"AIDS Without HIV"

The wave of publicity that seemed to propel Duesberg forward throughout 1992 picked up additional momentum in July, with the opening of the Eighth International AIDS Conference. Convening in Amsterdam like its "alternative" predecessor of a few months before, the conference was sidetracked by breathless reports in the mass media of an "epidemic" of cases of "AIDS" in people who tested negative for antibodies to both HIV-1 and HIV-2. "The patients are sick or dying, and most of them have risk factors," wrote Newsweek , describing a dozen such cases. "What they don't have is HIV."^[72] Perhaps a new virus was at work, a possibility that seemed to gain credibility in the media due to the coincidental report by a southern California scientist of the isolation of an apparently new retrovirus in AIDS patients.^[73] Or perhaps there were other routes that led to conditions like AIDS. Newsweek 's speculations must have inspired intense flashes of déjà vu in those familiar with the debates about causes of AIDS that had been enacted a long decade earlier: "Dr. Alvin Friedman-Kien of the New York University Medical Center notes that

gay men and IV drug users contract numerous infections, from gonorrhea to herpes and hepatitis. Some ostensible AIDS cases may simply reflect the immune-suppressing effects of common germs or of poor nutrition, he says."^[74]

Besieged by reporters, scientists, and activists, James Curran, the head of the CDC's AIDS office, was forced to address the new syndrome at a heated conference session. Curran acknowledged that the CDC had been tracking such cases, but insisted, "These are not cases of AIDS"; he then made the circular argument—which Duesberg must have appreciated—that a definition of AIDS requires the presence of HIV.^[75] Duesberg wasted little time sending in a letter to Science , offering to provide to anyone who was interested "a list of references to more than 800 HIV-free immunodeficiencies and AIDS-defining diseases in all major American and European risk groups," along with references to "more than 2,200 HIV-free African AIDS cases." Rather than rushing to conclusions about any new virus, Duesberg advised, Science should focus attention on alternative explanations "that could resolve the growing paradoxes of the virus-AIDS hypothesis."^[76]

Only days after the first reports of the mysterious cases, this newest controversy framed a debate in the pages of the Los Angeles Times about the arguments of Peter Duesberg. Steve Heimoff wrote one of the two, side-by-side, opposing op-ed pieces, leading off with the observation that reports of "AIDS without HIV" would "appear to signal at least partial, temporary vindication" of the Berkeley scientist.^[77] Describing Duesberg as "the unofficial leader of the revisionists," "an international star of virology long before anyone heard of AIDS," and "not just another conspiratorialist," Heimoff reported that many of his arguments "have the ring of common sense." It would seem that "there are now three legitimately contending theories regarding the causes of AIDS," Heimoff said: the official CDC theory, Montagnier's cofactor theory, and Duesberg's. Heimoff concluded: "If there is even a remote chance that Duesberg is correct—and the latest reports increase that possibility—then the powers that be must leap into action."

"Just because the Establishment has been wrong so often doesn't necessarily make all of its critics right," Duesberg's old foe Michael Fumento responded in the accompanying piece.^[78] "Duesberg's methodology in determining that HIV doesn't cause AIDS is less science than a game in which he tells his opponents to go into a round room and sit in a corner." Turning to Duesberg's alternative hypothesis,

Fumento noted that the theory failed to explain AIDS in Africa, where neither AZT nor recreational drugs were in significant use. This prompted Duesberg and Ellison to respond, in a letter to the editor, that the official WHO statistics "reveal a tiny African AIDS epidemic" despite large numbers of HIV positives. They complained that Fumento also pointed to "media-publicized cases of ordinary people developing AIDS" but that he failed to mention that "Ali Gertz used cocaine, Ryan White suffered from fatal hemophilia, Paul Gann had traumatic heart surgery, Kimberly Bergalis used AZT, and Magic Johnson is symptom-free."^[79]

In the gay and lesbian press, responses to the "AIDS without HIV" flap were generally dismissive. Many denounced the "media circus" or "media feeding frenzies" that seemed predictably to ensue when too many reporters knowing too little about AIDS found themselves together in one place with too little hard news to write about.^[80] Martin Delaney, writing in his regular column in the Advocate , insisted on the "clear point" that "these events have nothing to do with the so-called Duesberg theory," and he warned that Duesberg's "supporters will no doubt seize on the new information as an assault on the role of HIV."^[81]

On the far end of the spectrum, Chuck Ortleb penned an editorial for the New York Native , entitled "Honey, I Blew Up the HIV Paradigm." Attacking the CDC for "promoting the religious belief that HIV is the cause of AIDS," Ortleb pushed the Native 's current theory, that AIDS and the chronic fatigue syndrome were "variants of the same disease": "If the C.D.C. wants to know all cases of HIV-negative AIDS, we hereby report to them 13 million cases: the estimate of the number of people in the U.S. with Chronic Fatigue Syndrome [CFS]."^[82] While the CDC was unlikely to have been impressed by Ortleb's statistics, indirect support for the Native 's publisher arrived from an unlikely source, when Newsweek published a follow-up story on "AIDS without HIV" that played up the chronic fatigue angle. "As more cases come to light, it's becoming clear that the newly defined syndrome has as much in common with CFS as it does with AIDS," said the Newsweek reporter, Geoffrey Cowley.^[83]

Following on Newsweek 's lead, Time magazine published a cover story entitled "Invincible AIDS," which suggested that the global fight against the epidemic was in disarray.^[84] But over the next few months, the AIDS establishment struggled to put its house back in order. In August the CDC convened a special panel to review all cases of "AIDS without HIV" that had been reported or that investigators

had been able to dig out of medical records.^[85] The panel dismissed as flawed the reports describing a new virus. But they agreed that a syndrome did exist—the CDC had dubbed it "idiopathic CD4+ T-lymphocytopenia" (ICL) to describe the depletion of helper T cells by an unknown cause^[86] —though only thirty confirmed cases could be found in the United States. Moreover, in contrast to the earliest reports, it now appeared that more than half the ICL patients reported none of the AIDS risk factors. As compared with AIDS cases, people with ICL were more likely to be older than fifty, more likely to be white, and more likely to be female.

The consensus of panel members was that different patients were immune-suppressed for different reasons. Most likely there had always been small numbers of such cases, but they had never before come to national attention because there was little medical emphasis on T-cell testing. "Only in the last three to four years has CD4 [helper T-cell] testing become a mass industry," commented Martin Hirsch of Harvard Medical School.^[87] The following month, the WHO reported similar findings based on a review of cases of ICL from around the world.^[88]