed to AIDS at the same rate following HIV infection, but this also has turned out to be untrue ....
We thought we knew that HIV always precedes immune suppression in people who develop AIDS. But many studies show that lymphocyte counts are as low in some HIV-negative gay men, intravenous drug users, and hemophiliacs as they are in non-symptomatic HIV-positive people--and sometimes lower ....
Root-Bemstein concluded his article with the admonition:
A diversity of opinion and of research has never hurt science. Dogmatism and politically motivated programs often have. The AIDS task force can foster one or the other, but not both.
I urge people to compare this admonition with the reactions of some establishment scientists, who have tried, so far mostly successfully, to keep reports questioning the establishment dogma about HIV out of the mainstream press. Sometimes they give as reason that such questioning presents a danger to public health.
A divisional meeting of the AAAS. On 21 June 1994, the Pacific Division of the American Association for the Advancement of Science (AAAS) sponsored a meeting--symposium--in San Francisco, to address: 'The Role of HIV in AIDS: Why There is Still a Controversy." The symposium was organized by Charles Geshekter, Professor of History at Calfornia State University, Chico. The symposium and the list of speakers was approved by the Executive Committee of the Pacific Division, and announced in the 25 January 1994 Pacific Division newsletter. The symposium took place, despite pressure on the AAAS in May 1994, by Nature and by some scientists not to allow this symposium, or to change its thrust, for instance in the article "AAAS criticized over AIDS sceptics' meeting" (Nature 369, 26 May 1994, p. 265).
- Nature's article started: "The American Association for the Advancement of Science (AAAS) has come under fire from US AIDS researchers and public health officials for its sponsorship of a meeting in San Francisco next month of which speakers will dispute the link between HIV and AIDS...But as criticism of the lineup mounted, AAAS executive officer Richard Nicholson indicated that the session might be called off. 'All options are still open, including cancellation', Nicholson said on Monday."
- Nature quoted Bernie Fields, professor of microbiology at Harvard Medical School: "This is a real fringe of people surrounding Peter Duesberg who have been saying these things for a while now. AAAS sponsorship makes it sound like a real issue when it's not. It think it's a disgrace."
- Nature quoted David Baltimore: "This is a group of people who have denied the scientific facts. There is no question at all that HIV is the cause of AIDS. Anyone who gets up publicly and says the opposite is encouraging people to risk their lives."(9) However, Nature did not specify which "scientific facts" are "denied." Furthermore the expression "group of people" is rather vague, and is sweeping in its characterization possibly involving anyone who talks to Duesberg. Hence the first sentence quoted above is defective on several counts. In itself this sentence represents unscientific behavior and tendentious journalism, both on the part of Baltimore and on the part of Nature.
- Nature also quoted scientists from the Bay area: "Michael Ascher, of the California Department of Health Services, and Warren Winkelstein, of the University of Califomia at Berkeley, have written to the AAAS journal Science questioning the AAAS sponsorship because 'some of the views to be expressed...have potentially serious adverse public health consequences.'" (For more on Ascher and Winkelstein, see the next section.)
Subsequently, the AAAS meeting itself was not covered by Nature. A fortiori, Nature did not report the reasons some scientists gave for questioning that "HIV is the cause of AIDS," so Nature's readers are not given evidence on which to base an informed or independent judgment. Thus does Nature manipulate its readers.
Criticisms similar to those in Nature were made in the San Francisco Chronicle under the tendentious headline "AIDS Rebels Try to Steal Show: But Scientists Stymie Plan By Mavericks Who Deny HIV Link" by David Perlman, 26 May 1994. No one was trying to "steal" anything. Furthermore, calling "rebels" scientists who raise questions and have gone through the proper AAAS channels to organize their meeting, documents how the S.F. Chronicle manipulates its readers. Perlman's article started: "Blindsided by a small band of AIDS gadflies, America's largest scientific organization moved yesterday to avoid sponsoring a one-sided spate of oratory over the causes of the global AIDS epidemic." Among other things, Perlman reproduced the criticism from Ascher and Winkelstein.
The AAAS symposium was subsequently covered by Perlman in the San Francisco Chronicle.(10) It also received a 500 word notice "Uncertain for sure" by Susan Gerhard in the San Francisco Bay Guardian (6 July 1994, p. 32), which I found perceptive and sharp. She had been alerted to the meeting via Celia Farber's interview with Kary Mullis in SPIN. Gerhard wrote: "While it may be OK for me and most of my friends to believe in science---we have to, as we're not equipped with our own labs and sets of petri dishes--we expect more than blind devotion from the men and women of Reason. It was truly frightening to watch how, with a few pointed questions, they [the HIV critics, Duesberg and Mullis in particular] made that religion--my religion for many of the last 10 years--look as arcane as the Vatican's." Gerhard concluded her piece with the comment: "The HIV critics didn't have answers; they just had questions. But from the looks of this public gathering, and the questions that cropped up from its audience of laypeople and pros, their position of oppositional prying has been more welcome outside science than within it." Gerhard's article is one among other pieces of evidence that the parallel local press (derived from the counter-press of the sixties) is beginning to warm up to the issue of HIV and the credibility of the scientific establishment with respect to HIV.
Neither the NIDA meeting nor the AAAS meeting were covered by Science and The New York Times. If this surprises you, come to the front of the class because you haven't been paying attention.
The AAAS symposium represented many views about the relationship of HIV and AIDS, including those who question the causality such as Duesberg and Kary Mullis; the UC Berkeley Molecular Biologist Harry Rubin, who is an agnostic as to the role of HIV in causing AIDS; and supporters of the establishment line, such as Jerold Lowenstein of the UC Medical Center in San Francisco.
An extensive account of the AAAS symposium is available on the electronic nets. The printout I was given has about 30 pages, and includes an article by John Lauritsen: "Truth is Bustin' Out All Over: HIV Symposium at AAAS Conference." This account is available from laurit@panix.com. It includes a more detailed account of the pressures put on the AAAS to cancel the symposium or to change its thrust, and it includes extensive direct quotes from the participants. Here is a sample quote from Kary Mullis, about the (non)existence of a scientific reference giving evidence whether HIV is the probable cause of AIDS:
I assumed there must be such a reference, and that there might be a controversy over who got credit for it, because I was under the impression that Gallo and Montagnier might have been fighting over who had first shown that HIV was the cause of AIDS...I went back over their early papers, and found that neither of them had shown that HIV was the probable cause of AIDS.
I was running into a lot of people who were doing AIDS research, and every time somebody would give a talk, I'd go up to them afterwards and ask politely: Who I should quote--was there a paper or a review that I should quote for that statement? It seemed like a perfectly reasonable question to ask. Some people took offence. Most people said the same thing: "But everybody knows, you don't have to prove it." Well, you know, everybody knows the sequence [of a certain chemical], but they also know where to find the references.
