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The breakout of the AIDS pandemic during the early eighties is considered one of the biggest challenges in modern medicine. Twenty years after the first AIDS cases were recorded, we are far from developing a cure for this devastating pandemic. Although our knowledge of this condition remains limited, the vast majority of scientists now agree that the human immunodeficiency virus, or HIV, is the predominant cause of AIDS, and the notion that HIV equals AIDS is widely regarded as a fact by the general public. Since 1998, however, a group of dissenters led by Dr. Peter Duesberg has questioned the validity of this theory. Duesberg, an accredited biologist, believes that there is no cause and effect relationship between HIV and AIDS. Instead, he has proposed that drugs, recreational or prescribed, are responsible for the onset of AIDS in humans. Although his claims have been largely refuted by the scientific community, Duesberg has generated a large supporter base, which includes activist Christina Maggiore and South African President Thabo Mbeki. Since Duesberg's ideas were first introduced to the public in 1987, hundreds of HIV positive patients have followed the dissenter's advice and stopped taking available medication, even when there is no clear scientific evidence supporting his theory. Despite the gravity of the situation, the approach taken by the media and the scientific community has been to ignore the issues at hand, giving little to no coverage of this critical topic. Meanwhile, the number of dissenters continues to rise, as does the number of patients jeopardizing their lives.
The first cases of the condition now known as AIDS (Acquired Immunodeficiency Syndrome) were reported in the United States in 1981, when five young males died from severe cases of pneumonia. At the time the disease was thought to be strongly associated with homosexuality and was known as the "gay cancer" or "gay pneumonia" (Duesberg 1996). The number of deaths under similar circumstances rose to over eight hundred in 1982, but it was not until 1984 that Dr. Robert Gallo successfully isolated the human immunodeficiency virus and declared it "the probable cause of AIDS" (Derbyshire 1997). No one has ever acquired AIDS symptoms without first having HIV. Over the past twenty years, our knowledge of HIV and AIDS has increased. We know that HIV can be transmitted through sexual contact, as well as through blood transfusions and during pregnancy from mother to child.
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Those who question the direct link between HIV and AIDS are generally referred to as HIV or AIDS dissenters. The main figure in the AIDS dissenter movement is Dr. Peter Duesberg, a professor of Molecular and Cell Biology at the University of California at Berkeley. Duesberg believes that there is no concrete evidence, neither virological nor epidemiological, to back up a cause and effect theory between HIV and AIDS (Duesberg 1996). Instead, he attributes the onset of AIDS to lifestyle factors, in particular to the use of highly toxic drugs for recreational or prescription use. According to Duesberg, those individuals who have developed AIDS from HIV were exposed to toxic substances that in turn were responsible for the failure of that individual's immune system. He points out that the first AIDS victims in the US were documented as primarily homosexual males who used drugs commonly known as "poppers," as well as cocaine and heroin, on a regular basis. In addition, he maintains that those who developed AIDS in later years, and were not regular drug users, were instead exposed to substances that produced adverse effects on human cells, also known as cytotoxic drugs. Duesberg maintains that these substances are responsible for the onset of AIDS in their system.
Duesberg's theories on drugs and AIDS have led him to campaign against HIV medications. Ever since prescription drugs for those with HIV became available in 1987, a major cause for concern has been the high toxicity of these substances. Those infected with HIV must choose between experiencing the devastating illnesses characteristic of AIDS or suffering from the strong side effects of the drugs prescribed to slow its onset. Among the drugs available to treat HIV patients, azidothymidine (AZT), which is marketed under the names Zidovudine or Retrovir, is one of the most often prescribed (Duesberg 1993). AZT falls under a class of drugs known as transcriptase inhibitors. Like other inhibitors, azidothymidine works by blocking a cell's DNA sequence, preventing it from further dividing, and eventually killing it off. Although the drug is quite effective in obstructing the cellular division process, it is unable to recognize healthy cells from those infected with the virus. In the case of AIDS, the ratio between infected and healthy cells is approximately 1 to 500, and according to Duesberg, "AZT must kill 499 good T-cells to kill just one that is infected by the hypothetical AIDS virus" (Duesberg 1996). The rapid loss of T-cells results in long-term side effects like body fat redistribution which thins the face, broadens the waist and causes humps to develop on the back of the neck. Additionally, an increase in the toxic acidity of the blood and thinning of the bones is usually present (Mestel 2001). Duesberg and his supporters maintain that the failure of the immune system that characterizes AIDS is caused by the high toxicity levels of these drugs. This stance is supported by other virologists, like Dr. Jason Levy from the University of California at San Francisco, who believes that drugs like AZT "can only hasten the demise of the individual by further[ing the] harm to an already decimated immune system" (Duesberg 1996).
In addition to protesting the toxicity of both transcriptase and protease inhibitors, Duesberg has denounced their rapid approval process by the US Food and Drug Administration. He believes that following proper protocol for the drug's approval was superseded by the pressure to come up with a treatment for the AIDS epidemic. Duesberg is quick to point out that AZT was developed in 1964, long before the first AIDS outbreak occurred (Duesberg 1996). At the time, cancer was believed to be a viral disease, and AZT was one of the many retroviral drugs manufactured as possible treatments. Although AZT was proven to be effective in killing cancerous cells, its toxicity level was so high that it was considered unsafe for human consumption. Despite these conclusions, AZT was resurrected in 1986 as a viable option for HIV treatment. Duesberg also questions the legitimacy of the studies that were presented to secure FDA approval. The studies, which had a mere follow-up time of six months, were aborted after four months as a result of what scientists considered to be highly successful results. The conditions under which the study was conducted are also known to have been irregular. Patients were allowed to take drugs other than AZT throughout the course of the study, and none of these outside substances were properly documented. Despite these anomalies, the results of the studies were considered to be legitimate, and the drug was approved by the FDA in 1987.
