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30 Mar 2004 15:30:47 -0000

Aids & HIV?

press-release

 

 

The Institute of Science in Society Science Society

Sustainability http://www.i-sis.org.uk

 

General Enquiries sam Website/Mailing List

press-release ISIS Director m.w.ho

========================================================

 

AIDS & HIV?

***********

 

Does HIV cause AIDS? Is AIDS a single disease? Do anti-viral

drugs really help? Dr. Mae-Wan Ho investigates

 

 

A fully referenced version of this report is posted on ISIS

member's website. www.i-sis.org.uk/membership.php

 

 

Box 1

*****

AIDS as commonly defined AIDS (Acquired Immune

Deficiency Syndrome) is the final and most serious stage of

Human Immunodeficiency Virus (HIV) disease. HIV causes AIDS.

The virus attacks the immune system and leaves the body

vulnerable to a variety of life-threatening illnesses and

cancers.

 

HIV is transmitted through sexual contact, through blood

(via blood transfusions) or needle sharing (in injecting

drugs use), and from mother to child in pregnancy or during

nursing.

 

The Centers for Disease Control has defined AIDS as

beginning when a person with HIV infection has a CD4 cell (a

type of immune cell) count below 200. It is also defined by

numerous opportunistic infections and cancers that occur in

the presence of HIV infection.

 

The symptoms of AIDS are primarily the result of infections

that do not normally develop in individuals with healthy

immune systems. These are called “opportunistic infections.”

 

Common symptoms are fevers, sweats (particularly at night),

swollen glands, chills, weakness, and weight loss.

 

The AIDS-related infections and cancers that people with

AIDS acquire as their CD4 count decreases are as follows.

 

CD4 count below 350/ml: Herpes Simplex Virus causing ulcers

in the mouth or genitals; Tuberculosis;oral or vaginal

thrush due to yeast infection; Herpes zoster causing ulcers

over a discrete patch of skin; non-Hodgkins lymphoma or

cancer of the lymph glands.

 

CD4 count below 200/ml: Pneumocystis carinii pneumonia;

Candida esophagitis (painful yeast infection of the

esophagus)

 

CD4 count below 100/ml: Cryptococcal meningitis (infection

of the brain by this fungus); AIDS Dementia; Toxoplasmosis

encephalitis (infection of the brain by this parasite

frequently found in cat feces); progressive multifocal

leukoencephalopathy (a viral disease of the brain caused by

the JC virus that results in a quick decline in cognitive

and motor functions); wasting syndrome (extreme weight loss

and anorexia)

 

CD4 count below 50/ml: Mycobacterium Avium (a blood

infection by a bacterium related to tuberculosis;

Cytomegalovirus infection (a viral infection that can affect

almost any organ system, especially the eyes.

 

There is currently no cure for AIDS. However, several

treatments are available that can delay the progression of

disease for many years and improve the quality of life of

those who have developed symptoms. Antiviral therapy

suppresses the replication of the HIV virus in the body. A

combination of several antiretroviral agents, termed Highly

Active Anti-Retroviral Therapy (HAART), has been highly

effective in reducing the number of HIV particles in the

blood stream (as measured by a blood test called the viral

load). This can help the immune system bounce back for a

while and improve T-cell counts.

 

However, HIV tends to become resistant in patients who do

not take their medications every day. Also, certain strains

of HIV mutate easily and may become resistant to HAART

especially quickly.

 

Treatment with HAART is not without complications. HAART is

a collection of different medications, each with its own

side effect profile. Some common side effects are nausea,

headache, weakness, malaise, and fat accumulation on your

back and abdomen ( " buffalo hump, " lipodystrophy). When used

long-term, these medications may increase the risk of heart

attack by affecting fat metabolism.

 

Medications are also used to prevent opportunistic

infections (such as Pneumocystis carinii pneumonia) and can

keep AIDS patients healthier for longer periods of time.

Source: Medical Encyclopedia, MedlinePlus, updated 6/12/2002

*****************************************************

 

 

“HIV is not the cause of AIDS”

 

******************************

 

Peter Duesberg was, and still is, professor of molecular

biology at the University of California at Berkeley, member

of the National Academy of Sciences and recipient of a 1985

Outstanding Investigative Grant from the National Institutes

of Health. He was tipped as a Nobel candidate for his work

on viral oncogenes (genes causing cancer).

 

But all that came to a crashing end in 1987, when he

published a paper [1] claiming that HIV did not cause AIDS,

contrary to what the scientific community had come to

believe to this day (Box 1), but was instead the result of

drug use. He soon lost all his research grants, but that has

not silenced him.

 

Ironically, Duesberg’s hypothesis was generally held before

the idea that HIV caused AIDS became accepted (see Box 2).