And I started getting uncomfortable with the fact that nobody seemed to know. So I changed the question to, "When did you, personally, become convinced that HIV is the probable cause of AIDS? (I mean, you're working on it as though you are.) [laughter] What papers did you read?" And they'd say, "I've got it in my office." And I'd say, "Would you send me the titles, so I can look them up..." [They never did.]
The Lauritsen account on the e-nets reproduced a telling exchange between Jerold Lowenstein and some scientists questioning the role of HIV in causing AIDS. Lowenstein's talk was entitled "The medical and scientific evidence for HIV being the cause of AIDS." Harvey Bialy raised a question:
BIALY .... And finally, why are hemophiliacs not dying of AIDS? They were all infected ten years ago or more--way long enough to have exceeded the latency period. Half the hemophiliacs in the United States should be dead or dying of AIDS now, and yet it's less than 12%. You need to explain that. Please!
LOWENSTEIN. I don't see why I need to explain that. Hemophiliacs are dying of AIDS.
BIALY. The HIV-AIDS hypothesis postulates a ten-year latent period between infection and disease. That means that if you have 16,000 people with the infection, after a ten-year period, approximately half of them should have the disease. But only 10-12% have the disease. This is a discrepancy! How do you explain it?
LOWENSTEIN. How do you explain the 10-12% who do die? [groans from the audience]
BIALY. What are they dying of?. They're dying of the same diseases that hemophiliacs always die of, but now they're called "AIDS" because they've been diagnosed as having HIV-antibodies.
DUESBERG. Those hemophiliacs are not immortal. [laughter]
BIALY. What is your evidence that HIV is destroying T-cells by infection? I would love to see it. I've been waiting ten years for it. [no response from Lowenstein]
Harry Rubin made several points, including some technical points about retroviruses and some of the history of these viruses associated with leukemia in chickens. As he said (quotes taken from the Lauritsen account on the e-nets):
Notice, I used the words, "associated with." They were given the name, Avian Leukosis Virus, indicating they cause a type of leukemia in chickens, along with many other symptoms, incidentally. Now what I learned from my own work--I developed the way of assaying these viruses in culture so they could be worked with, in a fairly expedient manner--is that these leukemias could and would occur in the absence of the retroviruses...
Every cell in the chicken is infected, and every cell is constanfly producing virus, but even then...only 15% of those chickens, who were congenitally infected, developed the leukosis. In spite of these findings, these viruses are still called Leukemia or Leukosis viruses, as they have been for 85 years. The assumption is made that they are the sole, or at least the prime, cause of the disease in chickens...
One of the things I want to point out is the tricky business of naming a virus. Naming something HIV, Human Immunodeficiency Virus, Avian Leukosis Virus, Avian Myelocytosis Virus--all of those names fix in the minds of those who use them, or work with them, that this is the proof.
Rubin also addressed the "political problem":
What's transpired in the development of this symposium is illustrative of the difficulty of making a critical scientific analysis of the AIDS problem. It's really more of a political than a scientific problem...
Now I've come to my point about the politicization of this issue. In 1988 the American Foundation for AIDS Research (AmFAR) convened a meeting in Washington, DC, which had the obvious purpose of silencing Peter Duesberg. As I had discussed the matter with Peter on many occasions, he asked me to join the meeting, even though he knew I was an agnostic about the role of HIV--more like Erasmus than Martin Luther. I reluctantly agreed, feeling I could play the role of an intermediary. How naive I was! I did some extensive reading before the meeting, and a lot of questions occurred in my mind, that I thought needed discussion. When I raised those questions at the meeting, I got the response you might expect from a bunch of fundamentalists confronted with someone who questioned the virgin birth. [laughter] For example, Anthony Fauci interrupted me at one point, in a rage, saying how could anyone doubt the compelling role of HIV, when there was this HIV-infected baby, who had never been exposed to other viruses, bacteria or drugs, and developed AIDS. Well, I had no answer. If I did, I couldn't get up, he was so mad. Well, I later learned that the mother of that baby was an intravenous drug user who had all sorts of health and nutritional problems...
Rubin addressed the circularity of the definition of AIDS:
Subsequently after that meeting, at a little social gathering, I had a discussion with a medical corps major (I won't mention any names) who was the Army's leading AIDS specialist. He told me that he had seen AIDS cases with Kaposi's sarcoma in recruits, a condition then commonly associated with AIDS, at least in homosexuals. He told me that some of these cases were AIDS. And I asked him if they differed clinically from the other six cases [which were not AIDS]. He said no, they didn't differ clinically at all, but they had antibodies to HIV. So I realized then I was dealing with a self-fulfilling prophecy. If there are HIV antibodies when you have Kaposi's, then it's AIDS, and if no antibodies when it's Kaposi's, then it's not AIDS, just Kaposi's. No wonder there's such a strong association between the virus and AIDS, if the diagnosis is based on the presence of the virus...
Finally, Rubin brought up Duesberg:
In closing, let me say a word about Peter Duesberg, who has been pilloried from post to post in the press, as you have seen. I made it clear that I do not go along with his total rejection of a role for the virus. I will say, that if it were not for Peter Duesberg, there would be no one raising questions at all, including me. [applause for Duesberg] So while I continue to disagree with him, and find him a pain sometimes [laughter], I respect what he's done, and I might say that he's done it at enormous sacrifice to his reputation and to his career. [applause]
§5. A Press Release on a "Commentary" in Nature
A piece "Does drug use cause AIDS?" by M.S. Ascher, H.W. Sheppard, W. Winkelstein Jr. and E. Vittinghoff, was published in the Nature issue of 11 March 1993.(11) This piece was published as a "Commentary." About a week before publication, Nature issued a press release concerning this piece, headlined: "DRUG USE DOES NOT CAUSE AIDS." The press release concluded: 'These findings seriously undermine the arguement [sic] put forward by Dr. Peter Duesberg, of the University of Califomia at Berkeley, that drug consumption causes AIDS, and instead provides [sic] strong support for the hypothesis that HIV causes the disease," Numerous members of the press started calling Duesberg to get his comments on the forthcoming article in Nature, but the article had not been made available to Duesberg. Despite the fact that the press release was marked "Embargoed for release 6:00 pm EST, Wednesday, March 10, 1993," Duesberg told me that on 4 March he got several calls from journalists, including one from the New Scientist in Washington. Duesberg told these journalists that he could not comment on a piece he had not seen. The New Scientist then faxed him a copy on 4 March. He received a copy from Nature only on 9 March. Thus Nature and the authors of the article use the media to manipulate public opinion before their article had been submitted to scientific scrutiny by other scientists (other than possible referees), and especially by Duesberg who is principally concerned.
