The Case
of HIV and AIDS - Part 2
Part 1 Part 3
Part 4 Part 5
Updates,
January-September 1995
The
Mess in Science and the Gutknecht-Shalala Exchange
Part 2 - Contents
§6. An article in Science, 9 December 1994 pp 648-650
§7.
Other Viruses and the Unreliable Mess in Science pp 650-655
§8.
Rep. Gutknecht's Letter and Shalala's Answer pp 655-656
§6. An article in Science, 9 December 1994
On
9 December 1994, Science published an 8-page analysis of some
dissent concerning HIV as a cause of AIDS (pp. 1642-1649). The
article in several parts, authored by Jon Cohen, was headlined:
The
Duesberg Phenomenon
A
Berkeley virologist and his supporters continue to
argue that HIV is not the cause of AIDS.
A 3-month
investigation by Science evaluates their claims.
Science
(and not just its reporter Jon Cohen) took responsibility for
the investigation and its conclusions. Aside from the displayed
responsibility of "a 3-month investigation by Science" in the
heading, responsibility was further taken on the very first page,
where Science was mentioned three more times as follows:
But
because the Duesberg phenomenon has not gone away and may be growing,
Science decided this was a good time to examine Duesberg's
main claims. In a 3-month investigation, Science interviewed
more than 50 supporters and detractors... The main conclusions
of Science's investigation are that:
pg 649
-
In hemophiliacs ... there is abundant evidence that HIV causes disease
and death (see p. 1645).
- According
to some AIDS researchers, HIV now fulfills the classic postulates
of disease causation established by Robert Koch (see p. 1647).
- The AIDS
epidemic in Thailand, which Duesberg has cited as confirmation of
his theories, seems instead to confirm the role of HIV (see p. 1647).
- AZT and illicit
drugs, which Duesberg argues can cause AIDS, don't cause the immune
deficiency characteristic of that disease (see p. 1648).
One effect
of the Science article of 9 December 1994 was to acknowledge officially,
in the #1 magazine of the scientific establishment, the existence
of an expanding challenge to the HIV/AIDS hypothesis and to the
establishment's way of dealing with this challenge in the past.
On the other
hand, I regard the Science article of 9 December 1994 as
tendentious and skewed, but here is not the place to make a comprehensive
detailed analysis. However, I give a couple of examples.
First I object
to personalizing dissent about the official line that "HIV causes
AIDS" in the context of "The Duesberg Phenomenon." I object to lumping
together different people such as Harry Haverkos (who sponsored
the NIDA May 1994 meeting on nitrite inhalants), the co-authors
of the article on AIDS in Africa14
referred
Footnotes
for page 649
14 These
co-authors include especially Harvey Bialy, research editor of Biotechnology.
Cohen tried to interview me. I asked that his questions be put in
writing, and he faxed me a letter containing questions on 1 November
1994. I found Cohen's questions and statements so defective that
I refused to deal with him, and wrote a letter to Koshland explaining
in detail why I refused to deal with Cohen. I made a line by line
analysis of Cohen's letter to me. For example, Cohen wrote me: "You
extensively cite Duesberg's writings and references that he has
provided you with, yet I do not see any other references of AIDS
literature. Have you investigated the AIDS literature to address
the question about the link between HIV and AIDS?"
Cohen
was referring to the present article, which I had sent to him before
publication in the Yale Scientific. As I wrote to Koshland, Cohen's
statement ("Yet I do not see...") documents blindness, as well as
incompetence in processing information. To cite just two examples,
in my article I quote from a paper by Papadopoulos et al (especially
Bialy), and I devote an entire section to the paper by Ascher et
al., published by Nature, and reported in the New York Times among
many other newspapers which took seriously a press release by Nature.
I did not get either of these papers from Duesberg. Bialy himself
sent me his preprint.
In
any case, what of it if Duesberg is kind enough to provide me with
scholarly references at my request? I learned that malaria tests
false positive for HIV antibodies from the Kary Mullis interview
in the California Monthly, and I learned of a similar situation
with respect to leprosy and tuberculosis from Neville Hodgkinson
in the London Sunday Times. I asked Duesberg to provide me with
the scholarly references to that effect, and he brought to my attention
the actual scientific papers by others, reporting these facts. Scientifically,
it does not matter who provided me with these references or when,
but it was appropriate to acknowledge Duesberg for his bibliographical
help.
pg 650
to in footnote
4, or myself among many others, as part of "the Duesberg phenomenon."
What has "not gone away" is that an increasing number of individual
scientists, with different points of view, different backgrounds,
and different responsibilities, have publicly documented reservations
about the official position of the government or the scientific
establishment concerning HIV and AIDS. Lumping together independent
scientists under the single category of Duesberg "supporters" skewed
the perspective on the dissenters and on their multiple reasons
for dissent.
