Rethinking AIDS

By Huw Christie
BIG SCIENCE: AIDS Disputes
INDEX ON CENSORSHIP 3 1999

A whole industry, involving big business, political interests, personal ambition and large sums of money, has evolved around AIDS. Its pronouncements go largely unchallenged within the scientific establishment, and those who dare criticise or question orthodoxies are silenced

In so far as is possible to establish a coherent 'orthodoxy' in the fractured world of HIV/AIDS research, this would hold that a singular syndrome of by now 29 or 30 previously known illnesses (the number depends on your national medical jurisdiction), often linked by immune deficiency as interpreted from cell counting, is caused by a retrovirus HIV that is transmitted through body fluids and kills immune cells. Once infected, a person may remain well for a time, though infectious to others, before going on to develop AIDS and, if untreated, dying with dramatic speed. There is no overall cure though there are experimental drug therapies to slow the disease and CD4 (T-cell) and Viral Load counts to quantify pathology.

That the 'probable cause of AIDS' had been discovered at all in 1984 was a political Golden Fleece for the Reagan government; the announcement at a Washington press conference that it was a retrovirus was equally satisfying for the seasoned National Institutes of Health (NIH) virologist Robert Gallo, who was claiming to have discovered it.

Unfortunately, he was not the only one making claims. In the months leading up to the announcement, the race to identify an infectious cause of the described syndrome AIDS (or GRID - Gay Related Immune Deficiency - as it was still occasionally known in those days) had generated fierce competition between Gallo's laboratory and that of Luc Montagnier at the Pasteur Institute in Paris. But although Gallo and the NIH were granted their US HIV-test patents the day of the press conference, Montagnier's had been put on hold. A subsequent investigation led to Gallo's conviction by a Senate committee for scientific misconduct (cleared on appeal) for misappropriating French data and photographs.

The ensuing dispute over who 'discovered HIV', the French or the Americans, was resolved only in 1987 when the governments concerned settled the matter between them. The document that was eventually agreed included an 'official history' of events by the two leading virus-hunters. This contains a clause binding them neither 'to make nor publish any statement which would or could be construed as contradicting or compromising the integrity of the said history', and to share credit for 'the discovery'. Observed British historian Jad Adams: 'If scientific fraud is the worst professional crime a scientist can conceive of, probably the worst for a historian is the rewriting of history to accommodate some establishment view.'

In the UK, Professors Robin Weiss and Richard Tedder took patents on their own locally developed version of an HIV antibody test for the pharmaceutical giant Burroughs Wellcome, the company that also went on to deliver the only licensed anti-viral drug for test-positive people, AZT, for several years.

The pivotal political scoop of a government press conference announcing the discovery of the 'probable cause' of AIDS blazed in US and world headlines before a single scientific paper had been made available to the scientific community for scrutiny through peer-review and publication - a fact made much of by scientists dubious to this day of Gallo's claims all those years ago. Gallo's four papers suggesting isolation of a retrovirus were published in Science some three weeks after the Washington jamboree to a mixture of derision and enthusiasm. His virus isolation methodology left much to be desired, and when (illogically, said some scientists) he had used antibody tests rather than virus isolation from the blood of patients diagnosed with AIDS, his first experimental batch had yielded a very low rate of antibody positives; inexplicably, his second batch was very high. Eyebrows were raised. On the other hand, a silent deadly invader had been invoked, and those so motivated could turn their minds to combat. A vaccine was promised for use in two years.

Analysts of HIV/AIDS realpolitik have noted that few people at the time recalled 'the first ever human retrovirus', HL23V, also invoked by Robert Gallo, together with Robin Weiss, in the mid-1970s. As its discoverer, he published electron microscope images of virus-like particles. Antibody tests very like those available for HIV diagnosis purported to detect HL23V specifically. Within three years, as the antibody tests reacted positive on unconscionable numbers of the population, even Gallo himself agreed there was no such virus: he blamed his error, at least in part, on genetic contamination in the laboratory among sections of three monkey viruses. Further scrutiny decisively reversed his conclusions.

