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THE CULPRIT
IS NONCONTAGIOUS RISK FACTORS
By
Peter Duesberg
The Scientist 20 March 1995
WOULD you
have believed in 1984 that AIDS was infectious if you had known
that not even one of the health-care workers who have treated
more than 401,000 American AIDS patients over the last 10 years
contracted AIDS from a patient-despite the absence of an antiviral
vaccine or effective drug? No infectious agent that is so difficult
to transmit could survive as a microbe.
Moreover, the
median age of the 15,000 total American HIV-positive hemophiliacs
increased from 11 in 1972 to 27 in 1987, although they were all
infected in the decade prior to 1984. From 1988 to 1993 their annual
risk of AIDS diseases, not corrected for the normal incidence of
HIV-free AIDS diseases, was constant at 2 percent (Centers for Disease
Control and Prevention, HIV/AIDS Surveillance, 5:1-33, 1994; P.H.
Duesberg, Genetica, in press). The hypothesis that HIV causes AIDS
after 10 years predicts that more than half of them would have died
by now.
Furthermore,
if HIV is a blood-borne virus, one would expect that recipients
of HIV from transfusions would develop all AIDS-defining diseases,
yet nobody ever contracted AIDS-Kaposi's sarcoma from a transfusion.
In contrast
to AIDS, all known infectious diseases are characterized by equal
distribution between the sexes; the appearance of primary symptoms
within days or weeks after infection, and prior to antimicrobial
immunity; a common, active microbe in all acute cases; and patients
who are generally under 20, with underdeveloped immune systems,
or over 60, with failing immune systems. While sexually transmitted
diseases share AIDS's age distribution (between 20 and 50), they
are all equally distributed between the sexes. (For references on
this and other points, see P.H. Duesberg, Proceedings of the National
Academy of Sciences, 88:1575-9, 1991; P.H. Duesberg, Pharmacology
and Therapeutics, 55:201-77, 1992; P.H. Duesberg, International
Archives of Allergy and Applied Immunology, 103:131-42, 1994.)
A Passenger
Virus
Owing to the
relentless campaigns against viruses by epidemiologists and virologists,
even scientists have forgotten that the vast majority of viruses
never cause disease (retroviruses, adenoviruses, reoviruses, echoviruses,
and so forth). Just like humans, viruses are here to continue their
species, and they succeed best if they do this without harming their
host, certainly without causing a fatal disease. Such viruses are
called passenger viruses (Lionel Crawford in H. Fraenkel-Conrad,
ed., Molecular Basis of Virology, New York, Van Nostrand Reinhold,
1968, pages 393-434).
A passenger
virus infects at totally unpredictable times (even 10 years!) prior
to a disease, just like HIV, while a causative microbe is pathogenic
within days or weeks. Given a generation time of two days and a
yield of 100 HIVs per cell, AIDS should occur 14 days after infection
if it were a causative microbe. By that time, HIV would have infected
all 1014 cells of the body. Moreover, a passenger virus may be absent
during a disease-as in the 4,621 HIV-free cases of AIDS reported
in the literature. And, if present, a passenger virus can be active
or passive during disease. In the majority of AIDS patients, active
HIV cannot be found, only antibodies against the virus. Because
of antiviral immunity, HIV infects only about one in 1,000 T cells
of AIDS patients. There are only a minority of cases in the literature
in which HIV is found in moderate or high titers.
Thus, I propose
that HIV is merely a passenger virus, which does not cause any disease.
A Hypothesis
Diseases can
be "acquired" by microbes-but are now acquired in the
U.S. and Europe much more often by drugs. There are 50 million smokers
and many millions of alcoholics in the U.S. "acquiring"
emphysema, lung cancer, and liver cirrhosis. And millions use illicit
recreational drugs.
In view of
this, I propose that all AIDS diseases in America and Europe that
exceed their long-established, normal backgrounds are caused by
the long-term consumption of illicit recreational drugs and by AZT
and its analogs. The normal low background of AIDS-defining diseases
like tuberculosis, diarrhea, and pneumonia would be a consequence
of their long-established causes. Hemophilia-AIDS, transfusion-AIDS,
and the extremely rare AIDS cases of the general population reflect
the normal incidence of the AIDS-defining diseases, plus the AZT-induced
incidence of these diseases under a new name. "African AIDS"
is likewise a new name for old diseases caused by malnutrition,
parasitic infections, and poor sanitation.
The drug hypothesis
predicts American/European AIDS precisely:
1.American
AIDS will be restricted to intravenous and oral users of recreational
drugs and of AZT. Since 1981, 94 percent of all American AIDS cases
have been from risk groups who had used such drugs. About one-third
of these were intravenous drug users (CDC, HIV/AIDS Surveillance
Report, 6:1-27, 1994) and two-thirds were male homosexuals who had
used oral recreational drugs and AZT. The drug correlation is even
better than 94 percent if those HIV-positive hemophiliacs and transfusion
recipients receiving AZT are included.
2. American
AIDS predominantly affects adult males, because they are the predominant
users of recreational drugs and AZT. CDC reports that 87 percent
of all American AIDS patients are males. This number is the sum
of the following constituents: First, the National Institute on
Drug Abuse (NIDA) and the Bureau of Justice Statistics report that
more than 75 percent of hard, recreational drugs are consumed intravenously
by males. Second, CDC and independent investigators report that
nearly all male homosexuals with AIDS and at risk for AIDS are long-term
users of oral drugs such as nitrite inhalants, ethylchloride inhalants,
amphetamines, cocaine, and others to facilitate sexual contacts,
particularly anal intercourse (A.R. Lifson et al., American Journal
of Epidemiology, 131:221-31, 1990; M.S. Ascher et al., Nature, 362:103-4,
1993). And third, many HIV-positive homosexuals are prescribed AZT.
