KANGAROO COURT ETIOLOGY

By John Lauritsen

New York Native 9 May 1988

A "Scientific Forum on the Etiology of AIDS", sponsored by the American Foundation for AIDS Research (AmFAR), was held on April 9, 1988 at the George Washington University in Washington, D.C. In the words of the AmFAR "fact sheet", the Forum was "convened to critically examine the evidence that human immunodeficiency virus (HIV) or other agents give rise to the disease complex known as AIDS. Data from laboratory, clinical, and epidemiological research will be presented and evaluated. The forum seeks no consensus, instead it is designed to permit discussion among experts on the conclusions the facts permit."

As one of the 17 journalists who attended, I looked forward to the forum as the first opportunity for an open discussion of the pros and cons of the hypothesis that HIV is the cause of AIDS. Ever since Secretary Heckler announced in 1984 that the cause of AIDS had been discovered, HIV has been accepted as the cause despite the lack of proof that it is. The Public Health Service and the rest of the medical establishment have acquiesced in a "Proof by Proclamation". The forum offered the first opportunity for Peter Duesberg, Professor of Molecular Biology at the University of California at Berkeley, to confront members of the "AIDS establishment" over their HIV hypothesis. Over a year ago Duesberg provided a comprehensive and cogently argued refutation of the HIV hypothesis, to which the "AIDS establishment" has intransigently refused to reply (New York Native 220).

Despite these praiseworthy intentions, the forum appears to have had a hidden agenda: to discredit Duesberg. Even Michael Specter, a reporter who caters to the "AIDS establishment" and is bitterly opposed to Duesberg, admitted that the April 9 meeting "was billed as a scientific forum on the cause of AIDS but was really an attempt to put Duesberg's theories to rest."

The forum represented several steps forward, and several backward. At least the ice has been broken, and the causes of AIDS are now an acceptable topic for public discussion. While no blows were struck, some of the HIV protagonists fell below the standards of civility that are expected in scholarly debate. Nothing particularly new was said, and there was little of the give and take that characterize genuine scientific dialogue. At the same time, the positions of both sides have become more sharply defined; it is now clear what directions future debate should take.

On the whole, I regard the forum as a victory for Duesberg. The forum was a well-orchestrated media event, heavily stacked against him, and he took a lot of abuse. Nevertheless, he stood by his guns; he did not recant (as he apparently was expected to); and to the more discerning participants, he exposed the bankruptcy of the arguments currently advanced in favor of the HIV hypothesis. At all times Duesberg retained good manners and a sense of humor, in the face of invective, insults, and clowning from his opponents.

Before going into what each of the panelists said, I'd like to discuss a couple of general issues which came to the fore: Koch's Postulates and the nature of scientific evidence.

Koch's Postulates

The forum was haunted by the specter of Robert Koch, and the postulates that he formulated for "establishing the specificity of a pathogenic micro-organism". For a century, medical science has used Koch's postulates as the standards for proving that a particular micro-organism causes a particular disease. The first Postulate requires that the microbe be found in all cases of the disease; the second, that the microbe, having been grown in pure culture, be injected into susceptible animals with the result that the same disease is produced; and the third, that the microbial agent create the disease upon transfer from animals made ill by inoculation.

Duesberg has taken the position that Koch's first Postulate should be amended in a conservative direction, so that the microbe must not only be present in all cases, but must also be biochemically active to a clinically relevant degree. His rationale is that present-day technology makes it possible to see viruses that would have remained unknown and undetectable only ten years ago. It is now possible to identify a virus that is present in only one in 100,000 T-cells. So it is not enough to detect a microbe; it must be proven that the microbe is doing something harmful, and to a sufficient degree, that illness results. Duesberg has also commented, that if Koch's first Postulate is not satisfied, there is no need to bother about the remaining postulates.

The HIV advocates, on the other hand, now wish to revise Koch's in a more permissive direction: it would no longer be necessary to find the microbe in all cases of the disease. Mere correlations between microbial antibodies and the progression of the disease would be sufficient. HIV could be proved "epidemiologically" to be the cause of AIDS.

Actually, the HIV advocates talked out of both sides of their mouths with regard to Koch's postulates. On the one hand, they disparaged them as in need of "modification" (read: abandonment); on the other hand, they were doing their best to come up with data that would satisfy at least the first postulate, which is troublesome because it amounts to good common sense.

Public vs. Private Facts

Duesberg has based his critique of the HIV hypothesis on a thorough review of the published literature on AIDS. In the course of the debate, it appeared that the HIV advocates are trying to shore up their arguments by revising the facts, particularly with regard to the crucial questions of whether or not HIV is ever biochemically active in people with AIDS (PWAs), and whether or not HIV can be detected in all PWAs.

