Peter H. Duesberg,
'Inventing the AIDS Virus'
Regnery USA 1996, 720 pages, ISBN 0-89526-470-6.
(NEW YORK TIMES)
a decade, Peter Duesberg has been publicly arguing that AIDS is
not caused by H.I.V. infection. Given his prominence as a professor
of molecular and cell biology at the University of California, Berkeley,
and his membership in the National Academy of Sciences, his arguments
commanded attention. Since he first made this claim, in 1987, many
major biomedical research journals have arranged for formal, published
debates between Mr. Duesberg and other distinguished scientists.
They have disagreed almost uniformly with his increasingly strident
contentions, but he has remained undaunted, writing voluminously
about his belief.
the AIDS Virus" is the next assault in Mr. Duesberg's war on
what he perceives to be a monolithic scientific establishment. Any
reviewer who is also a scientist, as I am, is placed in an awkward
position, for his iconoclasm is extreme. One wants to begin with
a rebuttal that evokes the overwhelming numbers of biomedical scientists,
physicians, public health and health care professionals who have
considered the evidence in depth and have arrived at conclusions
very different from his. But the book's central theme is that we
are all wrong-that the entire scientific army is out of step except
for Mr. Duesberg. And he perceives self-interested collusion behind
that nearly universal agreement. After eight years of such exchanges,
he continues to object vehemently to the nearly unanimous conclusion
in the microbiological community that H.I.V. is a newly pandemic
virus that over a period of years causes inexorable depletion of
immunologically important cells in almost all the people it infects,
thus leading to AIDS.
of the argument is clear: if H.I.V. is the cause of AIDS, it follows
that prevention of the further spread of H.I.V. is critical to stem
the swelling tide of the disease. Scientists at the National Institutes
of Health, the World Health Organization and elsewhere who have
studied the new phenomenon of lethal immunosuppressive illness are
convinced not only that the advent of H.I.V. explains the worldwide
spread of AIDS but that it represents a striking premonitory example
of an emerging infection and deserves intensive, coordinated reaction
around the globe.
They are all
wrong, Mr. Duesberg says: myopic or worse. He hints at vested interests
and implies that diligent, intelligent scientists at every level
have bought into an empty H.I.V. hypothesis for self-aggrandizement
or material gain.
At the core
of Mr. Duesberg's thesis is his belief that, by definition, there
can be no such thing as an illness induced by a virus that has its
overt onset years after initial infection. Further, he asserts that
no virus can cause more than a single disease, or any disease that
appears after a neutralizing immune response develops.
belief flies in the face of decades of progress in understanding
infectious diseases. Early in this century, when the germ theory
of disease was quite new, research focused on examples of acute,
clear-cut interactions between parasitic microbes and their infected
hosts. But with each passing decade, the potential complexity of
so-called host-parasite relationships has become better appreciated.
In recent years, many chronic viral infections (such as recurrent
herpes simplex or the reactivation of the latent chicken pox virus
to cause shingles) have been studied in depth, and investigation
of the role played by viruses is considered by most researchers
to offer a particularly rich source of insight into the cause of
other chronic diseases and even of cancer.
Those of us
struggling with the problems presented by AIDS are somewhat inured
to the author's acrid complaints and accusations, for he has indeed
had his day in court many times over. He has made his views familiar
through initial colloquies in the journals Science, Proceedings
of the National Academy of Sciences, and Nature, and he has maintained
a reiterative public correspondence contending that H.I.V. does
not cause AIDS. In itself his dissent is not unreasonable, for in
most arenas, but particularly in science, conflicting interpretations
should always be attended to carefully.
In this book
Mr. Duesberg now goes considerably farther, saying in essence that
there is no pandemic at all-that nothing unusual is happening, that
there is no such thing as AIDS. He ascribes the loss of life-more
than 300,000 deaths in this country alone in the 15 years since
the epidemic surfaced- to drugs or to underlying generic ill health
Gay men in
whom AIDS was diagnosed in the early years, he asserts, were not
being truthful if they denied drug use. More recently, he believes,
the decimation of their ranks is exacerbated by treatment with AZT
(zidovudine). Mr. Duesberg feels that AZT is so toxic it should
be banned by the Food and Drug Administration.
It is generally
held that the large number of hemophiliacs now suffering from AIDS
were made ill by their use of Factor VIII concentrate (needed to
stem their bleeding), which is prepared by pooling plasma from literally
thousands of donors. Before the development of heat-treated plasma
in 1983, and before blood donor screening became possible in 1985,
many hemophiliacs were given clotting factor contaminated with the
virus and became infected with H.I.V. But Mr. Duesberg argues that
H.I.V. is not the cause of their illness: they were sick anyway,
and are simply dying of their underlying disease and, again, of
the toxic effects of AZT.
