CAN WE BE POSITIVE?
By Neville Hodgkinson
The Sunday Times (London) 26 April 1992
sounds possible. After worldwide campaigns for "safer sex",
and eight years of anti-viral research and treatment costing billions
of pounds, a growing number of senior scientists are challenging
the idea that the human immunodeficiency virus (HIV) causes AIDS.
The idea seems
outrageous to doctors who have seen their patients fall sick and
die after becoming infected with the virus, which was discovered
believed HIV was a new, sexually-transmitted disease, and predicted
that it would eventually put the sexually-active population at risk.
But the failure of the epidemic to "explode" into the
general population has encouraged some experts to ask whether a
simple cause-and-effect link between HIV and AIDS really exists.
They do not
question the existence of the disease called AIDS the acquired immune
deficiency syndrome in which the body's normal deaga a variety of
infections, and some rare cancers, cease to work. What they are
saying is that new ideas are emerging that question the extent of
HIV's role in AIDS.
Some of these
scientists now suggest that the virus can be harmless on its own,
but may play a part in throwing the immune system into disarray
when other infections are present. This could mean some people who
are HIV-positive will never fall ill.
That in itself
is dramatically different frm the view held for years by most AIDS
scientists: that the presence of HIV in the body is a time-bomb
which sooner or later will explode, seeking out and destroying all
the body's T-cells, an essential part of the immune system.
But other sceptics
go further. They argue that the virus is not new, that it is not
normally sexually transmitted, and that it is almost certainly harmless
almost no different from scores of other innocuous viruses in the
same class that may have been around for centuries, but which have
only come to light recently because of modern techniques of analysis.
They do not
deny that HIV is usually present in people whose immune systems
have failed, but argue that this is because those people have been
exposed to special health risks that bring them into contact with
many infectious agents.
the AIDS epidemic, many favour an idea originally proposed when
the first cases were discovered in a group of male homosexual drug
users with devastating bacterial and other infections: that a dangerous
lifestyle, rather than a new microbe, is mostly to blame.
the main factor is the unprecedented level of drug use, both inhaled
and injected, during the 1970s and 1980s and more recently, inappropriate
use of medical drugs in trying to counter AIDS.
such as haemophiliacs, transfusion recipients and babies born to
drug-abusing or otherwise sick mothers, have suffered illnesses
that in the past would have been attributed to their physical condition
or circumstances, the sceptics argue. Being exposed to other people's
blood means their chances of showing antibodies to a wide variety
of infectious agents, including HIV, are much higher than average.
So are their chances of falling ill but not for reasons that need
have anything to do with HIV.
Africans have been shown to be HIV-positive, according to the World
Health Organisation. But again, a long-awaited explosion of AIDS
has not happened, the dissident scientists claim. In all, 120,000
AIDS cases have been reported during the past eight years. That
is a small percentage of the total number of deaths that could be
expected anyway over that period out of a 6m-strong group.
victims suffer from a completely different pattern of illnesses
to those in the West: largely old African diseases such as slim
disease, fever, diarrhoea and tuberculosis, usually associated with
malnutrition, parasitic infections and poor sanitary conditions.
They are being rediagnosed as AIDS because virus-hunters can point
to the presence of HIV, the critics argue.
this view, the entire edifice of international alarm and expenditure
surrounding HIV is based on a faulty premise: that HIV is a new,
deadly virus. If the critics prove to be right, the HIV-AIDS link
would be seen as the biggest medical and scietific blunder this
AIDS scientists now accept that HIV cannot work as simply as originally
believed, they regard those who say it has nothing to do with AIDS
as irresponsible "flat-earthers" who do not deserve to
be taken seriously.
dissident, Dr Peter Duesberg, professor of molecular biology at
the University of California in Berkeley, has lost his $350,000
"outstanding investigator" funding from the National Institutes
of Health, the American government's premier scientific research
organisation. In a letter cancelling his grant, officials referred
to his recent research as being "less productive, perhaps reflecting
a dilution of his efforts with non-scientific issues".
Some of the
dissidents say they have had their work boycotted, and become marginalised
from mainstream scientific meetings.