Second, the
article completely omitted mention of dissenters such as Bialy and
Haverkos, as well as many points raised by the dissenters. For example,
the NIDA meeting of May, the position of Harry Haverkos on nitrite
inhalants, the situation in Africa, the fact that malaria, tuberculosis,
leprosy, and influenza, test false positive on the HIV antibodies
test, were still not mentioned in the Science article. The AAAS
June meeting was mentioned in only one sentence: "In June, the Pacific
Division of the American Association for the Advancement of Science
(publisher of Science) sponsored a daylong meeting at which the
dissidents offered their points of view." No indication was given
what were these points of view.
Especially
significantly, as we shall see below, the 9 December 1994 article
also made no mention of Kaposi's sarcoma.
§7.
Other Viruses and the Unreliable Mess in
Science
No hypothesis
can be dismissed a priori. It is still a possibility that some virus(es)
other than HIV sometimes cause some of the diseases listed under
the "AIDS" umbrella by the CDC. We have already mentioned the possibility
that different diseases in different risk groups may have different
causes. The medical literature
In
any case, what of it if Duesberg is kind enough to provide me with
scholarly references at my request? I learned that malaria tests
false positive for HIV antibodies from the Kary Mullis interview
in the California Monthly, and I learned of a similar situation
with respect to leprosy and tuberculosis from Neville Hodgkinson
in the London Sunday Times. I asked Duesberg to provide me with
the scholarly references to that effect, and he brought to my attention
the actual scientific papers by others, reporting these facts. Scientifically,
it does not matter who provided me with these references or when,
but it was appropriate to acknowledge Duesberg for his bibliographical
help.
pg 651
has a number
of papers raising questions about many viruses, whether they are
harmful or not, and how. Here I shall mention two of them.
HHV-6.
One candidate has been the Human Herpes Virus 6, abbreviated HHV
6, as in the article "Human Herpesvirus 6 in lung tissue from patients
with pneumonitis after bone marrow transplantation" (New England
J. of Medicine 329, 15 July 1993, pp. 156-161). However, the article
starts: "Human herpesvirus 6 (HHV6) infects over 90 percent of the
U.S. population early in life, causing fever or rash in some children."
To what extent does it make sense that such a common virus is "the"
or "a" cause of some of the AIDS-defining diseases and under what
circumstances? The above article itself is cautious in the summary
conclusion at the beginning, where it states: "The concentrations
of HHV-6 genomes in lung tissue and their relation to changes in
serologic titers support an association between HHV-6 infection
and idiopathic pneumonitis in immunocompromised hosts." Here we
meet typical examples of arising questions: whether there is merely
an "association" between a virus and some diseases, or whether a
virus is a cause, and if so how. It is then a problem to make experiments
to determine whether a given virus is merely a passenger virus,
whether it lies dormant, and if it is awakened (how?.) whether it
merely shows its presence by testing positive in various ways (antibodies?),
or whether it is or becomes harmful (how?.), under certain circumstances
(which?).
Still
another Herpesvirus. On 16 December 1994,
Science published a technical paper suggesting that a new virus
may cause Kaposi's sarcoma.15
News articles on this paper occurred on that same day both in the
New York Times and in Science as we shall now describe.
The New
York Times (16 December 1994, p. 1). For the first time to my
knowledge an article by Lawrence K. Altman mentioned another virus
besides HIV as a possible cause for "AIDS," under the title: "Apparent
Virus May Be a Cause Of Fatal Cancer in AIDS Patients." A salient
fact is that HIV is nowhere mentioned in the article. A paragraph
describing a certain phenomenon concerning the distribution of Kaposi's
sarcoma among "people with
Footnotes
for page 651
15
Y. Chang et al., "Identification of Herpesvirus-Like DNA Sequences
in AIDS-Associated Kaposi's Sarcoma", Science (16 December 1994)
pp. 1865-1869.
pg 652
AIDS...gay
and bisexual men...and women with AIDS," is followed by the sentences:
"Experts say the introduction of a previously unknown virus that
coincided with the advent of the epidemic of AIDS could explain
such a phenomenon. Although a number of efforts have been made to
link known infectious agents with Kaposi's sarcoma, none have held
up."
Words in the
headline such as "apparent" and "may be" were fully appropriate
to the subsequent write up. Altman stated: "Scientists at Columbia
University said they had found strong evidence of an apparent newly
detected virus that, they said, might cause Kaposi's sarcoma in
people with AIDS. Kaposi's is the most common cancer affecting gay
men with AIDS, and one of the principle [sic] causes of death among
that group."
Science (16
December 1994, p. 1803). Jon Cohen wrote the Science "Research
News" article headlined:
Is
a New Virus the Cause of KS?
Kaposi's sarcoma,
a once-rare skin tumor, is a scourge of gay men
with AIDS.
