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WHAT CAUSES
AIDS?
IT'S
AN OPEN QUESTION
By Charles A. Thomas Jr., Kary B. Mullis, & Phillip E.
Johnson
Reason June 1994
Most people believe they know what causes AIDS.
For a decade, scientist, government officials, physicians, journalists,
public-service ads, TV shows, and movies have told them that AIDS
is caused by a retrovirus called HIV. This virus supposedly infects
and kills the "T-cells" of the immune system, leading
to an inevitably, fatal immune deficiency after an asymptomatic
period that averages 10 years or so. Most people do not know-because
there has been a visual media blackout on the subject-about a
longstanding scientific controversy over the cause of AIDS. A
controversy that has become increasingly heated as the official
theory's predictions have turned out to be wrong.
Leading biochemical scientists, including University
of California at Berkeley retrovirus expert Peter Duesberg and Nobel
Prize winner Walter Gilbert, have been warning for years that there
is no proof that HIV causes AIDS. The warnings were met first with
silence, then with ridicule and contempt. In 1990, for example,
Nature published a rare response from the HIV establishment, as
represented by Robin A. Weiss of the Institute of Cancer Research
in London and Harold W. Jaffe of the U.S. Centers for Disease Control.
Weiss and Jaffe compared the doubters to people who think that bad
air causes malaria. "We have . . . been told," they wrote,
"that the human immunodeficiency virus (HIV) originates from
outer space, or as a genetically engineered virus for germ warfare
which was tested in prisoners and spread from them. Peter H. Duesberg's
proposition that HIV is not the cause of AIDS at all is, to our
minds, equally absurd." Viewers of ABC's 1993 Day One special
on the cause of AIDS-almost the only occasion on which network television
has covered the controversy-saw Robert Gallo, the leading exponent
of the HIV theory, stomp away from the microphone in a rage when
asked to respond to the views of Gilbert and Duesberg.
Such displays of rage and ridicule are familiar
to those who question the HIV theory of AIDS. Ever since 1984, when
Gallo announced the discovery of what the newspapers call "HIV,
the virus that causes AIDS," at a government press conference,
the HIV theory has been the basis of all scientific work on AIDS.
If the theory is mistaken, billions of dollars have been wasted-and
immense harm has been done to persons who have tested positive for
antibodies to HIV and therefore have been told to expect an early
and painful death. The furious reactions to the suggestion that
a colossal mistake may have been made are not surprising, given
that the credibility of the biomedical establishment is at stake.
It is time to think about the unthinkable, however, because there
are at least three reasons for doubting the official theory that
HIV causes AIDS.
First, after spending billions of dollars, HIV researchers
are still unable to explain how HIV, a conventional retrovirus with
a very simple genetic organization, damages the immune system, much
less how to stop it. The present stalemate contrasts dramatically
with the confidence expressed in 1984. At that time Gallo thought
the virus killed cells directly by infecting them, and U.S. government
officials predicted a vaccine would be available in two years. Ten
years later no vaccine is in sight, and the certainty about how
the virus destroys the immune system has dissolved in confusion.
Second, in the absence of any agreement about how
HIV causes AIDS, the only evidence that HIV does cause AIDS is correlation.
The correlation is imperfect at best, however. There are many cases
of persons with all the symptoms of AIDS who do not have any HIV
infection. There are also many cases of persons who have been infected
by HIV for more than a decade and show no signs of illness.
Third, predictions based on the HIV theory have
failed spectacularly. AIDS in the United States and Europe has not
spread through the general population. Rather, it remains almost
entirely confined to the original risk groups, mainly sexually promiscuous
gay men and drug abusers. The number of HIV-infected Americans has
remained constant for years instead of increasing rapidly as predicted,
which suggests that HIV is an old virus that has been with us for
centuries without causing an epidemic.
No one disputes what happens in the early stages
of HIV infection. As other viruses do, HIV multiplies rapidly, and
it sometimes is accompanied by a mild, flulike illness. At this
stage, while the virus is present in great quantity and causing
at most mild illness in the ordinary way, it does no observable
damage to the immune system. On the contrary, the immune system
rallies as it is supposed to do and speedily reduces the virus to
negligible levels. Once this happens, the primary infection is over.
If HIV does destroy the immune system, it does so years after the
immune system has virtually destroyed it. By then the virus typically
infects very few of the immune system' s T-cells.
