Twice a year, Peter Duesberg is invited to give a guest lecture in PH253, an undergraduate course in the UC Berkeley School of Public Health. Its subject is always some variation of 'AIDS is a non-infectious designation', and the hall (as is usual with Duesberg appearances) is always filled to over-flowing with students and others eager to hear what the dreaded dean of the denialists has to say. Berkeley is after all the birthplace of the free speech movement on our university campuses, so it should come as no great surprise that there is at least one colleague who is (tenured and therefore) unafraid to expose his students to denialist rot twice a year for 90 minutes.
This year, in honor I suppose of the recent Rodriguez et al. admission in JAMA, the thrust of the talk is to be directed at the careful discrimination between a pathogenic microbe and a passenger one -- a distinction that like so much else in post-HIV virology has gone by the proverbial wayside. Today, all microbes, like all mutations, are medically important, or so goes the new scientific gospel, at least as long as the gravy train keeps rolling.
These are the notes the old fashioned professor intends to pass around as a handout.
"HIV, a passenger virus"
"Definition: A passenger virus is defined as a virus that can be either present or absent, rare or abundant, and active or inactive during the course of a disease. Moreover the passenger can infect long prior to or during the course of a disease.
Four independent studies show that HIV is a passenger virus.
In 1989 Fauci et al. (Schnittman) in the US and in 1990 Simmonds et al. in the UK show that only 1 in 500 to 1000 T cells of AIDS patients is infected by HIV (1, 2).
In 1993 Duesberg collects references for 4,621 HIV-free AIDS cases from the AINS-literature (3).
In 1993 Piatak et al. including Fauci show that HIV RNA levels in AIDS patients vary from 100 to 22 x 10^6 copies per ml plasma. But only 60,000 HIV RNAs were reported to correspond to one infectious virus. Thus many patients contained no infectious virus (4).
In 2006 Rodriguez et al. show that in hundreds of HIV carriers there was no correlation between HIV RNA “loads” (determined by PCR) and AIDS. HIV RNA was high, low or undetectable in asymptomatic carriers and in AIDS cases (5).
1. Schnittman, S. M., Psallidopoulos, M. C., Lane, H. C., Thompson, L., Baseler, M., Massari, F., Fox, C. H., Salzman, N. P., and Fauci, A. The reservoir for HIV-1 in human peripheral blood is a T cell that maintains expression of CD4. Science, 245: 305-308, 1989.
2. Simmonds, P., Balfe, P., Peutherer, J. F., Ludlam, C. A., Bishop, J. O., and Leigh-Brown, A. J. Human immunodeficiency virus-infected individuals contain provirus in small numbers of peripheral mononuclear cells and at low copy numbers. J. Virol., 64: 864-872, 1990.
3. Duesberg, P. The HIV gap in national AIDS statistics. Biotechnology, 11: 955-956, 1993.
4. Piatak, M., Jr., Saag, M. S., Yang, L. C., Clark, S. J., Kappes, J. C., Luk, K. C., Hahn, B. H., Shaw, G. M., and Lifson, J. D. High levels of HIV-1 in plasma during all stages of infection determined by competitive PCR. Science, 259: 1749-1754, 1993.
5. Rodriguez, B., Sethi, A. K., Cheruvu, V. K., Mackay, W., Bosch, R. J., Kitahata, M., Boswell, S. L., Mathews, W. C., Bangsberg, D. R., Martin, J., Whalen, C. C., Sieg, S., Yadavalli, S., Deeks, S. G., and Lederman, M. M. Predictive value of plasma HIV RNA level on rate of CD4 T-cell decline in untreated HIV infection. Jama, 296: 1498-1506, 2006."
At the bottom of the email with the handout was a single line that read. "Remember Maddox and Genetica?"
And indeed, how could I ever forget, since that most memorable of times was enshrined in Genetica, the oldest, continuously published journal of genetics, in 1995, beginning with a contemporaneous recollection of a telephone conversation with my sometime colleague, sometime nemesis, Sir John Maddox.
"On the afternoon of January 12,  the day the Nature issue containing the Ho and Wei et al. papers appeared, and one day after the press conference announcing these landmark publications, I received a rare telephone call from my colleague, the newly knighted, Sir John Maddox, editor of Nature. The essence of the ensuing conversation is summarized below.
After congratulating John on his recently acquired honorific, I asked to what did I owe the pleasure of his call. He then asked me what I thought of the "HIV-1 dynamics" papers. I replied by thanking him for publishing them, as they were so transparently bad, they would convince any reasonable scientist who had the endurance to read them that the HIV-AIDS hypothesis was absolutely intellectually bankrupt. I also chided him by saying that even Wain-Hobson didn't know what to make of them, judging by his incoherent News & Views piece that accompanied their publication.
To my surprise, his response to these remarks was remarkably devoid of any outrage. We discussed in a cursory manner some of the more obvious criticisms of the papers, such as their lack of controls, and the methodological and biological problems with their estimates of free and infectious virus. I also mentioned that I thought it ironic that after years of denying that T cells turned over at the rate of 5% in two days, the HIV-AIDS protagonists were now at last admitting this well known fact. He responded by asking how did I explain the "dramatic increase in T cells after treatment with the protease inhibitor." I replied that this transient, hardly dramatic, increase was also a well known phenomenon called lymphocyte trafficking, which occurs in response to many chemical insults.
The conversation then changed direction and John said that he had, without success, been trying to reach Peter (Duesberg) to inform him that he was, in this instance, willing to rescind his previous "refusal of the right of reply" and would welcome a correspondence from Peter (and myself) addressing what we perceived as the shortcomings of Ho and Wei et al. He promised me that if the piece was relevant, succinct and not personally rude, he would publish it "unslagged." When I asked him what this meant, he said that it would be published as received, without prior review and without a response appearing in the same issue. I said "do you mean it will be allowed to generate its own replies?," and he said "yes." I congratulated him on his willingness to open a proper scientific debate, and said I would communicate our conversation to Peter.
I was a bit surprised to see his editorial in the following week's Nature (miniature above) in which he went much further than our conversation in offering its pages to uncensored debate. I was, however, not surprised to discover, some weeks later, that the response which appears unedited in this issue of Genetica, was deemed "too long by half and too unfocussed" to warrant publication in his own highly esteemed journal."
The years since 1995 have been much kinder to the points raised above, and that Peter and I elaborated in the remainder of the Genetica essay, than they have to David Ho and his fanciful notions of what constituted viral and cellular dynamics in an AIDS patient and how to measure them -- ideas that have been thoroughly repudiated in the scientific literature. This is a fact of such common knowledge that stating it requires no reference.
But as with so much else in AIDS there is an enormous disconnect between what is told to the media to tell to the public and what is really so as acknowledged now even in the best journals, like JAMA.
Although the waffle language is closer to what is found in difficult to negotiate UN resolutions than the prose expected of esteemed journals only a few short decades ago, the students in PH253 and the rest of the attentive audience will not miss the inescapable, and only proper scientific conclusion after 20+ years of assuming HIV was appropriately named*. And that conclusion is?
Harvey Bialy is the editor of "You Bet Your Life".
*Last month, I published a brief account of exactly how HIV did receive its terrible and terrifying name as a "Comment". It is worth reprinting in its entirety now as many fewer were reading this page then.
A True Story about the Father of AZT, Sam Broder, MD.