Duesberg On AIDS Causation: The Culprit Is Noncontagious Risk Factors

Editor's Note: Since 1987, Peter Duesberg, a University of California, Berkeley, retrovirologist, has been contending that HIV is not the cause of AIDS. Eight years after he first put forth his revolutionary hypothesis, dissenters from the once-gospel theory that HIV alone is the culprit have become more visible, and articles about Duesberg's hypothesis have appeared sporadically in the scientific and popular press (see story on page 1). Duesberg's assessment of the role of HIV, however, remains highly controversial; a number of researchers who support his contention that AIDS must be reconsidered nonetheless believe that HIV plays some role, perhaps operating with a cofactor or cofactors. In the interest of fostering an open discussion of the issue, and for the benefit of those who have not had the opportunity to read Duesberg's views offered in his own words, The Scientist presents the following essay. Would you have believed in 1984 that AIDS was infectious if you had known that not even one of the health-care workers who have treated more than 401,000 American AIDS patients over the last 10 years contracted AIDS from a patient--despite the absence of an antiviral vaccine or effective drug? No infectious agent that is so difficult to transmit could survive as a microbe. Moreover, the median age of the 15,000 total American HIV- positive hemophiliacs increased from 11 in 1972 to 27 in 1987, although they were all infected in the decade prior to 1984. From 1988 to 1993 their annual risk of AIDS diseases, not corrected for the normal incidence of HIV-free AIDS diseases, was constant at 2 percent (Centers for Disease Control and Prevention, HIV/AIDS Surveillance, 5:1-33, 1994; P.H. Duesberg, Genetica, in press). The hypothesis that HIV causes AIDS after 10 years predicts that more than half of them would have died by now. Furthermore, if HIV is a blood-borne virus, one would expect that recipients of HIV from transfusions would develop all AIDS-defining diseases, yet nobody ever contracted AIDS- Kaposi's sarcoma from a transfusion. In contrast to AIDS, all known infectious diseases are characterized by equal distribution between the sexes; the appearance of primary symptoms within days or weeks after infection, and prior to antimicrobial immunity; a common, active microbe in all acute cases; and patients who are generally under 20, with underdeveloped immune systems, or over 60, with failing immune systems. While sexually transmitted diseases share AIDS's age distribution (between 20 and 50), they are all equally distributed between the sexes. (For references on this and other points, see P.H. Duesberg, Proceedings of the National Academy of Sciences, 88:1575-9, 1991; P.H. Duesberg, Pharmacology and Therapeutics, 55:201-77, 1992; P.H. Duesberg, International Archives of Allergy and Applied Immunology, 103:131-42, 1994.) Owing to the relentless campaigns against viruses by epidemiologists and virologists, even scientists have forgotten that the vast majority of viruses never cause disease (retroviruses, adenoviruses, reoviruses, echoviruses, and so forth). Just like humans, viruses are here to continue their species, and they succeed best if they do this without harming their host, certainly without causing a fatal disease. Such viruses are called passenger viruses (Lionel Crawford in H. Fraenkel-Conrad, ed., Molecular Basis of Virology, New York, Van Nostrand Reinhold, 1968, pages 393-434). A passenger virus infects at totally unpredictable times (even 10 years!) prior to a disease, just like HIV, while a causative microbe is pathogenic within days or weeks. Given a generation time of two days and a yield of 100 HIVs per cell, AIDS should occur 14 days after infection if it were a causative microbe. By that time, HIV would have infected all 1014 cells of the body. Moreover, a passenger virus may be absent during a disease--as in the 4,621 HIV-free cases of AIDS reported in the literature. And, if present, a passenger virus can be active or passive during disease. In the majority of AIDS patients, active HIV cannot be found, only antibodies against the virus. Because of antiviral immunity, HIV infects only about one in 1,000 T cells of AIDS patients. There are only a minority of cases in the literature in which HIV is found in moderate or high titers. Thus, I propose that HIV is merely a passenger virus, which does not cause any disease. Diseases can be "acquired" by microbes--but are now acquired in the U.S. and Europe much more often by drugs. There are 50 million smokers and many millions of alcoholics in the U.S. "acquiring" emphysema, lung cancer, and liver cirrhosis. And millions use illicit recreational drugs. In view of this, I propose that all AIDS diseases in America and Europe that exceed their long-established, normal backgrounds are caused by the long-term consumption of illicit recreational drugs and by AZT and its analogs. The normal low background of AIDS-defining diseases like tuberculosis, diarrhea, and pneumonia would be a consequence of their long- established causes. Hemophilia-AIDS, transfusion-AIDS, and the extremely rare AIDS cases of the general population reflect the normal incidence of the AIDS-defining diseases, plus the AZT-induced incidence of these diseases under a new name. "African AIDS" is likewise a new name for old diseases caused by malnutrition, parasitic infections, and poor sanitation. The drug hypothesis predicts American/European AIDS precisely: American AIDS will be restricted to intravenous and oral users of recreational drugs and of AZT. Since 1981, 94 percent of all American AIDS cases have been from risk groups who had used such drugs. About one-third of these were intravenous drug users (CDC, HIV/AIDS Surveillance Report, 6:1-27, 1994) and two-thirds were male homosexuals who had used oral recreational drugs and AZT. The drug correlation is even better than 94 percent if those HIV- positive hemophiliacs and transfusion recipients receiving AZT are included. American