To try to break
through this impasse, nearly 50 biomedical scientists, statisticians
and other professionals have come together to form an international
body, The Group for the Scientific Reappraisal of the HIV/AIDS-Hypothesis.
Some are to take part in an "alternative" AIDS symposium
in the Netherlands next month.
They are also
launching a newsletter, Rethinking AIDS, that will examine the scientific
basis for claims made about AIDS and propose experiments for testing
the HIV theory.
It is edited
by a molecular biologist, Dr Harvey Bialy, scientific editor of
the journal BioTechnology, a sister publication to Nature.
Asked why such
a publication was needed, Bialy said: "The vast majority of
instruments of public information, as well as the majority of scientists
involved in biomedical research, have indiscriminately subscribed
to a single hypothesis, that a virus called HIV is the cause of
the disease syndrome called AIDS.
has become all things to all people. It violates everything we previously
knew about virus disease, and allows any kind of therapy, any kind
of research, to generate research bucks.
kind of science continues to place all its marbles, all its faith,
all its research bucks, in such a theory?
I keep coming back to is that it has nothing to do with science;
the reasons are all unscientific.
taken sex and equated it with death, and into that mixture we have
thrown money. What an ugly stew."
The new group
has been trying to persuade a leading medical or scientific journal
to publish a letter outlining its concerns. It states:
widely believed by the general public that a retrovirus called HIV
causes the group of diseases called AIDS. Many biomedical scientists
now question this hypothesis. We propose that a thorough reappraisal
of the existing evidence for and against this hypothesis be conducted
by a suitable independent group. We further propose that critical
epidemiological studies be devised and undertaken."
None of the
journals approached so far has been willing to publish this letter,
despite several distinguished signatories.
frozen out," says Dr Charles Thomas, the group's co-ordinator,
a former professor of biological chemistry at Harvard University
who now heads the Helicon Foundation, a non-profit research organisation.
Yet he says
he is unable to name "a single scientific publication that
purports, either convincingly or unconvincingly, to demonstrate
that HIV causes AIDS it's really a quite extraordinary story".
scientist in the group, Dr Kary Mullis, inventor of the polymerase
chain reaction (PCR) technique, a breakthrough in genetic testing
now used worldwide, also questions the HIV hypothesis, but says
other experts are unwilling to because so many livelihoods and reputations
depend on it.
find a single virologist who will give me references which show
that HIV is the probable cause of AIDS," he says.
issue as important as this, there should be a set of scientific
documents somewhere, research papers written by people who are accessible,
demonstrating this. But they are not available. If you ask a virologist
for that information, you don't get an answer, you get fury."
have dared question the HIV hypothesis. Notable exceptions include
Gordon Stewart, emeritus professor of public health at Glasgow University,
who says he has been repeatedly frustrated in his attempts to publicise
inconsistencies and inadequacies in the conventional view; and writer
Jad Adams, whose 1989 book AIDS: The HIV Myth described how an "AIDS
Establishment" had come into being, committed to the HIV hypothesis
and fiercely resisting anyone who challenged it.
small medical documentary film-making company, has produced three
films challenging the AIDS orthodoxy, shown on Channel 4's Dispatches
programme. The second of these, The AIDS Catch, shown in June 1990,
was bitterly attacked by leading figures from the Medical Research
Council, and was reported to the Broadcasting Complaints Commission
by the Wellcome Foundation, manufacturer of the anti-AIDS drug AZT,
and the Terrence Higgins Trust, the AIDS group. The commission partially
upheld the complaints, but its findings were rejected by the Independent
Television Commission and Channel 4 itself.
that HIV is the cause of AIDS has become so axiomatic for most doctors
working in the field that they view any suggestion to the contrary
as dangerously irresponsible.
observations support the view that HIV can no longer be considered
a lone, infectious assassin. Originally, it was thought that the
virus killed billions of T-cells, vital to the body's immune defences.
Later studies have shown it is active in only one in 10,000 T-cells,
far fewer than would be needed to kill off the cells faster than
the body replaces them.
About 97% of
all American AIDS patients are from abnormal health risk groups:
heterosexual intravenous drug users, male homosexuals who use oral
aphrodisiacs and psychoactive drugs, haemophiliacs, babies of drug-addicted
mothers and recipients of blood transfusions. And about 91% of American
AIDS patients are males. If the disease is sexually transmitted,
why do so few women (other than drug users, and some from ethnic
minority groups in poverty-stricken circumstances) develop AIDS?
