Kicking the Sacred Cow

by James P. Hogan

  While bad news for some, this came at a propitious time for a huge, overfunded and largely out-of-work army within the biomedical establishment, which, it just so happened, had been set up, equipped, trained, and on the lookout for exactly such an emergency. 226 Following the elimination of polio in the fifties and early sixties, the medical schools had been churning out virologists eager for more Nobel Prizes. New federal departments to monitor and report on infectious diseases stood waiting to be utilized. But the war on cancer had failed to find a viral cause, and all these forces in need of an epidemic converged in a crusade to unravel the workings of the deadly new virus and produce a vaccine against it. No other virus was ever so intensively studied. Published papers soon numbered thousands, and jobs were secure as federal expenditures grew to billions of dollars annually. Neither was the largess confined to just the medical-scientific community and its controlling bureaucracies. As HIV came to be automatically equated with AIDS, anyone testing positive qualified as a disaster victim eligible for treatment at public expense, which meant lucrative consultation and testing fees, and treatment with some of the most profitable drugs that the pharmaceuticals industry has ever marketed.

  And beyond that, with no vaccine available, the sole means of prevention lay in checking the spread of HIV. This meant funding for another growth sector of promotional agencies, advisory centers, educational campaigns, as well as support groups and counselors to minister to afflicted victims and their families. While many were meeting harrowing ends, others had never had it so good. Researchers who would otherwise have spent their lives peering through microscopes and cleaning Petri dishes became millionaires setting up companies to produce HIV kits and drawing royalties for the tests performed. Former dropouts were achieving political visibility and living comfortably as organizers of programs financed by government grants and drug-company handouts. It was a time for action, not thought; spreading the word, not asking questions. Besides, who would want to mess with this golden goose?

  Storm-Cloud Over the Parade

  And then in the late eighties, Peter Duesberg began arguing that AIDS might not be caused by HIV at all—nor by any other virus, come to that. In fact, he didn't even think that "AIDS" was infectious! This was not coming from any lightweight on the periphery of the field. Generally acknowledged as one of the world's leading authorities on retroviruses, the first person to fully sequence a retroviral genome, Duesberg had played a major role in exploring the possibility of viruses as the cause of cancers. In fact it was mainly his work in the sixties that showed this conclusively not to be the case, which had not exactly ingratiated him to many when that lavishly funded line of research was brought to a close. But this didn't prevent his being tipped as being in line for a Nobel Prize, named California Scientist of the Year in 1971, awarded an Outstanding Investigator Grant by the National Institutes for Health in 1985, and inducted to the prestigious National Academy of Sciences in 1986.

  What Duesberg saw was different groups of people getting sick in different ways for different reasons that had to do with the particular risks that those groups had always faced. No common cause tying them all together had ever been convincingly demonstrated; indeed, why such conditions as dementia and wasting disease should have been considered at all was something of a mystery, since they are not results of immunosuppression. Drug users were ruining their immune systems with the substances they were putting into their bodies, getting TB and pneumonia from unsterile needles and street drugs, and wasting as a consequence of the insomnia and malnutrition that typically go with the lifestyle; homosexuals were getting sarcomas from the practically universal use of nitrite inhalants, and yeast infections from the suppression of protective bacteria by overdosing on antibiotics used prophylactically; hemophiliacs were immune-suppressed by the repeated infusion of foreign protein contained in the plasmas of the unpurified clotting factors they had been given up to that time; blood recipients were already sick for varying reasons; people being treated with the "antiviral" drug AZT were being poisoned; Africans were suffering from totally different diseases long characteristic of poverty in tropical environments; and a few individuals were left who got sick for reasons that would never be explained. The only difference in recent years was that some of those groups had gotten bigger. The increases matched closely the epidemic in drug use that had grown since the late sixties and early seventies, and Duesberg proposed drugs as the primary cause of the rises that were being seen. 227

  Although Duesberg is highly qualified in this field, the observations that he was making really didn't demand doctorate knowledge or rarefied heights of intellect to understand. For a start, years after their appearances, the various "AIDS" diseases remained obstinately confined to the original risk groups, and the victims were still over 90 percent male. This isn't the pattern of an infectious disease, which spreads and affects everybody, male and female alike. For a new disease loose in a defenseless population, the spread would be exponential. And this was what had been predicted in the early days, but it just hadn't happened. While the media continued to terrify the public with a world of their own creation, planet Earth was getting along okay. Heterosexuals who didn't use drugs weren't getting AIDS; for the U.S., subtracting the known risk groups left about five hundred per year—fewer than the fatalities from contaminated tap water. The spouses and partners of AIDS victims weren't catching it. Prostitutes who didn't do drugs weren't getting it, and customers of prostitutes weren't getting it. In short, these had all the characteristics of textbook non-infectious diseases.

  It is an elementary principle of science and medicine that correlation alone is no proof of cause. If A is reported as generally occurring with B, there are four possible explanations: (1) A causes B; (2) B causes A; (3) something else causes both A and B; (4) the correlation is just coincidence or has been artificially exaggerated, e.g., by biased collecting of data. There's no justification in jumping to a conclusion like (1) until the other three have been rigorously eliminated.