Several theories have attempted to explain it.
The latest:
a novel herpesvirus
Cohen quoted
one of the co-authors of the scientific paper, Patrick Moore, as
saying that "this virus is probably playing a central role." Cohen
then added: "That thesis will be intensely scrutinized over the
coming months. But if it stands up, solid headway will have been
made toward solving a vexing riddle that arose more than a decade
ago when an old tumor began popping up in new places, with deadly
results."
These Science
and New York Ties articles are questionable on several grounds.
(a)
What is "AIDS"? No definition of "AIDS"
was given in either article. We have seen that KS is listed among
the 29 diseases which define AIDS in the presence of HIV according
to the CDC (see footnote 1). Expressions such as "Kaposi's sarcoma
in people with AIDS" (New York Times), and "Kaposi's sarcoma...is
a scourge in gay men with AIDS" (Science), represent shifting terminology,
compounding the confusion about HIV and AIDS, and possibly representing
the beginning of a rewriting of history concerning "AIDS" and what
it means.
(b) What
virus? Furthermore, no virus had been found. The New York
Times article subsequently stated that the scientists
pg 653
found sequences
of DNA which an "expert in herpes viruses at Yale University" said
were "consistent with a new herpes virus." But the "expert" who
said that also cautioned: "There is a long step between finding
DNA sequences and having a virus."
(c) What
cause? There is also a long step between finding yet another
latent virus, and showing that it causes various forms of cancer,
especially while it is dormant. The Times article contained one
sentence to the effect that "even if the virus turns out to be a
previously unknown one, they said, much research needed to be done
to prove that it was the cause of Kaposi's sarcoma. The possibility
exists that the virus is present in Kaposi's sarcoma only after
the cancer develops." According to Duesberg, the fact that the DNA
sequences were discovered only by amplification via PCR indicates
that whatever is there, virus or not, is inactive and sparse. Duesberg
added that there is no precedent for a virus causing cancer or another
fatal disease while it is latent.
Harold Jaffe
was quoted in the New York Times as saying: "It's a strong
candidate to be the Kaposi sarcoma agent." So Jaffe was up to his
usual rhetoric, since first, there is no candidate yet, and second
the definite article ("the" Kaposi sarcoma agent) is unwarranted
since Kaposi's sarcoma could be caused by several different agents,
depending on the time, place, risk groups, various practices, or
whatever, as I have repeatedly emphasized. Jaffe was similarly quoted
in Science: "I think it's a tremendously exciting result. At this
point, we can't say it's the etiologic agent, but I think it's a
very good candidate."
So the New
York Times and Science articles are worth mentioning
here as important examples of the ongoing problematic and questionable
journalistic treatment of HIV and AIDS (whatever AIDS is), as well
as examples of the fixation by some scientists, the New York
Times and Science on the finding of a virus, without
bringing up other possibilities (e.g. toxic agents such as drugs).
(d)
Joining the dissenters. By bringing up
a new virus as a possible cause of KS, and by the evaluation "solid
headway" concerning possible developments about such a "new virus,"
Altman and Cohen became HIV dissidents. Since KS is a hallmark of
"AIDS" according to the CDC definition, it follows that Lawrence
K. Altman, Jon Cohen, and the scientists whom they quoted as proposing
a "new virus" to be the cause of KS, joined those who dissent from
the unqualified view that "HIV causes AIDS."
Still
another Science article. The hype on the
new herpes virus
pg 654
was followed
up in another article by Jon Cohen, "AIDS Mood Upbeat--For a Change"
(Science 267, 17 February 1995, pp. 959-960). This article reported
on a meeting sponsored by the American Society of Microbiology in
Washington D.C., 29 January-2 February 1995. Cohen's article stated
in part:
Among the
more dramatic examples of progress was the strengthening evidence
linking a new virus to KS. Last December, Patrick Moore, Yuan
Chang, and their collaborators stunned AIDS researchers when they
reported in Science that they had found a prime suspect...
In spite of the accumulating evidence, Moore and Chang were reluctant
to declare that they have found the cause of KS, but others, at
the meeting were less restrained. Steven Miles, a KS researcher
from the University of California, Los Angeles, who initially
had serious reservations about the putative new virus, enthusiastically
embraced the new findings. "I'm convinced that it is a herpesvirus,
and it is very definitely the cause of Kaposi's sarcoma," said
Miles, whose lab has replicated Moore and Chang's initial work.
Readers will
note Cohen's hyped rhetoric: "...dramatic examples of progress ...
stunned AIDS researchers..." Actually, in December 1994, Moore,
Chang, et al. had not "found a prime suspect." They found DNA sequences,
not a virus. Cf. (b) above.
