WHAT CAUSES AIDS?
It's An Open Question
By Charles A. Thomas Jr., Kary B. Mullis, & Phillip E. Johnson
Reason June 1994
Most people believe they know what causes AIDS. For a decade, scientist,
government officials, physicians, journalists, public-service ads, TV shows,
and movies have told them that AIDS is caused by a retrovirus called HIV.
This virus supposedly infects and kills the "T-cells" of the
immune system, leading to an inevitably, fatal immune deficiency after
an asymptomatic period that averages 10 years or so. Most people do not
know-because there has been a visual media blackout on the subject-about
a longstanding scientific controversy over the cause of AIDS. A controversy
that has become increasingly heated as the official theory's predictions
have turned out to be wrong.
Leading biochemical scientists, including University of California at
Berkeley retrovirus expert Peter Duesberg and Nobel Prize winner Walter
Gilbert, have been warning for years that there is no proof that HIV causes
AIDS. The warnings were met first with silence, then with ridicule and
contempt. In 1990, for example, Nature published a rare response from the
HIV establishment, as represented by Robin A. Weiss of the Institute of
Cancer Research in London and Harold W. Jaffe of the U.S. Centers for Disease
Control. Weiss and Jaffe compared the doubters to people who think that
bad air causes malaria. "We have . . . been told," they wrote,
"that the human immunodeficiency virus (HIV) originates from outer
space, or as a genetically engineered virus for germ warfare which was
tested in prisoners and spread from them. Peter H. Duesberg's proposition
that HIV is not the cause of AIDS at all is, to our minds, equally absurd."
Viewers of ABC's 1993 Day One special on the cause of AIDS-almost the only
occasion on which network television has covered the controversy-saw Robert
Gallo, the leading exponent of the HIV theory, stomp away from the microphone
in a rage when asked to respond to the views of Gilbert and Duesberg.
Such displays of rage and ridicule are familiar to those who question
the HIV theory of AIDS. Ever since 1984, when Gallo announced the discovery
of what the newspapers call "HIV, the virus that causes AIDS,"
at a government press conference, the HIV theory has been the basis of
all scientific work on AIDS. If the theory is mistaken, billions of dollars
have been wasted-and immense harm has been done to persons who have tested
positive for antibodies to HIV and therefore have been told to expect an
early and painful death. The furious reactions to the suggestion that a
colossal mistake may have been made are not surprising, given that the
credibility of the biomedical establishment is at stake. It is time to
think about the unthinkable, however, because there are at least three
reasons for doubting the official theory that HIV causes AIDS.
First, after spending billions of dollars, HIV researchers are still
unable to explain how HIV, a conventional retrovirus with a very simple
genetic organization, damages the immune system, much less how to stop
it. The present stalemate contrasts dramatically with the confidence expressed
in 1984. At that time Gallo thought the virus killed cells directly by
infecting them, and U.S. government officials predicted a vaccine would
be available in two years. Ten years later no vaccine is in sight, and
the certainty about how the virus destroys the immune system has dissolved
Second, in the absence of any agreement about how HIV causes AIDS, the
only evidence that HIV does cause AIDS is correlation. The correlation
is imperfect at best, however. There are many cases of persons with all
the symptoms of AIDS who do not have any HIV infection. There are also
many cases of persons who have been infected by HIV for more than a decade
and show no signs of illness.
Third, predictions based on the HIV theory have failed spectacularly.
AIDS in the United States and Europe has not spread through the general
population. Rather, it remains almost entirely confined to the original
risk groups, mainly sexually promiscuous gay men and drug abusers. The
number of HIV-infected Americans has remained constant for years instead
of increasing rapidly as predicted, which suggests that HIV is an old virus
that has been with us for centuries without causing an epidemic.
No one disputes what happens in the early stages of HIV infection. As
other viruses do, HIV multiplies rapidly, and it sometimes is accompanied
by a mild, flulike illness. At this stage, while the virus is present in
great quantity and causing at most mild illness in the ordinary way, it
does no observable damage to the immune system. On the contrary, the immune
system rallies as it is supposed to do and speedily reduces the virus to
negligible levels. Once this happens, the primary infection is over. If
HIV does destroy the immune system, it does so years after the immune system
has virtually destroyed it. By then the virus typically infects very few
of the immune system' s T-cells.