3.American
AIDS is new because the American drug-use epidemic is new. In the
U.S., recreational drug use is epidemiologically new, as it has
increased over the last two decades from statistically undetectable
levels to epidemic levels at about the same rate as AIDS. Cocaine
consumption increased 200-fold from 1980 to 1990, based on cocaine
seizures that increased from 500 kg in 1980 to 100,000 kg in 1990.
During the same time cocaine-related hospital emergencies increased
from 3,296 cases in 1981 to 80,355 cases in 1990 and 119,843 in
1992. Amphetamine consumption has increased 100-fold from 1980 to
1990 (Bureau of Justice Statistics, Catalog of Federal Publications
on Illegal Drug and Alcohol Abuse, Washington, D.C., U.S. Department
of Justice, 1991). According to a recent report from NIDA and CDC,
"nitrite use has increased in the 1990s in gay men in Chicago
and San Francisco" after a decline in the 1980s. And in 1992
alone, 200,000 HIV-positives were given AZT.
4.Only a small
fraction of drug users will get AIDS. The cumulative total of 401,749
American AIDS cases since 1981 that were reported in June 1994 have
been recruited from a much larger reservoir of drug users. There
were 8 million cocaine addicts in the U.S. in 1992. In 1980, 5 million
Americans had used nitrite inhalants. In 1989, 100 million doses
of amphetamines were consumed in the U.S. In addition, about 150,000
HIV-positive Americans were on AZT in 1992.
The small percentage
of AIDS patients among the many American drug users represents the
heaviest drug abusers, just as lung cancer and emphysema generally
occur among the heaviest smokers. The long "latent period of
HIV" is a euphemism for the time that its human host needs
to accumulate sufficient drug dosage for AIDS.
5.Specific
drugs cause specific AIDS-defining diseases. Indeed, group-specific
drug use explains risk-group-specific AIDS diseases. For example,
Kaposi's sarcoma as an AIDS diagnosis is 20 times more common among
homosexuals who use nitrite inhalants than among AIDS patients who
are intravenous drug users or hemophiliacs. Because of their carcinogenic
potential, nitrites were originally proposed as causing Kaposi's
sarcoma (H.W. Haverkos, J.A. Dougherty, eds., Health Hazards of
Nitrite Inhalants, NIDA Research Monograph 83, Washington, D.C.,
U.S. Department of Health and Human Services, 1988). "Aggressive
and life-threatening" Kaposi's sarcoma is observed exclusively
in male homosexuals (E. Sloand et al., Southern Medical Journal,
86:1219-24, 1993), 32 percent of which occur in the lungs-the primary
site of exposure to nitrite inhalants (D.H. Irwin, L.D. Kaplan,
Seminars in Respiratory Infections, 8:139-48, 1993).
6.Eighty percent
of pediatric AIDS cases in America and Europe are also predicted
by the drug hypothesis. These children were born to mothers who
were intravenous drug users during pregnancy. The remainder reflects
the normal incidence of AIDS-defining diseases among newborns.
Case Studies
The abundant
AIDS literature in fact includes conclusive evidence that cessation
of drug use prevents, stabilizes, or cures AIDS-defining diseases.
For example,
10 out of 11 HIV-positive, AZT-treated AIDS patients recovered cellular
immunity after discontinuing AZT in favor of an experimental vaccine
(M. Scolaro et al., Lancet, 337:731-2, 1991). Since AZT is now licensed
for treatment or prevention of AIDS, no large-scale studies have
been done in which patients are taken off AZT.
Another investigation
found that the T-cell counts of 65 HIV-positive intravenous drug
users from New York dropped 35 percent over nine months, compared
with stable T-cell counts for HIV-positive controls who had stopped
injecting (D. Des Jarlais et al., AIDS, 1:105-11, 1987).
In yet another
report, the T cells of 29 percent of 1,020 HIV-positive male homosexuals
and intravenous drug users even increased over two years (M.D. Hughes
et al., Journal of Infectious Diseases, 169:28-36, 1994). These
HIV-positives belonged to the placebo arm of an AZT trial for AIDS
prevention and thus were not intoxicated by AZT.
There was no
mortality reported among a group of 918 British HIV-positive homosexuals
who had "avoided the experimental medications on offer"
and chose to "abstain from or significantly reduce their use
of recreational drugs, including alcohol" during the course
of a study lasting 1.25 years (J. Wells, Capital Gay, Aug. 20, 1993,
pages 14-15). Assuming a 10-year latent period from HIV to AIDS,
the virus AIDS hypothesis would have predicted at least 115 AIDS
cases among 918 HIV-positives over 1.25 years (918/10 x 1.25). Furthermore,
as of July 1, 1994, there was still not a single AIDS case in this
group (J. Wells, London, personal communication).
In sum, the
drug AIDS hypothesis correctly predicts all aspects of American/European
AIDS, while the HIV hypothesis predicts none. The solution of AIDS
could be as close as a very testable, and very affordable, alternative
hypothesis.
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