Before these facts were well understood, Robert
Gallo and his followers insisted that the virus does its damage
by directly infecting and killing cells. In his 1991 autobiography,
Gallo ridiculed HIV discoverer Luc Montagnier's view that the virus
causes AIDS only in the company of as yet undiscovered "cofactors."
Gallo argued that "multifactorial is multi-ignorance"
and that, because being infected by HIV was "like being hit
by a truck," there was no need to look for additional causes
or indirect mechanisms of causation.
All that has changed. As Warner C. Greene, a professor
of medicine at the University of California, San Francisco, explained
in the September 1993 Scientific American, researchers are increasingly
abandoning the direct cell-killing theory because HIV does not infect
enough cells: "Even in patients in the late stages of HIV infection
with very low blood T4 cell counts, the proportion of those cells
that are producing HIV is tiny-about one in 40. In the early stages
of chronic infection, fewer than one in 10,000 T4 cells in blood
are doing so. If the virus were killing the cells just by directly
infecting them, it would almost certainly have to infect a much
larger fraction at any one time."
Gallo himself is now among those who are desperately
looking for possible co-factors and exploring indirect mechanisms
of causation. Perhaps the virus somehow causes other cells of the
immune system to destroy T-cells or induces the T-cells to destroy
themselves. Perhaps HIV can cause immune-system collapse even when
it is no long present in the body. As Gallo put it at an AIDS conference
last summer: "The molecular mimicry in which HIV imitates components
of the immune system sets events into motion that may be able to
proceed in the absence of further whole virus."
But researchers have not been able to confirm experimentally
any of the increasingly exotic causal mechanisms that are being
proposed, and they do not agree about which of the competing explanations
is more plausible. When The New York Times interviewed the government'
s head AIDS researcher, Anthony Fauci, in February, reporter Natalie
Angier summarized his view as a sort of stew of all the leading
possibilities: "It [HIV] overexcites some immune signaling
pathways, while eluding the detection of others. And though the
main target of the virus appears to be the famed helper T-cells,
or CD-4 cells, which it can infiltrate and kill, the virus also
ends up stimulating the response of other immune cells so inappropriately
that they eventually collapse from overwork or confusion."
No other virus is credited with such a dazzling repertoire of destructive
skills.
Perhaps it is the HIV scientists who are collapsing
from overwork or confusion. The theory is getting ever more complicated,
without getting any nearer to a solution. This is a classic sign
of a deteriorating scientific paradigm. But as HIV scientists grow
ever more confused about how the virus is supposed to be causing
AIDS, their refusal to consider the possibility that it may not
be the cause is as rigid as ever. On the rare occasions when they
answer questions on the subject, they explain that "unassailable
epidemiological evidence" has established HIV as the cause
of AIDS. In short, they rely on correlation.
The seemingly close correlation between AIDS and
HIV is largely an artifact of the misleading definition of AIDS
used by the U.S. government' s Centers for Disease Control. AIDS
is a syndrome defined by the presence of one or more of 30 independent
diseases-when accompanied by a positive result on a test that detects
antibodies to HIV. The same disease conditions are not defined as
AIDS when the antibody test is negative. Tuberculosis with a positive
antibody test is AIDS; tuberculosis with a negative test is just
TB.
The skewed definition of AIDS makes a close correlation
with HIV inevitable, regardless of the facts. This situation was
briefly exposed at the International AIDS Conference in Amsterdam
in 1992, when the existence of dozens of suppressed "AIDS without
HIV" cases first became publicly known. Instead of considering
the obvious implications of these cases for the HIV theory, the
authorities at the CDC, who had known about some of the cases for
years but had kept the subject under wraps, quickly buried the anomaly
by inventing a new disease called ICL (Idiopathic CD4+Lympho-cytopenia)--a
conveniently forgettable name that means "AIDS without HIV."
