the AIDS Virus, Peter H. Duesberg
1996, 720 pages, ISBN 0-89526-470-6.
Review- New York Review of Books
The May 23 issue of the New York Review of Books has a long
article by Richard Horton (editor of Lancet) titled "Truth
and Heresy About AIDS." It is a review of Duesberg's Inventing
the AIDS Virus, and also of two collections of essays edited
by Duesberg that were published at about the same time. Horton's
review essay is very long, and will not be available on-line as
far as I know, so I will post a summary with quotations. Direct
quotations are indented. My commentary is included in brackets throughout,
and at the end.
I hope this summary is widely read. I do not think the NYR
will object to the direct quotations, especially since I urge all
readers to purchase this issue and read the article in its entirety.
I think the NYR has covered itself with glory by devoting
so much space to such a substantial article, even though I am severely
critical of some parts. I have to use quotations because it is so
important not to give the ever-present HIV-obscurantists a chance
to complain that anything has been misreported.
The review essay is in 5 parts.
After characterizing Duesberg as "a brilliant virologist,
and the former recipient of an award for outstanding investigative
research from the NIH," Horton summarizes the Duesberg position:
"If AIDS was caused by an infectious agent, Duesberg claims,
one would expect it would have five specific characteristics: (1)
it would spread randomly between the sexes: (2) the disease would
rapidly appear -- at least within months: (3) it would be possible
to identify "active and abundant [HIV] microbes in all cases",
(4) cells would die or be impaired, beyond the ability of the body
to replace them; and (5) we would see the development of a consistent
pattern of symptoms in those infected. None of these expectations
has been met. In the US and Europe, men are affected far more commonly
than women; the onset of clinical disease takes a median of ten
years; the virus is difficult to isolate in patients with AIDS.
Nor are the direct effects of the virus on one group of target cells,
called CD4 lymphocytes, believed to be responsible for the observed
immunodeficiency. And the symptoms vary strikingly, for example,
between Africa and America, although they have a supposedly common
Arguments such as these have persuaded respected scientists to
express their skepticism that HIV is the cause of AIDS. Kary Mullis,
who won the Nobel Prize for chemistry in 1993, writes in his foreword
to Inventing the AIDS Virus, "I like and respect Peter Duesberg.
I don't think he knows necessarily what causes AIDS; we have disagreements
about that. But we're both certain about what doesn't cause AIDS.
We have not been able to discover any good reasons why most of the
people on earth believe that AIDS is a disease caused by a virus
called HIV. There is simply no scientific evidence demonstrating
that this is true."
Horton goes on to describe Duesberg's "drug-AIDS hypothesis,"
and then concludes:
" Here Duesberg's arguments take him into dangerous territory.
For if HIV is not the cause of AIDS, then every public health injunction
about the need for safer sex becomes meaningless; every call to
offer clean needles to injecting drug users may be unnecessary --
or worse. Duesberg notes that "the clean needle program of
the AIDS-establishment would appear to encourage rather than discourage
intravenous drug use." And he writes, most remarkable of all,
that "screening of blood for antibodies to HIV is superfluous,
if not harmful, in view of the anxiety that a positive test generates."
In his opinion "AZT is AIDS by prescription"; this drug
should "be banned immediately."
[It may be "dangerous" for Duesberg to oppose AZT, but
it is far more dangerous for the AIDS establishment to prescribe
it, especially for infants, in view of the acknowledged toxicity
and inadequate evidence of clinical benefit. Avoiding known venereal
diseases is sufficient reason to refrain from unsafe sex practices,
regardless of what one thinks about AIDS.]
Horton concludes Part One with the obvious question:
"How could so many scientists have got it all so badly wrong?"
[Indeed, that is a very excellent question. But in the next section
seems to answer it by saying in effect that -- "Of course,
they couldn't have got it wrong. To forestall that unacceptable
possibility, their most dubious evidence must be accepted as absolute,
Horton observes that the Duesberg dissent emphasizes that even
a perfect correlation cannot prove causation without "functional
evidence" -- i.e., evidence of how the virus supposedly does
its damage. He goes on to comment that That "functional evidence"
is now accumulating rapidly. However, researchers readily admit
that there are huge gaps in our understanding. In the recent authoritative
account, The Molecular Biology of HIV/AIDS, edited by A.M.L. Lever,
"Despite knowing so much about the molecular biology of HIV
we still have little understanding of how HIV causes AIDS and why
progression to disease can take a long and variable time.