Several times Duesberg was accused by Anthony Fauci and William Haseltine of having based his arguments on research that was "out of date". Duesberg replied that some of the key figures he cited had been used recently by members of the AIDS establishment, and that he looked forward to reading reports of any new data.

A fundamental difference in philosophy is involved here, one which needs to be articulated. On several occasions Duesberg and Harry Rubin, Duesberg's colleague at Berkeley, asked Fauci or Haseltine for references to back up assertions they had made, and they were rudely rebuffed. Both Duesberg and Rubin belong to the old school, according to which facts are not entirely "real" until they have been published. Scientists are expected to make their data available, together with a detailed description of methodology, so that other scientists, working independently, could attempt to replicate the experiments and verify the results. Science is thus a public activity, where scientists check out each other's work in a mutual endeavor to establish the truth.

Unfortunately, government scientists and others in the AIDS establishment have sometimes been motivated by considerations other than the truth. In the interests of profit, prestige, and public relations, they have resorted to secrecy and deception. A case in point is the well-documented episode in which Robert Gallo attempted to steal credit from the French for the discovery of the "AIDS virus".

The difference in philosophy needs to be emphasized. Duesberg, basing his arguments on public facts, was countered by Fauci and Haseltine, who referred to their own private facts. Now, it is possible that Duesberg's public facts may be wrong, and that Haseltine's and Fauci's private facts may be correct. But even if that were the case, it would be a grave injustice to Duesberg to criticize him for having used public information. When Duesberg insists upon references, he is not quibbling; he is acting in the best tradition of science.

Harold Ginsberg

The panel was moderated by Harold Ginsberg, Professor of Medicine and Microbiology at Columbia University. He began by saying that recording of the forum would not be permitted, although there would be an official transcript of the proceedings, and that the purpose of the forum was to "discuss in an informal and friendly manner the etiology of AIDS." He then went into a presentation of his own. After conceding that "the pathogenesis of HIV is still pretty much a black box", he discussed the characteristics of several viral diseases, including influenza, poliomyelitis, measles, herpes simplex, and hepatitis B. He emphasized that neutralizing antibodies could be present when disease occurs, and did not necessarily prevent viruses from being present in the blood.

Ginsberg's comments served to set the stage against Duesberg by toppling a straw dummy representing selective statements, torn out of context, which Duesberg had made on antibodies. It became obvious that the forum would not favor free and impartial discussion of the issues -- an impartial discussion, after all, requires an impartial moderator. It was also obvious that the HIV protagonists would employ information overload as a propaganda technique. While Ginsberg's comments were true enough, so far as they went, they were mostly irrelevant to the central issues of the debate. Nevertheless, they conveyed the impression that a vast body of knowledge argued against Duesberg's critique of the HIV hypothesis. Novice reporters, straining to take in all of Ginsberg's information (without the aid of tape recorders), ended up with little space in their heads for the relevant issues.

Marcel Beluda

The next speaker was Marcel Beluda, Professor of Pathology at the University of California at Los Angeles. His presentation dealt with the complex structure and reproduction cycles of retroviruses, and what rules a retrovirus would have to follow in order to cause disease. He said that, with regard to Koch's first Postulate, retroviral DNA should be present in 100% of the cases, and that it was a serious weakness in identifying HIV as the etiological agent that this requirement could not be satisfied.

Beluda's presentation was complex and highly nuanced, and he ran out of time. Nevertheless, his concluding statement came out clear and strong: "We must resolve the 'black box' HIV biological phenomenon."

Harry Rubin

Harry Rubin, Professor of Molecular Biology at the University of California at Berkeley, was one of the pioneers in the field of retrovirology. Twenty years ago Rubin was king of the field; he trained many of the scientists who are today the world's leading retrovirologists.

Rather than discussing the intricacies of molecular biology, Rubin went instead to the heart of the matter: the conceptual problems of AIDS. Rubin said that he was disturbed by the simplicity of the causal explanation that had been put forward. An enormous complexity of disease states constitute the AIDS Syndrome; no fewer than 20 different diseases are classified as "AIDS". Cartesian reductionism -- the notion that complex phenomena can be reduced to a single cause -- didn't make much sense in this context. The simplistic notion of a single disease entity caused by a single virus ignored the role played by the condition of the host -- the complex, life-long interaction between the host, the environment, and microbes.