It cannot be because of the spread of "safer sex" conventional
venereal diseases and unwanted pregnancies are increasing.
year that goes by, the length of time the virus is said to take
before it produces disease has had to be extended. Even assuming
that HIV causes AIDS, on the basis of present statistics it will
take 33 years for most HIV-positive haemophiliacs in America to
develop the disease. That compares with original predictions of
three to five years.
50% of American AIDS patients are tested for HIV the diagnosis is
made on the basis of their disease symptoms. And of those who are
tested, 5% never show signs of HIV infection. It means that even
if HIV does cause AIDS, there are other causes as well.
agents shown to cause suppression of the body's immune defences
are present in AIDS patients. These include immunological response
to semen following anal intercourse; use of recreational rugs such
as nitrites ("poppers"); chronic antibiotic use (often
associated with promiscuity); opiate drugs; repeated blood transfusions;
anaesthetics; malnutrition (whether caused by bowel dysfunction
in homosexuals, drug use, poverty or anorexia nervosa); multiple
infections by diverse micobes; and infection by specific viruses
such as cytomegalovirus, Epstein-Barr virus, and hepatitis B virus.
are infected experimentally with HIV they do not develop AIDS. Even
a monkey equivalent of HIV, called simian immunodeficiency virus
(SIV), does not cause disease when carried by monkeys living in
mothers can give birth to healthy babies, and some HIV-positive
babies have so far never developed AIDS-related symptoms.
Out of several
thousand reported cases of needle injuries and cuts among health
workers and laboratory researchers handling HIV-contaminated material,
only 5% have become HIV-positive; and of those, only one person
lacking other identified risks has developed AIDS.
were reported for at least 100 years before 1980.
None of this
proves that HIV cannot cause AIDS, says another of the critics,
Dr Robert Root-Bernstein, associate professor of physiology at Michigan
State University and a prize-winning researcher in immunology. But
he argues in a paper entitled Do We Know The Cause(s) of AIDS? published
in the specialist journal, Perspectives in Biology and Medicine,
that "premature closure of inquiry lays us open to the risk
of making a colossal blunder".
ON APRIL 23,
1984, Margaret Heckler had an announcement as dramatic and rewarding
as any politician could wish to make. The American secretary for
health and human services told a press conference in Washington,
DC, that Dr Robert Gallo, a senior researcher at the National Cancer
Institute, had found the virus responsible for AIDS.
It was the
news all America, but especially the homosexual community, with
2,000 dead from AIDS and 100 new cases being reported every week,
had been anxiously awaiting.
It was also
desperately important to the Western medical and scientific community,
whose proud record of mastery over microbial enemies was being challenged
these powerful emotions accurately. "Today we add another miracle
to the long honour roll of American medicine and science,"
she said. "Today's discovery represents the triumph of science
over a dreaded disease.
who have disparaged this scientific search those who have said we
weren't doing enough have not understood how sound, solid, significant
medical research proceeds."
A blood test
for the virus would be available within months, she said, and a
vaccine ready for testing within two years.
The blood test
did indeed arrive, and became the basis of a multi-million-dollar
industry. Gallo had already developed it, and a patent was filed
the same day as Heckler's announcement.
As he strode
into the press conference, Gallo was a picture of confidence, fastidiously
dressed. "He approached the podium like the only kid in the
school assembly to have won a national merit scholarship,"
a journalist, David Black, wrote later.
seemed to me condescending, as though he were the Keeper of Secrets
obliged to deal with a world of lesser mortals."
world seemed hypnotised by his certainty, and Gallo's conviction
that HIV alone explained the arrival of AIDS "who needs co-factors
when you've been hit by a truck?" he is quoted as saying became
the established view.
on, Gallo's superstar status and scientific credibility have been
undermined. The scientific community has now accepted that the virus
was first isolated in 1983 by a group led by Dr Luc Montagnier at
the Institut Pasteur in Paris, and had been sent to Gallo's laboratory
for further testing.