It remains to be established precisely how viral replication and
viral gene expression are regulated and how they influence progression
to clinically significant immunodeficiency.
The cell type which is first infected following HIV transmission
has still not been defined."
"These uncertainties do not mean that HIV is not the cause
of AIDS. Here is an important distinction that Duesberg ignores.
Though we may not understand exactly how HIV causes AIDS, we have
a large, most scientists would say overwhelming, mass of evidence
linking HIV to this form of acquired immunodeficiency. HIV has been
shown to be a necessary factor for the occurrence of AIDS. Whether
it is sufficient remains open."
[Throughout the article, Horton uncritically repeats as fact the
claim that AIDS never exists except in the presence of HIV, ignoring
that this is true only because the syndrome is defined that way,
and never mentioning that exactly the same symptoms or (29) indicator
diseases are diagnosed as AIDS only when HIV (usually, antibody)
is either shown or presumed to be present. Tuberculosis (for example)
accompanied by a positive antibody test is AIDS; if the test is
negative, it is just tuberculosis. Horton does not even refer to
the dozens of cases admitted by the AIDS establishment to exist
and reclassified as "ICL" solely because no trace of HIV
cannot be found even after prolonged efforts. The reason that so
many scientists could be so wrong is that they have not bothered
to observe elementary principles of logic in evaluating claims of
correlation. Horton must know about the circular definition because
the Duesberg books and articles make the point repeatedly. Hence
his failure to note the point and respond to it appears to be a
Horton's position, then, is that HIV is necessary but not necessarily
sufficient for AIDS. So he goes into the question of possible co-factors:
"Could drugs be an additional cofactor? Duesberg writes that
there are high rates of drug use among AIDS patients, and he has
correlated drug use "epidemiologically and chronologically"
with the AIDS epidemic in both the US and Europe. He cites studies
showing that 96 percent of representative groups of male homosexuals
had used nitrite inhalants, up to 70 percent had used amphetamines,
and up to 60 percent cocaine or LSD. His uncompromising rejection
of the causal power of epidemiological evidence is temporarily set
aside when he dogmatically affirms that distinct AIDS diseases occur
in distinct risk group[s] -- because they use distinct drugs (e.g.,
users of nitrites get Kaposi sarcoma, users of intravenous drugs
get tuberculosis, and users of AZT get leukopenia and anemia). .
. . The duration and toxicity of drug consumption and individual
thresholds for disease determine when AIDS occurs, irrespective
of when and whether HIV infects."
"Here Duesberg has abandoned the skepticism about epidemiology
that he deployed so tenaciously in his criticisms of HIV causality.
In fact, the issues he raises have been tackled by researchers.
Well-designed studies cited in A.M.L. Lever's book show that the
annual probability of developing AIDS does not differ significantly
between hemophiliacs infected via factor VIII [i.e., a clotting
protein, whose absence leads to bleeding], homosexuals infected
sexually and those who acquired HIV as a consequence of intravenous
drug use. These findings provide presumptive evidence against a
role for bacterial infections or for drug and alcohol use, all of
which are more common in intravenous drug users, in disease progression."
[Duesberg is guilty of no inconsistency. Correlations point to
suspects, but more is needed to prove causation. That is why Duesberg
makes well-designed research proposals to (for example) study the
effects of poppers in mice. After HIV was identified as a suspect
in AIDS, biomedical researchers expected to see it infecting and
destroying cells directly. Once they learned that HIV does not even
infect most of the cells it is supposed to be destroying, and that,
as Horton admits, there is no direct cell-killing mechanism, the
HIV theory should have been reconsidered. Duesberg predicts that
unbiased epidemiological studies, in which the HIV-positive subjects
are (for the first time) compared with a carefully matched group
of HIV negatives who are otherwise identical in health risks, will
discredit the alleged correlation between HIV and immune deficiency,
Kaposi's sarcoma, or other AIDS-defining diseases.
Correlation is not proof, but evidence well short of proof may
be a sufficient basis for urging people to give up some recreational
substance like cigarettes or amyl nitrites. A much greater degree
of proof should be required before prescribing some highly toxic
drug like AZT, that is likely to make them very sick.]
Horton concludes his Part Two with an unwitting demonstration of
the misuse of correlation evidence to protect the HIV theory:
"In Musuka district, in southwest Uganda, if you are an HIV-positive
adult you are twenty times more likely to die than if you are HIV-negative.