Before these facts were well understood, Robert Gallo and his followers
insisted that the virus does its damage by directly infecting and killing
cells. In his 1991 autobiography, Gallo ridiculed HIV discoverer Luc Montagnier's
view that the virus causes AIDS only in the company of as yet undiscovered
"cofactors." Gallo argued that "multifactorial is multi-ignorance"
and that, because being infected by HIV was "like being hit by a truck,"
there was no need to look for additional causes or indirect mechanisms
All that has changed. As Warner C. Greene, a professor of medicine at
the University of California, San Francisco, explained in the September
1993 Scientific American, researchers are increasingly abandoning the direct
cell-killing theory because HIV does not infect enough cells: "Even
in patients in the late stages of HIV infection with very low blood T4
cell counts, the proportion of those cells that are producing HIV is tiny-about
one in 40. In the early stages of chronic infection, fewer than one in
10,000 T4 cells in blood are doing so. If the virus were killing the cells
just by directly infecting them, it would almost certainly have to infect
a much larger fraction at any one time."
Gallo himself is now among those who are desperately looking for possible
co-factors and exploring indirect mechanisms of causation. Perhaps the
virus somehow causes other cells of the immune system to destroy T-cells
or induces the T-cells to destroy themselves. Perhaps HIV can cause immune-system
collapse even when it is no long present in the body. As Gallo put it at
an AIDS conference last summer: "The molecular mimicry in which HIV
imitates components of the immune system sets events into motion that may
be able to proceed in the absence of further whole virus."
But researchers have not been able to confirm experimentally any of
the increasingly exotic causal mechanisms that are being proposed, and
they do not agree about which of the competing explanations is more plausible.
When The New York Times interviewed the government' s head AIDS researcher,
Anthony Fauci, in February, reporter Natalie Angier summarized his view
as a sort of stew of all the leading possibilities: "It [HIV] overexcites
some immune signaling pathways, while eluding the detection of others.
And though the main target of the virus appears to be the famed helper
T-cells, or CD-4 cells, which it can infiltrate and kill, the virus also
ends up stimulating the response of other immune cells so inappropriately
that they eventually collapse from overwork or confusion." No other
virus is credited with such a dazzling repertoire of destructive skills.
Perhaps it is the HIV scientists who are collapsing from overwork or
confusion. The theory is getting ever more complicated, without getting
any nearer to a solution. This is a classic sign of a deteriorating scientific
paradigm. But as HIV scientists grow ever more confused about how the virus
is supposed to be causing AIDS, their refusal to consider the possibility
that it may not be the cause is as rigid as ever. On the rare occasions
when they answer questions on the subject, they explain that "unassailable
epidemiological evidence" has established HIV as the cause of AIDS.
In short, they rely on correlation.
The seemingly close correlation between AIDS and HIV is largely an artifact
of the misleading definition of AIDS used by the U.S. government' s Centers
for Disease Control. AIDS is a syndrome defined by the presence of one
or more of 30 independent diseases-when accompanied by a positive result
on a test that detects antibodies to HIV. The same disease conditions are
not defined as AIDS when the antibody test is negative. Tuberculosis with
a positive antibody test is AIDS; tuberculosis with a negative test is
The skewed definition of AIDS makes a close correlation with HIV inevitable,
regardless of the facts. This situation was briefly exposed at the International
AIDS Conference in Amsterdam in 1992, when the existence of dozens of suppressed
"AIDS without HIV" cases first became publicly known. Instead
of considering the obvious implications of these cases for the HIV theory,
the authorities at the CDC, who had known about some of the cases for years
but had kept the subject under wraps, quickly buried the anomaly by inventing
a new disease called ICL (Idiopathic CD4+Lympho-cytopenia)--a conveniently
forgettable name that means "AIDS without HIV."
There are probably thousands of cases of AIDS without HIV in the United
States alone. Peter Duesberg found 4,621 cases recorded in the literature,
1,691 of them in this country. (Such cases tend to disappear from the official
statistics because, once it's clear that HIV is absent, the CDC no longer
counts them as AIDS.) In a 1993 article published in Bio/Technology, Duesberg
documented the consistent failure of the CDC to report on the true incidence
of positive HIV tests in AIDS cases. The CDC concedes that at least 40,000
"AIDS cases" were diagnosed on the basis of presumptive criteria-that
is, without antibody testing, on the basis of diseases such as Kaposi's
sarcoma. Yet these diseases can occur without HIV or immune deficiency.