Institutes of Health inquiry panel has accused Gallo of "intellectual
appropriation" of the virus. It says that an article announcing
the discovery published in Science magazine in 1984, of which Gallo
was joint author, contained "misrepresentations or falsifications"
of methodology and data.
also faces federal inquiries alleging perjury and fraud in his patent
application, denies any intention to mislead and blames the errors
in the article on the rush to publish.
telvision viewers, however, his decline from fame was encapsulated
earlier this month as he was chased by a camera crew with the interviewer
demanding: "Did you steal the virus, Dr Gallo? Did you steal
significant as Gallo's fall from grace is a sharp shift in Montagnier's
position on AIDS. As one of the speakers at the "alternative"
symposium next month, he will be outlining his current view that
HIV can be a benign, "peaceful" virus, which only becomes
dangerous in the presence of other organisms (see story on below).
naive," he says."We thought this one virus was doing all
the destruction. Now we have to understand the other factors in
first made some of his views on these "co-factors" known
at the sixth international AIDS conference in San Francisco nearly
two years ago, seven years after his original discovery of HIV.
He thought his message would be a bombshell. But it was not one
the conference wanted to hear.
Of 12,000 delegates
present, only 200 went to hear his talk. By the time he had finished,
almost half of those had walked out. His views were dismissed by
leading American AIDS scientists and public health officials.
was Montagnier, the Jesus of HIV, and they threw him out of the
temple," one observer commented.
was puzzled by Heckler and Gallo's 1984 announcement. As the first
scientist to map the genetic structure common to all retroviruses,
of which HIV is one, he knew that mice and chickens, for example,
contain 50 to 100 retroviruses that never cause disease.
He knew that
if you look hard enough, "when you're in the retrovirus business
you can detect a retrovirus". But attempts to prove that the
viruses cause disease have uniformly failed, according to Duesberg.
He wondered what was so special about this new one that could make
it the cause of AIDS. Three years later, he challenged the HIV-AIDS
hypothesis on biological grounds in the specialist journal, Cancer
from other medical scientists was dismissive. While it was not known
how HIV could be so devastating, they argued that the epidemiological
evidence studies of what was actually happening in people showed
such a close link between HIV and AIDS that the virus was clearly
has returned to the attack with an 8,000-word critique in the Paris-based
journal, Biomedicine and Pharmacotherapy. In it he maintains that
not only the virology, but also the patterns of illness in the American
and European AIDS epidemics, fail to support the theory that HIV
He says that
in he seven years since HIV testing became available, the official
estimate of the number of Americans carrying the virus has stayed
constant, at about 1m. Screening by the US Army among potential
recruits has also shown a constant proportion of both men and women
0.03% with antibodies to HIV.
those observations is consistent with the arrival of a new, infectious
disease, Duesberg says, for which cases would be expected to spread
exponentially in susceptible populations.
that best fits the data, Duesberg now says, is that HIV is not new
"it is perhaps as old as America". He thinks it survives
naturally, at a low level, by being passed from mothers to their
children, as is the case with most retroviruses.
The fact that
the 0.03% figure is equal in men and women indicates that it is
reflecting this harmless "background" HIV. It is unrelated
to AIDS, for which the vast majority of American victims are men.
babies seen by health authorities are different: they come mainly
from drug-abusing parents, and it is adverse emotional and physical
circumstances, not HIV, that may prove lethal to them. When they
come from good homes, or are adopted and well cared for, most stay
In fact, almost
all Americans who develop AIDS have been exposed to abnormal health
risks, Duesberg says. The virus acts as a risk "marker".
The medical profession's mistake has been to jump to the conclusion
that when that marker is present, the patient's illness is a consequence
One way of
establishing HIV's role in causing illness would be to compare the
progress of carefully matched groups of haemophiliac men, some with
HIV and some without. No such study has been published.
There is, however,
a group of 32 haemophiliacs in Edinburgh who are all thought to
have been exposed to a single contaminated batch of Factor VIII,
the blood-clotting substance in which their own bodies are deficient,
in 1984. Eighteen became HIV-positive, and 10 of those have developed
immune deficiencies. The other 14 did not, and all of those have
to demonstrate that HIV must be responsible. But last November,
doctors reported in The Lancet that as a group, the 10 differed
from the others in that their immune systems were hyperactive before
they became infected with HIV.
suggested this might be a genetic trait predisposing to HIV disease.