To claim that HIV is not causally associated with immunodeficiency-related
diseases is to ignore the evidence of thousands of deaths."
"Another crucial, and decisive, line of evidence refuting
Duesberg comes from the hemophiliac population. The British researcher
Sarah C. Darby reported last year on deaths among the UK population
of hemophiliacs between 1977 and 1991. Between 1977 and 1984, the
annual death rate among patients with severe hemophilia was 8 per
1000. Between 1985 and 1992, this rate remained identical among
HIV-negative hemophiliacs, but increased to 81 per 1000 in 1991-92
in those with HIV infection. Moreover, interruption of the spread
of HIV clearly prevents the occurrence of AIDS. Contrary to Duesberg's
hypothesis, preventing HIV transmission prevents AIDS."
[Such raw correlations between HIV (actually, proteins which are
linked to antibodies to HIV), and such a very general condition
as "death," can be very misleading when employed as proof
of causation. The reasoning rests on a non-sequitur: More people
with positive antibody tests die of something-or-other; therefore
HIV causes immunodefiency." Most of those Ugandans did not
die from "AIDS" --even though that syndrome is diagnosed
in Africa by the very broad "Bangui" definition. Hemophiliacs
have a multitude of health risks -- including, now, AZT. If epidemiologists
accept as "decisive proof of causation" mere correlations
between some factor and death from whatever cause, then it is no
wonder that they can come to disastrously wrong conclusions. But
I am sure Horton understands these elementary points -- so why does
he disregard them?]
Horton said in PART ONE that "functional evidence of how HIV
causes AIDS is now accumulating rapidly." In this brief section,
he explains what he means by that statement:
"It was formerly thought that the virus, once integrated in
a host cell, existed in a latent phase. Duesberg makes much of this
belief. In l995 he wrote that HIV is latent, and neither chemically
nor clinically detectable in 'HIV antibody-positives' [i.e., people
with HIV] with and without AIDS."
"This is not so. Soon after it is assembled, HIV undergoes
tremendous replicative activity and a high level of virus can be
found in the blood. Although the virus is then cleared from the
blood, replication continues apace throughout the body's lymphoid
tissue, which is the main repository of our immune system. This
continued and damaging activity over the long term is believed to
lead to immunodeficiency, leaving the infected individual susceptible
to infections, such as Pneumocystics, and cancers, such as lymphoma."
[This is mainly handwaving, since even "tremendous replicative
activity" does not show immune cell destruction. (HIV is grown
for these experiments in "immortal" T-cell lines, which
somehow avoid destruction.) Moreover, the conclusion -- "is
believed to lead to immunodeficiency" -- is phrased in language
which betrays its speculative nature. Anyway, Duesberg and his supporters
argue that claims of massive replication of HIV (following the clearing
of the primary infection) in the lymph nodes or elsewhere are an
artifact of the quantitative PCR method which is employed to detect
traces of viral particles. (Kary Mullis, the inventor of the PCR
technique, is a famous Duesberg supporter.)
If live and active virus were really present in such quantity,
it could be found without employing the PCR. Just as HIV-partisans
have accepted obviously dubious epidemiological correlations as
"proof," they have viewed claims of biochemical support
for their theory with a notable lack of skepticism.]
This section deals with the failure of AZT and other so-called
"antivirals" to meet expectations. Horton reports:
"Trials of drugs to combat HIV infection have passed through
three phases. The first period began and ended in 1987 with the
publication of a single clinical trial that showed that AZT helped
patients with HIV infection who had symptoms of disease to survive
longer. AZT was licensed for use shortly afterward and optimism
ran high. From 1987 to 1994, a deepening mood of pessimism bordering
on cynicism set in. Several early studies were based on the notion
that early treatment-- when the patient was infected but free of
symptoms -- was the sensible and biologically plausible course.
They seemed to indicate that intervention n symptom-free or early
symptomatic stages of HIV infection might be beneficial. However,
in 1992 J.D. Hamilton and his colleagues showed that AZT produced
no survival benefit in patients with early symptoms. This result
was followed by the devastating findings of the Anglo-French Concorde
study group. In this, the largest and longest trial of AZT in HIV-positive
men and women, early use of the drug conferred no advantages. Worse
still, further studies have shown significantly more deaths in the
group treated early. The Concorde study also showed that commonly
used "soft" measures of a drug's efficacy, such as the
lower or higher number of CD4 cells in the blood, were no substitute
for "harder" clinical measures, such as survival."