A misrepresentation in Nature's press release. Among other things, Nature's press release misrepresented how the sample of 1,034 men for the purported study was determined. The press release stated: "These were selected by random sampling of San Francisco households regardless of sexual preference, lifestyle, HIV status or drug use." But a qualification from the "Commentary" itself was left out in the press release. Indeed, the "Commentary" actually referred to a "random sampling from neighborhoods of San Francisco where the AIDS epidemic had been most intense before 1984." Thus the press release suppressed the additional information that the sampling came from a definite segment of San Francisco households rather than random San Francisco households.
The "Commentary" further claimed: "Participants were recruited without regard to sexual preference, lifestyle, or HIV serostatus (not known at the time), and thus constitute a representative cross-section of men in this community." However, an area where the "epidemic had been most intense" might already have a preponderance of people in the major risk groups. This was indeed the case. The sample had a butt in selection in the direction of "sexual preference" and drug use. For instance, about 4/5th of the "random sample" classified themselves as homosexual or bisexual.
As for HIV status and drug use, about 1/4th of the "random sample" had AIDS-defining diseases (from the CDC list). Because of the CDC circular definition, Ascher et al. identified 215 AIDS patients, and reported that 100% of the AIDS patients were HIV positive. However, an independent re-analysis of the data brought to light another 45 patients with AIDS-defining diseases, but HIV negative, and thus showed that 83% of the patients with the AIDS defining diseases were HIV positive. On the other hand, 100% of the AIDS patients had used nitrites. Furthermore, 84% were also on AZT. Finally, homosexuals used twice as many recreational drugs as did the heterosexuals (marijuana not included). (12)
The independent re-analysis documented other problems in the Ascher et al. "Commentary," invalidating the statement made by Ascher et al. (p. 104, column 2): "However, the population-based SFMHS provides a rigorously controlled epidemiologial model for the evaluation of aetiological hypotheses." For instance: "The Commentary, however, lacked the rigor of a scientific paper. No detailed description of methods was given, numbers were 'adjusted' using unexplained techniques, and graphs were presented without error bars, among other critical problems. Moreover, the analysis itself suffered several fatal flaws, such as using a circular HIV-based definition of AIDS, failing to quantify total drug use over time, and ignoring drug-use-differences between HIV-positive and -negative men."
The article "Debunking Doubts That H.I.V. Causes AIDS," by Gina Kolata in the New York Times (11 March 1993, p. AI 1) followed the Nature press release in reporting incorrectly "a group of 1034 randomly selected single men who lived in San Francisco and were 25 to 54 years old in 1984, when the study began." The New York Times also reported uncritically the misleading data from the Ascher et al. "Commentary." Thus did the New York Times propagate the misinformation of the press release and of the "Commentary."
I take no position here on the relative merits of the AIDS virus hypothesis or the AIDS drug hypothesis (in whatever form they may be formulated). I do take a position against the announcement of purported scientific results via superficial and defective press releases, and before scientists at large have had a chance to evaluate the scientific merits of such results and the data on which such results are purportedly based.
Some other scientists reacted negatively to Nature's publication. For example, Richard Strohman wrote a letter to the editors of the San Francisco Chronicle, which had rushed into print about the Nature article. Strohman's letter was never printed, and I quote it in full:
Letter to the editors of the San Francisco Chronicle by Richard Strohman (sent 11 March 1993, never printed). I am dismayed by your treatment of the AIDS-drug hypothesis (4/11/93). As a piece of reporting it is a masterpiece of scientific ignorance. First, in the article in question all conclusions, dutifully reported by Mr. Perlman, were drawn from hearsay. It is hearsay because the article is not a scientific paper that survived any rigorous review process; it was instead part of what is called "scientific correspondence" that gets by with often cursory review by journal editors. Second, as a result of lack of thorough review there is no detail given on methods used to collect data. Third, without details on methods we can not evaluate the data itself, never mind conclusions drawn from that data. Thus, all standards of real science are violated. What remains is only "scientific correspondence," at best a mechanism for developing opinion or debate. In the mainstream of science or in a court of law it would be thrown out as hearsay evidence. Instead of asking why the authors of this very "important" study did not take the trouble to submit their work through normal channels, but instead chose the less rigorous process, the Chronicle chooses to treat the work as valid, proven, information. The Chronicle owes all its readers, and especially all HIV+ people a profound apology.
The authors of the "Commentary" in Nature ended their piece as follows:
The energies of Duesberg and his followers could better be applied to unraveling the enigmatic mechanism of the HIV pathogenesis of AIDS. To this end, we have proposed an alternative model(14,15)
based on HIV signalling at CD4 cells. This model and others are now being evaluated, and we cordially invite Duesberg to participate in this endeavour. [I omit the footnotes 14 and 15.]
I find it presumptuous and objectionable for scientists to tell others where energies "could better be applied." Scientific standards as I have known them since I was a freshman at Caltech require that some energies be applied to scrutinize data on which experiments are based, in documenting the accuracy of the data, its significance, its completeness, and to determine whether conclusions allegedly based on these data are legitimate or not.
Especially in connection with the last paragraph telling scientists where to apply their energies, Strohman also wrote an open letter to Warren Winkelstein, one of the authors and a colleague at UC Berkeley (The Daily Californian, 1 April 1993).
Extract from Strohman's open letter to Wlnkelstein. Dear Warren, The HIV-AIDS hypothesis is a crucial problem that must be either discarded or proven. We all agree to that. As stated in your recent Nature article, scientists still do not know how HIV works, and until that time we must all strive to do what we can to find a solution. Your own work has striven to develop a strong correlation between HIV and AIDS, but you agree that correlation does not establish cause. More than 90% of a multibillion dollar budget is dedicated to finding a molecular link between the virus and immunosuppression, with still no definitive proof after more than 10 years. Meanwhile, there are some scientists, myself included, calling for approaches to AIDS other than the near-monolithic HIV theory. Perhaps other factors are involved; goodness knows, there certainly is convincing evidence for co-factors, and for Peter Duesberg's theory that AIDS is caused by drugs alone. The drugs he mentions most often are recreational drugs taken by some, but not all, gay men, and intravenous drug addicts. In addition, AZT, which is prescribed to deal with bacterial and viral infections, is known to be cytotoxic to human cells, and in itself could be the culprit.
My question, really for all of us, is the following. Why is it necessary to insistently call on dissenters from the mainstream theory to abandon their dissent and to join ranks with those who believe that HIV, and only HIV, causes AIDS? You yourself issue such a call in your recent Nature article (as quoted now in newspapers all over the country; SF Chronicle of 3/11/93). This is not how science is supposed to operate. It is supposed to be pluralistic; it is historically best when dissent is open and wide; results come more quickly when support is given not only to those who follow the major paradigm, but also to those who have reasoned the unpopular approaches ....
