Pharmac. & Ther. Vol. 55: 201-277, 1992


Department of Molecular and Cell Biology, 229 Stanley Hall, University of California at Berkeley, Berkeley, CA 94720, U.S.A.

Note Added in Proof

Sparked by an article in Newsweek (Cowley, 1992), numerous HIV-free AIDS cases were unexpectedly reported by many independent (!) investigators at the VIII International Conference on AIDS/III STD World Congress in Amsterdam in July 1992 (now a joint meeting with sexually transmitted diseases, STDs). Surprisingly, some of the recently announced HIV-free AIDS cases had been studied for years (Altman, 1992a; Cohen, 1992a,b; Laurence et al., 1992), even by the CDC (Spira and Jones, 1992). As a result the CDC had to alter its long-held position that HIV causes all AIDS to "HIV causes the vast majority of AIDS cases ..." (Nicholson, 1992). In its monthly HIV/AIDS Surveillance Reports the CDC still states that "AIDS is a specific group of diseases which are indicative of severe immunosuppression related to infection with the human immunodeficiency virus (HIV)" (Centers for Disease Control, 1992b). The AIDS risk factors of most of these HIV-free "AIDS patients" were reported to be "intravenous drugs, unprotected sex and transfusions" and the corresponding diseases were Kaposi's sarcoma and pneumonia (Cowley, 1992).

AIDS-virus matchmakers soon reached the consensus that an as yet undiscovered "new AIDS virus," that "doesn't appear any more contagious than HIV" (Cowley, 1992), was to be blamed for HIV-negative AIDS (Bowden et al., 1991; Castro et al., 1992; Huang et al., 1992; Altman, 1992a,b; Cohen, 1992a,b; Laurence et al., 1992). And the director for AIDS research at the NIH reassured the public, "If there is something, scientists will find it" (News Report, 1992). States The New York Times, "Arguably, the greatest thrills for a scientist are in discovering a new microbe, a new disease, cure and prevention ... Many ... know how quickly the exhilaration that comes from believing they are on the verge of making such a discovery vanishes when the initial findings cannot be confirmed" (Altman, 1992b).

However, the new HIV-free AIDS cases are entirely consistent with those listed above that were caused by drug consumption and other noncontagious risk factors (Section 4.5). Although public recognition of HIV-free AIDS cases is new, the new cases just complement the over 1200 cases of "acquired" immunodeficiency and AIDS-defining diseases described above including 334 hemophiliacs (Section, Table 3), 265 male homosexuals (Sections and 4.5), 444 intravenous drug users (Section 4.5) and 183 mostly male tuberculosis patients from Florida (Pitchenik et al., 1987, 1990). If the 2466 HIV-free AIDS cases from Africa were included (Section, the number of documented HIV-free AIDS cases would exceed 3000!

Moreover healthy HIV carriers who have been infected for over 10 years and have transmitted their HIV to at least 5 healthy persons via blood transfusions over 7-10 years ago have now received public recognition (Altman, 1992c; Learmont et al., 1992). These cases supplement the 1 million Americans, 0.5 million Europeans, 0.3 million Thais and 6 million Africans who are healthy, although most had been infected by 1985 (Section 3.5.1).

Thus both predictions of the hypothesis that AIDS is noncontagious are now generally accepted: (1) HIV-free AIDS and (2) AIDS-free transmission of HIV. Asks John Maddox, editor of Nature, "Does that mean Duesberg has been right all along, and that HIV plays no part in the causation of AIDS?" (Maddox, 1992b). Indeed, it would be an evolutionary miracle if the last decade had generated three different AIDS viruses, HIV-1, HIV-2 and the "new AIDS virus," when no such virus has ever emerged before in the history of medicine.


I thank Janie Stone (Berkeley) for numerous corrections of the manuscript, David Shugar (Associate Editor of Pharmacology and Therapeutics, Warsaw, Poland) for his courage to take up the AIDS controversy and for playing the devil's advocate of HIV, Annette Gwardyak (Managing Editor) for accommodating many "final" revisions, Hansueli Albonico (Langrau, Switzerland), Harvey Bialy (New York), Julie Castiglia (San Diego), Robert Cramer (Montlhery/Paris), Bryan Ellison (Berkeley), Celia Farber (New York), Harry Haverkos (Rockville, Maryland), Robert Hoffman (San Diego), Geoff Hoffmann (Vancouver, Canada), Phillip E. Johnson (Berkeley), Bill Jordan (Los Angeles), John Lauritsen (New York), Nathaniel Lehrman (New York), Anthony Liversidge (New York), Claus Pierach (Minneapolis), Paul Rabinow (Berkeley), Robert Root-Bernstein (East Lansing, Michigan), Harry Rubin (Berkeley), Frank Rothschild (Berkeley), Russell Schoch (Berkeley), Craig Schoonmaker (New York), Jody Schwartz (Berkeley), Joan Shenton (London), Gordon Stewart (Bristol, U.K.), Richard Strohman (Berkeley), Charles Thomas, Jr (San Diego), Fritz Ulmer (Wuppertal, Germany), Michael Verney-Elliott (London), Warren Winkelstein (Berkeley) and Yue Wu (Berkeley) for critical and catalytic information, Gedge Rosson (Berkeley) for Fig. 1, Brian Davis for fact-checking and typing, Osias Stutman for suggesting the Lewis Carroll quotation, Ted Gardner (Santa Barbara) for a generous donation and encouragement, and the librarians of UC-Berkeley, particularly Chris Campbell, Ingrid Radkey, Pat Stewart and Norma Kobzina, for AIDS references that were not even cited in the daily American newspapers. I am still supported by Outstanding Investigator Grant 5-R35-CA39915-07 from the National Cancer Institute.


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