[But AZT is still widely used for asymptomatics, and is being forced
upon mothers and their infants despite the lack of evidence of any
health benefits. "Dangerous"? You bet! Horton attributes
the failure to develop a vaccine or cure to the fact that "HIV
does not play by the old rules." Another possibility is that
HIV researchers do not play by the elementary rules of logic and
Horton concludes his section on failed therapies with this observation:
"The obstacles to developing new treatments and ascertaining
the precise mechanisms by which HIV damages the immune system have
had profound effects on AIDS research in the U.S. For instance,
the fifteen-member National Task Force on AIDS Drug Development,
launched with government fanfare in 1993 by Donna Shalala, the Secretary
of Health and Human Services, was recently disbanded owing to lack
of progress. The $1.4 billion US AIDS budget is undergoing careful
review: it is projected to increase by only 1.6 percent in 1997,
according to the President's latest research and development budget.
And the organization of AIDS research has recently been subjected
to critical scrutiny by a congressionally mandated review panel
chaired by Arnold Levine from Princeton. A consistent message running
through his report is that HIV research, especially vaccine development,
needs to be freed from the "impediment" of the NIH establishment.
What is needed, according to the panel, is a climate in which more
innovative and imaginative lines of investigation can be pursued."
A plausible example of what the committee had in mind might be
an inquiry into the interaction between viral particles and potential
cofactors, such as drugs.
[In brief: orthodoxy is getting nowhere, and we had better be prepared
to consider some new ideas, much as we may hate the thought. I judge
this to be the true overall message Horton is trying to convey.]
[Horton gives a moving description of the brutal censorship that
has characterized HIV-science since 1984. He quotes scientific politicians
like John Maddox and June Osborn, who would not recognize the truth
if it hit them straight between the eyes. As Horton himself said
at the end of PART ONE, "How could so many scientists have
got it all so badly wrong?" Horton's answer is all too painfully
"I remember clearly the press conference called by the Wellcome
Institute in London at the time of the Concorde study's publication.
The gathering was not intended, as one might imagine, to explain
to medical journalists the intricacies of the research and how it
might be interpreted."
"The room was, instead, packed with financial journalists
who were there to hear of the resolve of the company officials to
destroy the credibility of a new study that they had helped to design
and analyze, but which had gone against their project."
"Apparently under pressure from the company, two coauthors
of the study withdrew their support from the clear implication of
the trial that AZT was ineffective in otherwise healthy HIV-positive
individuals. At the same time, in the final trial report published
in The Lancet, it was noted that "representatives of the Wellcome
Foundation, who were also members of the Co-ordinating Committee,
. . . declined to endorse this report." if the latest crop
of new drugs -- the protease inhibitors -- proves successful, both
Merck and Abbott would each earn from their products several hundred
million dollars in the US alone. An open debate with Duesberg could
have grave commercial consequences."
[Oh yes it could, and that helps to explain why the drug companies
and their scientific retainers have been so determined to prevent
that debate from occurring, or from reaching the attention of the
public. So now at last we get to the bottom line]:
"Yet another part of the current medical landscape that the
Duesberg affair illuminates is political and ideological. What does
the orthodox scientific establishment do to a scientist whose work
and views are out of step with majority opinion? Apparently, in
some cases, cut off his funding."
"One of the most disturbing aspects of the dispute between
Duesberg and the AIDS establishment is the way in which Duesberg
has been denied the opportunity to test his hypothesis. In a discipline
governed by empirical claims to truth, experimental evidence would
seem the obvious way to confirm or refute Duesberg's claims. But
Duesberg has found the doors of the scientific establishment closed
to his frequent calls for tests. To begin with, the grant he was
awarded in 1985 to support his work on cancer was not renewed despite
an appeal supported by the administration of the University of California
at Berkeley. The experimental virology study section of NIH wrote
that Duesberg was an "applicant whose productivity has recently
diminished both in quantity and most disturbingly in quality."
Between May 1993 and December 1994, six further grants to Duesberg
to fund cancer research were rejected. In AIDS research, between
February 1993 and August 1994, Duesberg tried to secure funding
to investigate his hypothesis (which has with time hardened into
more of a belief) that nitrite inhalants are a cause of AIDS. These
applications were made to the university-wide AIDS Research Program
at the University of California and twice to the National Institute
of Drug Abuse. His two grant applications to NIDA -- both entitled
"Animal tests of the AIDS risks of nitrite inhalants"
-- were supported by letters from Daniel E. Koshland, then editor
of Science. All three applications were rejected, and the validity
of his hypothesis still remains unknown."