Winkelstein answered Strohman's letter in The Daily Cal of 13 April 1993, stating in part:
Extract from Winkelstein's answer to Strohman. Your assertions regarding alternative approaches and dissenting opinions is best answered by quoting what we actually wrote in the Nature commentary: "The main purpose of the cohort studies conducted in San Francisco and elsewhere has been to look for associations of environmental or behavioral factors with the development of AIDS. Had any factor other than HIV infections been found, it would have been reported immediately... [elision by the Daily Californian. In his reply, Winkelstein also repeated the paragraph I have quoted from his article, about where the energies of Duesberg and his followers could better be spent. He then added the following:]
In a New York Times article reporting the content of our Nature commentary, Dr. Jerome Groopman, a distinguished medical scientist, is quoted as follows: "Science keeps an open mind at all times, but there comes a time when you have to declare that the earth is not flat. It is incumbent on those who reject HIV to come to terms with this."
Thus Winkelstein and the "distinguished medical scientist Groopman equate those who question the HIV hypothesis with flat-earthers. I ask readers to evaluate Winkelstein's scientific standards in light of:
- the criticisms to which the "Commentary" with Winkelstein as co-author was subjected in the article "HIV as a surrogate marker for drug use: A re-analysis of the San Francisco Man's Health Study" (see footnote 12);
- the challenges to the HIV-AIDS hypothesis by a number of scientists, including those mentioned in this article;
- the questions which have been raised at the AAAS and NIDA meetings concerning drug use as a possible cause of some AIDS-defining diseases.
The above-mentioned article critical of the Ascher et al. "Commentary" was submitted for publication in Nature, but rejected. As we have already mentioned, Nature's editor John Maddox expressed his position clearly about the refusal to publish: ."..the right of reply has to be modulated by its content." (Nature 363, 13 May 1993, p. 109.)(13) Neville Hodgkinson reported Nature's refusal to publish these criticisms of the Ascher et al. paper in the London Sunday Times (1 May 1994), under the title: "Poppers and Propaganda - Censorship is blocking the debate vital to discovering the truth about AIDS." He wrote that
repeated efforts by Duesberg and others to reply to the attacks on him have been frustrated by John Maddox, the journal's editor. Their latest effort, re-analyzing data from an eight-year study of homosexual men in San Francisco, was rejected two weeks ago. It reaches conclusions that directly contradict those in the original article. Almost 100% of the men who died had used poppers, and there was a much higher level of general drug use (including heroin and cocaine) among HIV-positive men than their HIV-negative counterparts...To refuse Duesberg and colleagues any right of reply is an act of censorship on one of the most important scientific debates of our time.
Updates, January-September 1995
The Mess in Science and the Gutknecht-Shalala Exchange
§6. An article in Science, 9 December 1994
On 9 December 1994, Science published an 8-page analysis of some dissent concerning HIV as a cause of AIDS (pp. 1642-1649). The article in several parts, authored by Jon Cohen, was headlined:
The Duesberg Phenomenon
A Berkeley virologist and his supporters continue to argue that HIV is not the cause of AIDS
A 3-month investigation by Science evaluates their claims
Science (and not just its reporter Jon Cohen) took responsibility for the investigation and its conclusions. Aside from the displayed responsibility of "a 3-month investigation by Science" in the heading, responsibility was further taken on the very first page, where Science was mentioned three more times as follows:
But because the Duesberg phenomenon has not gone away and may be growing, Science decided this was a good time to examine Duesberg's main claims. In a 3-month investigation, Science interviewed more than 50 supporters and detractors... The main conclusions of Science's investigation are that:
- In hemophiliacs ... there is abundant evidence that HIV causes disease and death (see p. 1645).
- According to some AIDS researchers, HIV now fulfills the classic postulates of disease causation established by Robert Koch (see p. 1647).
- The AIDS epidemic in Thailand, which Duesberg has cited as confirmation of his theories, seems instead to confirm the role of HIV (see p. 1647).
- AZT and illicit drugs, which Duesberg argues can cause AIDS, don't cause the immune deficiency characteristic of that disease (see p. 1648).
One effect of the Science article of 9 December 1994 was to acknowledge officially, in the #1 magazine of the scientific establishment, the existence of an expanding challenge to the HIV/AIDS hypothesis and to the establishment's way of dealing with this challenge in the past.
On the other hand, I regard the Science article of 9 December 1994 as tendentious and skewed, but here is not the place to make a comprehensive detailed analysis. However, I give a couple of examples.
First I object to personalizing dissent about the official line that "HIV causes AIDS" in the context of "The Duesberg Phenomenon." I object to lumping together different people such as Harry Haverkos (who sponsored the NIDA May 1994 meeting on nitrite inhalants), the co-authors of the article on AIDS in Africa(14) referred to in footnote 4, or myself among many others, as part of "the Duesberg phenomenon." What has "not gone away" is that an increasing number of individual scientists, with different points of view, different backgrounds, and different responsibilities, have publicly documented reservations about the official position of the government or the scientific establishment concerning HIV and AIDS. Lumping together independent scientists under the single category of Duesberg "supporters" skewed the perspective on the dissenters and on their multiple reasons for dissent.
Second, the article completely omitted mention of dissenters such as Bialy and Haverkos, as well as many points raised by the dissenters. For example, the NIDA meeting of May, the position of Harry Haverkos on nitrite inhalants, the situation in Africa, the fact that malaria, tuberculosis, leprosy, and influenza, test false positive on the HIV antibodies test, were still not mentioned in the Science article. The AAAS June meeting was mentioned in only one sentence: "In June, the Pacific Division of the American Association for the Advancement of Science (publisher of Science) sponsored a daylong meeting at which the dissidents offered their points of view." No indication was given what were these points of view.
Especially significantly, as we shall see below, the 9 December 1994 article also made no mention of Kaposi's sarcoma.
§7. Other Viruses and the Unreliable Mess in Science
No hypothesis can be dismissed a priori. It is still a possibility that some virus(es) other than HIV sometimes cause some of the diseases listed under the "AIDS" umbrella by the CDC. We have already mentioned the possibility that different diseases in different risk groups may have different causes. The medical literature has a number of papers raising questions about many viruses, whether they are harmful or not, and how. Here I shall mention two of them.