Perhaps some of the patients diagnosed as having AIDS would have tested
negative, or actually did test negative, for HIV. Physicians and health
departments have an incentive to diagnose patients with AIDS symptoms as
AIDS cases whenever they can, because the federal government pays the medical
expenses of AIDS patients under the Ryan White Act but not of persons equally
sick with the same diseases who test negative for HIV antibodies.
The claimed correlation between HIV and AIDS is flawed at an even more
fundamental level, however. Even if the "AIDS test" were administered
in every case, the tests are unreliable. Authoritative papers in both Bio/Technology
(June 1993) and the Journal of the American Medical Association (November
27, 1991) have shown that the tests are not standardized and give many
"false positives" because they react to substances other than
HIV antibodies. Even if that were not the case, the tests at best confirm
the presence of antibodies and not the virus itself, much less the virus
in an active, replicating state. Antibodies typically mean that the body
has fought off a viral infection, and they may persist long after the virus
itself has disappeared from the body. Since it is often difficult to find
live virus even in the bodies of patients who are dying of AIDS, Gallo
and others have to speculate that HIV can cause AIDS even when it is no
longer present and only antibodies are left.
Just as there are cases of AIDS without HIV, there are cases of HIV-positive
persons who remain healthy for more than a decade and who may never suffer
from AIDS. According to Greene's article in Scientific American, "It
is even possible that some rare strains [of HIV] are benign. Some homosexual
men in the U.S. who have been infected with HIV for at least 11 years show
as yet no signs of damage to their immune systems. My colleagues . . .and
I are studying these long-term survivors to ascertain whether something
unusual about their immune systems explains their response or whether they
carry an avirulent strain of the virus."
The faulty correlation between HIV and AIDS would not disprove the HIV
theory if there were strong independent evidence that HIV causes AIDS.
As we have seen, however, researchers have been unable to establish a mechanism
of causation. Nor have they succeeded in confirming the HIV model by inducing
AIDS in animals. Chimps have repeatedly been infected with HIV, but none
of them have developed AIDS. In the absence of a mechanism or an animal
model, the HIV theory is based only upon a correlation that turns out to
be primarily an artifact of the theory itself.
In light of the importance of the correlation argument, it is astonishing
that no controlled studies have been done for three of the major risk groups:
transfusion recipients, hemophiliacs, and drug abusers. Two ostensibly
controlled studies involving men's groups in Vancouver and San Francisco
purportedly show that AIDS developed only in the HIV-positive men and never
in the "control group" of HIV negatives. These studies were designed
not to test the HIV theory but to measure the rate at which HIV-positive
gay men develop AIDS. They did not compare otherwise similar persons who
differ only in HIV status, did not control effectively for drug use, and
did not fully report the incidence of AIDS-defining diseases in the HIV-negative
men. The research establishment accepted these studies uncritically because
they give the HIV theory some badly needed support. But the main point
they supposedly prove has already been thoroughly disproved: AIDS does
occur in HIV-negative persons.
According to the official theory, HIV is a virus newly introduced into
the American population, which has had no opportunity to develop any immunity.
It follows that viral infection should spread rapidly, moving from the
original risk groups (gays, drug addicts, transfusion recipients) into
the general population. This is what the government agencies confidently
predicted, and AIDS advertising to this day emphasizes the theme that "everyone
is at risk."
The facts are otherwise. AIDS is still confined mainly to the original
risk groups, and AIDS patients in the United States are still almost 90-percent
male. Health-care workers, who are constantly exposed to blood and bodily
fluids of AIDS patients, have no greater risk of contracting AIDS that
the population at large. Among millions of health- care workers, the CDC
claims only seven or eight (poorly documented) cases of AIDS supposedly
developed through occupational exposure. By contrast, the CDC estimates
that accidental needle sticks lead to more than 1,500 cases of hepatitis
infection each year. Even prostitutes are not at risk for AIDS unless they
also use drugs.