For Rubin a red flag went up when he learned that Burkitt's lymphoma was classified along with the many other manifestations of AIDS. He recalled that for many years attempts had been made to explain Burkitt's lymphoma and other cancers in terms of viruses, with such candidates as Epstein-Barr virus proposed. The generally favored explanation came to be chromosomal abnormalities. And now, apparently, "HIV infection" is supposed to be a cause of some cancers.

Rubin said that the simplistic HIV causal explanation raised a lot of questions, and recalled a theory that was popular 20 years ago to explain the origin of cancer. The "immune surveillance theory" held that the body somehow lost its immune capacity and, in consequence, its ability to hold down cancers. The theory is no longer talked about owing to experiments on athymic mice, known as "nude mice". (Lacking thymus glands, nude mice cannot manufacture T-cells, and therefore lack a cellular immune system.) What dissolved the "immune surveillance theory" was the discovery that nude mice, while susceptible to many different diseases, had no higher incidences of any cancer than did mice with normal immune systems. So, Rubin asked, how can we talk about "immune deficiency" as being responsible for the cancers that are considered to be a part of the syndrome known as "AIDS"?

Rubin concluded by saying that he found any single cause of the enormous complex of diseases to be seriously inadequate. While he was not willing categorically to rule out the possibility that HIV might play some role in some cases, he was "not ready blandly to accept it as the single cause of all of the disease complex." Rubin posed the question, to what extent is the virus itself an opportunistic infection? He found it irresponsible to focus exclusive attention on the putative viral cause while failing to address the associated practices of high risk groups (heavy use of recreational drugs, overuse of antibiotics, promiscuous sexual behavior) which are themselves known to compromise the immune system.

In the question period following Rubin's presentation, William Haseltine bluntly challenged Rubin on the issue of high- risk behavior, and asserted that the best correlation with AIDS is "evidence of viral infection", and that there were many instances of AIDS in persons with no known risk factors. Rubin replied that the serological evidence seemed to argue against HIV, since in many PWAs neither antibodies nor virus could be detected.

Beluda then intervened, apparently annoyed by Haseltine's belligerence, to state that sometimes even a single exception is sufficient to disprove a theory. HIV antibodies are reportedly found in 90% of PWAs, but what about the other 10%? "This is the crux of the matter", Beluda said, "the virus cannot be found in all cases of AIDS."

Fauci responded to Beluda by saying that a "good lab" was able to isolate the virus in 90-100% of the cases, that there was "no question about it". Fauci did not provide a reference to published data, nor did he indicate what the "good labs" were, or how exactly they differed from the not-so-good labs.

Peter Duesberg

(Since Duesberg's presentation covered a lot of ground, I'll try to summarize just the main points here. To understand the full scope of his arguments, the articles listed below under "References" should be consulted.)

Basically Duesberg argued that HIV does not have the physical properties to cause disease, let alone the devastating pathology associated with AIDS. The HIV hypothesis is fraught with contradictions (or "paradoxes"); it violates the rules that all other microbes follow when they cause disease; indeed, the hypothesis sometimes violates the principle of causality itself.

Duesberg began by attacking the prevailing hypothesis: that HIV kills T-cells after a bizarre latent period of 5-8 years. This cannot be true, he said, because retroviruses do not kill cells -- in fact, retroviruses make cells grow faster. The "AIDS virus" hypothesis is now the basis for over $1 billion research efforts annually, making it the most expensive virus in history. The HIV hypothesis is the basis for the "AIDS test", which is in fact only a test for HIV antibodies. Antibodies, which for 200 years have been interpreted as good news, are now interpreted as a prognosis for death. Positive results on the antibody test have resulted in suicides and broken marriages; they would be the basis for denying residence in China. The presence of HIV antibodies is now being used to justify treatment with AZT, which has one known effect: to stop DNA synthesis; the obligatory consequence of incorporating AZT into a human cell is either a dead or a mutated cell.

The "AIDS virus" hypothesis is based only on correlation -- between HIV antibodies and AIDS -- a correlation in the neighborhood of 80-90% ("They never say 100%"). And even if the correlation were 100%, this would not prove causality. Further, antibodies are not the same as the virus itself, which is so extremely difficult to detect that only the most expensive laboratories in the country are capable of doing so, and even then, only in about half of the cases of AIDS.

All known viruses (polio, hepatitis, et al.) are biochemically active when they cause disease. They have to kill or intoxicate more cells than the host can regenerate. Paradoxically: HIV is inactive and latent, even in patients who are dying from AIDS. A virus cannot cause harm without doing something. Although viruses can go through periods of latency, neither herpes nor any other virus is inactive at the time that it causes disease. HIV actively infects fewer than one in 10,000 T-cells, even in fatal cases of AIDS. This is trivial, the equivalent of losing one drop of blood every day.