There are probably thousands of cases of AIDS without
HIV in the United States alone. Peter Duesberg found 4,621 cases
recorded in the literature, 1,691 of them in this country. (Such
cases tend to disappear from the official statistics because, once
it's clear that HIV is absent, the CDC no longer counts them as
AIDS.) In a 1993 article published in Bio/Technology, Duesberg documented
the consistent failure of the CDC to report on the true incidence
of positive HIV tests in AIDS cases. The CDC concedes that at least
40,000 "AIDS cases" were diagnosed on the basis of presumptive
criteria-that is, without antibody testing, on the basis of diseases
such as Kaposi's sarcoma. Yet these diseases can occur without HIV
or immune deficiency. Perhaps some of the patients diagnosed as
having AIDS would have tested negative, or actually did test negative,
for HIV. Physicians and health departments have an incentive to
diagnose patients with AIDS symptoms as AIDS cases whenever they
can, because the federal government pays the medical expenses of
AIDS patients under the Ryan White Act but not of persons equally
sick with the same diseases who test negative for HIV antibodies.
The claimed correlation between HIV and AIDS is
flawed at an even more fundamental level, however. Even if the "AIDS
test" were administered in every case, the tests are unreliable.
Authoritative papers in both Bio/Technology (June 1993) and the
Journal of the American Medical Association (November 27, 1991)
have shown that the tests are not standardized and give many "false
positives" because they react to substances other than HIV
antibodies. Even if that were not the case, the tests at best confirm
the presence of antibodies and not the virus itself, much less the
virus in an active, replicating state. Antibodies typically mean
that the body has fought off a viral infection, and they may persist
long after the virus itself has disappeared from the body. Since
it is often difficult to find live virus even in the bodies of patients
who are dying of AIDS, Gallo and others have to speculate that HIV
can cause AIDS even when it is no longer present and only antibodies
are left.
Just as there are cases of AIDS without HIV, there
are cases of HIV-positive persons who remain healthy for more than
a decade and who may never suffer from AIDS. According to Greene's
article in Scientific American, "It is even possible that some
rare strains [of HIV] are benign. Some homosexual men in the U.S.
who have been infected with HIV for at least 11 years show as yet
no signs of damage to their immune systems. My colleagues . . .and
I are studying these long-term survivors to ascertain whether something
unusual about their immune systems explains their response or whether
they carry an avirulent strain of the virus."
The faulty correlation between HIV and AIDS would
not disprove the HIV theory if there were strong independent evidence
that HIV causes AIDS. As we have seen, however, researchers have
been unable to establish a mechanism of causation. Nor have they
succeeded in confirming the HIV model by inducing AIDS in animals.
Chimps have repeatedly been infected with HIV, but none of them
have developed AIDS. In the absence of a mechanism or an animal
model, the HIV theory is based only upon a correlation that turns
out to be primarily an artifact of the theory itself.
In light of the importance of the correlation argument,
it is astonishing that no controlled studies have been done for
three of the major risk groups: transfusion recipients, hemophiliacs,
and drug abusers. Two ostensibly controlled studies involving men's
groups in Vancouver and San Francisco purportedly show that AIDS
developed only in the HIV-positive men and never in the "control
group" of HIV negatives. These studies were designed not to
test the HIV theory but to measure the rate at which HIV-positive
gay men develop AIDS. They did not compare otherwise similar persons
who differ only in HIV status, did not control effectively for drug
use, and did not fully report the incidence of AIDS-defining diseases
in the HIV-negative men. The research establishment accepted these
studies uncritically because they give the HIV theory some badly
needed support. But the main point they supposedly prove has already
been thoroughly disproved: AIDS does occur in HIV-negative persons.
According to the official theory, HIV is a virus
newly introduced into the American population, which has had no
opportunity to develop any immunity. It follows that viral infection
should spread rapidly, moving from the original risk groups (gays,
drug addicts, transfusion recipients) into the general population.
This is what the government agencies confidently predicted, and
AIDS advertising to this day emphasizes the theme that "everyone
is at risk."
The facts are otherwise. AIDS is still confined
mainly to the original risk groups, and AIDS patients in the United
States are still almost 90-percent male. Health-care workers, who
are constantly exposed to blood and bodily fluids of AIDS patients,
have no greater risk of contracting AIDS that the population at
large. Among millions of health- care workers, the CDC claims only
seven or eight (poorly documented) cases of AIDS supposedly developed
through occupational exposure. By contrast, the CDC estimates that
accidental needle sticks lead to more than 1,500 cases of hepatitis
infection each year. Even prostitutes are not at risk for AIDS unless
they also use drugs.
