aids reappraisal

The Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis came into existence as signatories of an open letter to the scientific community, dated June 6, 1991 which stated:

"It is widely believed by the general public that a retrovirus called HIV causes the group diseases called AIDS. Many biochemical scientists now question this hypothesis. We propose that a thorough reappraisal of the existing evidence for and against this hypothesis be conducted by a suitable independent group. We further propose that critical epidemiological studies be devised and undertaken."

A verson of this letter was published in 1995. Since 1984, various activists, journalists, citizens, scientists, researchers, and doctors had expressed a range of opinons such as:

HIV has not been found in people with AIDS
HIV is a harmless retrovirus (Peter Duesberg)
HIV does exist, but does not cause AIDS: AIDS is not a contagious disease (Peter Duesberg)
HIV does exist, and may cause AIDS, but only in combination with other cofactors. (This was the public position in 1991 of Luc Montagnier and Robert Gallo the co-discoverers of HIV, who were both active in the search for cofactors.)

Some people have claimed that continued discussion of some of these opinions is irresponsible and poses a dangerous threat to public health. The debate and controversy regarding AIDS from the early 1980s to the present has provoked heated emotions and passions. The disagreement over the cause of AIDS is ultimately a conflict between scientific theories, which will be resolved by publication of scientific evidence. Meanwhile supporters of various perspectives seek to influence politicians and others who are under public pressure to make decisions on the best available information.

Is AIDS infectious?

Unusually-long latency period

AIDS has not behaved like a typical infectious disease. Typically, infectious diseases spread rapidly, even exponentially, and the latency period of many infectious diseases is usually measured in weeks whereas AIDS progresses slowly in comparison, with some cases of latency periods up to 11 years. There are infectious diseases which develop slowly and spread slowly, such as the prion-induced Creutzfeldt-Jakob disease whose latency period can be as long as 30 years; the slow rate of development of AIDS does not imply that it is not infectious. The relatively slow spread of AIDS may be due to HIV's long latency period and to new treatments and prevention campaigns which have slowed the spread of AIDS.

Koch's postulates

For HIV to satisfy Koch's postulates as the cause of AIDS,

It must be found in all individuals with AIDS (and not in those without AIDS)
It must be possible to isolate HIV from someone with AIDS
The isolated HIV should cause AIDS when introduced into a healthy person
It should be possible to isolate HIV from the newly infected individual

Although HIV cannot be found in the blood of people with AIDS a range of antibody, antigen, RNA tests and cell culture techniques provide indirect evidence of HIV activity that cannot be ignored.

Infection pattern

In North America and Western Europe, AIDS affects specific groups of people, and is fragmented into distinct sub-epidemics with differnet AIDS-defining diseases. According to the definition from WHO and the US health authority CDC, AIDS in Africa looks completely different from the corresponding syndrome in North America and Western Europe; one example that has been cited is that in Africa AIDS affects roughly equal numbers of men and women, while in North America and Western Europe it affects more men than women. Another statistic that is sometimes cited is that AIDS is highly correlated with drug use in Western countries, while it is associated with malnutrition and poor living conditions in Africa.

Is HIV harmless?

There are many people who are HIV-positive and remain healthy 15 or 20 years after testing positive for HIV. Conversely, some HIV-seronegative people develop what would have been considered AIDS-defining diseases had they tested positive. The long period of HIV infection preceding AIDS manifestations is to be expected; if HIV can take years to cause the immunosuppression necessary to permit opportunistic disease to occur. HIV has remained prevalent at a relatively constant rate in the United States population the past 20 years, suggesting that it has existed long before the outbreak of AIDS.

Is AIDS inconsistently defined?