  In the haste to find an infectious agent, Duesberg maintained, the role of HIV had been interpreted the wrong way around. Far from being a common cause of the various conditions called "AIDS," HIV itself was an opportunistic infection that made itself known in the final stages of immune-system deterioration brought about in other ways. In a sense, AIDS caused HIV. Hence, HIV acted as a "marker" of high-risk groups, but was not in itself responsible for the health problems that those groups were experiencing. The high correlation between HIV and AIDS that was constantly being alluded to was an artifact of the way in which AIDS was defined:

  HIV + indicator disease = AIDS

  Indicator disease without HIV = Indicator disease.

  So if you've got all the symptoms of TB, and you test positive for HIV, you've got AIDS. But if you have a condition that's clinically indistinguishable and don't test positive for HIV, you've got TB.

  And that, of course, would have made the problem scientifically and medically trivial.

  Anatomy of an Epidemic

  When a scientific theory fails in its predictions, it is either modified or abandoned. Science welcomes informed criticism and is always ready to reexamine its conclusions in the light of new evidence or an alternative argument. The object, after all, is to find out what's true. But it seems that what was going on here wasn't science. Duesberg was met by a chorus of outrage and ridicule, delivered with a level of vehemence that is seldom seen within professional circles. Instead of willingness to reconsider, he was met by stratagems designed to conceal or deny that the predictions were failing. This is the kind of reaction typical of politics, not science, usually referred to euphemistically as "damage control."

  For example, statistics for new AIDS cases were always quoted as cumulative figures that could only get bigger, contrasting with the normal practice with other diseases of reporting annual figures, where any decline is clear at a glance. And despite the media's ongoing stridency about an epidemic out of control, the actual figu
res from the Centers for Disease Control (CDC), for every category, were declining, and had been since a peak around 1988. This was masked by repeated redefinitions to cover more diseases, so that what wasn't AIDS one day became AIDS the next, causing more cases to be diagnosed. This happened five times from 1982 to 1993, with the result that the first nine months of 1993 showed as an overall rise of 5 percent what would otherwise—i.e., by the 1992 definition—have been a 33 percent drop. 228

  Currently (January 2003) the number of indicator diseases is twenty-nine. One of the newer categories added in 1993 was cervical cancer. (Militant femininists had been protesting that men received too much of the relief appropriations for AIDS victims.) Nobody was catching anything new, but suddenly in one group of the population what hadn't been AIDS one day became AIDS the next, and we had the headlines loudly proclaiming that heterosexual women were the fastest-growing AIDS group.

  A similar deception is practiced with percentages, as illustrated by figures publicized in Canada, whose population is around 40 million. In 1995, a total of 1,410 adult AIDS cases were reported, 1,295 (91.8%) males and 115 (8.2%) females. The year 1996 showed a startling decrease in new cases to 792, consisting of 707 males (89.2%) and 85 females (10.8%). So the number of adult female AIDS cases actually decreased by 26% from 1995 to 1996. Yet, even though the actual number decreased, because the percentage of the total represented by women increased from 8.2% in 1995 to 10.8% in 1996, the Quarterly Surveillance Report (August 1997) from the Bureau of HIV/AIDS and STD at the Canadian Laboratory Centre for Disease Control issued the ominous warning that AIDS cases among Canadian women had dramatically increased. 229

  Meanwhile, a concerted campaign across the schools and campuses was doing its part to terrorize young people over the ravages of teenage AIDS. Again, actual figures tell a different story. The number of cases in New York City reported by the CDC for ages 13–19 from 1981 to the end of June 1992 were 872. When homosexuals, intravenous drug users, and hemophiliacs are eliminated, the number left not involving these risks (or not admitting to them) reduces to a grand total of 16 in an eleven-year period. (Yes, 16. You did read that right.) 230

  The correlation between HIV and AIDS that was repeatedly cited as proving cause was maintained by denying the violations of it. Obviously if HIV is the cause, the disease can't exist without it. (You don't catch flu without having the flu virus.) At a conference in Amsterdam in 1992, Duesberg, who had long been maintaining that dozens of known instances of AIDS patients testing negative for HIV had been suppressed, produced 4,621 cases that he had found in the literature. The response was to define them as a new condition designated Idiopathic CD4+ Lymphocytopenia, or ICL, which is obscurese for "unexplained AIDS symptoms." The figures subsequently disappeared from official AIDS-counting statistics. 231

  Questioning the Infectious Theory

  Viral diseases strike typically after an incubation period of days or weeks, which is the time in which the virus can replicate before the body develops an immunity. When this didn't happen for AIDS, the notion of a "slow" virus was introduced, which would delay the onset of symptoms for months. When a year passed with no sign of an epidemic, the number was upped to five years; when nothing happened then either, to ten. Now we're being told ten to fifteen. Inventions to explain failed predictions are invariably a sign of a theory in trouble. (Note: This is not the same as a virus going dormant, as can happen with some types of herpes, and reactivating later, such as in times of stress. In these cases, the most pronounced disease symptoms occur at the time of primary infection, before immunity is established. Subsequent outbreaks are less severe—immunity is present, but reduced—and when they do occur, the virus is abundant and active. This does not describe AIDS. A long delay before any appearance of sickness is characteristic of the cumulative buildup of a toxic cause, like lung cancer from smoking or liver cirrhosis from alcohol excess.)

