FIRST THINGS FIRST Some Thoughts on the "AIDS Virus" and AZT

By John Lauritsen

New York Native 1 June 1987

A few years ago, when there was still free and open discussion of the possible causes of AIDS, theorists were split into two main camps: the multifactorialists, who thought that AIDS resulted from repeated assaults upon the immune system from both infectious and non- infectious causes; and those who believed in a single infectious agent, presumably a "new" microbe. Microbes-as-enemies represented the mind-set of the latter faction, an outlook epitomized in a Readers Digest headline, "The War Against Viruses" (as though viruses were not a part of the universe, as though our species had not evolved along with viruses from the very beginning.)

After the 1984 announcement of the "discovery" of the virus which was then called "HTLV-III", the multifactorialists were relegated to the sidelines, and the "AIDS virus" (HIV) dogma rapidly came to pre- vail. The microbial enemy had been identified. Research efforts from this point on were to concentrate on developing a vaccine against HIV. Education efforts were to be predicated solely upon "preventing the transmission of HIV". All government epidemiological studies were to have such titles as, "Risk Factors For Seroconversion To Human Immuno- deficiency Virus Among Male Homosexuals". Treatment was anticipated as being a new drug ("silver bullet") that would kill HIV. All other research efforts were shunted aside, ostracized and unfunded. There was one serious problem with all this. HIV is not the cause of AIDS.

HIV Is Not The Cause Of AIDS

Even though the Public Health Service and the media have asserted untold thousands of times that HIV is *the* cause of AIDS, no convinc- ing evidence has ever been presented that it is. Since 1984, there have been a few of us who stated in print that epidemiological evi- dence, together with the failure of HIV to fulfill any of Koch's Pos- tulates, made it most unlikely that HIV could be the sole cause of AIDS; and that it was still in the realm of speculation whether HIV was even necessary. We were isolated. Some AIDS researchers did not believe in the "AIDS virus" ideology, but, in the interests of self- preservation, they remained silent. As of two months ago, not a sin- gle challenge to the HIV dogma had appeared in the medical press, giv- ing the impression of global unanimity within the medical sector.

All this has changed. The 1 March 1987 issue of Cancer Research featured a 21-page article, "Retroviruses as Carcinogens and Patho- gens: Expectations and Reality", by Peter H. Duesberg, a molecular biologist at Berkeley. A powerful and elegantly persuasive piece of argumentation, Duesberg's article examines virtually everything that is known about HIV, from the perspectives of molecular biology, epi- demiology, serology, and animal experiments. By the time he reaches his conclusion, Duesberg has built a thoroughly convincing case: "It is concluded that AIDS virus is not sufficient to cause AIDS and that there is no evidence, besides its presence in a latent form, that it is necessary for AIDS."

Unless HIV's champions can do some very fancy explaining, Duesberg's article has unambiguously relegated the AIDS virus etiology to medical history's trash heap of falsified hypotheses. From now on, no one can maintain, except in ignorance or dishonesty, that HIV is *the* cause of AIDS.

At the end of his article, Duesberg acknowledges 17 distinguished scientists for "critical comments or review of this manuscript or both" and R.C. Gallo, for "discussions".

It will be interesting to see how Gallo and the other "AIDS virus" ideologues will respond -- and, in the interests of scientific dialogue, they must respond to it, fully and in detail. In my opin- ion, the best thing they could do would be to apologize and say they were wrong, but I doubt that they will. If the Public Health Service and the media remain silent about Duesberg's article, and persist in expounding the discredited HIV mythology, then gay men will have cause to be gravely concerned. This would mean that the government and their confederates in the medical establishment are not acting in good faith, that nothing they say can be trusted, that their interests are hostile to ours. Their silence would raise the possibility of a hor- rible hidden agenda.

