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AIDS Epidemiology: Inconsistencies with Human Immunodeficiency Virus and with Infectious Disease PETER H Proc. Nati. Acad. Sci. USA Vol. 88, pp. 1575-1579, February 1991 Medical Sciences AIDS epidemiology: Inconsistencies with human immunodeficiency virus and with infectious disease PETER H. DUESBERG Department of Molecular and Cell Biology, 229 Stanley Hall, University of California, Berkeley, CA 94720 Contributed by Peter H. Duesberg, October 11, 1990 ABSTRACT The newly defined syndrome AIDS includes (12) human T-cell leukemia virus (HTLV) as causes of AIDS. 25 unrelated parasitic, neoplastic, and noninfectious indicator However, psychoactive drugs, like aphrodisiac nitrite inhal- diseases. Based on epidemiological correlations, the syndrome ants ("poppers"), were also proposed as causes for Kaposi is thought to be due to a new, sexually or parenterally trans- sarcoma and pneumonia in homosexuals (3-7, 9). mitted retrovirus termed human immunodeficiency virus In April 1984 the Secretary of Health and Human Services (HIV). The following epidemiological data conflict with this announced that HIV was the cause ofAIDS, and an antibody hypothesis. (i) Noncorrelations exist between HIV and AIDS; test for HIV, termed the AIDS test, was registered as a patent for example, the AIDS risks of infected subjects vary >10-fold by Gallo and collaborators (13-15). This happened before with their gender or country. Abnormal health risks that are even one American study on HIV had been published (13). never controlled as independent AIDS causes by AIDS statis- According to this view HIV is a lymphotropic retrovirus that is sexually transmitted (16-20). On average 10-11 years after tics, such as drug addiction and hemophilia, correlate directly infection and appearance of neutralizing antibodies, HIV is with an abnormal incidence of AIDS diseases. Above all, the postulated to cause immunodeficiency by killing billions ofT AIDS diseases occur in all risk groups in the absence of HIV. cells (16-21). Only then, indicator diseases are said to de- (ii) American AIDS is incompatible with infectious disease, velop from which patients die on average within 1 year because it is almost exclusively restricted to males (91%), (21-26). Thus HIV became the first virus for which a positive because if it occurs, then only on average 10 years after antibody test is interpreted as an indicator for primary transfusion of HIV, because specific AIDS diseases are not diseases that have yet to come. Antibodies against conven- transmissible among different risk groups, and because unlike tional viruses typically signal protection against disease and a new infectious disease, AIDS has not spread exponentially those against some persistent viruses also signal a small risk since the AIDS test was established and AIDS received its of secondary disease upon virus reactivation (27, 28). Al- current definition in 1987. (Wi) Epidemiological evidence indi- though no retrovirus has ever been shown to be pathogenic cates that HIV is a long-established, perinatally transmitted in humans (29), HIV is thought to be 50-100% fatal, more retrovirus. HIV acts as a marker for American AIDS risks, than any other human virus (16-21). The novelty of AIDS is because it is rare and not transmissible by horizontal contacts postulated to reflect the novelty of HIV. The large variety of other than frequent transfusions, intravenous drugs, and re- indicator diseases are postulated to reflect underlying immu- peated or promiscuous sex. It is concluded that American AIDS nodeficiency, and the almost exclusive concentration of is not infectious, and suggested that unidentified, mostly non- AIDS in 20- to 40-year-olds (1) is postulated to reflect sexual infectious pathogens cause AIDS. or parenteral transmission of HIV (16-20). This virus-AIDS hypothesis was accepted by most medical Epidemiology is like a bikini: what is revealed scientists, in particular virologists, by 1986 (16-18, 30). is interesting; what is concealed is crucial. Accordingly, the virus was named HIV by an international committee of retrovirologists (30) and became the only basis AIDS is a newly defined syndrome of 25 old parasitic, for the definition of AIDS: "Regardless of the presence of neoplastic, and noninfectious diseases, including in the other causes of immunodeficiency, in the presence of labo- United States 53% pneumonia, 19% wasting disease, 13% ratory evidence for HIV, any disease listed .. indicates a candidiasis, 11% Kaposi sarcoma, 6% dementia, 3% lym- diagnosis of AIDS" (2). AIDS is now diagnosed whenever phoma, and 2% tuberculosis (1). These unrelated diseases are antibody to HIV is detectable along with any of the 25 grouped together because they are all thought to be indicators indicator diseases, even if no immunodeficiency or opportu- of an acquired immunodeficiency (2). In America AIDS is nistic infections are detected, as in cases of Kaposi sarcoma, almost completely restricted (91%) to males (1). About 90% lymphoma, dementia, and wasting