Viruses cause disease before, not after antiviral immunity. This is why vaccination works. Paradoxically: HIV is said to cause AIDS only after a peculiar latent period of 5 to 8 years.

HIV is a retrovirus, and retroviruses do not kill cells. On the contrary, they depend on living cells to reproduce. This is why retroviruses were the most plausible viral carcinogens in President Nixon's "War on Cancer". Paradoxically: the retrovirus called HIV is said to cause AIDS by killing T-cells. In fact, Robert Gallo and others have observed that T-cells in culture produce much more virus than is ever produced in AIDS patients, yet survive indefinitely, developing into immortal lines.

No known virus discriminates between men and women, or between heterosexuals and homosexuals. Paradoxically: even eight years into the epidemic, AIDS shows an absolute preference for men (92%).

The transfusion cases have been used as an argument for the HIV hypothesis, yet transfusions do not discriminate between HIV and all other microbes, toxins, etc. that are in the blood. That the transfusion argument is not strong, but tenuous, is shown by the control group of 14,000 hemophiliacs in the United States who are antibody positive, yet only 300 (2%) of whom have developed any of the many symptoms of AIDS. The low incidence is even more striking in light of the fact that hemophiliacs are a congenitally sickly population; only a few years ago, their average life expectancy was 11 years. Furthermore, it is now three years since the HIV antibody test came into use to screen blood. We should have seen at least a levelling off of the "transfusion cases", but contrary to expectations, they have just doubled.

According to basic logic, a virus or other pathogen would at least have to be present when it causes disease. This is Koch's first postulate for identifying a causative pathogen, which states that the presumed causative agent must be present in all cases of the disease. However, HIV can only be isolated in 50% of AIDS cases. Although there are unpublished observations that the figure can be pushed up to 100%, this is not consistent with the fact that pro-viral DNA cannot be detected in a substantial proportion of AIDS cases. Gallo could only detect pro-viral DNA in 15% of AIDS cases. A recent article in Science Magazine reported being unable to detect pro-viral DNA in a significant number of AIDS cases, even using the most sensitive techniques.

Duesberg posed the question, why is the "AIDS virus" hypothesis so popular, in the face of so many paradoxes? He suggested that this was due to two problems in the field:

1. Progress in biological thought has not kept up with the rapid progress in technology. Only ten years ago, scientists would never have detected a latent virus that is only active in one out of every 100,000 T-cells. With their limited tools, Koch or Pasteur or Enders or Sabin were forced to look for microbes at clinically relevant titers. Indeed, Koch's first postulate needs to be amended now, in light of the technology of the present, to state that pathogens must not only be detectable, by the most sensitive techniques available, but must also be biochemically active in more cells than the host can spare or regenerate.

2. AIDS is a syndrome, not a single infectious disease. The spectrum of diseases is truly impressive... yet such things as lymphoma and Kaposi's sarcoma cannot be attributed to immune deficiency, as is shown by the example of the nude mice. Nor does immune deficiency explain dementia.

In short, the one-virus, one-disease concept is hard to reconcile with the AIDS situation, although people would like to see it that way. AIDS propaganda has transformed a latent, non- cytocidal retrovirus, a "Sleeping Beauty", into a vicious killer virus. AIDS propaganda has reduced a complex syndrome to a single disease entity with a single cause. What we need to do is look at "risk behavior", which may hold the keys to the many diseases of AIDS.

Anthony Fauci

Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, has become the most publicly prominent member of the "AIDS establishment", often quoted in the press and featured on television shows. His presentation, while aspiring to be a point-by-point rebuttal to Duesberg, consisted mainly of disconnected assertions, delivered in a tone of petulant indignation.

Epidemiological studies conducted in San Francisco and unpublished laboratory reports seemed to be the basis of most of his statements. So far as I could tell, he understood virtually none of Duesberg's arguments; whatever else he may be, Fauci is not a philosopher.

It is not true, Fauci said, that HIV is inactive; sometimes there are "bursts of activity". According to Fauci, it is false to say that nothing is happening: HIV is "insidiously destroying the immune system" in asymptomatic but infected people.

Fauci claimed that the AIDS virus is unique in that its major target is the immune system itself. The disease is not HIV infection; "it is the opportunistic infections and neoplasms that kill the individual." Auto-immune phenomena, etc. can also be taken into account, in addition to the direct cytocidal effect, which is clearly demonstrated in vitro. The macrophages can serve as a reservoir, where the virus can hide out without being detected by the immune system.

