'Pestilences have a way of recurring in the world; yet somehow we find
it hard to believe in ones that crash down on our heads from the blue sky"
(Albert Camus, The Plague) Camus was describing a fictional plague that
originated from a dormant organism which arose unbidden in an Algerian
town in the 1940s. Later, in an intriguing piece of prognostic fiction
from the 1970s, an author called Russell Foreman produced The Ringway Virus
which threatened the human race. (It was traced to a single outbreak in
Australia and differed from all known viruses in its speed of spread and
deadliness of action.) In the 1980s, the virus of the moment is undoubtedly
HIV. The epidemic is AIDS. But is this a matter of cause and effect?
Jad Adams, a journalist with a claim to scientific respectability, has
written a meticulously researched book whose title leaves little doubt
about his answer to the question. The implication of the title is reinforced
by inclusion of a foreword by Peter Duesberg, the most articulate of those
who are sceptical that HIV is the cause of AIDS. Adams summarises his conclusions
thus: "my view, informed only by literature on the subject... is that
HIV does not cause AIDS. Another pathogen... is the causative agent...
We will find out whether HIV causes AIDS but I predict this will happen
a long way into the future and few will emerge from the historical record
with much distinction".
Here I have jumped from the title page to the end of the book. What
lies in between are a number of highly readable chapters on the origin
of AIDS and the syndrome itself, the four Hs (haemophiliacs, heroin users,
homosexuals, Haitians) who have proved most susceptible to the causative
agent (whatever it may be) and the fifth H (hookers) who might by now have
been expected to join the statistics on AIDS, but have not. To my mind,
the most thought-provoking chapter is that simply entitled "Syphilis".
Here Adams lays the groundwork for his contention that an organism like
the spirochete Treponema pallidum should be seriously considered as a contributing
factor to AIDS; symptoms of AIDS parallel those of syphilis; many patients
are said to respond to antibiotic therapy (conventional viruses do not);
and syphilis in some stages is immunosuppressive. "The great masquerade"
might even exist in a filterable form, filtration being one of the prime
pieces of evidence, in lieu of any animal model, for assuming AIDS is caused
by a virus. If Adams wants support for his notions about syphilis he may
find some in statements taken from the World Health Organization (see The
Lancet, 18 February 1989, p.396) on sexually transmitted diseases as risk
factor for HIV transmission.
What about HIV? Adam's response to the "myth" is a chapter
called "HIV Challenged". He also presents the whole sorry story
about the politics of the discovery, the people involved, the mistakes
that occurred, the failure of Richard Nixon's war on cancer and so on.
Scientists in general do not fare too well at Adam's hands, nor do grant-giving
bodies. He quotes from Paul Feyerabend: "as opposed to its immediate
predecessor, later twentieth-century science has given up all philosophical
pretentions and has become a powerful business that shapes the mentality
of its practitioners". Named scientists are the butt of Adam's invective
as he draws attention to their abandonment of the scientific approach,
acquisition of vested interests in the virus they champion and use of steam-roller
tactics to silence any opposition. In "Virus Hunters" he reveals
a Gallic bias. The AZT story, a medical trial that was neither anonymous
nor completed but resulted in the release of a drug for AIDS treatment,
is also discussed in a further chapter entitled "Finance".
Many will say that this book is totally flawed. I will say it has minor
flaws. Adams concentrates too forcefully on the extremes - HIV is not the
cause of AIDS - and too little on the middle position wherein HIV is seen
as a contributing factor to the disease(s) with other, as unidentified,
cofactors also being required. (This is not fence-sitting - there is a
precedent for the involvement of a latent virus, the herpesvirus EBV in
this case, together with cofactors in several human malignancies.) one
could even hope that HIV is involved because, in the normal sense, it is
a relatively non-infectious virus. Therefor changes in life-style and the
use of safer blood products (for the five Hs and the potentially large
'at risk' African population) could result in a decline in the AIDS epidemic.
Adams also falls into the trap (following Duesberg) of assuming that
the presence of HIV antibodies should in fact mean vaccination protection
for the patient. Again, to quote from the EBV literature, increased viral
antibody titres are used diagnostically to predict people at risk of developing
EBV-associated diseases. Thus, not all viral antibodies can be deemed to
be markers of protection. Finally, as one who works with young scientists
and medical technicians, I regret, and in part strongly disagree with Adam's
cynical assessment of the 'scientific method'.
Thus, however, are minor points. Adams has written a highly provocative
but important book on a huge medical problem. It deserves to be read (even
by Nobel committees). There must be many 'HIV=AIDS agnostics' who will
feel a great sense of relief if this book frees them from the pressures
of silence imposed by the establishment (including journalists and journals).
It will surely lead to a scientifically healthier society if the burden
of proof for HIV as a deadly pathogen is returned to where it belongs -
to those who maintain that HIV causes AIDS - and others are allowed to
pursue alternative approaches in the battle for eradication of the disease.