A group of doctors, scientists and writers has called for a re-evaluation of the theory that only one virus, HIV, causes AIDS.
Their call was prompted by the continued inability of researchers to pinpoint what causes people infected with HIV -- human immunodeficiency virus -- to develop the fatal disease.
Included in the loosely knit group of about 40, which calls itself “The Group for the Scientific Reappraisal of the HIV/AIDS Hypothesis,” are scientists who believe that one or more “co-factors” may be working with HIV to trigger the onset of AIDS. The co-factor theory is gaining support in the mainstream AIDS-research community, as well.
The more radical members of the group include scientists whom many mainstream researchers consider dangerous to public health because those members believe that HIV plays no role in AIDS.
The group says that it is time for a debate on the possibility of various causes of AIDS. They argue that such a debate has not occurred since HIV was identified in 1984 and the National Institutes of Health and other government agencies began spending billions of dollars on studies related to HIV.
“We closed the door too soon,” says Robert S. Root-Bernstein, a member of the group and a professor of physiology at Michigan State University. “It would have been a lot healthier to try a variety of ideas and find out that some of them don’t work.”
Peter H. Duesberg, a professor of molecular and cell biology at the University of California at Berkeley, lays the blame for the lack of debate at the door of the NIH, which he contends has a “vested interest” in the HIV theory. “They have policy makers there who decide in consultation with outside scientists what is the right science to do now,” he adds. “Academic freedom has become a victim of centralization and mega-grants.”
Mr. Duesberg and Mr. Root-Bernstein illustrate the different camps represented in the group of renegade scientists.
Mr. Root-Bernstein believes that HIV helps to damage the immune system, but he suggests that researchers should be looking for other viruses and co-factors that may work with HIV to cripple the immune system and enable AIDS-related diseases to develop. Those who believe in the co-factor theory say it could challenge the commonly held belief that the estimated one million Americans now infected with HIV will develop AIDS someday.
Mr. Duesberg, a virologist who has won acclaim for his cancer research, is an outspoken critic of any role for HIV, charging that the virus is incapable of causing AIDS. He contends that the virus affects too few cells of the immune system to be dangerous and that the HIV theory is scientifically flawed because a virus that later immobilizes the immune system cannot exist in a person’s body for several years without causing serious ill effects. He believes that drug abuse, malnutrition, and other factors can suppress the immune system and lead to AIDS without help from HIV.
His opinions have been vehemently attacked by scientists and public-health officials who say his views are incorrect and could cause people to disregard warnings about contracting HIV. June E. Osborn, chair of the National Commission on AIDS and dean of the School of Public Health at the University of Michigan, says the suggestion that HIV is not dangerous is “a distracting and misleading line of thought, which is shared by hardly anybody.”
Charles A. Thomas, Jr., a former professor of biochemistry at Harvard University and an organizer of the group seeking a reappraisal of the HIV theory, acknowledges the differences among members of the group. However, he says, they are united in opposing the conventional wisdom that HIV alone leads to the disease.
“It’s a question of what’s the truth,” says Mr. Thomas, who now heads the Helicon Foundation, a research institute based in San Diego. “We’re all united by that concept.”
Mr. Root-Bernstein of Michigan State says he believes that scientists should be looking for factors other than HIV that are common to patients who develop AIDS. Researchers, he says, should examine the combined impact of HIV and other viruses like the Epstein-Barr virus, hepatitis B, or herpes, and other factors that may suppress the immune system. Those factors may include malnutrition, blood transfusions, cocaine use, the abuse of morphine-based drugs, or even the overuse of antibiotics.
Mr. Root-Bernstein says the co-factor theory may explain why not all AIDS patients develop the same disease. He points out that gay men are much more likely to develop Kaposi’s sarcoma, a rare form of cancer characterized by skin blotches, than are other people infected with HIV. He suggests that a co-factor common to the gay community may favor the development of that particular disease.
He and other supporters of the co-factor theory say the idea of a second agent has gained support since the 1990 assertion by Luc Montagnier, a prominent French AIDS researcher, that mycoplasmas may act as co-factors in causing the disease. Mycoplasmas are bacteria that do not have cell walls.
Steven Jonas, a professor of preventive medicine at the State University of New York at Stony Brook and a member of the group seeking a reappraisal of HIV, acknowledges that a big gap exists between looking at potential microscopic co-factors, like mycoplasmas, and looking at environmental co-factors like drug use.
“It’s a start,” he says. “Once a scientist says, `Maybe we weren’t entirely correct, let me take another look at this,’ that opens the door to scientific thinking.”
