What Causes AIDS?

The debate continues

From the December 1994 issue

(Page 5 of 7)

The authors state, "In the absence of any agreement about how HIV causes AIDS, the only evidence that HIV does cause AIDS is correlation." Aside from ignoring the medical literature, they fail to recognize that epidemiology has always been about correlation. Long before there were electron microscopes, cell lines, and the National Institutes of Health, epidemiologists were identifying diseases and saving millions of lives from them based strictly on careful observance of who was getting sick and why. Walter Reed didn't have the least idea of what yellow fever did on a cellular level, but he saw that it was transmitted by mosquitoes and he was thus able to practically eliminate it. Edward Jenner developed the first anti-viral vaccine a century before anyone knew what a virus was.

The conspiracists cavalierly dismiss the San Francisco study, reported on in Nature, along with the Vancouver one, reported on in the Lancet, without providing any detail on them. Here is a brief summary of the San Francisco one. Researchers directly tested the Duesberg thesis that "either drug consumption (frequently associated with malnutrition) by recently established behavioral groups or conventional clinical deficiencies are necessary and sufficient to cause indicator diseases of AIDS." They compared a set of heterosexuals who were heavy drug users and were negative for HIV with homosexuals who were heavy drug users who were both positive and negative for the virus. Reporting their results in the March 11, 1993 issue of Nature, they found that among homosexuals who were seropositive at the beginning of the study, over half had contracted AIDS and most had died. Among the homosexuals who were negative in the beginning and stayed negative, about 2 percent had died but none had been diagnosed with AIDS even when HIV status was excluded as part of the AIDS definition. Among the heterosexuals, less than 1 percent had died and none had gotten AIDS. In addition to devastating the drug-use-causes-AIDS thesis, this study showed as close a correlation between pathogen and disease as one could ever hope to attain. ,P>All this means nothing to the REASON authors. Forget those studies; they weren't set up to our exact specifications, they say. No, and none ever could be. Besides, they say, "the main point they supposedly prove has already been thoroughly disproved: AIDS does occur in HIV-negative persons." But no, it doesn't. Certainly one can get diseases that resemble AIDS, just as one can get a disease that resembles the flu. (How often do we hear of someone suffering a "flu-like illness"?) A chronic cough and expectoration of blood can be symptomatic for bronchitis, tuberculosis, or lung cancer. It doesn't mean these are all the same disease. As the authors themselves point out, the definition of AIDS symptoms covers a wide area. Certainly, it's not difficult for other diseases to mimic that which some AIDS patients may be suffering. This doesn't make them AIDS cases any more than a bloody cough makes TB be lung cancer.

Among hundreds of thousands of sufferers of any given disease there will be a tremendous spectrum in manifestation of symptoms and plenty of anomalies, but with HIV there is a strong pattern of disease progression. After a few years of infection persons begin to lose T-helper cells, then begin to develop outward manifestations of immune dysfunction such as oral candidiasis, then begin to suffer life-threatening diseases such as pneumocystis carinii pneumonia. Outside of persons given immune-suppressing drugs, PCP is remarkably rare, so much so that prior to the AIDS epidemic the CDC was dispensing fewer than 100 prescriptions of pentamidine (at that time the only treatment for the disease) a year. In 1993, however, there were over 12,000 confirmed PCP diagnoses and another 7,000 suspected cases, all in HIV-positive persons. In other words, if you don't have HIV your odds of getting PCP are one in several millions. If you do have it, your odds before the introduction of aerosolized pentamidine as a preventative treatment were better than 50- 50. Even now, they may be better than one in four. What an amazing coincidence.

HIV cohorts have shown that after about 10 years of infection, half of all persons will be dying while almost all of the rest will be suffering severe symptoms. The authors make much of the fact that some HIV carriers remain healthy even after 11 years of infection. As always, they ignore the rule for the exception, making us think the edge of the bell curve is the top. Probably no pathogen known kills with 100 percent efficacy; indeed, about 90 percent of persons carrying the bacteria that causes tuberculosis will never manifest the disease. An even smaller percentage will suffer symptoms from infection with cytomegalovirus. Indeed, the correlation between HIV and manifestation of symptoms, and the correlation between HIV and death, may prove to be stronger than that for any pathogen present in the human population.

Much of what the authors say is unquestionably true, and just as unquestionably doesn't support their case.