 

Box 2

*****

A brief history of HIV-AIDS hypothesis In 1981,

a new epidemic began to strike male homosexuals and

intravenous drug users in the United States and Europe. The

US Centers for Disease Control (CDC) termed the epidemic,

AIDS, for acquired immunodeficiency syndrome.

 

Between 1981 and 1984, leading researchers, including those

from CDC proposed that recreational drug use was the cause

of AIDS.

 

But in 1984, the US government researchers proposed that a

virus, now termed human immunodeficiency virus (HIV), is the

cause of the epidemic in US and Europe, and also in Africa.

 

This hypothesis - HIV causes AIDS – gained instant

acceptance within the scientific community.

 

**************************

 

Within a few years of Duesberg’s paper, HIV-negative AIDS

cases began to turn up, and people started to take notice of

his theory, which has been refined over the years together

with his colleague David Rasnick and others.

 

In a hefty review published in June 2003, Duesberg and

Rasnick, together with Claus Koehnlein from Kiel, Germany

[2] presented a long list of questions (“paradoxes”) that

the HIV-AIDS hypothesis cannot answer, or at least not

satisfactorily according to the usual understanding of a

viral disease.

 

One major difficulty that AIDS dissidents have with the HIV-

AIDS hypothesis is that the HIV virus is very unusual. It

cannot readily be isolated from the AIDS patients. The

‘viral load’ measured in patients refers, not to actual

virus present, but to the amount of viral DNA fragments that

can be amplified by PCR from the RNA of a rare virus or of

DNA of rare latently infected cells from the patient.

 

But defenders of the HIV-AIDS hypothesis have no difficulty

at all in acknowledging that HIV is a strange new virus that

can remain latent for years, being held in check by the

body’s immune system, which, nevertheless finally succumbs

to the virus (see “Can exercise help AIDS?” this series).

 

The most contentious of Duesberg’s claim is that AIDS is not

contagious, and not sexually transmitted. That, his

infuriated critics say, is simply to encourage people to

have unprotected sex, and to use dirty needles for injecting

drugs, both of which would expose them to high risks of

infection with HIV and a host of other disease agents

besides. Yet, that is perhaps the single point on which

Duesberg and Rasnick are most adamant. Rasnick has stated

categorically, “I want to stress that AIDS is not

contagious, sexually transmitted or caused by HIV or any

other virus.” And he is able to cite at least as many papers

to support his thesis as his opponents can to refute him.

 

“HIV does not cause AIDS, it is just a harmless passenger

virus,” that’s the claim of Duesberg and colleagues. The WHO

(World Health Organization) estimates that 34.3 million are

HIV-positive worldwide in 2000, yet only 1.4% developed

AIDS. Similarly, in 1985, only 1.2% of the 1 million US

citizens with HIV developed AIDS.

 

Defenders of HIV-AIDS hypothesis will readily admit that the

progression from HIV infection to AIDS disease may indeed

take years, though it will almost invariably happen.

 

Like all passenger viruses, it is inherited, i.e.,

transmitted from mother to offspring, but is not infectious.

AIDS disease in infants and children, Duesberg and Rasnick

claim, results from prenatal consumption of recreational and

anti-HIV drugs by unborn babies through their mothers. That

too is a very contentious claim.

 

Duesberg and colleagues charge that, “the HIV-AIDS

hypothesis has remained entirely unproductive” to this day.

There is as yet no anti-HIV-AIDS vaccine, no effective

prevention and not a single AIDS patient has ever been

cured. Those are “the hallmarks of a flawed hypothesis”.

 

A much more productive hypothesis, they say, is that AIDS is

a collection of chemical epidemics, caused by recreational

drugs, anti-HIV drugs, and malnutrition.

 

The Durban Declaration

 

**********************

 

Duesberg is by no means a lone voice. A growing number of

“AIDS dissidents” within the scientific community posed such

a threat to the establishment that a remarkable “Durban

Declaration” was made in Durban, South Africa, as thousands

were about to gather for the 13th International AIDS

Conference in July 2000. The Declaration began: “HIV causes

AIDS. Curbing the spread of this virus must remain the first

step towards eliminating this devastating disease” The

Declaration, published in Nature [3], was signed by over 5

000, including Nobel prizewinner, directors of leading

research institution, scientific academies and medical

societies, such as US national Academy of Sciences, Max

Planck Institutes, the Pasteur Institute in Paris, the Royal

Society of London, the AIDS society of India and the

National Institute of Virology in South Africa.

 

At the time, President Mbeki of South Africa had assembled a

Presidential AIDS Advisory Panel, which included Duesberg

and Rasnick among other AIDS dissidents, together with many

scientists holding the conventional view. Duesberg and

Rasnick were among the 11 co-authors who signed a rebuttal

to the Durban Declaration, published in Nature

correspondence [4], stating that they “reject as outrageous”

the attempt to outlaw open discussion of alternative

viewpoints; it was an act of intolerance “which has no place

in any branch of science.”

