In response to:
Truth and Heresy About AIDS from the May 23, 1996 issue
To the Editors:
The war on AIDS has been a complete disappointment in terms of public health benefits. For $35 billion from the US taxpayer alone there is no vaccine, no effective drug, not a single AIDS patient has ever been cured, and despite ubiquitous “education” on AIDS prevention, AIDS continues to increase. Inventing the AIDS Virus, Infectious AIDS: Have We Been Misled?, and AIDS: Virus- or Drug Induced? explain why: AIDS does not meet the standards of an infectious epidemic; American and European AIDS is caused by the long-term consumption of recreational drugs and anti-viral drugs like AZT; and human immunodeficiency virus (HIV) meets all the classical criteria of a harmless, passenger virus. Science cannot produce on the basis of a flawed hypothesis!
After reviewing these books [NYR, May 23] Richard Horton, editor of The Lancet, concedes, “The case against HIV is made by Duesberg…into a historically and logically coherent tale.” Indeed, Horton flirts with the drug-AIDS hypothesis because it “resolves several longstanding paradoxes of the AIDS pandemic”:
1) Since AIDS is new, it is paradoxical that it should be caused by an old retrovirus like HIV. The solution in Horton’s words: “American AIDS is new, not because of HIV, which is an old infection, but because drug use has spiraled during the past twenty years.”
2) Since infectious diseases are equally distributed between the sexes, it is paradoxical that American and European AIDS is 90 percent male. Here too, Horton adopts the solution of the drug-hypothesis: AIDS is 90 percent male because “especially men below the age of forty” consume 90 percent of the cocaine, heroin, nitrite inhalants, amphetamines, and anti-HIV drugs like AZT.
3) Horton also recognizes the paradox that: “Many diseases associated with AIDS, such as dementia, do not depend on a state of immunodeficiency.” Kaposi sarcoma, wasting, lymphoma, and cervical cancer also appear in people with functional immune systems. Solution: drugs are toxic to all cells, not only to cells of the immune system.
Horton omits to say that Inventing the AIDS Virus and the other books he reviewed document exactly how drugs and immunosuppressive proteins of blood transfusions resolve all other paradoxa of the HIV hypothesis as well. For example:
1) Since only about one of 1000 immune cells lost by AIDS patients is ever infected, it is paradoxical that HIV would cause immunodeficiency. HIV would have to act like one bullet that kills 1000 soldiers. The simple solution is that drug use kills immune cells.
2) It is paradoxical that HIV, with a generation time of one to two days and a multiplication rate of over 100 (every one to two days 100-fold more virus), would need ten years or more to cause AIDS, as is claimed. If AIDS were caused by HIV, it should appear within two to three weeks after infection, by which time there should be more viruses than susceptible cells in a human body (unless the immune system is even faster). Solution: accumulated toxicity from years of recreational drug use causes AIDS. Just as lung cancer and emphysema appear only after ten to twenty years of smoking and cirrhosis of the liver only after many years of drinking.
3) It is extremely paradoxical that the professional literature does not describe even one doctor who contracted AIDS from the over 500,000 American AIDS patients—particularly since there is neither a vaccine nor an antiviral drug. Solution: drug diseases are not contagious.
4) AIDS-defining diseases have been described in thousands of HIV-free recreational drug users. For example, The Lancet has published a study of male homosexual nitrite users with Kaposi’s sarcoma—without any trace of HIV.1 So drugs appear to cause AIDS.
Based on what Horton says, and what he omits from the books he reviewed, it is clear that he has taken a big bite from the apple. Perhaps mindful of the political realities of his position—the over 10,000 scientific papers published annually by mainstream journals for the well-funded virus-AIDS establishment compared to none for HIV “heretics” like me—Horton sides with the majority: “How could so many scientists have got it all so badly wrong?”
Since Horton seems unable to distance himself from the drug hypothesis with scientific logic, he uses the argument of fear: “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….”