Fauci accused Duesberg of having said if you're infected this means, "hurrah, your body has won!" According to Fauci, this flies negatively in the face of the data [based on an unpublished San Francisco study] that within five years, 90% of seropositive individuals will have deleterious effects on their immune system.

Fauci countered Duesberg's point on "discrimination" -- that the virus seems to attack mostly homosexual men -- by saying that the point was the mechanism of transmission. Risk behavior simply meant coming into contact with the virus. He then asked a series of abusively rhetorical questions.

"What kind of risk behavior", he demanded, "does the infant born of an infected mother have?"

"And what about the 50-year-old woman who received a blood transfusion from an infected donor?"

(The answer to the first question is: 1) in the decade of the AIDS epidemic, there have been only a few hundred reported cases of infants with AIDS, 2) infants are not yet immunocompetent, and 3) virtually all infants with AIDS were born to mothers who were drug abusers -- as everyone ought to know, drugs cause birth defects. The answer to the second question is that a 50-year old woman who requires a blood transfusion is already at risk, and that blood transfusions involve massive exposure to microbes, human cells, and toxins of all kinds.)

Fauci addressed the question of Koch's first postulate by asserting that "good labs" could find the virus in 90-95% of the cases -- that it was too much to expect 100%, because any technique has a limitation. He concluded by saying, "The data strongly, if not overwhelming, indicates [sic] that HIV is the cause of AIDS." (This is a step backward -- only a few weeks ago, Fauci found the evidence "overwhelming".)

In the question period, Beluda asked if the evidence were sufficient that HIV is necessary for the development of AIDS. Fauci replied that he hoped the epidemiologists would answer that question.

William Haseltine

William Haseltine, Chief of the Laboratory of Biochemical Pharmacology at the Dana Farber Cancer Center of Harvard Medical School, appeared to be an angry man. His presentation was devoted largely to personal attacks on Duesberg, in a manner which two of my colleagues described as "brutal" and "vicious". Haseltine's anger can probably be attributed to Celia Farber's interview with Duesberg in Spin Magazine (January 1988), in which Duesberg stated:

William Haseltine and Max Essex, who are two of the top five AIDS researchers in the country, have millions in stocks in a company they founded that has developed and will sell AIDS kits that test for HIV. How could they be objective?

When Celia Farber contacted Haseltine, he confirmed his and Essex's business arrangement with Cambridge Bio-Science, a company that sells HIV testing kits. Said Haseltine: "I deeply resent the implication that my business investments have affected my work."

Haseltine accused Duesberg of "serious confusion and misrepresentation of fact". He said that when rational arguments don't hold up, Duesberg "has resorted to personal attack; he has impugned the motivations of individuals and institutions."

Haseltine asserted that "HIV is demonstrably cytopathic", though he didn't say how.

He quoted Duesberg as having said that antibodies were "good news". Not so, said Haseltine, to be antibody positive is very bad news for the health of the individual.

Haseltine said it was not true that there was no detectable viremia in AIDS patients, and said he would show a slide "with the current perception with regard to viremia...during the later course of infection, one sees rising antigenemia in most persons infected."

He attacked Duesberg's "paradox", that the AIDS virus seemed to be able to discriminate between boys and girls, by saying that this was not true outside the U.S. -- in Africa, about equal numbers of men and women develop AIDS. (He seemed oblivious to the paradox that a microbe should be able to discriminate in one country, but not in another.)

According to Haseltine, Rubin and Duesberg were confused about nude mice, which in certain classes were capable of "mounting a vigorous immune response".

The most dramatic moment in the forum came when Haseltine began showing his slides.

Haseltine's Fake Slide

In presenting his first slide, Haseltine said, "This gives us a summary of the virology. Dr. Duesberg asserts that during the later phases of the disease one does not see free virus in circulation. That is not generally reflected in the patients. During the latter phase of the disease, the black line represents either virus titer or viral antigens directly detectable in the circulation. It rises later in the disease. That rise is concomitant with the period when T-cells fall. So it is not the case, the central assertion he has made in his arguments, that one does not have viremia."

At this point Duesberg asked, "Why are there no units on that slide?"

"Don't interrupt me", responded Haseltine, "I didn't interrupt you."

"I merely asked why the slide has no units on it", replied Duesberg.

Haseltine angrily refused to answer the question, and the chairman intervened, saying that questions would have to wait until the presentation was finished.

Perhaps Duesberg ought to have waited, but one can understand his impatience. Witnessing a fast-flowing stream of propaganda, he spotted something that was obviously wrong, and wanted to confront it before the moment was lost. That his suspicions were more than justified became clear later.