For Duesberg, it supports other evidence that haemophiliacs develop
immune deficiencies not because of HIV, but because of their condition
and its treatment. Their regular transfusions cause repeated challenges
to their immune system. Other studies have shown that the length
of time they have been receiving these transfusions is their biggest
risk factor for developing immune disorders.
If the real
cause of haemophiliac AIDS is haemophilia, how come their wives
occasionally die of AIDS after sexual transmission of HIV?
according to Duesberg, is that they don't. The US Centres for Disease
Control has reported that a total of 94 wives of haemophiliacs have
been diagnosed with "AIDS" diseases in the past seven
years, on average about 13 a year. Although HIV is difficult to
transmit sexually, requiring on average about 1,000 sexual contacts,
some of the wives have become HIV-positive.
But about 80
deaths a year could be expected anyway in this group, on the basis
of standard death rates. And the wives don't get illnesses such
as Kaposi's sarcoma, or dementia, or lymphoma, or wasting syndrome,
which currently account for 39% of all American AIDS diseases.
you see here are pneumonias, mostly, and a few other infections
typical diseases of older age. Normal morbidity and mortality may
be the simplest explanation, but because they are the wives of haemophiliacs
it is called AIDS."
is proved right in believing HIV does not cause AIDS, where does
the epidemic come from? In his latest paper, Duesberg claims its
origin rests with the explosion in the use of "recreational"
drugs; and that in addition it is now being driven by the toxic
side-effects of AZT, originally developed as chemotherapy for cancer
patients but now prescribed to about 120,000 HIV-positive Americans,
and 180,000 people worldwide.
of drugs to break down the immune system is well documented, Duesberg
says. "It's not one bath house party, or two, or even 10 or
20, but if you do it over and over and over again. One gay activist
in New York says that when he was wild in the bath houses, he had
3,000 sexual contacts.
do that on testosterone (naturally occurring male hormone).
you fall asleep after one or two contacts. But if they are flying
on amphetamines and poppers they go in for two or three days, and
with 20 or 30 contacts. Poppers sound so cute, but they contain
a very reactive compound, which is mutagenic and carcinogenic.
mutate and oxidise and damage their DNA and RNA, and they don't
get any sleep, and in the long run if they go on harder drugs such
as cocaine and so on they can't pay for their food any more and
don't eat the vitamins and proteins they need to regenerate, and
they come down in hospital with pneumonia.
along comes Dr Gallo and he looks for a latent retrovirus. Then
they give them AZT, which is inevitably toxic, and a year later
you are definitely dead."
several studies in which patients have recovered from AIDS-type
illnesses after coming off AZT, which he maintains is "AIDS
he believes the same could have been true for Kimberley Bergalis,
the 23-year-old American student who died four years after having
two wisdom teeth extracted by her dentist.
A year after
the operation, and shortly before graduating from the University
of Florida, Kimberley who was a virgin, and had never injected drugs
developed oral thrush. Her health declined further, and doctors
considered stress and hepatitis as possible causes. In December
1989 she was found to be HIV-positive, and it was assumed she had
picked up the virus from her dentist, a bswhod of AIDS in September
In a bitter
farewell letter, Kimberley wrote of her hair falling out, of losing
more than 40lb, of blisters on her sides, of nausea and vomiting,
night sweats, chronic fevers, cramping, diarrhoea, acne infesting
her face and neck, and of the white fungus, with which her illness
had started, running wild.
The world was
devastated on hearing what it took to be the horror of AIDS. Yet
every one of these symptoms could readily be attributable to the
AZT Kimberley was given to the end because of its known mode of
action, Duesberg says. By contrast, no mechanism whereby HIV could
produce such symptoms has ever been demonstrated.