syndrome (2, 18, 23-26, of all AIDS patients are 20- to 40-year-olds, 30% are intra- 31). Moreover, infection in the absence of any clinical venous drugs users and their children, 60% are male homo- symptoms is now termed, and often treated as, "HIV dis- sexuals and some heterosexuals who frequently use oral ease" (18). However, all efforts directed by the virus-AIDS psychoactive drugs (3-7), and 7% are hemophiliacs and other hypothesis, for over 2 billion dollars annually, have failed to recipients of transfusions (1). contain or cure AIDS (32, 33). As of 1982, the Centers for Disease Control (CDC) consid- Since 1987 I have challenged the virus-AIDS hypothesis ered AIDS infectious because it appeared to be transmitted because HIV is latent and is present in only 1 out of500 T cells among intravenous drug users and homosexuals by sexual during AIDS, because retroviruses typically do not kill cells, contact or by contaminated blood (8). Among infectious and because AIDS appears on average 10 years after the virus agents, cytomegalovirus and various bacteria were proposed has been neutralized by antibodies (7, 29, 34). In response to as causes ofAIDS (6, 8, 10). In 1983 Montagnier and cowork- this challenge it was agreed that the hypothesis cannot be ers (11) suggested lymphadenopathy-associated virus [now defended in terms of orthodox virology, based on known termed human immunodeficiency virus (HIV)] and Gallo et al. genetic and biochemical properties ofHIV (35-47). However, it was claimed that epidemiological evidence supports the The publication costs of this article were defrayed in part by page charge payment. This article must therefore be hereby marked "advertisement" Abbreviations: CDC, Centers for Disease Control; HIV, human in accordance with 18 U.S.C. §1734 solely to indicate this fact. immunodeficiency virus; HTLV, human T-cell leukemia virus. 1575 Downloaded by guest on September 30, 2021 1576 Medical Sciences: Duesberg Proc. Natl. Acad. Sci. USA 88 (1991) virus-AIDS hypothesis (35, 36, 38-41, 44-47) and that Gallo (1, 18, 35, 36, 38, 44, 45, 47). However, competing causes for (48), Montagnier (editorial comment in ref. 7, p. 5), and AIDS diseases have not been excluded in any of these cases. possibly others (editorial footnote in ref. 34, p. 755) would (i) Transfusions of blood and factor VIII and intrinsic prove it. Here this epidemiological evidence is called into deficiencies associated with hemophilia, acting over the long question. time periods said to be latent periods of HIV, have all been identified as pathogenic factors for AIDS-like diseases in Noncorrelations Between AIDS and HIV hemophiliacs (55-61). To determine whether HIV or clinical deficiencies and their treatment cause AIDS in hemophiliacs, AIDS Risks of HIV-Infected Persons Differ 10- to 65-Fold either controlled epidemiological studies comparing matched Depending on Their Country. If AIDS is caused by HIV, the hemophiliacs, with and without HIV, or epidemiological ratio of infected to diseased carriers should be similar in evidence that the mortality of hemophiliacs is increased by different countries. However, in the United States about 10% HIV would be necessary. (or 100,000) (1) of 1 million HIV-positives (16, 18, 49, 50) have Surprisingly, in view of the many claims that HIV causes developed AIDS since 1985, but in Uganda only 0.8% (or AIDS in hemophiliacs, there is not one controlled study that 8000) of 1 million (51), and in Zaire only 0.15% (4636) (52) of has found HIV to be a health risk. There is also no report from 3 million HIV-positives (34). Although AIDS surveillance by any country that the mortality rate of hemophiliacs has some African countries has been questioned, surveillance by increased due to the infection of hemophiliacs with HIV (59). Uganda is reported as "highly successful," providing "the In fact, it appears to be lower than ever (56, 59). About 75% highest number . .. of cases . in Africa" (51). Since the of the 20,000 severe hemophiliacs in the United States are HIV epidemics of both the United States and Africa are said reported to be HIV-positive at least since 1980 to 1982, owing to be new and to have an African origin (17, 20, 36, 45), but to the administration of blood or factor VIII (16, 18, 59, 61, the AIDS risks ofinfected Americans are 10- to 65-fold higher 62). Because the administration of plasma fractions prepared than those of Africans, country-specific pathogens are nec- from large numbers of donors started in 1965, many hemo- essary for AIDS. Moreover, if AIDS equaled opportunistic philiacs may have been HIV-positive for >10 years now (56, infections resulting from immunodeficiency, more, instead of 59). Since 50-100% ofHIV-infected persons are postulated to less, AIDS per HIV carrier would be expected in Africa than develop AIDS after an average latent period of 10 years (18, in the United States. 21, 34), at least half of the 15,000 HIV-positive hemophiliacs AIDS Risks Among HIV-Infected Americans Differ About should have died from AIDS.
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