A separate article will be required to do justice to Duesberg's arguments. In the meantime, those who can obtain a copy of his arti- cle should do so. Because of the technical nature of much of its material, it is not easy reading, although Duesberg writes very clearly -- he is one of the few specialists who is also a superb gen- eralist. Every physician who treats AIDS patients, every AIDS researcher, and everyone involved in AIDS work has an obligation to study the article and to help spread the word. HIV is not the cause.

AZT: Miracle Or Mass Murder?

The theory behind AZT (or Retrovir, as it is now known) is that it prevents the replication of HIV by attacking at the point at which the reverse transcriptase acts. My understanding is that this has been demonstrated in vitro (in the laboratory) but not in vivo (in a living animal).

Obviously, since HIV is not the cause of AIDS, the theory behind AZT is false. And even if AZT did prevent HIV from replicating, noth- ing would be gained thereby, inasmuch as HIV infection is nonpatho- genic (read Duesberg!).

However, it is possible that a drug might have beneficial effects, even though its theoretical underpinnings were false. In "Surviving and Thriving With AIDS", Callen proposes two criteria for judging a particular drug or therapy: "(1) Is there a theoretical rea- son to believe that a particular drug or therapy will have some bene- fit? If so, (2) does it have any bad side effects?"

In the case of AZT, there seems to be a near consensus on both points. On 17 March 1987, the New York Times devoted a full-page article to the latest AIDS drugs, with the greatest emphasis on AZT as "the best hope of many AIDS patients". The benefit anticipated from AZT was very modest indeed: "The near-term prospect is that the lives of many patients afflicted with AIDS will be prolonged." On the other hand, the primary side effect of AZT was serious: "The chemical has a destructive effect on the bone marrow, the ultimate source of the blood and cells of the immune defense system."

To get another viewpoint, I called the "AZT Federal Hotline", (800) 843-9388, and spoke to a pleasant young woman there. In response to my question, she said that the "AZT Federal Hotline" was handled by a private company, which was funded by Burroughs-Wellcome. Asked what benefits AZT might offer, she replied that it "may prolong life for some patients" and that "some patients feel better". I probed by asking whether there were any other benefits, but got no response, so apparently that was all she was allowed to say. When I asked what side effects there were, she immediately rattled them off ("lower white cell counts, lower red cell counts, headaches, nausea, confusion, high fevers") as though these were little more than the things listed on the package of an over-the-counter analgesic. She added, "Some patients have to be taken off the drug." She did not know what percentage of patients on AZT suffer side effects, but said that some had none, even after being on the drug *for weeks*.

To get still another viewpoint, I called Project Inform in San Francisco, (800) 822-7422. The man I talked to pointed out that we have very little information on AZT: that the first trials on it began in February 1986, little over a year ago; that we do not know what percentage of the double-blind patients are still alive at this point in time; that nothing on AZT has ever been published in a medical journal. According to him, the FDA acted irresponsibly in giving its hasty approval to AZT, since nothing was known about the long-term toxicities of the drug. Apparently the anemic condition, caused by the destruction of bone marrow, is so severe that some patients require blood transfusions as often as every ten days.

In New York, the members of the PWA Coalition I have spoken to take a negative view of AZT. They estimate that about two-thirds of those on AZT suffer serious side effects, and that the majority of them feel *worse* rather than better. In an editorial in the April 1987 issue of the PWA Coalition Newsline, Max Navarre challenges the claim that patients on AZT "feel better":

"Most people who are taking AZT at this time are people who are fairly newly diagnosed, people who are in the grossly misnamed 'honeymoon stage' of their illnesses anyway. Who's to say that, if those people are doing well, it's because of AZT? I felt great for a year after I was diagnosed. With no medication."

Navarre concludes his editorial by making a connection between low self-esteem and the willingness to try dangerous experimental drugs:

"We should never again hold ourselves so cheaply that, in desperation and panic, we poison ourselves with unsafe AIDS drugs just because they might become available. At $10,000 bucks a throw, no less."