Some of the approximately 30 AIDS-defining diseases, including Kaposi's Sarcoma and Pneumocystis carinii pneumonia (PCP), are considered diagnostic of AIDS only when HIV antibodies are present. In the absence of such evidence, these diseases are thought to be related to other immune problems, and are not diagnosed as AIDS. The definition of AIDS is an example of circular logic: because diagnosis with AIDS requires the presence of HIV antibodies, there can be no AIDS without HIV, by definition. Moreover, many of the AIDS-defining diseases, such as cervical cancer, have nothing to do with immune deficiency, and should not be considered part of the definition of AIDS. AIDS was originally defined without reference to HIV—by necessity, since AIDS was defined as a syndrome before HIV was discovered. The first definition of AIDS by the CDC in September 1982 listed 13 diseases, "at least moderately predictive of a defect in cell-mediated immunity, occurring in a person with no known cause for diminished resistance to that disease." Supporters of the HIV theory claim that it is not uncommon in medical science for a disease to first be described in terms of its physical manifestations, and to later have its definition altered as its causes become more evident. HIV was discovered in 1984, and a year later, after discussion with epidemiologists, the CDC changed its operational definition of AIDS to add a small additional number of conditions which would be considered AIDS-defining if (and only if) they occurred in conjunction with a positive HIV test. The original list of conditions continued to trigger an AIDS diagnosis with or without a positive HIV test. Once the idea that HIV causes AIDS had become widely accepted, it was added to the definition of the syndrome. As experience with the disease continued, it became clear that it was associated with a broader array of illnesses than those initially identified. In 1987 the CDC added some of these to the case definition, including encephalopathy and wasting syndrome. These had not been in the initial definition because they are not conditions that are recorded during epidemiological surveillance. It became apparent, however, that the operational case definition did not adequately reflect clinical experience. There were patients who were HIV infected but who did not have AIDS-defining illnesses who were doing poorly, and others who had AIDS-defining illnesses (such as one Kaposi's sarcoma lesion) yet were doing well. In January, 1993, the definition was again changed, to trigger an AIDS diagnosis on the basis of a CD4 cell count below 200 or a CD4 percentage below 14, and adding additional indicator diseases based on epidemiological observation: invasive cervical cancer, pulmonary tuberculosis and recurrent pneumonia. The core list of diseases identified in the original definition of the disease in 1982 continue to be AIDS-defining, even if an HIV test is not performed. It is for these reasons that the changing AIDS definition is merely a reflection of a broadened understanding of the disease, rather than a "circular" definition requiring a specific etiology. There is a strong correlation between HIV and AIDS, and thus it is perfectly natural for the presence of HIV antibodies to be a defining characteristic of AIDS. There is no consistent definition of AIDS across political or international boundaries. In Africa, a laboratory test is not required for a diagnosis of AIDS—this is because impoverished nations consider the test too expensive for routine use. This leaves global AIDS epidemiology without clear standards or norms.

Is HIV testing unreliable?

False positive test results incorrectly identify as HIV positive people who are not infected with HIV. The most commonly cited study is where 83% of all positive HIV antibody tests (10,000 out of 12,000 tests) were false-positives (New Eng. J. Med. 319, 961-964, 1988). "Is a Positive Western Blot Proof of HIV Infection?" by Eleni Papadopoulos- Eleopulos et al., was published in Bio/Technology, Vol. 11:696, June 11, 1993. All tests have false positives and false negatives. Scientists work with aggregate data, not individual data, so that a few false results do not unduly skew aggregate results.

Does HIV exist?

The Perth Group argue that the HIV/AIDS experts have not proven:

The existence of a unique, exogenously acquired retrovirus, HIV.
The "HIV" antibody tests are specific for "HIV" infection.
The "HIV genome", (RNA or DNA) originates in a unique, exogenously acquired infectious retroviral particle.

Defining AIDS

Although immune deficiency has long existed in humans, the current epidemic of immune deficiency is a new phenomenon that has only existed since the onset of the AIDS epidemic. If HIV is not a plausible cause, there other possible causes (e.g., drug use) which temporally fit the onset of the AIDS epidemic and have a more immediate biological mechanism. The recent drug epidemic has been quantitatively different from previous human drug use, and a particular class of nitrite drugs ("poppers") that became popular just before the initial outbreak, also many cases of AIDS closely resemble chronic nitrite poisoning. Much of the debate concerns the very conceptualisation of the syndrome itself. Is the concept of "AIDS" is itself artificial and a false construct. Is the AIDS construct is a conceptual response to a natural phenomenon: the diseases included in the syndrome were selected by observation, not arbitrarily. The definition of AIDS was a description of a new syndrome and needed to be refined once the causative organism had been found. This resulted in the so-called "circular" definition that certain diseases marked progression to AIDS only in the presence of HIV infection: it had always been known that these diseases occurred outside the context of the syndrome. There are clearly great epistemological divides between the two camps, as has been pointed out by several sociologists of science and other observers (e.g. Steven Epstein). Many scientists believe that scientific progress is primarily a matter of experimentation, not debate. Scientific progress is not simply a matter of experimentation -- as recognized in the philosophy of science, it also involves thinking processes and logical deduction.