HHV-6. One candidate has been the Human Herpes Virus 6, abbreviated HHV 6, as in the article "Human Herpesvirus 6 in lung tissue from patients with pneumonitis after bone marrow transplantation" (New England J. of Medicine 329, 15 July 1993, pp. 156-161). However, the article starts: "Human herpesvirus 6 (HHV6) infects over 90 percent of the U.S. population early in life, causing fever or rash in some children." To what extent does it make sense that such a common virus is "the" or "a" cause of some of the AIDS-defining diseases and under what circumstances? The above article itself is cautious in the summary conclusion at the beginning, where it states: "The concentrations of HHV-6 genomes in lung tissue and their relation to changes in serologic titers support an association between HHV-6 infection and idiopathic pneumonitis in immunocompromised hosts." Here we meet typical examples of arising questions: whether there is merely an "association" between a virus and some diseases, or whether a virus is a cause, and if so how. It is then a problem to make experiments to determine whether a given virus is merely a passenger virus, whether it lies dormant, and if it is awakened (how?.) whether it merely shows its presence by testing positive in various ways (antibodies?), or whether it is or becomes harmful (how?.), under certain circumstances (which?).
Still another Herpesvirus. On 16 December 1994, Science published a technical paper suggesting that a new virus may cause Kaposi's sarcoma.(15) News articles on this paper occurred on that same day both in the New York Times and in Science as we shall now describe.
The New York Times (16 December 1994, p. 1). For the first time to my knowledge an article by Lawrence K. Altman mentioned another virus besides HIV as a possible cause for "AIDS," under the title: "Apparent Virus May Be a Cause Of Fatal Cancer in AIDS Patients." A salient fact is that HIV is nowhere mentioned in the article. A paragraph describing a certain phenomenon concerning the distribution of Kaposi's sarcoma among "people with AIDS...gay and bisexual men...and women with AIDS," is followed by the sentences: "Experts say the introduction of a previously unknown virus that coincided with the advent of the epidemic of AIDS could explain such a phenomenon. Although a number of efforts have been made to link known infectious agents with Kaposi's sarcoma, none have held up."
Words in the headline such as "apparent" and "may be" were fully appropriate to the subsequent write up. Altman stated: "Scientists at Columbia University said they had found strong evidence of an apparent newly detected virus that, they said, might cause Kaposi's sarcoma in people with AIDS. Kaposi's is the most common cancer affecting gay men with AIDS, and one of the principle [sic] causes of death among that group."
Science (16 December 1994, p. 1803). Jon Cohen wrote the Science "Research News" article headlined:
Is a New Virus the Cause of KS? Kaposi's sarcoma, a once-rare skin tumor, is a scourge of gay men with AIDS. Several theories have attempted to explain it. The latest: a novel herpesvirus.
Cohen quoted one of the co-authors of the scientific paper, Patrick Moore, as saying that "this virus is probably playing a central role." Cohen then added: "That thesis will be intensely scrutinized over the coming months. But if it stands up, solid headway will have been made toward solving a vexing riddle that arose more than a decade ago when an old tumor began popping up in new places, with deadly results."
These Science and New York Ties articles are questionable on several grounds.
(a) What is "AIDS"? No definition of "AIDS" was given in either article. We have seen that KS is listed among the 29 diseases which define AIDS in the presence of HIV according to the CDC (see footnote 1). Expressions such as "Kaposi's sarcoma in people with AIDS" (New York Times), and "Kaposi's sarcoma...is a scourge in gay men with AIDS" (Science), represent shifting terminology, compounding the confusion about HIV and AIDS, and possibly representing the beginning of a rewriting of history concerning "AIDS" and what it means.
(b) What virus? Furthermore, no virus had been found. The New York Times article subsequently stated that the scientists found sequences of DNA which an "expert in herpes viruses at Yale University" said were "consistent with a new herpes virus." But the "expert" who said that also cautioned: "There is a long step between finding DNA sequences and having a virus."
(c) What cause? There is also a long step between finding yet another latent virus, and showing that it causes various forms of cancer, especially while it is dormant. The Times article contained one sentence to the effect that "even if the virus turns out to be a previously unknown one, they said, much research needed to be done to prove that it was the cause of Kaposi's sarcoma. The possibility exists that the virus is present in Kaposi's sarcoma only after the cancer develops." According to Duesberg, the fact that the DNA sequences were discovered only by amplification via PCR indicates that whatever is there, virus or not, is inactive and sparse. Duesberg added that there is no precedent for a virus causing cancer or another fatal disease while it is latent.
Harold Jaffe was quoted in the New York Times as saying: "It's a strong candidate to be the Kaposi sarcoma agent." So Jaffe was up to his usual rhetoric, since first, there is no candidate yet, and second the definite article ("the" Kaposi sarcoma agent) is unwarranted since Kaposi's sarcoma could be caused by several different agents, depending on the time, place, risk groups, various practices, or whatever, as I have repeatedly emphasized. Jaffe was similarly quoted in Science: "I think it's a tremendously exciting result. At this point, we can't say it's the etiologic agent, but I think it's a very good candidate."
So the New York Times and Science articles are worth mentioning here as important examples of the ongoing problematic and questionable journalistic treatment of HIV and AIDS (whatever AIDS is), as well as examples of the fixation by some scientists, the New York Times and Science on the finding of a virus, without bringing up other possibilities (e.g. toxic agents such as drugs).
(d) Joining the dissenters. By bringing up a new virus as a possible cause of KS, and by the evaluation "solid headway" concerning possible developments about such a "new virus," Altman and Cohen became HIV dissidents. Since KS is a hallmark of "AIDS" according to the CDC definition, it follows that Lawrence K. Altman, Jon Cohen, and the scientists whom they quoted as proposing a "new virus" to be the cause of KS, joined those who dissent from the unqualified view that "HIV causes AIDS."
Still another Science article. The hype on the new herpes virus was followed up in another article by Jon Cohen, "AIDS Mood Upbeat--For a Change" (Science 267, 17 February 1995, pp. 959-960). This article reported on a meeting sponsored by the American Society of Microbiology in Washington D.C., 29 January-2 February 1995. Cohen's article stated in part:
Among the more dramatic examples of progress was the strengthening evidence linking a new virus to KS. Last December, Patrick Moore, Yuan Chang, and their collaborators stunned AIDS researchers when they reported in Science that they had found a prime suspect... In spite of the accumulating evidence, Moore and Chang were reluctant to declare that they have found the cause of KS, but others, at the meeting were less restrained. Steven Miles, a KS researcher from the University of California, Los Angeles, who initially had serious reservations about the putative new virus, enthusiastically embraced the new findings. "I'm convinced that it is a herpesvirus, and it is very definitely the cause of Kaposi's sarcoma," said Miles, whose lab has replicated Moore and Chang's initial work.
Readers will note Cohen's hyped rhetoric: "...dramatic examples of progress ... stunned AIDS researchers..." Actually, in December 1994, Moore, Chang, et al. had not "found a prime suspect." They found DNA sequences, not a virus. Cf. (b) above.
