Book review.


Peter H. Duesberg, 'Infectious AIDS: Have We Been Misled?' North Atlantic Books USA 1995, 582 pages, ISBN: 1-55643-195-3.


Infectious AIDS is a collection of papers by Peter Duesberg arguing that AIDS is not a consequence of viral infection but of extended exposure to pathogens from illicit drugs or unpurified factor VIII. It is a view that has caused Duesberg to be shunned.

According to the book's preface by Richard C Strohman, in 1987 Duesberg was an active and very successful molecular biologist "at the top of his career" with a promising future. In 1992, however, renewal of his prestigious Outstanding Investigator Award Grant was refused. This was followed, and preceded, by a score of other refusals. Today his research is at a halt. Supporters of Duesberg contend that his ideas were wilfully suppressed by AIDS investigators for reasons associated with ideology and personal gain. This view challenges the whole integrity of AIDS science. Fortunately it does not square with reality.

Duesberg has, nevertheless, been maltreated. His seminal work on AIDS made valuable observations and pointed to anomalies in HIV research (including the slow progression of the disease and the apparent inactivity of HIV) which have since been conceded, by John Maddox, the editor of Nature, among others, as correct. At the time, however, Duesberg was treated with disdain. He was ignored by many, told to "grow up" by Maddox, and described as a "dissenter"--a term more common in religious discourse than scientific dispute; research money was jealously guarded from him.

That unorthodox ideas in science may meet with such an inappropriate response is worrying but does not amount to systematic suppression. Nor does it suggest that researchers were wilfully misleading the public with a false model of AIDS transmission. Duesberg is correct to point to the exaggeration and hype of the AIDS pandemic as perverting AIDS research, but he is wrong to suggest that researchers conspired with the Centers for Disease Control, drug companies, and the American government to produce the HIV-AIDS hypothesis. Although researchers should remind themselves that AIDS is just a disease, not the wrath of God, they have not been led as far astray as Duesberg contends.

There is now overwhelming evidence that HIV infection leads to AIDS. A recent report in Nature showed that HIV accounted for 85% of the deaths in a sample of 1020 HIV positive haemophilic patients. A subsequent BMJ report showed that 53% of a smaller sample of HIV positive patients with haemophilia developed AIDS, while no patients matched for factor VIII usage did so. Duesberg's suggestion that the "risk of AIDS is proportional to... lifetime dosage of factor VIII" and the use of zidovidine-- giving false hope to those infected and unnecessarily worrying for those who are not--is now unsupportable. The gains in life expectancy with purified factor VIII, cited as supporting his theory, do not stand up to scrutiny. The discussion of zidovidine also misrepresents the truth. Zidovidine is a toxic drug but has only recently been suggested as a prophylactic; it is mischievous for Duesberg to suggest that it has been widely prescribed in the absence of life threatening illness.

Duesberg has asked some awkward questions and deserves to have his views properly considered. It is unfortunate that he seems unwilling to accept refutation of his ideas by evidence. For this he should remain peripheral to the mainstream AIDS debate, but as a maverick rather than a heretic. *

Review by Stuart Derbyshire
Source: British Medical Journal 11 May 1996