View metadata, citation and similar papers at core.ac.uk brought to you by CORE OPINION ARTICLE published: 23 Septemberprovided by 2014 Frontiers - Publisher Connector PUBLIC HEALTH doi: 10.3389/fpubh.2014.00154 Questioning the HIV-AIDS hypothesis: 30 years of dissent Patricia Goodson* Department of Health & Kinesiology, Texas A&M University, College Station, TX, USA *Correspondence: [email protected] Edited by: Sanjay P.Zodpey, Public Health Foundation of India, India Reviewed by: Lalit Raghunath Sankhe, Grant Government Medical College, India Preeti Negandhi, Indian Institute of Public Health – Delhi, India Keywords: HIV,AIDS, dissent, causation, multifactorial causality Since 1984, when the hypothesis that hypothesis’ value? Have these advances “probable cause” of the alarming immune HIV-causes-AIDS was announced, many been able to silence the questioning? system collapse emerging in the US since scholars have questioned the premise and Here, I synthesize the main criticisms 1981 (4). When scientists identified anti- offered alternative explanations. Thirty aimed at the HIV-AIDS hypothesis, along- bodies to a retrovirus known as LAV, or years later, competing propositions as well side select unorthodox1 theories propos- HTLV-III, in 48 persons (from a sample as questioning of the mainstream hypoth- ing non-viral cause(s) for AIDS, to argue: of 119, with and without immune defi- esis persist, often supported by prominent far from being condemned to extinction, ciency symptoms), the retrovirus became scientists. This article synthesizes the most competing explanations for, and thorough the culprit of what would be perceived as salient questions raised, alongside theories questioning of the mainstream premise “the most urgent health problem facing the proposing non-viral causes for AIDS. The persist. Perhaps better known by the lay country” in recent history [(5, 6), p. 1]. synthesis is organized according to four public than by health professionals, many The announcement intended to assure categories of data believed to support the explanations are, in fact, attracting a grow- the public: the mystery surrounding this HIV-AIDS hypothesis: retroviral molecular ing number of sympathizers. To support apparently contagious and decidedly fatal markers; transmission electron microscopy the argument, I employ historical research illness – later labeled AIDS for acquired (EM) images of retroviral particles; efficacy and data synthesis methods. I utilize, as immune deficiency syndrome – was solved. of anti-retroviral drugs; and epidemiologi- data, trade and professional publications The newly identified virus – soon renamed cal data. Despite three decades of concerted in tandem with authoritative scientific HIV,for human immunodeficiency virus – investments in the mainstream hypothe- sources. was, almost certainly, responsible for debil- sis, the lingering questions and challenges It is important to note that my purpose itating people’s immune system and mak- synthesized herein offer public health pro- is not to review the state of the science ing them vulnerable to infections which, fessionals an opportunity to reflect on regarding HIV/AIDS,nor to persuade read- before AIDS, were either rare or not par- their assumptions and practices regarding ers to reject the mainstream hypothesis. ticularly dangerous. Now, however, infec- HIV/AIDS. Instead, I aim to expose readers to the per- tions such as Kaposi’s Sarcoma and Pneu- “The HIV/AIDS hypothesis is one hell sisting controversies, and to motivate them mocistis carinii Pneumonia had morphed of a mistake”, wrote Kary Mullis in 1996 to raise questions of their own. Ultimately, into vicious killers (4, 6). By identify- [(1), p. 14]. Mullis – Nobel Laureate in then, this article invites the public health ing the perpetrator, scientists’ attention Chemistry, 1993 – and other distinguished workforce to reflect on prevailing assump- and government resources could then scientists have claimed the HIV-causes- tions and practices regarding HIV-AIDS. focus on treatment, cure, and vaccine AIDS hypothesis is false, unproductive, and Reflecting on assumptions and practices development. unethical. They have done so since 1984, represents a central task for public health Yet almost immediately, scientists who when the hypothesis was proposed. Thirty professionals; a vital step to ensure their knew a great deal about retroviruses and years after countless studies, resources, and (our) practice continually grounds itself in immunology began to voice misgivings attempts to cure have been poured into the the most rigorous ethical standards (3). regarding the HIV-causes-AIDS hypothe- HIV-AIDS hypothesis, it may be fruitful sis, and to question it. They highlighted the to ask: What happened to those views and HIV-CAUSES-AIDS: HOW VALID ARE difficulties, flaws, and contradictions they voices that once disagreed? Have the past THE DATA? saw in the hypothesis, and offered alter- three decades, with their scientific, tech- In 1984, Margaret Heckler (then Secretary native explanations. Many of the original nological, and public health developments, of the Department of Health and Human misgivings have survived, and others have been sufficient to convince critics of the Services) announced a retrovirus was the been raised, in the past three decades. 