AIDS predominantly affects adult males, because they are the predominant users of recreational drugs and AZT. CDC reports that 87 percent of all American AIDS patients are males. This number is the sum of the following constituents: First, the National Institute on Drug Abuse (NIDA) and the Bureau of Justice Statistics report that more than 75 percent of hard, recreational drugs are consumed intravenously by males. Second, CDC and independent investigators report that nearly all male homosexuals with AIDS and at risk for AIDS are long-term users of oral drugs such as nitrite inhalants, ethylchloride inhalants, amphetamines, cocaine, and others to facilitate sexual contacts, particularly anal intercourse (A.R. Lifson et al., American Journal of Epidemiology, 131:221-31, 1990; M.S. Ascher et al., Nature, 362:103-4, 1993). And third, many HIV-positive homosexuals are prescribed AZT. American AIDS is new because the American drug-use epidemic is new. In the U.S., recreational drug use is epidemiologically new, as it has increased over the last two decades from statistically undetectable levels to epidemic levels at about the same rate as AIDS. Cocaine consumption increased 200-fold from 1980 to 1990, based on cocaine seizures that increased from 500 kg in 1980 to 100,000 kg in 1990. During the same time cocaine-related hospital emergencies increased from 3,296 cases in 1981 to 80,355 cases in 1990 and 119,843 in 1992. Amphetamine consumption has increased 100-fold from 1980 to 1990 (Bureau of Justice Statistics, Catalog of Federal Publications on Illegal Drug and Alcohol Abuse, Washington, D.C., U.S. Department of Justice, 1991). According to a recent report from NIDA and CDC, "nitrite use has increased in the 1990s in gay men in Chicago and San Francisco" after a decline in the 1980s. And in 1992 alone, 200,000 HIV-positives were given AZT. Only a small fraction of drug users will get AIDS. The cumulative total of 401,749 American AIDS cases since 1981 that were reported in June 1994 have been recruited from a much larger reservoir of drug users. There were 8 million cocaine addicts in the U.S. in 1992. In 1980, 5 million Americans had used nitrite inhalants. In 1989, 100 million doses of amphetamines were consumed in the U.S. In addition, about 150,000 HIV-positive Americans were on AZT in 1992. The small percentage of AIDS patients among the many American drug users represents the heaviest drug abusers, just as lung cancer and emphysema generally occur among the heaviest smokers. The long "latent period of HIV" is a euphemism for the time that its human host needs to accumulate sufficient drug dosage for AIDS. Specific drugs cause specific AIDS-defining diseases. Indeed, group-specific drug use explains risk-group-specific AIDS diseases. For example, Kaposi's sarcoma as an AIDS diagnosis is 20 times more common among homosexuals who use nitrite inhalants than among AIDS patients who are intravenous drug users or hemophiliacs. Because of their carcinogenic potential, nitrites were originally proposed as causing Kaposi's sarcoma (H.W. Haverkos, J.A. Dougherty, eds., Health Hazards of Nitrite Inhalants, NIDA Research Monograph 83, Washington, D.C., U.S. Department of Health and Human Services, 1988). "Aggressive and life-threatening" Kaposi's sarcoma is observed exclusively in male homosexuals (E. Sloand et al., Southern Medical Journal, 86:1219-24, 1993), 32 percent of which occur in the lungs--the primary site of exposure to nitrite inhalants (D.H. Irwin, L.D. Kaplan, Seminars in Respiratory Infections, 8:139-48, 1993). Eighty percent of pediatric AIDS cases in America and Europe are also predicted by the drug hypothesis. These children were born to mothers who were intravenous drug users during pregnancy. The remainder reflects the normal incidence of AIDS-defining diseases among newborns. The abundant AIDS literature in fact includes conclusive evidence that cessation of drug use prevents, stabilizes, or cures AIDS-defining diseases. For example, 10 out of 11 HIV-positive, AZT-treated AIDS patients recovered cellular immunity after discontinuing AZT in favor of an experimental vaccine (M. Scolaro et al., Lancet, 337:731-2, 1991). Since AZT is now licensed for treatment or prevention of AIDS, no large-scale studies have been done in which patients are taken off AZT. Another investigation found that the T-cell counts of 65 HIV- positive intravenous drug users from New York dropped 35 percent over nine months, compared with stable T-cell counts for HIV-positive controls who had stopped injecting (D. Des Jarlais et al., AIDS, 1:105-11, 1987). In yet another report, the T cells of 29 percent of 1,020 HIV- positive male homosexuals and intravenous drug users even increased over two years (M.D. Hughes et al., Journal of Infectious Diseases, 169:28-36, 1994). These HIV-positives belonged to the placebo arm of an AZT trial for AIDS prevention and thus were not intoxicated by AZT. There was no mortality reported among a group of 918 British HIV-positive homosexuals who had "avoided the experimental medications on offer" and chose to "abstain from or significantly reduce their use of recreational drugs, including alcohol" during the course of a study lasting 1.25 years (J. Wells, Capital Gay, Aug. 20, 1993, pages 14-15). Assuming a 10-year latent period from HIV to AIDS, the virus AIDS hypothesis would have predicted at least 115 AIDS cases among 918 HIV-positives over 1.25 years (918/10 x 1.25). Furthermore, as of July 1, 1994, there was still not a single AIDS case in this group (J. Wells, London, personal communication). In sum, the drug AIDS hypothesis correctly predicts all aspects of American/European AIDS, while the HIV hypo-thesis predicts none. The solution of AIDS could be as close as a very testable, and very affordable, al-ternative hypothesis. Peter Duesberg is a professor of molecular and cell biology at the University of California, Berkeley.

Duesberg On AIDS Causation: The Culprit Is Noncontagious Risk Factors

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