The NIH also has taken a role in the search for co-factors, supporting the work of Shyh-Ching Lo, chief of molecular pathobiology at the Armed Forces Institute of Pathology in Washington. He is studying the possibility that a strain of one mycoplasma, known as Mycoplasma fermentans, may be a co-factor to HIV.
The NIH is currently reviewing applications for $1-million a year in grants for more research on Mycoplasma fermentans.
“The idea that there’s more than just HIV necessary to develop AIDS is one that keeps getting stronger,” says Robert L. Quackenbush, chief of the bacteriology and mycology branch of the National Institute of Allergy and Infectious Diseases. “We want to really find out how significant mycoplasmas are in relation to AIDS.”
Adds Anthony S. Fauci, director of the NIH’s Office of AIDS Research: “We’ve always been very open to the whole idea of co-factors.” He rejects the criticism that federal officials have not engaged in sufficient debate on the possible causes of AIDS.
Dr. Fauci says that NIH’s spending levels for any area of research, including co-factors, reflect the interest of scientists and the number of high-quality grant applications in the field. He adds that the institutes have tried to “drum up support” for co-factor research by holding scientific workshops on the subject.
Mr. Root-Bernstein says the NIH’s support for Dr. Lo’s research gives him cause for “some optimism.” He notes, however, that NIH officials were reluctant to accept Dr. Lo’s work and provided him with a three-year grant worth $600,000 only after meticulously reviewing five years of his work.
Dr. Lo says he’s not sure that NIH officials are ready to stand behind his research yet. “I think they’re still waiting to say that our work is valid,” he says.
Adds Mr. Root-Bernstein: “If we have to go through that with every co-factor, this is going to be a long, slow process. One would hope we could look at the whole field of co-factors.”
Dr. Fauci says the NIH was not overly critical of Dr. Lo’s work. “We were somewhat skeptical as we are with all science,” he says.
Others, like Berkeley’s Mr. Duesberg, have less enthusiasm for co-factor research because it is based on the idea that HIV plays a role in AIDS.
“Co-factors are politically a good thing to move on, because they give a face-saving role for the incumbent HIV theory,” he says.
The group of 40 came together last spring to put pressure on the NIH and AIDS researchers to re-evaluate the HIV theory. A letter it sent to the editors of scientific journals and major newspapers has not yet been published, but the group says it will press on.
Mr. Duesberg, who has been attacking the HIV theory since 1987 in the news media and in such journals as Science and the Proceedings of the National Academy of Sciences, says he is glad to have the support of other scientists in questioning the theory, even if they don’t agree with him on what causes AIDS.
While Mr. Root-Bernstein describes as “untenable” Mr. Duesberg’s argument that HIV plays no role in AIDS, he applauds him for having “kept the door open” for others to question the HIV theory.
After years of consistent criticism within the community of AIDS researchers, Mr. Duesberg has won some positive comments in recent months. John Maddox, editor of the British journal Nature, wrote in his September 26 issue that Mr. Duesberg was “probably sleeping more easily” since British researchers reported that AIDS spread through the body not by the actions of HIV, but by an autoimmune reaction between immune-system cells.
Mr. Maddox added in his November 14 issue that his comments had “stimulated both vitriol and misunderstanding” in the scientific community by merely invoking Mr. Duesberg’s name. “Duesberg has made a nuisance of himself, it is true, but does that mean that everything he says and does is wrong?” Mr. Maddox wrote.
Mr. Duesberg takes Mr. Maddox’s comments in stride, saying that he is not optimistic that he is about to be taken off the blacklist that he says he has been put on.
He charges that the NIH has rejected his application to continue a $350,000-a-year “outstanding investigator” grant for cancer research beyond next August because of his opposition to the HIV theory. Rep. Ronald V. Dellums, a California Democrat, investigated the NIH’s handling of the grant application, Mr. Duesberg says, and was told by NIH officials that politics had not played a role in the decision.
Mr. Duesberg is angry with Berkeley officials, who, he says, have not helped him appeal the NIH decision because the university is beholden to the institutes for millions of dollars in AIDS research. A spokeswoman for the university says the institution has encouraged Mr. Duesberg to pursue his appeal to the NIH but has declined to become involved in any possible legal action against the institutes.
The episode, Mr. Duesberg says, illustrates the dangers inherent in a peer-review system when a particular theory commands widespread attention and billions of dollars in research funds. “The peer-review system tries to keep you in a pack, or maybe running behind it,” he says. “If you run too far ahead of it, then you’re threatening their livelihood.”
Mr. Duesberg charges that AIDS researchers have had too little success in demonstrating how HIV causes AIDS to dismiss as “kooks” those scientists who question the theory. “If you’re saving people left and right, then you don’t have to listen to acupuncturists and kooks.”