Far from threatening the general heterosexual population,
AIDS is confined mainly to drug users and gay men in specific urban
neighborhoods. According to a 1992 report by the prestigious U.S.
National Research Council, "The convergence of evidence shows
that the HIV/AIDS epidemic is settling into spatially and socially
isolated groups and possibly becoming endemic within them."
This factual picture is so different from what the theory predicts,
and so threatening to funding, that the AIDS agencies have virtually
ignored the National Research Council report and have continued
to preach the fiction that "AIDS does not discriminate."
Not only is AIDS mostly confined to isolated groups
in a few U.S. cities, but HIV infection is not increasing. Although
a virus newly introduced to a susceptible population should spread
rapidly, for several years the CDC has estimated that a steady 1
million Americans are HIV positive. Now it appears that the figure
of 1 million is finally about to be revised-downward. According
to a story by Lawrence Altman in the March 1 New York Times, new
statistical studies indicate that only about 700,000 Americans are
HIV positive, and the official estimate will accordingly be reduced
sometime this summer.
While HIV infection remains steady at this modest
level in the United States, World Health Organization officials
claim that the same virus is spreading rapidly in Africa and Asia,
creating a vast "pandemic" that threatens to infect at
least 40 million people by the year 2000, unless billions of dollars
are provided for prevention to the organizations sounding the alarm.
These worldwide figures, especially from Africa, are used to maintain
the thesis that "everyone is at risk" in the United States.
Instead of telling Americans that AIDS cases here are almost 90-percent
male, authorities say that worldwide the majority of AIDS sufferers
are female. With the predictions of a mass epidemic in America and
Europe failing so dramatically, AIDS organizations rely on the African
figures to vindicate their theory.
But these African figures are extremely soft, based
almost entirely on "clinical diagnoses," without even
inaccurate HIV testing. What this means in practice is that Africans
who die of diseases that have long been common there---especially
wasting disease accompanied by diarrhea-are now classified as AIDS
victims. Statistics on "African AIDS" are thus extremely
manipulable, and witnesses are emerging who say that the epidemic
is greatly exaggerated, if it exists at all.
In October 1993, the Sunday Times of London reported
on interviews with Philippe and Evelyne Krynen, heads of a 230-employee
medical relief organization in the Kagera province of Tanzania.
The Krynens had first reported on African AIDS in 1989 and at that
time were convinced that Kagera in particular was in the grip of
a vast epidemic. Subsequent years of medical work in Kagera have
changed their minds. They have learned that what they had thought
were "AIDS orphans" were merely children left with relatives
by parents who had moved away and that HIV-positive and HIV-negative
villagers suffer from the same diseases and respond equally well
to treatment. Philippe Krynen's verdict: "There is no AIDS.
It is something that has been invented. There are no epidemiological
grounds for it; it doesn't exist for us."
Krynen's remark calls attention to the fact that
AIDS is not a disease. Rather, it is a syndrome defined by the presence
of any of 30 separate and previously known diseases, accompanied
by the actual or suspected presence of HIV. The definition has changed
over time and is different for Africa (where HIV testing is rare)
than for Europe and North America. The official CDC definition of
AIDS in the United States was enormously broadened for 1993 in order
to distribute more federal AIDS money to sick people, especially
women with cervical cancer. As a direct result, AIDS cases more
than doubled in 1993. Absent the HIV mystique, there would be no
reason to believe that a single factor is causing cervical cancer
in women, Kaposi's sarcoma in gay males, and slim disease in Africans.
The HIV paradigm is failing every scientific test.
Research based upon it has failed to provide not only a cure or
vaccine but even a theoretical explanation for the disease-causing
mechanism. Such success as medical science has had with AIDS has
come not from the futile attempts to attack HIV with toxic antiviral
drugs like AZT but from treating the various AIDS-associated diseases
separately. Predictions based on the HIV theory have been falsified
or are supported only by dubious statistics based mainly on the
theory itself. Yet the HIV establishment continues to insist that
nothing is wrong and to use its power to exclude dissenting voices,
however eminent in science, from the debate.
Like other leaders of the scientific establishment,
Nature Editor John Maddox is fiercely protective of the HIV theory.