Since 1987, opposition to the hypothesis of a new retrovirus causing AIDS has developed along two main axes: Peter Duesberg of the US National Academy of Sciences contends that HIV would be the only human retrovirus to cause illness, and it doesn't; Eleni Eleopulos's Perth Group holds that the putative identification of HIV, perhaps like that of other human retroviruses, is one more misinterpretation of biological markers. Both predict the emergence of long-term survivors of HIV diagnosis - without having received anti-retroviral therapy - and, as this was increasingly demonstrated by the facts, their dissenting views, long rejected out of hand, began to gain credence.

Eleopulos, of the Medical Physics Department of the Royal Perth Hospital, Western Australia, was eventually endorsed by the scientific publishing mainstream in 1993 when her team's seminal paper 'Does a positive Western blot prove HIV infection?' appeared in Bio/technology, (now Nature Bio/technology). The paper presented abundant evidence that so-called 'HIV antibody tests' have never been validated against conventional detection and isolation of an actual virus ('HIV'); that the term 'virus isolation' was misleadingly applied in 1984; that a range of stimuli that are not a human immunodeficiency virus can be responsible for what are interpreted as HIV antibodies in test-positive people (including, reported later, 88 per cent of 'AIDS-defining' illnesses themselves, principally the fungal and mycobacterial); and that insofar as there is a unifying factor behind AIDS-defining illnesses in the so called risk groups, a theory of group/behavioural-specific oxidative stresses explains the mechanisms and predicts effective antioxidant therapy.

If this work were gaining credence, it may explain the publication last year of Oxidative Stress in Cancer, AIDS and Neurogenerative Diseases, with one Luc Montagnier as principal editor, seems to indicate growing interest in alternatives to the generally accepted view.

Nonetheless, clinical practice in HIV/AIDS is no more amenable to scientific revision than in other areas of medicine. The daily clinical round of HIV/AIDS focuses on immune system CD4/T-cell counting - 4 HIV is killing your CD4s quickly/slowly - and Viral Load Tests - you have x thousand viruses in each millilitre of your blood and it's rising/falling. Medical and scientific proponents of a re-evaluation of the HIV hypothesis argue that both these measuring procedures for indirect biological markers of presumed pathology depend on oversimplified interpretive applications of rootless technology.

CD4 counting (for the immune system cells known as Cluster Differentiation 4) is dogged by an acknowledged margin of error: any numerical result per millilitre in fact represents a range of approximately plus or minus 120 - although treatment decisions and patients' subjective well-being often depend on specific numerical values. And CD4 monitoring is rendered deeply ambiguous by the persistent failure to find evidence of the untoward destruction of T-cells in patients diagnosed with AIDS (as opposed to the redistribution of cells away from peripheral blood, or their transformation into CD-another cells). Least of all has there been any proof of CD4 destruction by lab cultures of 'HIV', a fact noted by a curious Montagnier among others.

The Viral Load test, a more recent addition to the clinical arsenal, has been lambasted by the inventor of its basic Polymerase Chain Reaction (PCR) technique, Nobel Prize-winning chemist Katy Mullis. He calls the use of his genetic amplification method for counting an 'oxymoron', inappropriate for 'AIDS-medicine'. In addition, say other scientists, there has never been agreement on the genetic structure of HIV which the PCP, seeks to amplify: there have been 19 discordant claims to have analysed a complete HIV genome.

This, say anti-HIV scientists, may be an inevitable consequence of the failure to purify or isolate any HIV when it was first 'discovered' or at any time since. In an interview published last year, Montagnier stated that he never presented any electron microscope images of purified HIV back in 1984/85, despite great efforts, because at the appropriate experimental density in test solution his team found no particles with 'morphology typical of retroviruses.' Pressed by the astonished interviewer, Djamel Tahi, Montagnier confirmed: 'I repeat, we did not purify.'