In the question period following Haseltine's presentation, Harry Rubin asked Haseltine if he could provide a reference for his statement that nude mice were capable of mounting a vigorous immune response. Haseltine said that there was a large literature on nude mice: "If you haven't read it, how can I discuss it with you?". Rubin gently replied that perhaps he had read it, but that he had only asked for a reference.

Duesberg then requested that the slide be shown on the screen again, and asked if it were an accident that the slide had no units on it.

[A PHOTOGRAPH OF THE SLIDE APPEARED IN THE NEW YORK NATIVE ARTICLE. IT SHOWS A GRAPH ENTITLED "AIDS VIRUS AND ANTIBODY". THE TWO VERTICAL AXES ARE LABELLED "VIRUS TITER" AND "AB TITER", BUT HAVE NO UNITS OF ANY KIND. THE HORIZONTAL AXIS HAS CHRONOLOGICAL NOTATIONS WHICH ARE GIBBERISH: "3-6 WEEKS", "2-10 YRS", AND "1.5-2 YRS".]

Haseltine was unable to answer the question himself, and asked Dr. Robert Redfield of the Walter Reed Army Research Institute, sitting in the audience, to explain how the slide was prepared. Redfield said something to the effect that "different measurements were used", a grossly inadequate explanation. When Duesberg persisted, Haseltine became truculent, and said that Duesberg should read the literature, because there were different measures that could be used. With no satisfactory answer forthcoming, the chairman moved on.

The truth about the Slide Without Units came out in the evening, at a party at the home of Dr. Harris Coulter (author of "AIDS and Syphilis: The Hidden Link"). In a relaxed and convivial mood, Redfield admitted, in the presence of Duesberg, Rubin, myself, and several other witnesses, that the graph had been prepared to illustrate a theoretical possibility. It had no units on it for the simple reason that it was not based on any data at all. In other words, the slide was a fake.

It is difficult to think of an innocent explanation for Haseltine's behavior. If he didn't know what the slide meant, or whether or not it was real, then he shouldn't have used it. Haseltine presented the slide as though it represented scientific findings, whereas it really represented speculation. It is not unfair to call this kind of misrepresentation, fraud. Nor is it making too much out of one fake slide. If someone will cheat in little things, he will cheat in big things as well. In my book, Haseltine has forfeited his claim to scientific credibility.

Warren Winkelstein

Warren Winkelstein, Professor of Biomedical and Environmental Health Sciences, School of Public Health, University of California at Berkeley, gave a talk entitled "Epidemiological Observations on the Causal Nature of the Association Between Infection by the Human Immunodeficiency Virus and the Acquired Immunodeficiency Syndrome". He was the only panelist to provide printed copies of his talk, something much appreciated by us journalists.

Briefly, the point of Winkelstein's presentation is that Koch's postulates should be superseded by new standards for establishing the causal relationship between microbes and disease, and that these standards should be based upon "epidemiology", or, as it were, correlations of various kinds.

Winkelstein and colleagues in San Francisco, under the auspices of Fauci's National Institute of Allergy and Infectious Diseases, studied a sample of single men, 25-54 years of age, over a period of three and a half years. Data were collected on HIV antibody status over time, on progression to AIDS, and on various other clinical parameters.

They found that none of the heterosexual males and none of the gay men who remained seronegative developed AIDS, whereas 13% of the men who were seropositive upon entry into the study, and 8% of those who became positive during the course of the study developed AIDS. Further, they found that a progressive decline in T-4 cells occurred among those who were seropositive.

They concluded that epidemiological data from their study, together with data from a related San Francisco study (conducted among a cohort of gay men recruited from VD clinics in 1978 for a hepatitis B study), supported "the hypothesis of a causal association between HIV infection and AIDS."

All in all, a grim scenario, according to which testing positive for HIV antibodies would truly be a "prognosis for death". I am skeptical, but as a survey research professional I reserve the right to withhold judgment until I have seen full reports on both San Francisco studies. At minimum such reports would have to include full descriptions of methodology; all questionnaires, recording forms, and field materials; sampling procedures; and computer tabulations.

At any rate, I do not accept the proposition that Koch's postulates should be abandoned in favor of epidemiological correlations. This would be a step backward, a step away from scientific rigor, a stop towards impressionism and confusion.

Murray Gardner

Murray Gardner, Chairman of the Department of Pathology, University of California at Davis, spoke about lentiviruses and animals. The man is apparently a failed stand-up comedian. During his presentation he danced back and forth behind the table, gesturing wildly, urging the audience to laugh along with him at the absurdity of doubting, even for a moment, that HIV was the cause of AIDS. We were told that the animals had "little understanding of co-factors", that their diseases had "nothing to do with lifestyle", and so on.