Far from threatening the general heterosexual population, AIDS is confined
mainly to drug users and gay men in specific urban neighborhoods. According
to a 1992 report by the prestigious U.S. National Research Council, "The
convergence of evidence shows that the HIV/AIDS epidemic is settling into
spatially and socially isolated groups and possibly becoming endemic within
them." This factual picture is so different from what the theory predicts,
and so threatening to funding, that the AIDS agencies have virtually ignored
the National Research Council report and have continued to preach the fiction
that "AIDS does not discriminate."
Not only is AIDS mostly confined to isolated groups in a few U.S. cities,
but HIV infection is not increasing. Although a virus newly introduced
to a susceptible population should spread rapidly, for several years the
CDC has estimated that a steady 1 million Americans are HIV positive. Now
it appears that the figure of 1 million is finally about to be revised-downward.
According to a story by Lawrence Altman in the March 1 New York Times,
new statistical studies indicate that only about 700,000 Americans are
HIV positive, and the official estimate will accordingly be reduced sometime
While HIV infection remains steady at this modest level in the United
States, World Health Organization officials claim that the same virus is
spreading rapidly in Africa and Asia, creating a vast "pandemic"
that threatens to infect at least 40 million people by the year 2000, unless
billions of dollars are provided for prevention to the organizations sounding
the alarm. These worldwide figures, especially from Africa, are used to
maintain the thesis that "everyone is at risk" in the United
States. Instead of telling Americans that AIDS cases here are almost 90-percent
male, authorities say that worldwide the majority of AIDS sufferers are
female. With the predictions of a mass epidemic in America and Europe failing
so dramatically, AIDS organizations rely on the African figures to vindicate
But these African figures are extremely soft, based almost entirely
on "clinical diagnoses," without even inaccurate HIV testing.
What this means in practice is that Africans who die of diseases that have
long been common there---especially wasting disease accompanied by diarrhea-are
now classified as AIDS victims. Statistics on "African AIDS"
are thus extremely manipulable, and witnesses are emerging who say that
the epidemic is greatly exaggerated, if it exists at all.
In October 1993, the Sunday Times of London reported on interviews with
Philippe and Evelyne Krynen, heads of a 230-employee medical relief organization
in the Kagera province of Tanzania. The Krynens had first reported on African
AIDS in 1989 and at that time were convinced that Kagera in particular
was in the grip of a vast epidemic. Subsequent years of medical work in
Kagera have changed their minds. They have learned that what they had thought
were "AIDS orphans" were merely children left with relatives
by parents who had moved away and that HIV-positive and HIV-negative villagers
suffer from the same diseases and respond equally well to treatment. Philippe
Krynen's verdict: "There is no AIDS. It is something that has been
invented. There are no epidemiological grounds for it; it doesn't exist
Krynen's remark calls attention to the fact that AIDS is not a disease.
Rather, it is a syndrome defined by the presence of any of 30 separate
and previously known diseases, accompanied by the actual or suspected presence
of HIV. The definition has changed over time and is different for Africa
(where HIV testing is rare) than for Europe and North America. The official
CDC definition of AIDS in the United States was enormously broadened for
1993 in order to distribute more federal AIDS money to sick people, especially
women with cervical cancer. As a direct result, AIDS cases more than doubled
in 1993. Absent the HIV mystique, there would be no reason to believe that
a single factor is causing cervical cancer in women, Kaposi's sarcoma in
gay males, and slim disease in Africans.
The HIV paradigm is failing every scientific test. Research based upon
it has failed to provide not only a cure or vaccine but even a theoretical
explanation for the disease-causing mechanism. Such success as medical
science has had with AIDS has come not from the futile attempts to attack
HIV with toxic antiviral drugs like AZT but from treating the various AIDS-associated
diseases separately. Predictions based on the HIV theory have been falsified
or are supported only by dubious statistics based mainly on the theory
itself. Yet the HIV establishment continues to insist that nothing is wrong
and to use its power to exclude dissenting voices, however eminent in science,
from the debate.
Like other leaders of the scientific establishment, Nature Editor John
Maddox is fiercely protective of the HIV theory. He indignantly rejected
a scientific paper making the same points as this article. When Duesberg
first argued his case in 1989 in the prestigious Proceedings of the National
Academy of Science, the editor promised that his paper would be answered
by an article defending the orthodox viewpoint. The response never came.