1In this article, I will use the terms unorthodox, non-orthodox, non-mainstream, and alternative, to refer collectively to those who disagree with the prevalent view, and to their propositions (despite their variability). I will favor the term “unorthodox” for it carries the notion of intention or willful deviation from the norm and connotes a power differential in which one set of theories (the orthodox or mainstream) dominates another – what Delborne calls “the epistemological tyranny of the intellectual majority” [(2), p. 510]. www.frontiersin.org September 2014 | Volume 2 | Article 154 | 1 Goodson HIV/AIDS: 30 years of dissent In this paper, therefore, I summarize It is not only this simple argument – anti- have minimal or no clinical evidence of some of these difficulties, and present what bodies suggest the immune system has con- disease for years” [(16, 17), p. 509]. critics propose as alternative causes of trolled the invading agents – that unortho- A more specific measure than the ELISA AIDS. I organize the challenges put forth dox scientists have debated. The tests them- test, the WB detects antibodies by identify- by unorthodox scholars into four cate- selves remain the target of critic’s intense ing proteins believed to be associated with gories of data that support the HIV-AIDS scrutiny. For instance, in 1996 Johnson HIV, and only with HIV. A person under- 2 hypothesis : (1) retroviral molecular mark- reported 60-plus factors capable of caus- goes a confirmatory WB after a prior ELISA ers; (2) transmission electron microscopy ing a false-positive result on tests for HIV screening test reacts positively (but it is (EM) images of retroviral particles; (3) effi- antibodies [either an ELISA or a western important to remember: over 60 conditions cacy of anti-retroviral (ARV) drugs; and blot (WB) test] (13). Because they react to can yield a false-positive ELISA) (13, 18). (4) epidemiological data (7,8). Because these factors, the tests may not be detect- Critics of the orthodox view decry the these data are proffered as solid evidence ing HIV at all. Worthy of notice, among lack of standardized criteria for a positive for HIV’s role in causingAIDS,it is useful to the list, are elements ubiquitous among all result in a WB, across countries, world- examine how critics question the evidence populations such as the flu, flu vaccina- wide (19). Bauer (Table 1), in a 2010 arti- in each category, specifically. tions, pregnancy in women who have had cle titled “HIV tests are not HIV tests” more than one child, tetanus vaccination, claims,“no fewer than five different criteria RETROVIRAL MOLECULAR MARKERS and malaria (an important element to con- have been used by different groups in the Mainstream scientists and physicians claim sider in the case of the AIDS epidemic United States” [(18), p.7]. Moreover – adds the molecular evidence for HIV-as-the- in Africa). Supporting each factor, John- Bauer – included in the contemporary cri- cause-of-AIDS is irrefutable (8,9) and son provides scientifically valid evidence – teria for a positive WB are p41 and p24, comprises: (a) HIV antibodies and (b) viral published in reputable peer-reviewed jour- protein–antigens “found in blood platelets load. As incontrovertible as these mole- nals such as AIDS, the Proceedings of the of healthy individuals.”This means some of cular markers appear to be, unorthodox National Academy of Sciences of the United the biological markers being used to “flag” scientists have meticulously examined each States of America, The Lancet, the Cana- the presence of HIV are not“specific to HIV one and detected significant problems in dian Medical Association Journal, and the or AIDS patients [and] p24 and p41 are both (7). Journal of the American Medical Association not even specific to illness.”In other words, (JAMA) (13). healthy persons may test positive on a WB HIV antibodies Celia Farber’s book, Serious Adverse but not carry HIV at all [(18), p. 6]. The first available tests to screen blood Events: An Uncensored History of AIDS An example may clarify: if tested in banks for HIV detected HIV antibod- (14) – an exposé of the epidemic’s eth- Africa, a WB showing reactivity to any two ies (10). Physicians still use these tests ically questionable history – contains an of the proteins p160, p120, or p41, would when screening blood for infection and, interesting appendix authored by Rodney be considered positive for HIV. In Britain, since 2004, direct-to-consumer home tests Richards. Richards – who helped to develop the test would be positive only if it showed have become available for identifying anti- the first ELISA test for HIV – outlines reactivity to one of these three proteins, bodies to HIV using only a saliva sam- the “evolution” of CDC’s stances regard- together with reactions to two other pro- ple (e.g., OraQuick) (11).