An evaluation of AZT should also take into account the fact that, contrary to the impression given in the media, the AIDS condition is not invariably fatal. Many PWAs are getting better. Given a chance, the human body has an amazing capacity to heal itself. However, for those patients who are treated with AZT, the chances for eventual recovery are probably nil. The long-term effects of the drug are unk- nown, but the prognosis cannot be good for a patient who, in addition to the underlying AIDS condition itself, must endure side effects so severe as to necessitate blood transfusions every ten days. In addi- tion there is the consideration that AZT is supposed to be taken every four hours, around the clock, meaning that a patient on AZT would never again know what a full night's sleep was like.

Some of the gay press and some gay leaders have shown a curious lack of critical thinking on AZT. Victoria Brownworth, in the Phi- ladelphia Gay News, has devoted literally hundreds of column inches to AZT, writing with such enthusiasm that at times she seemed like a pub- lic relations arm of Burroughs-Wellcome. An editorial of hers said that Burroughs-Wellcome should be "applauded" and that the FDA's approval of AZT was "good news" and "a momentous first step". To be fair, the last couple of issues of PGN have been more balanced, going into some of the darker aspects of AZT.

Michael Hellquist, writing in the Advocate (26 May 1987), lends credence to "leaks" from Burroughs-Wellcome and the CDC, which allegedly showed "survival rates doubling for those [with "AIDS or advanced ARC"] taking the antiviral for one year." Before accepting the claim that AZT/Retrovir had "prolonged life", I for one would like to know exactly how "advanced ARC" is defined, and to see some hard data on survival rates for those with this condition. Hellquist's willingness to toe the government-pharmaceutical industry line is evi- dent in his highlighted statement: "In time it seems likely that Retrovir or a similar antiviral will be considered a drug for *HIV infection* [emphasis added] rather than one only for ARC and AIDS."

Jeff Levi, speaking for the NGLTF, said that "Achieving federal funding for AZT will be a major priority of the Task Force in the months ahead." NGLTF may succeed -- a bill is pending in Congress to appropriate $30 million to pay for distributing AZT to needy patients. In my opinion, paying for someone's AZT treatments is not doing him a favor.

It is understandable that an AIDS patient who felt his situation was hopeless, might in desperation wish to try AZT, in the mistaken belief that doing anything, however dangerous, was better than doing nothing. However, the promoters of AZT have indicated that they will attempt to expand the market for their commodity beyond people with AIDS or ARC. They are now proposing that AZT is also an appropriate treatment for those who are "infected with HIV", meaning the hundreds of thousands of people who have antibodies to the virus. If such antibody positive people are perfectly healthy, then so much the better -- according to their (completely false) theories, giving them AZT (at $10,000 per year) would mean "intervening at an early stage of the disease". Here we have a glimpse of the evil that can result when issues of public health are determined by profit rather than the wel- fare of human beings. It is neither unreasonable nor overly emotional to regard these efforts, to put healthy people on a drug regimen that will destroy their bone marrow, as attempts at mass murder.

In introductory psychology courses one learns that in making a presentation it is always necessary to draw conclusions. It is not enough to present facts, no matter how dramatically, and hope that the audience will make associations and draw the appropriate conclusions. Most of them will draw no conclusions whatever, and many of the remainder will draw false conclusions. And I remember once, when I was stymied trying to write a conclusion to a market research report, the principal of the company informed me that I was being paid to solve problems, that it was my responsibility to interpret the data and to guide our corporate client in deciding what action he should take.

This section has been painful to write, as I am conscious of the many men, including friends of mine, who are presently on AZT. Prior to the FDA's approval, nearly 5000 people were already taking the drug, as part of experimental protocols, and many thousands more are now taking it. I wish them well, but the promotion of AZT must stop. If no one else is willing to come right out and say it, then I will.

AZT is not a cure for AIDS. AZT's alleged benefits are not backed up by hard data, and are not sufficient to compensate for the drug's known toxicities. Recovery from AIDS will come from strengthening the body, not poisoning it. Do not take, prescribe, or recommend AZT. *