But Horton does not warn the AIDS orthodoxy that “if HIV is not the cause of AIDS,” it would be in much more dangerous territory than unsafe sex for (i) prescribing a bewildering collection of poisonous drugs like pentamidine and chemotherapies like AZT, ddl, and ddC to about 200,000 HIV-positives with and without AIDS every year since 1987, (ii) handing deadly AIDS prognoses to hundreds of thousands who test HIV-positive, and (iii) even denying the health hazards of recreational drugs with publications in The Lancet2 and in Nature3 in order to blame HIV for the many AIDS-defining diseases of drug users.
Horton dedicates much space to the only argument that the orthodoxy offers to support its darling HIV: the “overwhelming mass of evidence linking HIV to this form of acquired immunodeficiency.” However, there are four serious problems with this argument:
1) Even a perfect correlation is not sufficient to prove causation. For example, everybody who eats a tomato dies. But this does not prove that tomatoes kill.
2) The correlations “linking” AIDS with HIV in reality link AIDS with the antibody against(!) HIV. But antibodies are nature’s ultimate antidote against viruses, the operating principle of vaccination, not causes of a disease.
3) In the US and Europe the antibody correlations are confounded by “overwhelming” correlations with recreational drugs and AZT. And drugs are causes of disease.
4) Horton does not explain that the over-whelming HIV-antibody—AIDS correlation is not a natural coincidence, but instead an artifact of the AIDS definition. AIDS is defined as one of thirty previously known diseases if they occur in the presence of antibody against HIV. For example, tuberculosis with antibody against HIV = AIDS, tuberculosis without HIV = tuberculosis. Thus it is not just tautologous but outright deceptive to offer the correlation with HIV-antibody as proof of the HIV hypothesis.
In the end Horton rises above the paradoxes of the HIV hypothesis and the hostility of its proponents toward those who offer other solutions. Fortunately for me, Horton’s ultimate neutrality overrides his faith in the orthodoxy: “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…. 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?”
Too bad that Horton does not disburse research funds himself. But he does recommend that “Duesberg deserves to be heard, and the ideological assassination that he has undergone will remain an embarrassing testament to reactionary tendencies of modern science….” Luckily Horton can easily remedy this situation by allowing me space in his journal to explain to the orthodoxy, for example, why “evidence…from the hemophilia population” is not “refuting Duesberg.” I await his offer with confidence.
Department of Molecular and Cell Biology
University of California
Richard Horton replies:
Let me begin by quoting, with permission, a letter I received from Barry Bloom, a respected investigator at the Howard Hughes Medical Institute in New York.
I was appalled at your review of Peter Duesberg’s book in The New York Review of Books. You have dignified a position which I believe cannot be justified, namely encouraging human beings to ignore a life threatening risk, either for the purpose of playing the ultimate devil’s advocate, or because of sheer opportunism.
Bloom goes on to invite Duesberg to prove that HIV is innocuous by means of a simple experiment. He writes that if Duesberg’s “convictions are as deeply felt and as strong as stated in his polemics, and if he sees the stakes as high as he advertises in proving that HIV is unrelated to AIDS, it is surprising that he has not availed himself of the noble tradition of self-experimentation.” Here is a startling challenge. Duesberg accuses me of using “the argument of fear.” If there is nothing to fear from HIV, he can easily prove it. If Duesberg seriously believes that HIV is harmless, let him inject himself with a suspension of the virus.
In his rebuttal, Duesberg repeats many of his arguments that I discussed and criticized in my review. Now he asks me, as editor of The Lancet, to consider offering further space for him to refute his critics once more. We have given him this opportunity on many occasions in recent years.1 On the specific matter of hemophilia, which he draws special attention to, we published his letter on November 18, 1995, in which he sets out ten reasons why he believes that the causal association between HIV and disease in this population is insecure.2 And, of course, Duesberg has made his case in his books to a far greater extent than he could in a research journal such as The Lancet. Still, he knows that we will consider all articles submitted to us and that we select for publication those, subject to careful review, which have the strongest claims to originality.