The editors of the leading scientific journals have refused to print even
the brief statement of the Group for the Scientific Reappraisal of the
HIV/AIDS Hypothesis, which has over 300 members. The statement notes simply
that "many biomedical scientists now question this hypothesis"
and calls for "a thorough reappraisal of the existing evidence for
and against this hypothesis."
Such a reappraisal would include the following elements:
Genuinely controlled epidemiological studies of all the major risk groups:homosexuals,
drug users, transfusion recipients, and hemophiliacs. The studies should
employ an unbiased definition of AIDS. Too often we have been told that
HIV always accompanies AIDS, only to learn that this is so because AIDS
without HIV is named something else. The studies should be performed by
persons who are committed to investigating the HIV theory rather than defending
it. There is reason to suspect that properly controlled studies of transfusion
recipients and hemophiliacs in particular will show that the incidence
of AIDS-defining diseases is independent of HIV status.
An audit of the CDC statistics to remove HIV bias and thereby allow
unprejudiced testing of the critical epidemiological evidence for the theory.
Every effort should be made to determine how many AIDS patients were actually
tested for antibodies and the testing method that was employed. Because
even the most reliable antibody test generates many false-positive results,
researchers should try to validate the tests by examining random samples
of AIDS patients to determine whether significant amounts of replicating
HIV can be found in their bodies. Statistics have been kept as if the purpose
were to protect the HIV theory rather than to learn the truth.
Research focusing on the cause of particular diseases rather than the
politically defined hodgepodge of diseases we now call AIDS. The cancer-like
skin disease called Kaposi's sarcoma (KS) is one of the best-known AIDS-defining
conditions, but leading KS and HIV experts Marcus Conant and Robin Weiss
now say that dozens of non-HIV KS cases are under study in the United States
and that KS is becoming much less frequent in gay male AIDS patients than
it formerly was. Conant, Weiss, and other AIDS researchers now frankly
attribute KS to an "unknown infectious agent" rather than to
HIV, but KS is nonetheless still called AIDS when it occurs in combination
with HIV. Duesberg attributes KS in gay males to the use of amyl nitrates
(poppers) as a sexual stimulant. His theory is eminently testable, and
it ought to be given a fair chance. Another example: Hemophiliacs in the
age of AIDS are living longer than they ever did in the past, but they
still often die of conditions related to receipt of the blood concentrate
called Factor VIII. Research published in The Lancet in February confirms
earlier reports that symptoms diagnosed as AIDS are best treated by providing
a highly purified form of Factor VIII. Researchers should study the role
of blood-product impurities in causing disease in hemophiliacs, without
the distortion that comes from arbitrarily assuming that HIV is responsible
whenever an HIV-positive hemophiliac becomes ill.
A critical re-examination of the statistics for AIDS and HIV in Africa
and Asia. Researchers should perform new, controlled studies of representative
African populations to test the relationship of confirmed HIV infection
to the incidence of AIDS-defining diseases. It will not do to rely upon
"presumptive diagnoses" or extrapolations from single antibody
tests that are now well known to generate many false positives.
The HIV establishment and its journalist allies have replied to various
specific criticisms of the HIV theory without taking them seriously. They
have never provided an authoritative paper that undertakes to prove that
HIV really is the cause of AIDS-meaning a paper that does not start by
assuming the point at issue. The HIV theory was established as fact by
Robert Gallo's official press conference in 1984, before any papers were
published in American journals. Thereafter, the research agenda was set
in concrete, and skeptics were treated as enemies to be ignored or punished.
As a result, the self-correcting processes of science have broken down,
and journalists have not known how to ask the hard questions. After 10
years of failure, it is time to take a second look. *
Charles A. Thomas Jr., a biochemist, is president of
the Helicon Foundation in San Diego and secretary of the Group for the
Scientific Reappraisal of the HIV/AIDS Hypothesis. Kary B. Mullis is the
1993 Nobel Prize winner in chemistry for his invention of the polymerase
chain reaction technique, for detecting DNA, which is used to search for
fragments of HIV in AIDS patients. Phillip E. Johnson is the Jefferson
E. Peyser Professor of Law at the University of California, Berkeley.
Several replies to the article have been published, as a reply by the
authors. You find them here.