The drug theory
leaves many questions unanswered. There seems to have been many
homosexual victims, for example, who either never took drugs or
who gave them up on learning of their antibody status, but who still
went into rapid decline.
the other scientists seeking a new look at AIDS admit that their
own ideas on its causes are speculative. But they say there should
at least be more studies into the specific risks of drugs and other
spending on HIV research and the hunt for a vaccine now running
at $4 billion a year in America Pounds 150m a year in Britain, perhaps
a wider look at AIDS is overdue.*
TO THINK AGAIN ON AIDS LINK, CLAIMS HIV PIONEER
looking up for Professor Luc Montagnier. After eight years and
numerous inquiries, the world scientific community has finally
accepted that he was the first scientist to discover the human
immunodeficiency virus (HIV), and not Dr Robert Gallo of the
US National Institutes of Health.
now faces a federal inquiry into allegations of perjury and patent
fraud, Montagnier has moved into a new Aids research wing at the
Institut Pasteur in Paris, where he is director of cancer research.
The institute is suing the American government for millions of dollars
in lost royalties arising from the test for detecting the virus.
battle, which Montagnier considers much more important, has yet
to be resolved: that of determining exactly how HIV can bring about
the conditions in the body that lead to Aids.
American critics of the "HIV equals Aids" theory, Montagnier
accepts there is "a very strong case that HIV has something
to do with Aids; without HIV, I don't think we would have Aids epidemics.
There are obvious cases of transmission of Aids from one person
to another where HIV was the only risk factor."
But he says
some people develop the symptoms of Aids the immune system failing,
and infections taking the body over as a result without HIV being
present or playing any part in their illness.
Even when the
virus is in the body, it may remain "benign", becoming
dangerous only in the presence of other organisms.
doesn't necessarily lead to Aids," he said. "There are
some people who could escape that. It may be a minority, but we
can hope by treatments to increase this number."
theory is that HIV works by triggering changes in the body that
may subsequently lead to Aids when other "co-factors"
are present. At that point, HIV would not necessarily still be involved.
This has important consequences. If he is right, it means a cure
is unlikely to be found in the anti-viral programmes, which are
the focus of most contemporary Aids research.
But other factors
involved in the disease process may offer vital leads for treatment
insists that contrary to what was originally thought, HIV does not
attack cells of the immune system directly.
believes that when the virus infects the body in the presence of
other microbes, it appears to spark a process in which some of the
cells contributing to immune defences against microbial invaders
become wrongly "programmed".
further attack, the immune cells fail to recognise the invaders
as foreign. Rather than countering them, they regard themselves
as redundant and "commit suicide".
to self-destruct, called apoptosis, is natural to many cells. It
forms part of a system of checks and balances that enables the body
to maintain itself in good repair.
But in people
with Aids, the process has gone haywire. Immune cells are destroying
themselves faster than they can be replaced, so eventually the patient
is left helpless against a variety of germs that in healthy people
do not cause any harm.
tests have shown that about 10-20% of the immune cells in HIV-positive
people demonstrate a readiness to react in this abnormal way when
challenged by other microbes, compared with almost none in healthy
does not prove HIV is to blame; people infected with HIV may have
been infected wlot other "foreign" agents as well. But
it puts it under strong suspicion of playing a part.
is planning a series of trials to test a variety of strategies for
redcing the abnormal reaction.
our new ideas we can derive some advice, if not some strong proposals,
for treating HIV-infected individuals to prevent evolution towards
the Aids stage," he said.
by micro-organisms is important, I think they should reduce their
risks of being exposed to such microbes, and have long-term antibiotic
are likely to include dietary advice and vitamin supplements, aimed
at easing chemical stresses in the body, which have also been seen
to provoke apoptosis.
In good health,
the body has its own methods for controlling the process and several
new drug treatments, which may make good a deficienc in these controls,
are also being explored.
is that individual HIV-positive people are vulnerable to specific
microbes, depending on what they were harbouring when they first
became exposed to HIV. By identifying those in the laboratory, doctors
would be able, Montagnier believes, to give very precise prophylactic
treatment to prevent the destruction of immune cells.
This new way
of looking at Aids also implies there should be great caution over
the therapeutic use of any conventionally designed anti-HIV vaccine,
Montagnier says, as the vaccine might trigger the very process it
should be preventing. "It would be a very small danger for
people who haven't seen HIV before, the correct way of using a vaccine,
but for people who are HIV-infected I don't think it would be very
good to inject them again with the virus protein. That could make
them worse." *