The Viral Load test is also problematic. It aims to amplify a fragment of just one HIV gene, yet traditional teaching texts hold that the healthy human genome contains over a hundred dormant quasi-retroviral genetic sequences, expression of which can be stimulated with oxidation. Without purifi-cation/isolation and characterisation of a genome of exogenous, infectious HIV, it is, therefore, a matter of guesswork as to exactly what the genetic fragments being found in people consenting to Viral Load tests derive from. Are they fragments of viral or human code?

Recently published accounts of positive Viral Load results in HIV-antibody negative people, and the clinically accepted margin of error in Viral Load testing - plus or minus 300 per cent - add to growing dis-quiet over the meaning and application of this reputedly 'smart' technology. Nor does the recent claim, universally and uncritical-ly reported, of the detection of the origins of HIV in chimpanzees offer any answers. The researchers had to cobble together a would-be viral genome: 'Because virus iso-lation from the autopsy tissues was unsuc-cessful, we used PCR to amplify four over-lapping subgenomic fragments'.

The other major area of analysis for the 'AIDS dissidents' is the prescription and use of anti-HIV drugs. The first, AZT, came into use in 1987, having sat on the shelf because of its excessive toxicity since its development as an anti-cancer agent in 1963. The large Anglo-French study of AZT, the Concorde Trial, co-sponsored by the UK Medical Research Council, found a 25 per cent higher mortality in asympto-matic people who took it than in those who didn't. Current anti-HIV medications, pro-tease (enzyme) inhibitors (PIs), often used in combination still with AZT and its like, were heralded at the pharmaceutical com-pany-sponsored Vancouver AIDS Conference in 1996, but are now acknowl-edged to be dangerous and of unclear bene-fit. The UK's All Party Parliamentary Group on HIV/AIDS reported in July last year: 'Serious side effects and long-term difficulties with this class of drugs are now emerging and have been shown to affect the majority of people taking them'. It encour-aged 'regimes that do not contain a PI'.

For want of a true gold standard (puri-fied, isolated HIV), there are currently at least nine differing official criteria world-wide for HIV-antibody positivity, even on the more respected of the HIV-antibody tests, the Western blot. A person can legal-ly test positive in Africa and negative in Australia, or negative in the US Red Cross and positive in the CDC (Centers for Disease Control and Prevention).

Fresh research from New York University Hospital shows that if a person's blood is not diluted 400 times before testing, everybody reacts positive on an HIV-antibodv test, demolishing the 15-year-old proposition that HIV antibodies are made only in response to HIV The results of the research imply either that HIV tests cannot reliably detect HIV, or that there is a 100 per cent public prevalence of HIV infection, albeit in many people at low levels, The pre-emptive legal defence by test-kit manufacturers in their product literature - 'At present there is no recognised standard for establishing the presence or absence of HIV antibody in human blood' - is essential, given that imprecision on this scale is a serious liability.

According to Perth Group scientist Dr Valendar Turner, in a 1998 report commissioned from Meditel Productions for the UK's Channel 4 ,News but never shown: 'If there is such a thing as an AIDS-causing retrovirus, then its unique body parts, that is its proteins, should only be found in HIV-positive individuals and individuals who have AIDS. But this is not the case. All the principle HIV proteins have been found in all manner of cells from healthy human beings who are HIV-negative.' Despite the fierce controversies that have dogged the history of HIV/AIDS research over the years, a resolution may be in sight. At last year's World AIDS Conference in Geneva, the Eleopulos team, and other scientists, including French electron microscope pioneer Professor Etienne de Harven, German virologist Dr Stefan Lanka and British epidemiologist Professor Gordon Stewart, officially presented for the first time at conference the data that challenge claims to have isolated and proved the existence of HIV, and to have established the specificity of HIV tests. Publication along these lines increases monthly. The implications culturally, legally, scientifically and medically of even a partial recognition that AIDS was defined by its own forging of a technocratic cul-de-sac would be extensive and profound, though not, perhaps, altogether unbearable.

Huw Christie is the editor of Continuum, the London-based magazine dedicated to providing a fuller understanding of HIV/AIDS