Nullifying the hype. A further article by Jon Cohen titled "Controversy: Is KS Really Caused By New Herpesvirus?" (Science 268, 30 June 1995, pp. 1847-1848) continued spreading the unreliable mess coming from various scientists. The article to a large extent nullified the hype in the 16 December 1994 and 17 February 1995 articles, by reporting "deep reservations" about the role of the purported Herpes virus as a cause of KS, and also reporting that "those misgivings had been muted--until the AIDS-KS meeting" sponsored by the National Cancer Institute, 5 and 6 June 1995 in Bethesda MD. Cohen reported that "Gallo was at the center of the debate" and that "Gallo's withering critique of KSHV packed a punch." Oncologist Parkash Gill of the University of Southern California is reported as saying that "she has failed to find DNA sequences from KSHV in 11 KS cell lines," and Cohen quoted her: "I think the interpretation has gone beyond the data." Cohen also wrote: "Other researchers such as NCI epidemiologist Robert Biggar, were enthusiastic about the early evidence but now have doubts about the virus."
On the other hand, Cohen reported: "Columbia University's Chang stuck by the data she and others have amassed that supports KSHV's role in KS... Steven Miles of the University of California, Los Angeles, went further: He is convinced KSHV causes the disease. He maintains that the inability to find the vital DBNA in some cell lines might be due to the fact that the lines have been regrown too many times, which may lead to the vital DNA sequences being cleaved out..."
§8. Rep. Gutknecht's Letter and Shalala's Answer
On 24 March 1995, Rep. Gil Gutknecht (R-MN) wrote a letter to Anthony Fauci with copies to high officials and scientists in the U.S. government, raising 12 specific questions about HIV and AIDS. HHS Secretary Donna Shalala answered on 10 July 1995, dealing with Gutknecht's questions seriatim in a 7-page letter. However, Shalala's response was severely defective, partly because she made repeatedly undocumented ex-cathedra assertions, several of which are false. Some of her responses misrepresented various situations. I shall select here one example concerning Gutknecht's question about the cause of Kaposi's Sarcoma. In this case one can document immediately in a particularly simple way the hype, misinformation, contradictions and unreliable mess which one gets from government officials and scientists in the context of challenges to the official governmental position on HIV and AIDS.
Gutknecht's question No. 5. If infectious HIV is the cause of AIDS, why is Kaposi's sarcoma--the signal disease of AIDS--exclusively observed in male homosexuals?
Shalala's response. The cause of Kaposi's sarcoma appears to be a newly described herpes-like virus; the tumor is much more common in persons with severe immunodeficiency such as that caused by HIV infection. While most cases have been reported among men who have sex with men, cases have been reported among women and among men who acquired HIV infection through exposures other than male-top-male sexual contact. In addition, Kaposi's sarcoma has also long been recognized among elderly men of Italian or Ashkenazi Jewish descent and among the Bantus of Southern Mrica, before the emergence of AIDS.
(a) Shalala's response to Gutknecht's question asserts: "The cause of Kaposi's Sarcoma appears to be a newly discovered Herpes-like virus;..." Shalala gave no reference for this assertion. As we analyzed in §7, the Science 16 December 1994 article on the role of a Herpesvirus already contained some cautious evaluations, mixed with some hype. Shalala's answer reflected only the hype of this article, as well as the hype in the 17 February 1995 article. In addition, Shalala's answer took no account of the subsequent Science article of 30 June 1995 reporting on the "controversy." Her answer, occurring almost at the same time as the "deep reservations...misgivings...Gallo's withering critique of KSHV .... " provides a typical example of the misinformation, contradictions, and unreliable mess which arise from officials in HHS or NIH concerning HIV and AIDS. Of course, Gallo is not a govemment scientist any more, but the "punch" he "packed" {according to Science} didn't knock out Shalala or the scientific cohorts who helped her prepare the response to Gutknecht. Caveat emptor.
(b) Readers can evaluate the rest of Shalala's response to the KS question on the basis of the differences of Kaposi's Sarcoma in Africa and in the U.S. documented in the Papadopulos-Eleopulos et al. article {see §3 and footnote 4), as well as in the statements of Harry Haverkos, making several distinctions between the various appearances of the disease. Haverkos also gave evidence against its being caused by an infectious agent. (See §4, statements by Haverkos at the NIDA meeting and in SPIN.) Shalala's answer is defective all the way through.
Whether Representative Gutknecht would follow up with a critical analysis of Shalala's answer, and possibly with hearings on HIV/AIDS, remains to be seen. How far the dynamics of the challenge to the HIV-AIDS hypothesis would further progress, and to what extent the credibility of the scientific establishment will be affected, is left to another historical account.
SOME IMPORTANT FIGURES
Some scientists who have promoted the establishment line on AIDS:
Anthony Fauci, Chairman of the National Institute of Allergy and Infectious Diseases.
Harold Jaffe, Acting Director of the HIV/AIDS division of the Center for Disease Control (CDC).
An establishment scientist who has supported AIDS research on nitrite inhalants:
Harry Haverkos, Clinical director of AIDS research at the National Institute on Drug Abuse (NIDA).
Some scientists who have raised questions about the definition and causes of AIDS:
Harvey Bialy, molecular biologist, research editor of Biotechnology.
Peter Duesberg, Professor of Molecular Biology, UC Berkeley.
Kary Mullis, Nobel Prize in Chemistry (1993) for the discovery of the polymerase chain reaction (PCR). "PCR made it easier to see that certain people are infected with HIV," as Mullis himself once said.
Robert Root-Bernstein, Associate professor of physiology at Michigan State University, East Lansing; author of Rethinking AIDS: The Tragic Cost of Premature Consensus, New York Free Press, 1993; author of Diversity (Harvard University Press, 1989; former MacArthur Fellow (1981-1986).
Harry Rubin, Professor of Molecular Biology, UC Berkeley.
Richard Strohman, Professor Emeritus of Molecular and Cell Biology, UC Berkeley; former Director of the Health and Medical Sciences Program at UC Berkeley.
Some journalists:
Celia Farber, author of several articles on AIDS over several years, in the magazine SPIN.
Neville Hodgkinson, science editor of the London Sunday Times.
Daniel Koshland, editor of Science.
John Lauritsen, author of The AIDS War and Poison by Prescription: The AZT Story.
John Maddox, editor of Nature.
WHAT THEY SAID
From an interview (Q&A) with Kary Mullis in the California Monthly (UC Berkeley Alumni Magazine), September 1994:
Q: You mentioned Nobel Prize-winner David Baltimore a moment ago. In a recent issue of Nature, he said: "There is no question at all that HIV is the cause of AIDS. Anyone who gets up publicly and says the opposite is encouraging people to risk their lives. "
A: So what? I'm not a lifeguard, I'm a scientist. And I get up and say exactly what I think. I'm not going to change the facts around because I believe in something and feel like manipulating somebody's behavior by stretching what I really know.