 

The full report of the Presidential AIDS Advisory Panel

published a year later [5] makes fascinating reading. It is

the best summary of the rather complex debate over all

aspects of AIDS, from causation to therapy. Unfortunately,

none of the scientific papers cited by the panel members

during the debate was included in the report.

 

 

 

AIDS is a collection of disparate diseases

 

******************************************

 

The starting point to this controversy is the disparate

nature of the diseases that have been lumped together as

AIDS. Even a staunch defender of the HIV-AIDS hypothesis,

Helene Gayle, then director of the US Centers for Disease

Control’s National Center of HIV, STD a nd TB Prevention,

and now director Bill and Melinda Gates Foundation’s HIV, TB

and Reproductive Health Program, admitted at the end of the

Presidential AIDS Advisory Panel debate, that there is a

general lack of standardization of the definition of AIDS

throughout the world [5]. After 15 years of research there

is the lack of a ‘gold standard’ against which to measure

the accuracy and reliability of the data generated from the

commonly used methods to diagnose HIV infection; and the

major task ahead was to develop such a golden standard.

Duesberg and colleagues show that different “risk groups”

for AIDS disease have different conglomerates of “AIDS-

defining” diseases. While Duesberg believes the AIDS disease

does exist, Rasnick has argued consistently that AIDS does

not exist and that it would “disappear instantaneously if

all HIV testing was outlawed and the use of antiviral drugs

terminated.”

 

For example, Kaposi’s sarcoma (a form of cancer) and

Pneumocystis pneumonia are highly representative diseases

among male homosexuals. But both of those are absent or rare

among African AIDS cases. Similarly, tuberculosis is highly

represented among Africans but absent or rare among male

homosexuals. More tellingly, haemophiliacs who risk

infection from blood transfusions have no highly

representative diseases at all, only two common infections -

yeast and Pneumocystis pneumonia - thereby distinguishing

them from all other risk groups.

 

 

 

AIDS and recreational drugs

 

***************************

 

At least 35 published studies have linked illicit

recreational use of drugs such as nitrite and other

inhalants, amphetamines, cocaine, heroin, steroids, with

AIDS, the most recent published in 2002. Shortly after the

AIDS epidemics in US and Europe began, researchers have

indeed found that illicit psychoactive and aphrodisiac drugs

consumed at massive doses were the common factors and

probable causes of AIDS. Drugs such as cocaine, heroin,

nitrite inhalants, amphetamines, steroids and lysergic acid

had become widely available and popular in US and Europe in

the “drug explosion” during and after the Vietnam war, which

coincided with the era of “gay liberation”.

 

The drug explosion rose steeply from 1980 to a peak between

1990 and 1995, and thereafter declined due to government

crackdown. The time course of the drug explosion correlates

well with the number of AIDS cases, which rose from zero in

1980 to a sharp peak between 1992 and 1993 before declining

sharply. Data from the CDC (Centers for Disease Control) for

1983 showed that all 120 male homosexual at risk for AIDS

and 50 with AIDS were drug users. Consequently, many AIDS

researchers favoured the hypothesis that drug-use or

“lifestyle” was the cause of AIDS well into the 1990s [6].

 

“African ‘epidemic’ caused by poverty”

 

**************************************

 

In contrast, the African epidemic is caused by poverty -

malnutrition and lack of drinkable water [7,8] – which is

consistent with its random distribution in the population.

According to some researchers, it is the same traditional

diseases of the poor reclassified as AIDS (see “African AIDS

epidemic?” this series). The problems begin with the

diagnosis of AIDS, which, in Europe and the United States

though not in Africa, is based on detecting anti-HIV

antibodies that is poorly standardized and prone to false

positives, and also poorly correlated with the presence of

the virus or other ‘surrogate markers’ of AIDS disease, such

as the level of CD4+ cells. According to Duesberg [5],

African studies of patients diagnosed clinically as having

AIDS showed that 50% were later found to be HIV-negative,

that is, free of anti-HIV antibodies.

 

African AIDS also have a different conglomerate of “AIDS

defining” diseases compared to other risk groups (see

above).

 

 

 

“AIDS caused by anti-AIDS drugs”

 

********************************

 

Most if not all HIV positive individuals with no sign of

AIDS disease would remain healthy, according to Duesberg,

especially if they avoid anti-HIV drugs like AZT and newer

cocktails. Since 1987, thousands of US citizens and

Europeans with AIDS, and since 1990, even larger numbers of

healthy HIV-positive people have been placed on lifetime

prescriptions of toxic drugs like azidothymidine (AZT),

which terminates DNA synthesis, and protease inhibitors

aimed at suppressing assembly of the virus. Since 1996, DNA

chain-terminators were mixed with HIV protease inhibitors in

drug cocktails.