History of the AIDS Reappraisal movement

The movement is often associated with one individual, Peter Duesberg, a professor of molecular and cell biology at the University of California, Berkeley. In 1987, Peter Duesberg was invited to publish Retroviruses as Carcinogens and Pathogens: Expectations and Reality. The paper was published at the time that major public health campaigns were being launched and AZT was being promoted as a treatment. A major publication, Confronting AIDS, had been published in 1986, and this book set out an agenda for the public health sector in dealing with new epidemic. Many accused Duesberg of jeopardising public health by raising questions. During the same year, Lauritsen interviewed Duesberg, and his interview was published in the New York Native. In 1990, Lauritsen published Poison By Prescription: The AZT Story, a book that was highly critical of the studies demonstrating the efficacy and safety of AZT in the treatment of AIDS. In 1992, Duesberg published a lengthy paper promoting his own alternative causation theory of AIDS -- the "drug-AIDS hypothesis". He claimed that the majority of AIDS cases in North America and Western Europe were the result of recreational and pharmaceutical drug abuse. His arguments mirrored many that had been put forward by Lauritsen earlier. In 1993, Lauritsen published, The AIDS War, a collection of his writings on AIDS from 1985 to 1992. Robert Root-Bernstein, an associate professor of physiology at Michigan State University and previously a MacArthur prize recipient, professed his own doubts about the HIV theory in his 1993 book Rethinking AIDS: The Tragic Cost of Premature Consensus. In 1994, Neville Hodgikson and the London Sunday Times published a headline story , which attracted much media attention itself. In 1996, Duesberg published, Inventing the AIDS Virus, in which he put forward his arguments and positions to the general reader. A collection of scientific papers by dissidents was published by the journal Genetica the same year (AIDS: Virus or Drug Induced?), including articles and papers by Duesberg, mathematician Mark Craddock, NIDA researcher Harry Haverkos, Lauritsen, Nobel prize winner Kary Mullis, Yale math professor Serge Lang, public health professor Gordon Stewart, and journalist Celia Farber. Neville Hodgkinson wrote a book detailing his journalistic efforts, entitled AIDS: The Failure of Contemporary Science. A major internet website was launched during this time, currently at www.virusmyth.net. As dissident scientists continued their questioning, a patient/activist branch of the movement had also begun to develop. Heal Education AIDS Liaison (HEAL) was founded in New York in 1982 and it eventually became the most prominent activist organization in the dissident movement. Other groups have come into being since then, including Alive and Well. These groups have openly challenged the HIV theory. In 1997, Lauritsen and Ian Young co-published a collection of articles on the psychological aspects of AIDS, entitled The AIDS Cult: Essays on the Gay Health Crisis. In this book, they posit a sociopsychological aspect of the epidemic based on hysteria, fear, and forced conformity. One article which appears was written by the doctor Casper Schmidt in 1984 in the Journal of Psychohistory, entitled "The Group-Fantasy Origins of AIDS" ( www.virusmyth.net/aids/data/csfantasy.htm ). In this essay, Schmidt posits that AIDS is an example of "epidemic hysteria" in which groups of people are subconsciously acting out social conflicts, and he compares it to documented cases of epidemic hysteria in the past, which were mistakenly thought to be infectious. Other essays in the collection condemn the psychological aspects of AIDS education which equate sex and an HIV diagnosis with death. Thabo Mbeki, president of South Africa has openly questioned the HIV theory, and invited Duesberg and David Rasnick to South Africa to debate the nature of AIDS.

Quotations

"If there is evidence that HIV causes AIDS, there should be scientific documents which either singly or collectively demonstrate that fact, at least with a high probability. There is no such document." -- Kary Mullis, inventor of PCR, 1993 Nobel Prize in Chemistry (Sunday Times (London) 28 Nov 1993) "Epidemiology is like a bikini: what is revealed is interesting; what is concealed is crucial." -- Peter Duesberg (Proceedings of the National Academy of Sciences, Feb 1991) "If ever there was a rush to judgment with its predictable disastrous results, it has been the HIV-AIDS hypothesis and its aftermath." -- Dr. Richard Strohman, emeritus professor of molecular and cell biology, UC Berkeley (preface to Inventing the AIDS Virus, 1995) "If I saw a man get hit by a truck and run over, and you asked, "Did you get the proof? Did the truck do it?" OK, it comes to something like that. Silly." -- Robert Gallo (Spin, Feb 1988) "Last century there was a sharp difference of opinion between those, such as Koch and Pasteur, who proposed that disease could be caused by invisible microbes, and others who held that epidemics are the result of evil vapours (malaria). Arguments that AIDS does not have an infectious basis are as quaint as those of the miasmalists." -- Weiss and Jaffe (Nature, June 1990)

References

Current Opinions in Immunology 1996 Oct;8(5):613-8. "HIV causes AIDS: Koch's postulates fulfilled", O'Brien SJ, Goedert JJ.
"Duesberg, HIV and AIDS", Nature 1990 Jun 21;345(6277):659-60, Weiss RA, Jaffe HW. Erratum in: Nature 1990 Jul 5;346(6279):22.
"The AIDS dilemma", Genetica 1998 Jul 6;104;85-132, Peter Duesberg, David Rasnick