Nor is transfusion
with H.I.V.-infected blood a cause of AIDS, Mr. Duesberg says: studies
show surgery patients die with equal frequency within the first
year after surgery whether they have been infected with H.I.V. or
not. This is correct but irrelevant: what he is failing to note
is that there is an interval of no less than two years between initial
H.I.V. infection and overt AIDS. According to Mr. Duesberg's fundamental
assumption, such a long interval between infection and disease is
infants born to H.I.V.infected mothers? The mothers, according to
Mr. Duesberg's reasoning, must have been drug users (it's the only
possible explanation of their infection, according to Mr. Duesberg's
theories), and all of the infants would have been damaged anyway,
he asserts, since they spent nine months in the wombs of drug users.
That circular argument is downright dizzying-especially since it
is based on flawed premises at every turn, not the least of which
is the assumption that children born to drug-using mothers are always
As for H.I.V.
and AIDS in other countries, Mr. Duesberg dismisses the issue: existing
indigenous diseases explain everything. According to the Global
AIDS Policy Coalition's most recent estimate, there have been 7,600,000
AIDS deaths in sub-Saharan Africa, with 1,300,000 in 1995 alone.
seems oblivious of the fact that immune suppression caused by H.I.V.
takes a distinctive form. Nor does he acknowledge the existence
of enormous bodies of evidence based on epidemiologic or clinical
science that firmly implicate H.I.V. in AIDS. On occasion, when
he feels the need to deal with the reality of large numbers of people
dying with profound immune suppression, he invokes a diffuse (and
unproved) immune incompetence that he ascribes to drug use, life
in underdeveloped countries or underlying illness. Taken together,
those dismissive statements almost seem to suggest an assumption
of "poor protoplasm."
At every turn
Mr. Duesberg faults both modern microbiological science and the
way its insights have been translated into feasible public health
programs. His position is not simply that of a benign naysayer:
much of what he advocates would have truly malign effects on the
health of the public.
blithely disregards the mountains of data contributing to the present
understanding of microbial pathogenesis in general. He is at least
consistent in his iconoclasm, for he disbelieves many things. He
insists, for instance, that the late-stage neurologic disease that
threatens syphilis patients has nothing to do with the syphilis
bacterium: it occurs years later and thus must reflect instead the
results of toxic treatments. But syphilis patients don't get neurologic
disease unless the syphilis has gone untreated. In any case, the
treatment for syphilis is penicillin, which is not toxic.
hepatitis C as a pathogen or even as a virus because it cannot as
yet be grown in cell culture (a technical problem that has been
true of virtually all viruses early in their recognition). But he
goes much farther, criticizing the F.D.A. for approving the screening
of donated blood for hepatitis C. Most analysts believe that policy
has resulted in dramatic reduction of the occurrence of post-transfusion
hepatitis since it was instituted in the early 1990's. Mr. Duesberg
views it as collusion between government and industry to dupe the
rejects studies of so-called "slow viruses" like those
implicated in some cases of Creutzfeldt-Jakob disease. As for any
role for viruses in causing cancer in humans, he rejects the mounting
evidence as spurious.
makes virtually no effort to substantiate his most contrarian assertions,
many of which are contradicted by reams of published data, while
he berates his adversaries for failure to identify the "one
paper that proves" that H.I.V. causes AIDS. A disproportionate
number of footnotes refer to Mr. Duesberg's own work.
For the thousands
who are suffering from AIDS or trying to cope with the escalating
demands of treating this deadly illness, Mr. Duesberg's suggestion
that nothing new is happening is as outrageous as it is insulting.
Mr. Duesberg's last chapter sets forward what he thinks should be
done in its full simplicity: don't do drugs and don't have hemophilia
or other diseases.
credentials make his assertions both distracting and disabling of
preventive response. Denial has always been the most devastating
social and political dynamic of the AIDS epidemic-and his book feeds
it abundantly. In sum, this book is destructive of personal morale,
prevention efforts and public understanding both of H.I.V./AIDS
and of biomedical science in general. It has the potential to wreak
serious harm at a crucial point in the AIDS epidemic, which has
been judged by many to be one of the greatest public health challenges
of our time.
by June E. Osborn; June E. Osborn, a pediatrician and microbiologist,
was chairwoman of the National Commission on AIDS from 1989 to 1993.
The New York Times 7 April 1996
you find Duesberg's reply.