 

By 2002, more than 450 000 US citizens were taking drug

cocktails to prevent or cure AIDS, and well over half of the

450 000 were clinically healthy at the time they started the

anti-HIV drugs. The healthy HIV-positives were treated

according to the slogan, “Time to hit HIV, early and hard”,

introduced by the New England Journal of Medicine in 1995

[9].

 

Duesberg and colleagues cited at least 63 scientific papers

documenting diseases and death of HIV positive people placed

on anti-HIV drugs over and above those in untreated

controls. The diseases include AIDS-defining ones like

immunodeficiency, leukopenia (low white blood cell count),

fever, dementia, weight loss, lymphoma and diarrhoea; plus a

host of others that are non-AIDS defining: anaemia,

neutropenia (low neutrophil count), nausea, lipodystrophy

(redistribution of body fat), muscle atrophy, mitochondrial

dysfunction, hepatitis, birth defects, nephritis

(inflammation of the kidney), lactic acidosis, heart

infarct.

 

Similarly, at least 12 papers describe diseases and death in

HIV negative human babies and in HIV negative animals

treated with anti-HIV drugs before and after birth. The HIV

negative babies were born to mothers who have all been

treated with AZT, which was found to reduce the natural

transmission of HIV by 50% to 70%.

 

When the HIV infected infants born to mother taking AZT

during pregnancy, however, the results showed that the

children born to AZT+ mothers were 1.8 times more likely to

develop severe disease, 2.4 times more likely to have severe

immune suppression, and 3.2 times more likely to die than

those born to AZT- mothers [10].

 

There is little doubt that the drugs are associated with

numerous side effects including those that are “AIDS

defining”. Evidence of toxicities has been accumulating

throughout the late 1990s. This finally led the US

government to appoint a panel of AIDS researchers to review

the situation. In 2001, it issued recommendations to

restrict prescriptions of anti-HIV drugs, and that [11]

“treatment for the AIDS virus be delayed as long as possible

for people without symptoms because of increased concerns

over toxic effects of the therapy.”

 

 

 

Why not test Duesberg’s chemical hypothesis?

 

***********************************

 

Although there is extensive circumstantial evidence to

support Duesberg’s chemical hypothesis, at least for some

significant population of patients diagnosed with AIDS, it

is difficult to prove without appropriate long-term

controlled trials of anti-viral drugs. If they are right,

they claim, “AIDS would be entirely preventable by banning

anti-HIV drugs, by publicizing that recreational drugs cause

AIDS and by adequate nutrition. Moreover, many AIDS patients

could still be saved from fatal damage by drug intoxication,

if their AIDS-defining diseases were treated with time-

proven, disease-specific medications.”

 

If they are wrong, then many AIDS sufferers who could

benefit from anti-HIV therapy, will be misled. Though this

problem can be addressed by much more closely monitored and

selective anti-HIV drug administration.

 

Many researchers who think that HIV does cause AIDS, admit

that progression to disease – defined by low CD4 cell count

and high viral load (see Box 1) - can vary, and can be

significantly affected by cofactors including injecting drug

use and malnutrition. Others believe that HIV is necessary,

though not sufficient, for causing AIDS disease. Vejko

Veljkovic, AIDS virologist in Belgrade, Yugoslavia, says,

“AIDS is syndrome and its different manifestations in

different risk groups is not surprising because cofactors

which plays an important role in the AIDS development are

different.” Thus, toxic chemicals and drugs may be among the

cofactors that trigger the AIDS disease. Many cofactors

induce the production of cytokines, and can suppress the

immune system independent of HIV.

 

So why do current AIDS researchers not investigate, and not

even consider the role of chemicals in AIDS or study other

non-HIV-AIDS theories to solve the AIDS dilemma?

 

Duesberg and colleagues blame “the structure of the large,

government-sponsored research programs that dominate

academic research since World War II”, which favour an

establishment that can imposed sanctions on dissenters via

the “peer review system”. The most powerful of the sanctions

imposed are denial of funding and of publication.

 

Peer review is devolved to anonymous experts who do not fund

applications that challenge their own interests. The review

by Duesberg, Koehnlein and Rasnick [2] was blocked twice in

the course of more than three years by the peer review

process in two separate journals before it finally appeared

in print.

 

Perhaps the biggest hurdle to resolving the controversy is

the failure of both sides to acknowledge the full complexity

of the immune response. I am entirely persuaded that

recreational and toxic anti-HIV drugs as well as

malnutrition can all undermine the immune system to produce

immune deficiency syndromes. But I would certainly not like

to exclude something like HIV that could target the immune

cells directly, but that would be a whole new chapter by

itself.

 

 

 

========================================================

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