Gardner had begun his clown act even earlier, making faces during Rubin's presentation. Virtually nothing Gardner said was relevant, and little was memorable, except perhaps the mistakes. A slide of his referred to the "pathogenicity of new HIV strains, e.g., HIV-2". This is wrong: HIV-1 and HIV-2 are not different strains of each other; they are completely different viruses; they differ in genetic structure by up to 60%; they do not have a closely-related common ancestor.

(Based on these facts, Dr. Joseph Sonnabend, an independent AIDS researcher in New York City, has formulated an "evolutionary argument" against the HIV hypothesis, which runs roughly as follows: There is no longer just one "AIDS virus"; there are several, perhaps as many as four or five at last count. It is now claimed that both HIV-1 and HIV-2 are capable of causing AIDS, a disease which allegedly appeared in the world for the first time only a few years ago. However, viruses are products of evolution, and very ancient -- there is no such thing as a "new" virus. The proposition that, within the space of a few years, two different viruses, each capable of causing the same new disease, should have come into being, or should have gone from an animal reservoir to susceptible human populations, is seyond the bounds of probability.)

Gardner concluded his presentation by winking at the audience. It reminded me of one critic's comment on a cheaply made horror movie -- that the zombies were less frightening than the attempts at humor.

Roger Detels

Roger Detels, Professor of Public Health, University of California at Los Angeles, began his talk by saying that it was good to continue questioning judgments. In context, this amounted to an apology to Duesberg and Rubin for the rudeness with which they had been treated. It was a gracious gesture on his part.

Detels discussed the San Francisco "Multi-Center AIDS Cohort Study", in which an annual "attack rate" of 5% was found among the seropositive gay men studied. That is, each year 5% of the seropositives came down with AIDS. (Harry Rubin was to point out later, that if 1-3 million Americans are seropositive, according to CDC estimates, and if the annual attack rate is 5%, simple arithmetic indicates that every year 50,000 to 150,000 people ought to develop AIDS.)

During the question period, pathogenesis was mentioned again, and Haseltine entered the fray, insisting that there were plenty of mechanisms that could explain pathogenesis, and that it was not necessary to discuss it.

Questions From The Audience

The first audience participant was Harvey Bialy, Research Editor of "Biotechnology". His remarks were rather technical, and can be found in more detail in an editorial in the February issue of "Biotechnology". The gist is that several recent articles have cited antigenemia findings to suggest that HIV may, after all, be active during the fatal, late stages of AIDS. However, the papers contain serious mathematical and other discrepancies. Bialy maintained that it was the responsibility of scientists, as well as journalists, to look at data critically and ask the hard questions.

The second speaker from the audience was Coulter, who asked whether findings from the San Francisco City Clinic study, based on a sample of gay men who had hepatitis B, and who were highly promiscuous and heavily into recreational drugs, could be extrapolated to all of the people in the U.S. who were seropositive. For some reason, the epidemiologists were either unable or unwilling to answer his question. Coulter persisted, asking the question in several different ways, each of which was perfectly clear. But the "AIDS experts" could not respond. This was truly amazing, for the question was one of the most basic in all of statistics. It is the question of how representative a sample is of a particular universe or population -- of whether one can project findings from the sample to the target universe.

Next, Dr. Nathaniel Lehrman, an independent researcher from Long Island, spoke, emphasizing the need to re-examine the etiology of AIDS, not only because of the questions raised by Duesberg and others, but because its epidemiology is far more consistent with a toxic illness than with an infectious one. How could AIDS be only an infection, and spreading so rapidly, when, according to Surgeon General C. Everett Koop, M.D., not one of 750 accidental inoculees with the blood or body fluids of known AIDS patients developed the disease, and only three then developed antibodies to HIV?

Chemical causes of immune deficiency, stated Lehrman, have long been known, and one group of chemicals, known to produce immune suppression, may be a cause of AIDS in the homosexual community: inhaled nitrites, or "poppers". And although poppers are banned by law in New York State, they are as freely available on New York streets as any other illegal drug. Could other chemicals also be involved in producing immune suppression and AIDS? Lehrman concluded by saying that the possibility that chemical toxicity plays a significant causal role in AIDS ought to be investigated, and that therefore changes, or at least additional methods in diagnosing, treating and researching the syndrome should be adopted. One such step would be spectrophotometric and similar investigation of AIDS patients for unusual, immune-suppressive substances within their bodies.