For all Duesberg’s claims, though, how does his theory explain the experimental results of John Mellors?3 Mellors and his colleagues studied 180 gay or bisexual HIV-positive men who were recruited to a study in Pittsburgh during 1981 and 1985. The cases of each of these men were followed until immunodeficiency-related diseases or death supervened. Measurements of the quantity of HIV in the blood at the time of entering the study correlated closely with the clinical outcome. The correlation is not, as Duesberg would have us believe, between antibody and AIDS. It is between actual viral RNA and death. For example, when successive quartiles ranging from the lowest to the highest levels of viral RNA were examined, the time periods before death ensued were 10, 9.5, 7.4, and 5.1 years, respectively. One can hardly think of a more direct correlation. If the virus is harmless, why does its presence predict survival so precisely?
Duesberg also lambasts antiretroviral drugs and suggests that they have contributed “deadly AIDS prognoses” to their recipients. The facts are completely at variance with this astonishing claim. Cheryl Enger has studied two groups of gay men, one infected with HIV between 1985 and 1988 and another infected between 1989 and 1993.4 As Duesberg points out, antiretroviral agents became widely available from 1987 onward. When the outcomes of these men were analyzed, the later group that received drug therapy had substantially longer survival times than the earlier group that had not received drugs. It is true that these drugs have significant side effects, but it is also true that they have prolonged life. This evidence simply cannot be ignored.
Meyer Friedman points to the baboon work of Susan Barnett and colleagues5 as decisive proof that HIV causes AIDS. To be sure, these data are a part of the totality of evidence supporting the causal association between virus and disease.6 However, Friedman could have mentioned a more recent article in Science with different implications. In the May 10, 1996, issue Jon Cohen discusses new research that iden-tifies a substance found in human cells as an essential cofactor for HIV infectivity.7 In sum, HIV is necessary but not sufficient for disease to develop. This cofactor has been predicted for some time, as I said in my review. A further cofactor has also, more recently still, been reported.
The central role of HIV in the development of immunodeficiency is, in my view, established by the force of epidemiological and laboratory evidence. On this key issue, Duesberg is, I believe, in error. But there remains great uncertainty about the details of disease pathogenesis, as the cofactor data illustrate all too clearly. Duesberg has predicted, correctly, that the virus alone is not enough to explain all aspects of the immunodeficiency process. Many outstanding researchers have sought to resist this conclusion. Why? For provoking us to think beyond the virus, Duesberg deserves credit. But for failing to acknowledge the strength of the data I have cited here and earlier, he deserves censure.
August 8, 1996
A. E. Friedman-Kien, B. R. Saltzman, Y. Cao, M. S. Nestor, M. Mirabile, J. J. Li, and T. A. Peterman, “Kaposi’s sarcoma in HIV-negative homosexual men,” Lancet, Volume 335 (January 20, 1990), pp. 168—169. ↩
M. T. Schechter, K. J. P. Craib, K. A. Gelmon, J. S. G. Montaner, T. N. Le, and M. V. O’Shaughnessy, “HIV-1 and the aetiology of AIDS.” Lancet, Volume 341 (March 13, 1993), pp. 658—659. ↩
M. S. Ascher, H. W. Sheppard, W. Winkelstein, Jr., and E. Vittinghoff, “Does drug use cause AIDS?” Nature, Volume 362 (March 11, 1993), pp. 103—104. ↩
For example, The Lancet published five letters from Duesberg on this issue between 1992 and 1993. ↩
See Peter H. Duesberg, “Is HIV the cause of AIDS?”, The Lancet, Volume 346 (November 18, 1995), pp. 1371—1372. ↩
See John W. Mellors et al., “Prognosis in HIV-1 infection predicted by the quantity of virus in plasma,” Science, Volume 272 (May 24, 1996), pp. 1167—1170. ↩
See Cheryl Enger et al., “Survival From Early, Intermediate, and Late Stages of HIV Infection,” JAMA, Volume 275 (May 1, 1996), pp. 1329—1334. ↩
See Susan W. Barnett et al., “An AIDS-like condition induced in baboons by HIV-2,” Science, Volume 266 (October 28, 1994), pp. 642—646. ↩
For a further overview of this evidence, see The Relationship Between the Human Immunodeficiency Virus and the Acquired Immunodeficiency Syndrome, published in September 1995 by the US National Institute of Allergy and Infectious Diseases. ↩
See Jon Cohen, “Likely HIV Cofactor Found,” Science, Volume 272 (May 10, 1996), pp. 809—810. ↩