Certainly there are co-factors that increase the rate at which HIV decimates the immune system, co-factors that if blocked might greatly increase the length and quality of life for persons with HIV. Co-factors commonly play a role in disease causation. But nobody says that because mycobacterium tuberculosis appears to work with co-factors to manifest as TB that mycobacterium tuberculosis isn't the cause of the disease. The reason? Because you can have those co-factors, but without the mycobacterium, you don't get TB. Just so with HIV and AIDS. Further, quite the opposite of what the Duesberg conspiracists would have us think, scientists have already been devoting a tremendous amount of research to finding HIV co-factors, albeit with precious little to show for the effort.

And yes, certainly the African AIDS epidemic has been overstated, with every fatal disease under the African sun being dubbed AIDS because that seems to be the only disease West- erners care about. But this does nothing to support the conspiracists' hypothesis. Likewise, I was writing about-and staking my reputation on-the exaggeration of the American epidemic, especially with regards to middle-class heterosexuals, long before the authors published word one on the subject. I did so by analyzing patterns of both cases and infections. I noted back in 1989 that since stored blood samples indicated that HIV infections appear to have peaked out in American cities around 1981 and 1982 and since it takes on average about 10 years for an AIDS infection to manifest, the epidemic was probably on the verge of peaking. Indeed, the CDC noted recently (to the deafening silence of the media), that using the pre-1993 definition of the disease, AIDS cases did decline in 1992.

Of course I have now become one of the AIDS conspirators-that group of persons so callous and vicious that we are willing to let hundreds of thousands of Americans alone die of this horrible disease. That or I've just closed my mind like a steel trap, like John Maddox supposedly has. "Like other leaders of the scientific establishment," write the conspiracists, "Nature editor John Maddox is fiercely protective of HIV theory. He indignantly rejected a scientific paper making the same point as this article."

In fact, toward the end of Rethinking AIDS, a Duesberg conspiracy book, author Robert Root-Bernstein crowed: "John Maddox has written that he should have given critics of the HIV theory, such as Peter Duesberg, room to express their concerns." So he did. It was only after the aforementioned 1993 Nature article, along with two other Nature articles discussing how HIV causes AIDS, that Maddox editorialized, "Duesberg, having led many people with AIDS on a seductive path, should now admit the likelihood that he is mistaken."

But like the AIDS alarmists against whom they have rightly aligned themselves, neither Duesberg nor his acolytes are ever going to let a little thing like scientific evidence get in the way.

Michael Fumento
St. Petersburg, FL
(Michael Fumento is the author of The Myth of Heterosexual AIDS.)

Charles A. Thomas Jr., Kary B. Mullis, and Phillip E. Johnson reply: Many things have happened since our article was written, all of them supportive of our position. Here are some highlights:

1) Harvard Professor Bernard Fields published a commentary in Nature that signalled, in the words of The New York Times, that "a new consensus has emerged among many leading scientists that the nation's $1.3 billion AIDS research program is on the wrong track." Planned trials of candidate vaccines have been abandoned as unpromising and dangerous because, according to Fields, "We still have too many serious gaps in our fundamental knowledge to know how to prevent and treat AIDS, and must return to a broader base to study the scientific questions confronting us."

The primary gap, of course, is the absence of anything but speculation to explain how an ordinary retrovirus can be killing billions of immune cells that it doesn't even infect. (That the PCR technique can find genetic sequences associated with HIV -- not active virus -- in lymph nodes does nothing to solve the mystery.) Unfortunately, Fields's back-to-the- drawing board stance, which has been endorsed by top NIH officials, does not imply any real reconsideration of the HIV dogmas that have brought the researchers to this dead end. It means only that some of the AIDS money will be diverted to general biochemical research that is only tangentially related to AIDS.

2) Another Harvard professor and member of the HIV inner circle, Max Essex, published with African colleagues a paper in the Journal of Infectious Disease detailing an extremely high incidence of false positive results among both leprosy patients and their uninfected neighbors on HIV antibody tests. In a group of 57 leprosy patients, for example, 70 percent tested positive for antibodies but more extensive testing confirmed the presence of HIV in only 2 patients. The paper concluded that, due to an unexpectedly high rate of false positives on both the ELIZA and Western Blot tests, these standard antibody tests "may not be sufficient for HIV diagnosis in AIDS-endemic areas of Central Africa where the prevalence of mycobacterial diseases is quite high." These results clearly call into question all projections about HIV infection in Africa and elsewhere that are based on antibody testing.

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