Nullifying
the hype. A further article by Jon Cohen
titled "Controversy: Is KS Really Caused By New Herpesvirus?" (Science
268, 30 June 1995, pp. 1847-1848) continued spreading the unreliable
mess coming from various scientists. The article to a large extent
nullified the hype in the 16 December 1994 and 17 February 1995
articles, by reporting "deep reservations" about the role of the
purported Herpes virus as a cause of KS, and also reporting that
"those misgivings had been muted--until the AIDS-KS meeting" sponsored
by the National Cancer Institute, 5 and 6 June 1995 in Bethesda
MD. Cohen reported that "Gallo was at the center of the debate"
and that "Gallo's withering critique of KSHV packed a punch." Oncologist
Parkash Gill of the University of Southern California is reported
as saying that "she has failed to find DNA sequences from KSHV in
11 KS cell lines," and Cohen quoted her: "I think the interpretation
has gone beyond the data." Cohen also wrote: "Other researchers
such as NCI epidemiologist Robert Biggar, were enthusiastic about
the early evidence but now have doubts about the virus."
pg 655
On the other
hand, Cohen reported: "Columbia University's Chang stuck by the
data she and others have amassed that supports KSHV's role in KS...
Steven Miles of the University of California, Los Angeles, went
further: He is convinced KSHV causes the disease. He maintains that
the inability to find the vital DBNA in some cell lines might be
due to the fact that the lines have been regrown too many times,
which may lead to the vital DNA sequences being cleaved out..."
§8.
Rep. Gutknecht's Letter and Shalala's Answer
On
24 March 1995, Rep. Gil Gutknecht (R-MN) wrote a letter to Anthony
Fauci with copies to high officials and scientists in the U.S. government,
raising 12 specific questions about HIV and AIDS. HHS Secretary
Donna Shalala answered on 10 July 1995, dealing with Gutknecht's
questions seriatim in a 7-page letter. However, Shalala's response
was severely defective, partly because she made repeatedly undocumented
ex-cathedra assertions, several of which are false. Some of her
responses misrepresented various situations. I shall select here
one example concerning Gutknecht's question about the cause of Kaposi's
Sarcoma. In this case one can document immediately in a particularly
simple way the hype, misinformation, contradictions and unreliable
mess which one gets from government officials and scientists in
the context of challenges to the official governmental position
on HIV and AIDS.
Gutknecht's
question No. 5. If infectious HIV is the cause of AIDS, why
is Kaposi's sarcoma--the signal disease of AIDS--exclusively observed
in male homosexuals?
Shalala's
response. The cause of Kaposi's sarcoma
appears to be a newly described herpes-like virus; the tumor is
much more common in persons with severe immunodeficiency such as
that caused by HIV infection. While most cases have been reported
among men who have sex with men, cases have been reported among
women and among men who acquired HIV infection through exposures
other than male-top-male sexual contact. In addition, Kaposi's sarcoma
has also long been recognized among elderly men of Italian or Ashkenazi
Jewish descent and among the Bantus of Southern Mrica, before the
emergence of AIDS.
pg 656
(a) Shalala's
response to Gutknecht's question asserts: "The cause of Kaposi's
Sarcoma appears to be a newly discovered Herpes-like virus;..."
Shalala gave no reference for this assertion. As we analyzed in
§7, the Science 16 December 1994 article on the role of a Herpesvirus
already contained some cautious evaluations, mixed with some hype.
Shalala's answer reflected only the hype of this article, as well
as the hype in the 17 February 1995 article. In addition, Shalala's
answer took no account of the subsequent Science article of 30 June
1995 reporting on the "controversy." Her answer, occurring almost
at the same time as the "deep reservations...misgivings...Gallo's
withering critique of KSHV .... " provides a typical example of
the misinformation, contradictions, and unreliable mess which arise
from officials in HHS or NIH concerning HIV and AIDS. Of course,
Gallo is not a govemment scientist any more, but the "punch" he
"packed" {according to Science} didn't knock out Shalala or the
scientific cohorts who helped her prepare the response to Gutknecht.
Caveat emptor.
(b) Readers
can evaluate the rest of Shalala's response to the KS question on
the basis of the differences of Kaposi's Sarcoma in Africa and in
the U.S. documented in the Papadopulos-Eleopulos et al. article
{see §3 and footnote 4), as well as in the statements of Harry Haverkos,
making several distinctions between the various appearances of the
disease. Haverkos also gave evidence against its being caused by
an infectious agent. (See §4, statements by Haverkos at the NIDA
meeting and in SPIN.) Shalala's answer is defective all the way
through.
Whether Representative
Gutknecht would follow up with a critical analysis of Shalala's
answer, and possibly with hearings on HIV/AIDS, remains to be seen.
How far the dynamics of the challenge to the HIV-AIDS hypothesis
would further progress, and to what extent the credibility of the
scientific establishment will be affected, is left to another historical
account.
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