Finally, Duesberg justifies his theory by calling attention to those HIV patients who have not developed AIDS. According to the Center for Disease Control, an estimated one million Americans had HIV by 1985, but two thirds of those had not developed AIDS after the usual ten year turnaround period (Duesberg 1993). At the time, only a small fraction of HIV patients in the US received drug therapies because of the high cost involved. Duesberg believes that the number of patients who develop AIDS coincides with the number of individuals using recreational or prescription drugs. Even when the follow up time after testing is increased, the fraction of HIV positive patients who do not develop AIDS remains constant. According to Dr. Bruce Walker, director of the division of AIDS Research at Harvard Medical School, "some [HIV positive individuals] have been infected for over 20 years and are entirely healthy with exceedingly low levels of virus in their blood stream and very strong immune systems that appear to be keeping it in check" (Mestel 2001). The growing number of HIV patients in good health continues to be one of Duesberg's main selling points.
Although Duesberg is a renowned scientist who was previously nominated for a Nobel Prize, his theories on AIDS have been dismissed by the scientific community as unfounded. His detractors accuse him of using selective and unreliable data to support his arguments, and point to two major flaws in his reasoning. First, Duesberg's theory regarding AIDS and toxic substances does not accurately reflect the extent of the AIDS pandemic in countries where AZT and other HIV treatment drugs are unavailable to the public, such as South Africa. In addition, the Center for Disease Control has released studies correlating a drop off in the number of HIV related diseases with an increase in the number of protease and transcriptase inhibitor prescriptions (France 2000). These figures directly contradict Duesberg's theory by suggesting that the drugs currently prescribed to HIV positive patients do not harm the immune system, but instead strengthen it enough to control viral related infections.
Regardless of Duesberg's inability to support his theory with conclusive scientific evidence, the number of HIV dissidents is on the rise. The recent release of the documentary The Other Side of AIDS is one of many events that reflect the increasing support of Duesberg's theories among HIV patients and healthy individuals alike. The film focuses on the life of Christina Maggiore, head of Alive and Well, an organization that offers alternative treatment options to HIV patients. Although she tested positive for HIV in 1992, Maggiore has refused to undergo any drug treatments, and has since become one of the main leaders in the HIV dissident movement (France 2000). Maggiore is a firm supporter of Duesberg's theories who lacks any sort of scientific background, but still travels around the country encouraging HIV positive patients to stop taking their medication and worrying about spreading the virus to others. Since 1994, Alive and Well has received the support of bands such as the Foo Fighters, as well as of actors and other popular culture figures who champion her "fight against the establishment" (France 2000). During an interview in the year 2000, Sandra Thurman, White House AIDS Policy Director, condemned Maggiore for "putting lives in jeopardy" (France, 2000). However, despite the growing number of Maggiore supporters, the federal government has not made a more outright effort to denounce her beliefs and the lack of evidence to support them.
Although Maggiore's large supporter base is evidence of the increase of HIV dissidents, the growth of the movement is best embodied in South African President Thabo Mbeki. To this day more than eleven million people have died from AIDS related illnesses in Africa, and it is estimated that over ten percent of South Africa's population is HIV positive (France, 2000). Despite these numbers, the South African government has refused to provide the necessary medication to its citizens, citing the lack of evidence linking HIV and AIDS as the main reason behind this decision. Mbeki is known to be a supporter of both Duesberg's and Maggiore's beliefs. In the year 2000 Mbeki caused uproar among the international scientific community by appointing Peter Duesberg to the National AIDS Council, which has the task of finding a way to control the AIDS epidemic in South Africa. In the case of South Africa, HIV dissidents and their supporters are directly responsible for the lack of drug therapies available to the thousands of patients infected with HIV and the possible proliferation of the virus in the country.
Despite the influence that the growing number of HIV dissidents has had worldwide, the scientific community is reluctant to reexamine the theories on HIV and the development of AIDS. Although there is a clear need for studies that will prove or disprove Duesberg's theories, the necessary research presents significant difficulties. The studies would involve administering AZT to a controlled group of HIV positive patients while providing a placebo for a second group, which is regarded by many as unethical. Additionally, US laws state that any HIV-related work must be approved by the federal government. To this date, Peter Duesberg has submitted nine different research proposals to the National Institute of Health, all of which have been declined (Duesberg 1996). The time when this research takes place is nowhere in sight, and yet more and more HIV positive patients refuse to undergo HIV drug treatments. In 1995 John Maddox from the scientific magazine Nature wrote: "[t]he danger for the Duesbergs of this world is that they will be left high and dry, championing a cause that will have ever fewer adherents as time passes" (Maddox 1995). Ironically, ten years later, the opposite is true. As the number of HIV dissidents increases, it is critical that the media and the scientific community give the dissident movement the attention it deserves, before more lives are unnecessarily jeopardized.
Duesberg, P.H. "The HIV Gap in National AIDS Statistics." BioTechnology. 11 August 1993.
Duesberg, P.H. "With Therapies Like These, Who Needs Disease?" Inventing the AIDS Virus. Washington DC: Regenery Publishing, 1996. France, D. "The HIV Disbeliever." Newsweek. 28 Aug. 2000: 46-50.
Maddoxx, J. "Duesberg and the New View of HIV." Nature. 19 Jan. 1995: 189.
Mestel, R. "AIDS After 20 Years." Los Angeles Times . 4 June 2001: S1.