I think it's always the right thing and the safe thing for a scientist to speak one's mind from the facts. If you can't figure out why you believe something, then you'd better make it clear that you're speaking as a religious person, not as a scientist. People keep asking me, "You mean you don't believe that HIV causes AIDS?" And I say, "Whether I believe it or not is irrelevant! I have no scientific evidence for it." I might believe in God, and He could have told me in a dream that HIV causes AIDS. But I wouldn't stand up in front of scientists and say, "I believe HIV causes AIDS because God told me." I'd say, "I have papers here in hand and experiments that have been done that can be demonstrated to others." I believe it was decided in the 17th century around the founding of the Royal Society that that was the way science was to stake its claims. It's not what somebody believes, it's experimental proof that counts. And those guys don't have that.
The quote by David Baltimore is from the article "AAAS criticized over AIDS sceptics' meeting," by C. Macllwain, Nature 369 (1994) p. 265
At a meeting sponsored by the National Institute on Drug Abuse (NIDA) on the toxic effects of nitrite inhalants, 23 and 24 May 1994, Rockville MD:
...according to Jay Paul of the University of California at San Francisco, the highest risk for AIDS involves the use of poppers and four other drugs. And Lisa Jacobson of Johns Hopkins University (Baltimore, MD) reported that 60-70 percent of the several thousand gay men at risk for AIDS who participate in the Multicenter AIDS Cohort Study (MACS) have used nitrites.
In addition, those favoring a more direct role of nitrites in AIDS pointed to data from the MACS showing that HIV-negatives had, on average, 25 months of nitrite use, HIV-positives had 60 months of nitrite use, and AIDS patients had over 65 months of nitrite use--an apparent dose-response relation. When asked whether there was even one gay AIDS case in the cohort who had not used drugs, a somewhat-surprised Jacobson replied, "I have never looked at the data in this way."
[Reported in the article "NIH reconsiders nitrites' link to AIDS" by John Lauritsen, Biotechnology, 12 August 1994.]
Footnotes
1. For instance, in the publication Confronting AIDS Update by the Institute of Medicine (1988), we find:
p. 207: "The following revised case definition for surveillance of acquired immunodeficiency syndrome (AIDS) was developed by CDC in collaboration with public health and clinical specialists...The objectives of the revision are a) to track more effectively the severe disabling morbidity associated with infection with human immunodeficiency virus {HIV)...
p. 208: "For national reporting, a case of AIDS is defined as an illness characterized by one or more of the following "indicator" diseases, depending on the status of laboratory evidence of HIV infection, as shown below."
The updating occurs in the CDC publication Morb. Mort. Weekly Rep. 41 No. RR 17 (1 December 1992), giving "the revised classification system for HIV infection and expanded surveillance case definition for AIDS...'. This document asserts:
p. 1. "The etiologic agent of Acquired Immunodeficiency Syndrome is a retrovirus designated Human immunodeflciency virus (HIV)..."
p. 2. "Persons with AIDS-indicator conditions (Category C) as well as those with CD4+ T-lymphocyte counts <200uL (Categories A3 or B3) will be reportable as AIDS cases..."
p. 4. "Diagnostic criteria for AIDS-defining conditions included in the expanded surveillance case definition are presented in Appendix C...', which contains the 29 diseases, including Kaposi's sarcoma.
2. Duesberg gives the following references:
- for the flu, MacKenzie, W.R., Davis, J.P., Peterson, D.E., Hibbard, A.J., Becker, G. and Zarvan, B.S., "Multiple false-positive serologic tests for HIV, HTLV-1, and Hepatitis C following Influenza vaccination," J. Arm Med. Assoc. 268 (1992) pp. 1015-1017
- for tuberculosis, Pitchenik, A.E., Burr, J.J., Suarez, M., Fertel, D., Gonzalez, G. and Moas, C., "Human T-cell lymphotroplc virus-III (HTLV-III) seropositivity and related disease among 71 consecutive patients in whom tuberculosis was diagnosed: a prospective study," Am. Rev. Respir. Dis. 135 (1987) pp. 875-879
- also for tuberculosis, St. Louis, U.E., Rauch, K.J., Peterson, L.R. et al. "Seroprevalence rates of human immunodeficiency virus infection at sentinel hospitals in the United States," N. Eng. J. Med. 323 (1990) pp. 213-218
- for leprosy, Kashala, 0., Marlink, R., Ilunga, M., Diese, M., Gormus, B., Xu, K., Mukeba, P., Kasongo, K. and Essex, M., "Infection with Human Immunodeflciency Virus Type 1 (HIV-1) and Human T Cell Lymphtropic Viruses among Leprosy Patients and Contacts: Correlation between HIV-1 Cross-Reactivity and Antibodies to Lipoarabinomannan, J. Inf. Dis. 169 (1994) pp. 296-304.
3. Duesberg provided me with the following references for antibodies against malaria registering as false-positive for HIV:
Biggar, R.J., "Possible nonspeciflc associations between malaria and HTLV-III/LAV, N. Engl. J. Med. 315 (1986) p. 457
Biggar, R.J., Gigase, P.L., Melbye, M., Kestens, L., Sarin, P.S., Bodner, A.J., Demedts, P., Stevens, W.J., Paluku, L.C., D.H. et al., "ELISA HTLV retrovirus antibody reactivity associated with malaria and immune complexes in healthy Africans, Lancet 2 (1985) pp. 520-523
Volsky, D.J., Wu, Y.T., Stevenson, M., Dewhurst, S., Sinangil, F., Merino, F.L. R. and Godoy, G., "Antibodies to HTLV-III/LAV in Venezuelan patients with acute malarial infections [letter], N. Engl. J. Med. 10 (1986) pp. 647-648
4. For a more extensive account of such studies, see E. Papadopulos-Eleopulos, V.F. Tumer, J.M. Papadimitriou, and Harvey Bialy, "AIDS IN AFRICA: DISTINGUISHING FACT FROM FICTION", World J. Microbiology & Biotechnology (1995), pp. 135-143. Bialy is research editor of Biotechnology, and was an active participant at the AAAS Pacific Division meeting on HIV and AIDS, 21 June 1994; see below.
5. There are indications that mortality in the AZT group was substantially higher than in the placebo group. An editorial analysis is given in The Lancet 7 August 1994 under the title: "Zidovudine for mother, fetus, and child: hope or poison." "Zidovudine" is another name for AZT. Duesbcrg has also pointed to the toxic effects of AZT. So did Kary Mullis in his California Monthly interview, where he said that "most people who have HIV don't ever get AIDS, although people who have HIV and no symptoms and take AZT die...But they die from the poison AZT', not from AIDS."
