The AIDS Debate That Isn’t

WALL STREET JOURNAL, 2/26/88
Copyright Dow Jones & Co. Inc.
By Katie Leishman
SOURCE

Last week the Presidential Commission on the Human Immunodeficiency Virus Epidemic held hearings in New York.

Among the witnesses was Peter Duesberg, a professor of virology at the University of California at Berkeley, who is one of the world s foremost retrovirologists and a member of the National Academy of Sciences. Mr. Duesberg explained why he does not believe, with the majority of AIDS researchers, that the disease is caused by HIV, a retrovirus discovered in 1983.

According to Mr. Duesberg the viral model for AIDS contradicts too many principles of virology. HIV is said to destroy T4 cells, which are footsoldiers in the body’s immune system. But retroviruses, Mr. Duesberg counters, do not destroy cells. Moreover, he argues, HIV infects fewer than one in 10,000 to 100,000 cells, a number easily replaced by the body in a day. When the virus is most active it triggers no AIDS symptoms, whereas when AIDS symptoms arise, the virus is, paradoxically, inactive. Mr. Duesberg observes that no other virus, indeed no other infectious agent, is known to cause disease in this way.

In the year since Mr. Duesberg first advanced his theories in a paper in Cancer Research, leading AIDS investigators have been unanimous in their refusal to rebut him, despite requests from universities and press forums like the “MacNeil/Lehrer NewsHour.” They have been willing, however, to justify their silence at length. Anthony Fauci, coordinator of AIDS research at the National Institutes of Health, recently explained on National Public Radio, “Critiquing a dubious theory would take time away from more productive efforts.” A proposed White House seminar (“How Does HIV Cause AIDS? “) in which Mr. Duesberg was to participate was abruptly canceled when no AIDS researcher from the National Institutes would agree to attend. Mr. Duesberg has kept his views alive through occasional radio interviews, university addresses and a brief appearance on CNN. Mr. Duesberg was asked to speak by the Presidential Commission, although a member of one commissioner s staff readily acknowledged that Mr. Duesberg “was invited to discredit him.” Nowhere was this clearer than in his treatment by Commissioner Frank Lilly, chairman of the department of genetics at the Albert Einstein College of Medicine. At the conclusion of Mr. Duesberg s testimony, Mr. Lilly remarked: “You ve made your usual very charming presentation…I would like to recommend that perhaps you could sit through our graduate course on animal virology.”

That opening shot raised expectations that Mr. Lilly was about to put Mr. Duesberg away. Yet Mr. Lilly s reply to Mr. Duesberg s arguments contained several strange assertions. (His claim that the causative role of the polio virus was only proved by the discovery of its vaccine drew stares from the audience, which included physicians and research scientists as well as gay activists. An animal model of infection existed long before the vaccine.) Mr. Lilly noted that hepatitis virus, although inactive following that disease’s course, could cause liver cancer up to 20 years later. Mr. Duesberg asked if he might reply to that point and was told that he could not. In fact, the relationship between the virus and cancer remains entirely speculative.

Mr. Lilly conceded that scientists have offered no definitive mechanism by which HIV destroys the immune system and that retroviruses classically do not kill cells. In the middle of his summation he said: “You may be right. There is a slight possibility that HIV does not cause AIDS. The evidence to date is in fact circumstantial.”

This striking admission did not prevent another commission member, William Walsh, president of Project Hope, from joining in the scolding. He admonished Mr. Duesberg to confine his opinions to professional circles and to have “the scientific integrity” to resist appearing on television programs “until you have something more substantial to say.”

Dr. Walsh added: “Don’t confuse the public. Don’t confuse the poor people suffering from this disease.” Whether Mr. Duesberg is right or wrong, there is nothing confusing about his contentions. Moreover, the suggestion that the public and patients must be protected from confusion is not merely condescending but faintly sinister. America is spending a billion dollars in research on the assumption that HIV causes AIDS, and treating patients with AZT — one of the most toxic yet hastily approved drugs ever released. The commission heard testimony concerning AZT’s use as a prophylactic measure in HIV-infected but still healthy individuals, a practice that Mr. Duesberg believes verges on the irresponsible.

AZT works by blocking production of DNA in the cell, both viral DNA and cellular DNA. Yet, as Mr. Duesberg told the commission, no one has been able to detect viral DNA production in any AIDS patient. All that is known for certain about the drug’s activity is that it is killing healthy cells.

The only subject about which the public needs to be spared confusion is behavioral risk factors for AIDS, which Mr. Duesberg s questions do not concern. As for confusing the patients, clearly their medical “right to know” should include the right to any information that might affect their choice of treatment.

Mr. Duesberg is frequently challenged, “If HIV isn’t the cause, what is? ” He responds that his expertise permits him to suggest only what AIDS is not. He is often asked about the growing epidemiological evidence linking syphilis and AIDS.

Venereal-disease clinics in several major cities are reporting increases in the incidence of syphilis in heterosexuals of nearly 100% in a one-year period — after a 20-year decline. The syphilis being seen is distinctively aggressive, and many public-health officials are speculating about the new outbreak and its relationship to the emergence of AIDS in the syphilis-ridden gay community of nearly a decade ago.

Mr. Duesberg allows that syphilis may play a key role in many cases of AIDS. But, as he testified, he doubts that any single pathogen could explain all the conditions embraced in the Centers for Disease Control’s definition of AIDS.

It is unsettling to be offered Mr. Duesberg’s hypothesis seven years into the epidemic, but that seems no excuse for the disdainful treatment it has received. AIDS research is based on the assumption that all that remains to be found is a cure. But this urgency to put all resources behind what appear to be promising solutions has created an instant orthodoxy, which resists review.