  So against all this, on what grounds was AIDS said to be infectious in the first place? Just about the only argument, when you strip it down, seems to be the correlation—that AIDS occurs in geographic and risk-related clusters. This is not exactly compelling. Victims of airplane crashes and Montezuma's revenge are found in clusters too, but nobody takes that as evidence that they catch their condition from each other. It all becomes even more curious when you examine the credentials of the postulated transmitting agent, HIV.

  One of the major advances in medicine during the nineteenth century was the formulation of scientific procedures to determine if a particular disease is infectious—carried by some microbe that's being passed around—and if so, to identify the microbe; or else a result of some factor in the environment, such as a dietary deficiency, a local genetic trait, a toxin. The prime criteria for making this distinction are known as Koch's Postulates, from a paper by the German medical doctor Robert Koch published in 1884 following years of investigation into such conditions as anthrax, wound infections, and TB. It's ironic to note that one of problems Koch was trying to find answers to was the tendency of medical professionals, excited by the recent discoveries of bacteria, to rush into finding infectious causes for everything, even where there were none, and their failure to distinguish between harmless "passenger" microbes and the pathogens actually responsible for illness.

  There are four postulates, and when all are met, the case is considered proved beyond reasonable doubt that the disease is infectious and caused by the suspected agent. HIV as the cause of AIDS fails every one. 232

  (1) The microbe must be found in all cases of the disease.

  By the CDC's own statistics, for 25 percent of the cases diagnosed in the U.S. the presence of HIV has been inferred presumptively, without actual testing. And anyway, by 1993, over four thousand cases of people dying of AIDS diseases were admitted to be HIV-free. The redefinition of the criteria for AIDS introduced during that year included a category in which AIDS can be diagnosed without a positive test for HIV. (How this can be so while at the same time HIV is insisted to be the cause of AIDS is a good question. The required logic is beyond my abilities.) The World Health Organization's clinical case-definition for AIDS in Africa is not based on an HIV test but on certain clinical symptoms, none of which are new or uncommon on the African continent. Subsequent testing of sample groups diagnosed as having AIDS has given negative result in the order of 50 percent. Why diseases totally different from those listed in America and Europe, now not even required to show any HIV status, should be called the same thing is another good question.

  (2) The microbe must be isolated from the host

  and grown in a pure culture.

  This is to ensure that the disease was caused by the suspect germ and not by something unidentified in a mixture of substances. The tissues and body fluids of a patient with a genuine viral disease will have so many viruses pouring out of infected cells that it is a straightforward matter—standard undergraduate exercise—to separate a pure sample and compare the result with known cataloged types. There have been numerous claims of isolating HIV, but closer examination shows them to be based on liberal stretchings of what the word has always been understood to mean. For example, using chemical stimulants to shock a fragment of defective RNA to express itself in a cell culture removed from any active immune system is a very different thing from demonstrating active viral infection. 233 In short, no isolation of HIV has been achieved which meets the standards that virology normally requires. More on this later.

  (3) The microbe must be capable of reproducing the original disease when introduced into a susceptible host.

  This asks to see that the disease can be reproduced by injecting the allegedly causative microbe into an uninfected, otherwise healthy host. It does not mean that the microbe must cause the disease every time (otherwise everyone would be sick all the time).

  Two ways in which this condition can be tested are injection into laboratory animals, and accidental infection of humans. (Deliberate infection of humans would be unethical). Chimpanzees ha
ve been injected since 1983 and developed antibodies, showing that the virus "takes," but none has developed AIDS symptoms. There have been a few vaguely described claims of health workers catching AIDS from needle sticks and other HIV exposure, but nothing conclusively documented. For comparison, the figure for hepatitis infections is fifteen hundred per year. Hence, even if the case for AIDS were proved, hepatitis is hundreds of times more virulent. Yet we don't have a panic about it.

  (4) The microbe must be found present in the host so infected.

  This is irrelevant in the case of AIDS, since (3) has never been met.

  The typical response to this violating of a basic principle that has served well for a century is either to ignore it or say that HIV is so complex that it renders Koch's Postulates obsolete. But Koch's Postulates are simply a formalization of commonsense logic, not a statement about microbes per se. The laws of logic don't become obsolete, any more than mathematics. And if the established criteria for infectiousness are thrown away, then by what alternative standard is HIV supposed to be judged infectious? Just clusterings of like symptoms? Simple correlations with no proof of any cause-effect relationship? That's called superstition, not science. It puts medicine back two hundred years.

  Science by Press Conference