I spoke next, and said it was high time that those who advanced the hypothesis that HIV was the cause of AIDS should publish a monograph in an appropriate journal, which would bring together all the evidence supporting their hypothesis, which would take into account the critiques made by Duesberg and others, and which would contain proper references for all assertions made. Then I said that the epidemiological research on AIDS had been very poor, completely unacceptable by the standards of professional survey research. Ever since 1984, Public Health Service surveys have concentrated only on such things as "modes of transmission", or "risk factors for seroconversion", as a result of which we know almost nothing about the characteristics of PWAs. We have no idea what the IV drug users with AIDS are like, other than the "risk group" label that has been slapped on them. Finally, I said it was disgraceful that AZT was still being marketed, a poisonous drug without a single scientifically-established benefit. When would the AIDS establishment admit that the AZT trials, on which approval of the drug was based, were fraudulent?

Finally, Specter, the reporter from the Washington Post, demanded that Duesberg give him a yes or no answer to the question, "Do you still maintain that someone should be overjoyed to find out he is [HIV-antibody] positive?" Duesberg paused, and way one does when confronted with an obstreperous barbarian, Specter started yelling, "Answer the question! Yes or No? Why won't you answer the question?" When he finally got a chance, Duesberg replied that he would answer the question, but in his own words, not Specter's. Duesberg repeated his position, but the nuances of his answer were not appreciated by Specter.

Summing Up

For the debate on the cause or causes of AIDS to move forward, a number of questions of fact must be resolved: Does HIV kill cells in vivo (in living organisms)? If so, how? References? Is HIV really "more complex in its genetic makeup than any other known retrovirus" (as asserted in AmFAR's "Review of Operations: 1985-1986")? References? From what percentage of PWAs can HIV be isolated? From what percentage of PWAs can pro- viral DNA be detected? References? What is the definition of a "good lab"? References? Is viremia found in PWAs? If so, what virus titers are obtained, when, how, etc.? References? Are there (as asserted by Gallo et al.) both pathogenic and non- pathogenic strains of HIV? If so, how do they differ? References? Can "nude mice" really mount a vigorous immune response (as asserted by Haseltine)? Is a full report available on the epidemiological research conducted in San Francisco?

The forum exposed the bankruptcy of the arguments used by the HIV advocates. Only a few weeks ago they were trotting out at least half a dozen speculative mechanisms to explain how HIV might cause AIDS; during the forum, such speculations were abandoned, and the official line was, "We don't need to explain pathogenesis." The "AIDS virus" crowd cannot agree on even the most crucial questions of fact, as indicated above. At one moment HIV is ferociously killing T-cells; the next moment, "AIDS experts" are desperately scrounging around for "indirect mechanisms". "Epidemiology" has been called in as a last ditch effort to rescue the HIV hypothesis, and yet the epidemiology conducted by the AIDS establishment to date has been quite bad, totally unacceptable by the standards of professional survey research. While the San Francisco studies may "strongly support" the HIV hypothesis, they could not prove it, even if the data were correct (and this cannot be determined until a proper report is issued), because there remain alternative explanations to account for the correlation between HIV antibodies and AIDS -- namely, that HIV is itself an opportunistic infection in the AID Syndrome, that HIV is a marker for AIDS.

I am more sure than ever that HIV is not the cause of AIDS. If the HIV advocates were sure of their hypothesis, they would want to enlighten us; they would want to publish their arguments in a proper scientific journal, complete with references. They would not need to resort to stonewalling, deception, and personal abuse. *

References

1. For Duesberg's ideas see: Peter H. Duesberg, "Retroviruses as Carcinogens and Pathogens, Expectations and Reality", Cancer Research, March 1, 1987. "A Challenge to the AIDS Establishment", Bio/Technology, November 1987. Celia Farber, (interview with Duesberg) "a.i.d.s.: Words From the Front", Spin, January 1988. John Lauritsen, "Saying No to HIV: An Interview With Professor Peter Duesberg", New York Native, July 6, 1987; Christopher Street 118. Russell Schoch, "The 'AIDS virus' tests negative", California Monthly, December 1987.

2. Michael Specter, "Panel Rebuts Biologist's Claims on Cause of AIDS", Washington Post, April 10, 1988.)

3. See, for example, articles in the New York Native and the New Scientist (February 12, 1987).

4. Celia Farber, op.cit.

5. Harvey Bialy, "Commentary: Where is the Virus? And Where is the Press?", Biotechnology, February 1988, p. 121.

6. See my two articles, "AZT on Trial" (Native, October 19, 1987) and "AZT: Iatrogenic Genocide" (Native, March 28, 1988).