6. Actually, Mullis in April 1994 was at a scientific meeting in Europe, where he is reported to have acted like a jerk. Cf. a letter to Nature by John F. Martin, President of the European Society for Clinical Investigation, Nature 371, 8 September 1994. His capacity for acting like a jerk (his own word) was mentioned in his California Monthly interview. Nobody I know is hiding this aspect of his personality. My conclusion about dealing with Kary Mullis is to separate what he does on a personal basis, and which has sometimes been objectionable, from the insights he provides as a scientist when he's not behaving like a jerk.
He does not always act like a jerk at meetings, for instance at the Pacific Division AAAS meeting (see below), where he raised perfectly valid questions. The answer which Kary Mullis gave to the quote from Baltimore, extracted at the beginning of this article, was very sensible, to the effect that what he believes about AIDS is irrelevant, because beliefs have to do with religion, and we are attempting to deal with science. What is scientifically relevant is what documentation is available about the nature of HIV and its effects, and what documentation is available about various diseases and antibodies for certain viruses or bacilli.
It is unfortunate that in addition to all other problems one is facing in the confrontation about HIV and AIDS, one has in addition to cope with the personal behavior of a scientist who had enough insight to discover PCR. It is left for participants in the HIV-AIDS debate to sort out the personal behavior from the scientific one.
7. New York Times, 10 December 1993, p. A9. Sample from this article:
But the newspaper's latest crusade---a series of articles or prominently displayed articles boldly arguing that the AIDS epidemic in Africa is a myth and strongly suggesting that H.I.V. is not the way the AIDS infection spreads--has provoked bewilderment and anger among some Government health officials, AIDS organizations and many scientists, some of whom have accused The Sunday Times of betraying the public trust and misleading its four million readers...
Dissident theories on the putative cause of AIDS, including those of Dr. Peter Duesberg, an American molecular biologist, have been widely debated over the last decade and dismissed by most Government and research organizations as scientifically unsound...
In addition to Nature's stinging attack, the Sunday Times's coverage has prompted criticism from Government officials, charities, and relief agencies involved with AIDS. Kate O'Neil, a spokes-woman for the Terrence Higgins Trust, Britain's largest AIDS charity, said she agreed that newspapers have a responsibility to question any orthodox view. "But the problem is, they are not giving all the facts, which means they are misleading some and giving others false," Ms. O'Neil said.
Neville Hodgkinson, the Sunday Times's science editor and the author of most of the stories, said the paper is serving the public interest by telling readers that serious scientists and researchers dissent strongly from the accepted view that HIV causes AIDS.
8. The phrase "whatever Duesberg's friends say" is an example of Maddox's tendentious journalism. It contains an innuendo that only Duesberg's friends raise questions about the right of reply. But questions about the right of reply are independent of whether one is a friend of Duesberg or not.
9. Kary Mullis deals with this quote in his California Monthly interview. What is a "fact" for Baltimore (of Imanishi-Kari fame) may not be a fact at all. One of the criteria of scientific standards is the ability to tell the difference between a fact, an opinion, a hypothesis, and a hole in the ground.
10. "AIDS Rebels Try to Steal Show", 26 May p. A14; "AIDS Symposium Changes Line Up", 7 June p. A15, "S.F. Science Conference to Debate Cause of AIDS", 18 June p. A6; "Controversial AIDS Theories Debated at Forum in S.F.", 22 June p. A7.
11. Nature identifies the authors as follows: Michael S. Ascher and Haynes W. Sheppard are in the Viral and Rickettsial Disease Laboratory, California Department of Health Services, 2151 Berkeley Way, Berkeley, CA 94704. Warren Winkelstein Jr. and Eric Vittinghoff are in the Department of Biomedical and Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720.
12. See two articles: "Can epidemiology determine whether drugs or HIV cause AIDS?", by Peter Duesberg, Aidsforschung vol. 12 (1993) pp. 627-635; and "HIV as a surrogate marker for drug use: A re-analysis of the San Francisco Men's Health Study" by Bryan J. Ellison, Allen B. Downey, and Peter H. Duesberg, Genetica 95 (1995); reprinted in the collection AIDS: Virus---or Drug Induced?, Kluwer Academic Publishers 1996, pp. 97-104.
13. Maddox also claims it is Nature's responsibility to "censor" information. An interview with Der Spiegel (45/1994, p. 229), headed: "Filtern und zensieren'--Interview mit John Maddox uber die Rolle seiner Zeitschrift Nature, contains the following exchange:
DER SPIEGEL. Wissenschaftler werfen lhnen vor, Nature ube mit seinem Gutachtersystem zuviel Macht aus. Die Informationen wurden geflltert... MADDOX .... sogar zensiert: Wir haben uns zum Beispiel geweigert, die These von Peter Duesberg zu veroffentlichen, nicht HIV, sondem Drogenkonsum sei die Ursache von Aids.
Hodgkinson also gave the more general evaluation:
A kind of collective insanity over HIV and AIDS has gripped leaders of the scientific and medical profession. They have stopped behaving as scientists, and instead are working as propagandists, trying desperately to keep alive a failed theory.
Thus the scientific community, and especially the leaders of science, have exposed themselves to a loss of trust in the community at large.
14. These co-authors include especially Harvey Bialy, research editor of Biotechnology. Cohen tried to interview me. I asked that his questions be put in writing, and he faxed me a letter containing questions on 1 November 1994. I found Cohen's questions and statements so defective that I refused to deal with him, and wrote a letter to Koshland explaining in detail why I refused to deal with Cohen. I made a line by line analysis of Cohen's letter to me. For example, Cohen wrote me: "You extensively cite Duesberg's writings and references that he has provided you with, yet I do not see any other references of AIDS literature. Have you investigated the AIDS literature to address the question about the link between HIV and AIDS?"
Cohen was referring to the present article, which I had sent to him before publication in the Yale Scientific. As I wrote to Koshland, Cohen's statement ("Yet I do not see...") documents blindness, as well as incompetence in processing information. To cite just two examples, in my article I quote from a paper by Papadopoulos et al (especially Bialy), and I devote an entire section to the paper by Ascher et al., published by Nature, and reported in the New York Times among many other newspapers which took seriously a press release by Nature. I did not get either of these papers from Duesberg. Bialy himself sent me his preprint.
In any case, what of it if Duesberg is kind enough to provide me with scholarly references at my request? I learned that malaria tests false positive for HIV antibodies from the Kary Mullis interview in the California Monthly, and I learned of a similar situation with respect to leprosy and tuberculosis from Neville Hodgkinson in the London Sunday Times. I asked Duesberg to provide me with the scholarly references to that effect, and he brought to my attention the actual scientific papers by others, reporting these facts. Scientifically, it does not matter who provided me with these references or when, but it was appropriate to acknowledge Duesberg for his bibliographical help.
15. Y. Chang et al., "Identification of Herpesvirus-Like DNA Sequences in AIDS-Associated Kaposi's Sarcoma", Science (16 December 1994) pp. 1865-1869.