He indignantly rejected a scientific paper making the same points
as this article. When Duesberg first argued his case in 1989 in
the prestigious Proceedings of the National Academy of Science,
the editor promised that his paper would be answered by an article
defending the orthodox viewpoint. The response never came. The editors
of the leading scientific journals have refused to print even the
brief statement of the Group for the Scientific Reappraisal of the
HIV/AIDS Hypothesis, which has over 300 members. The statement notes
simply that "many biomedical scientists now question this hypothesis"
and calls for "a thorough reappraisal of the existing evidence
for and against this hypothesis."
Such a reappraisal would include the following elements:
Genuinely controlled epidemiological studies of
all the major risk groups:homosexuals, drug users, transfusion recipients,
and hemophiliacs. The studies should employ an unbiased definition
of AIDS. Too often we have been told that HIV always accompanies
AIDS, only to learn that this is so because AIDS without HIV is
named something else. The studies should be performed by persons
who are committed to investigating the HIV theory rather than defending
it. There is reason to suspect that properly controlled studies
of transfusion recipients and hemophiliacs in particular will show
that the incidence of AIDS-defining diseases is independent of HIV
status.
An audit of the CDC statistics to remove HIV bias
and thereby allow unprejudiced testing of the critical epidemiological
evidence for the theory. Every effort should be made to determine
how many AIDS patients were actually tested for antibodies and the
testing method that was employed. Because even the most reliable
antibody test generates many false-positive results, researchers
should try to validate the tests by examining random samples of
AIDS patients to determine whether significant amounts of replicating
HIV can be found in their bodies. Statistics have been kept as if
the purpose were to protect the HIV theory rather than to learn
the truth.
Research focusing on the cause of particular diseases
rather than the politically defined hodgepodge of diseases we now
call AIDS. The cancer-like skin disease called Kaposi's sarcoma
(KS) is one of the best-known AIDS-defining conditions, but leading
KS and HIV experts Marcus Conant and Robin Weiss now say that dozens
of non-HIV KS cases are under study in the United States and that
KS is becoming much less frequent in gay male AIDS patients than
it formerly was. Conant, Weiss, and other AIDS researchers now frankly
attribute KS to an "unknown infectious agent" rather than
to HIV, but KS is nonetheless still called AIDS when it occurs in
combination with HIV. Duesberg attributes KS in gay males to the
use of amyl nitrates (poppers) as a sexual stimulant. His theory
is eminently testable, and it ought to be given a fair chance. Another
example: Hemophiliacs in the age of AIDS are living longer than
they ever did in the past, but they still often die of conditions
related to receipt of the blood concentrate called Factor VIII.
Research published in The Lancet in February confirms earlier reports
that symptoms diagnosed as AIDS are best treated by providing a
highly purified form of Factor VIII. Researchers should study the
role of blood-product impurities in causing disease in hemophiliacs,
without the distortion that comes from arbitrarily assuming that
HIV is responsible whenever an HIV-positive hemophiliac becomes
ill.
A critical re-examination of the statistics for
AIDS and HIV in Africa and Asia. Researchers should perform new,
controlled studies of representative African populations to test
the relationship of confirmed HIV infection to the incidence of
AIDS-defining diseases. It will not do to rely upon "presumptive
diagnoses" or extrapolations from single antibody tests that
are now well known to generate many false positives.
The HIV establishment and its journalist allies
have replied to various specific criticisms of the HIV theory without
taking them seriously. They have never provided an authoritative
paper that undertakes to prove that HIV really is the cause of AIDS-meaning
a paper that does not start by assuming the point at issue. The
HIV theory was established as fact by Robert Gallo's official press
conference in 1984, before any papers were published in American
journals. Thereafter, the research agenda was set in concrete, and
skeptics were treated as enemies to be ignored or punished. As a
result, the self-correcting processes of science have broken down,
and journalists have not known how to ask the hard questions. After
10 years of failure, it is time to take a second look. *
Charles A. Thomas Jr., a biochemist, is president
of the Helicon Foundation in San Diego and secretary of the Group
for the Scientific Reappraisal of the HIV/AIDS Hypothesis. Kary
B. Mullis is the 1993 Nobel Prize winner in chemistry for his invention
of the polymerase chain reaction technique, for detecting DNA, which
is used to search for fragments of HIV in AIDS patients. Phillip
E. Johnson is the Jefferson E. Peyser Professor of Law at the University
of California, Berkeley.
Several replies to the article have been published,
as a reply by the authors.
You find them here.
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