As a frequent visitor to Internet, I am pleased that this essay is available in that medium. The prodigious information available on Internet, and perhaps even more the opportunities for immediate, uninhibited inter-country discussion renews the tradition of the free press in a form scarcely imaginable only a few decades ago.
There have been several notable developments in AIDS research since the publication of this study in November, and rather a lot since the completion of the text in July, 1994.
One is the purported discovery of a new herpes virus said to be the cause of Kaposi's sarcoma (KS) in gay men with AIDS by Columbia University researchers Yuan Chang and Patrick Moore. At a press conference in December, 1994, the team disclosed finding unique DNA sequences from what may be a new type of human herpes virus in 93 percent of KS lesions from 27 deceased AIDS patients. The sequences generally were not found in the patients' non-KS tissues. Although the findings demonstrate only an association between the virus and KS, UCLA scientist Dr. Steven Miles is convinced that it is a new human herpes virus and that it very definitely is the cause of Kaposi's sarcoma. The Columbia study found the virus in the cancer tissue of all 21 subjects who had the disease, but of these only 11 were HIV positive. This seemed to rule out HIV as the cause of one the major AIDS-defining diseases. If the findings are authenticated, it means that HIV/AIDS hypothesis is invalid for one of the major AIDS diseases. Between 30-50 percent of gay AIDS patients develop KS.
Herpes virus was in the news again at a conference hosted by Dr. Robert Gallo in December 1994. At that time Konstance Knox and Donald Carrigan, of the Medical College of Wisconsin, presented new evidence that HHV-6 and HIV interact to cause the cancer. Knox and Carrigan studied specimens of tissue from autopsies of patients with AIDS, and found active and disseminated HHV-6 infection in patients with terminal AIDS. Using polymerase chain reaction techniques (PCR), HHV-6 was found in most anatomical sites. The wide distribution of HHV-6 in terminal AIDS patients was confirmed using immunohistochemical techniques, which also showed conclusively that the infection is active. On this model, both viruses are inactive until under certain conditions they activate one another.
There was also good news for those who defend the standard HIV/AIDS model. In January 1995, Dr David Ho and colleagues claimed to solve the mystery of HIV infection hitherto. It was that AIDS patients suffer profound destruction of T4 immune cells, yet HIV is scarcely detectable in such patients and when it is detected, it is inactive. How then does it destroy the immune system? The lack of HIV activity had figured prominently in scepticism that HIV is the cause of immunosuppression and AIDS. Dr. Ho rescued standard AIDS science from this eleven year embarrassment by quantifying the day-by-day production and removal of HIV. Between 100 million and 1 billion free virus particles are produced and cleared daily—a massive turnover that until then had not been detected. The discovery was hailed as explaining the mystery of how HIV causes AIDS—a query that sceptics have previously used to great effect.
Thus in the course of a few months, scientists provided new evidence for the standard model of HIV etiology, for the heretic model in which HIV does nothing, and the compromise cofactor model in which HIV is active only in association with another organism. This paradox can be partially resolved by noting that the evidence in each of these cases is very indirect and circumstantial; but that great pressure on AIDS scientists to get results tends amplify meagre findings into significant discoveries. This amplification process is called: science by press conference.
The public notice generated by publication of The AIDS Mirage gave me the opportunity to expand on thoughts for which there was no space of the initial publication. I have included a statement on doctorless health.
There are many reflectors for AIDS discussion. The Group for the Scientific Reappraisal of the HIV/AIDS Hypothesis operates a news reflector whose address is: philjohn@garnet.berkeley.edu. The Group also operates a discussion reflector whose address is: quilty@philos.umass.edu as well as an HIV+ support group called HIV+ and Healthy. Its address is: hfflyynn@aol.com
sci.med.aids is a reflector for moderated discussion among AIDS scientists; it is accessible through World Wide Web.
Reviewers and critics pointed out several errors in the original version. These have been corrected in the present version.