By Peter Duesberg
Regnery. 722 pp. $29.95

Go to the First Chapter of Inventing the AIDS Virus

Go to Chapter One

Infectious Pessimism

By Steven Epstein
Thursday, March 14, 1996

In 1987 Peter Duesberg became the antichrist of AIDS research. A professor in Berkeley's Department of Molecular and Cell Biology and a member of the elite National Academy of Sciences, Duesberg was known as an expert on the properties of viruses. Taking up the case of a recently discovered retrovirus, Duesberg issued the equivalent of a declaration of war. The human immunodeficiency virus (HIV) had not been proved to cause AIDS, he insisted in the pages of a scientific journal. HIV was a harmless passenger in the AIDS epidemic -- just one of many microbes likely to take up residence within the bodies of people with a weakened immune system. While Duesberg wasn't the first to make such claims about the etiology of AIDS, he was the first prominent scientist to do so.

The battle lines were thereby drawn for one of the most vitriolic and high-stakes controversies in the contemporary scientific world -- an extraordinarily public scientific controversy. On one side stand Duesberg and a circle of defenders -- some of whom, like the Nobel Prize-winning Kary Mullis, are high-profile scientists, but none of whom is directly involved in AIDS research. These dissidents argue that millions of dollars are being poured into research to find vaccines and therapies and thousands of people are poisoning themselves with toxic medications, all in the goal of obstructing a virus that doesn't make anyone sick. On the other side are arrayed all the voices of authority and scientific respectability, from the National Institutes of Health to the Centers for Disease Control and Prevention to the World Health Organization, which insist that the evidence indicting HIV as the primary cause of AIDS is ample and irrefutable. To mainstream AIDS researchers, Duesberg is not simply a crank but a menace to society.

Perhaps the most striking feature of the controversy is its staying power. Now, in a move certain to extend the debate further, Duesberg has published a lengthy analysis for the general reader, organizing and summarizing the views he has presented over the years.

"Inventing the AIDS Virus" is a readable and engaging book, though at times digressive and in need of a stronger editorial hand. (Do we really need the complete, nine-page text of a letter received by Duesberg from an HIV-positive man who chose not to take AZT?) In the key middle section of the book, Duesberg lays out his argument in full: why he believes that HIV cannot cause AIDS; how he concludes that the real cause of AIDS in the United States is the long-term consumption of psychoactive drugs; and how he then explains (or explains away) the cases of AIDS in Africa, AIDS in transfusion recipients, AIDS in people with hemophilia, and AIDS in health-care workers infected by needle-stick injuries.

More than just a critique of the HIV hypothesis, this book offers a broad-ranging, revisionist history of the whole enterprise of virus hunting. Duesberg argues that AIDS is but the most recent example of virology's assertion of tenuous causal links between viruses and illnesses. "Nearly discredited by the failed War on Cancer," virus-hunting "has now enjoyed a spectacular revival," he claims, in large part thanks to AIDS.

Duesberg is at his most appealing in taking shots against the mores and customs of the modern, commercialized world of Big Science. But even here, incautious hyperbole -- take, for example, the assertion that "few scientists are any longer willing to question, even privately, the consensus views in any field whatsoever" -- detracts from the presentation. Duesberg is at his least convincing in responding to new evidence and contrary arguments. One of the scientist's central claims in 1987, repeated in this book, is that HIV is found in far too few blood cells of AIDS patients to be a plausible destroyer of the immune system. But new techniques have since revealed much higher blood levels of the virus, while other body cells have been found to be reservoirs of "massive covert infection." Duesberg also has little to say about the long-running "natural experiments" tracking thousands of individuals that have rendered a consistent conclusion: Over time, high percentages of HIV-positives experience a decline in T-cells and develop the opportunistic infections associated with immune dysfunction. HIV-negatives simply do not -- no matter how many psychoactive drugs they have consumed.

Duesberg rides on the coattails of broad dissatisfaction with antiviral drugs like AZT to argue that such drugs are themselves a cause of AIDS. But he misrepresents scientific conclusions in describing the emergence in 1993 of a "backlash" against AZT in the medical community, as if researchers had moved toward his own position. While several studies questioned the worth of "early intervention" in people with asymptomatic HIV infection, the scientific consensus has remained that existing antiviral drugs are indeed of temporary benefit in patients with advanced AIDS. Furthermore, these same studies have been widely read as providing strong evidence against Duesberg's claim that the use of AZT or similar drugs can itself cause the onset of the conditions associated with AIDS.

If Duesberg's arguments hold up less well than they did in 1987, the case still raises important questions about the scientific policing of deviant views. He reports being shunned and blackballed, and he points to an NIH peer review committee's decision not to renew his sizable grant. It is unfortunate (if understandable) that he appears to have responded to such personal attacks by elaborating, in "Inventing the AIDS Virus," a far-flung conspiracy theory of the promotion of the HIV hypothesis and the suppression of all dissent. The virus hunters "have used their combined influence, often behind the scenes," he writes, "to mobilize the government, media, and other institutions behind a global War on AIDS. Few outsiders have realized just how coordinated the whole strategy has been." To make this story plausible, he offers some imaginative claims, including that the mass media eagerly promoted the dangers of AIDS in the early 1980s (every analyst of the early media coverage has argued precisely the reverse) and that AIDS activists are simply pawns of the government and the pharmaceutical companies.

Duesberg complains that his adversaries are unscientific. But to mainstream AIDS experts, it is Duesberg who abandons science when he explains away, in ad hoc fashion, each new bit of evidence that contradicts his views. As in many other scientific controversies, what is at stake here is not just a specific scientific claim but notions of science itself, along with the very methods by which scientific claims are to be evaluated. Such disputes submit to no easy resolution.

This one, in any case, is unlikely to fade away soon. Duesberg knowingly appeals to the widespread impatience with biomedicine -- indeed, the popular sense of betrayal -- when he calls the war on AIDS a "colossal failure" and asks how "the largest and most sophisticated scientific establishment in history [could] have failed so miserably in saving lives. . . ." He further asserts that "something is very wrong with this picture," as if the absence of effective vaccines and therapies proved that the causal hypothesis must be bankrupt. This is bad logic, and manipulation to boot, but it will likely keep the "Duesberg phenomenon" in the public spotlight for some years to come.

The reviewer is assistant professor of sociology at the University of California, San Diego, and the author of the forthcoming "AIDS, Activism, and the Politics of Knowledge."

© 1996 The Washington Post Co.

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