"Although an overwhelming body of evidence exists to confirm
the causal association between HIV and AIDS, the principle that
original experimental investigation should be given primary importance
in science, recently emphasized by the Levine committee, supports
the argument that proposals made by serious scientists with proven
records of high-quality research deserve careful consideration.
This is especially the case in view of the current widely acknowledged
uncertainty about the origins and mechanisms of HIV disease. It
is not only Duesberg who points to this uncertainty. Michael Ascher
and his colleagues at Berkeley wrote in 1995 that those who would
see AIDS as a more-or-less conventional viral infection have consistently
refused to recognize the paradoxes that are clearly evident in the
experimental data -- the problem continues."
"And Jon Cohen commented in Science that no treatment, to
date, has had much success. And unless that bleak reality changes,
alternative thinkers will likely keep needling their establishment
colleagues and urging them to rethink their basic understanding
of the disease."
"But how far will this rethinking be allowed to proceed? Duesberg,
for his part, not only fails to understand the strengths and weaknesses
of the epidemiological method; he also, as has been seen, recklessly
deploys ill-thought-out epidemiological arguments to support his
own drug-AIDS point of view. Nevertheless, as a retrovirologist,
Duesberg deserves to be heard, and the ideological assassination
that he has undergone will remain an embarrassing testament to the
reactionary tendencies of modern science. Irrespective of one's
views about the validity of some of Duesberg's arguments, one is
forced to ask: At a time when fresh ideas and new paths of investigation
are so desperately being sought, how can the AIDS community afford
not to fund Duesberg's research?"
[Horton ends on so positive a note that I feel almost ungenerous
in stating the obvious: Duesberg understands perfectly well the
"strengths and weaknesses of the epidemiological method,"
and he "uses epidemiological arguments to support his own drug-AIDS
point of view" only to establish that the drug-AIDS hypothesis
is worthy of testing on a level playing field. Animal testing of
the long-term effects of amyl nitrites is an example of the kind
of research that the HIV establishment refuses to fund. This could
be because the reviewing authorities think that the nitrite hypothesis
has no merit, or it could be because they are afraid that it will
Why did Richard Horton choose to write, and the New York Review
of Books make available, so many pages to a dissenting position
that the HIV establishment, and the editors of Science and
Nature, have always insisted to be unworthy of serious consideration?
Why does Horton take a schizophrenic position, so intelligently
describing what is wrong with HIV-science at one point and so uncritically
endorsing the conclusions of that same HIV-science at other points
-- on the basis of correlations he must know to be faulty? Why does
he end with that powerful concluding sentence, that might have been
written by Duesberg himself?
Draw your own conclusions, but here are mine:
The most perceptive thinkers in the biomedical establishment can
see that HIV-science is headed towards a crackup. They have long
known how flimsy a basis there was for Gallo's announced "discovery"
of the cause of AIDS at that decisive 1984 press conference, when
the theory was set in concrete. For a long time they gave the benefit
of the doubt to the Gallo's and Fauci's, but now they begin to see
the handwriting on the wall. Even the hitherto acquiescent press
has begun to revolt, with publicity in the Wall Street Journal and
other newspapers about how the U.S. Government's CDC has deliberately
furthered the false impression that HIV-AIDS is rapidly infecting
the general population outside the original risk groups.
The HIV/AIDS establishment has been hoping desperately for a research
breakthrough that would rescue the situation, perhaps in the form
of discovery of a mechanism by which HIV could cause damage to the
cells of the immune system. I surmise that the well-connected Horton
knows that those hopes are fading. That is why "fresh ideas
and new paths of investigation are so desperately being sought."
Yes, the man said "desperately."
Eventually, the press and the public will catch on to the fact
that this very expensive research establishment is spinning its
wheels. In that case, how is the research community to extricate
itself from a blind alley? Admitting a fundamental error is out
of the question, with the financial and reputational interests that
are at stake. Think of the blizzard of lawsuits and recriminations
that would follow! The only way out is to move gradually to a new
theory or perhaps a redefinition of the syndrome. That will be a
very delicate operation; Horton is sending a signal that it is necessary
to begin. *
Summary by Phillip E. Johnson