AIDS maverick finds new villain

Saturday, March 18, 2000

THE VIRUS WITHIN:
A Coming Epidemic
By Nicholas Regush
Viking, 261 pages, $34.99

Reviewed by
Colman Jones

Medical researchers preparing for this summer's AIDS 2000 conference in Durban, South Africa are under ever-increasing pressure, as the threat posed by the global pandemic inevitably inches its way into the agendas of the world's powerful institutions.

AIDS is no longer simply seen as a public-health problem, with the UN Security Council designating it a danger to international security, and Al Gore leading the fight with a $150 million initiative for vaccines and education campaigns. Meanwhile, activists continue to press pharmaceutical firms for better and cheaper drugs to save the millions of infected - and supposedly doomed - people around the globe.

The generally accepted culprit decimating the developing world, of course, is the deadly virus named HIV. The announcement of this virus as the cause of AIDS in 1984 swept aside other suggested candidates at the time, including other venereal diseases, esoteric viruses, even tanning salons.

HIV's quick rise to prominence in medical thinking - despite other, equally plausible explanations for this peculiar syndrome - is given a critical examination in this latest offering by former Montreal Gazette reporter Nicholas Regush. Now an online medical columnist for ABC News, Regush is one of the few journalists still willing to raise what has become a taboo question in AIDS circles: is HIV really the sole factor responsible for this seemingly new plague?

He notes that the question was first pursued with great vigour by University of California molecular biologist Peter Duesberg, a renowned expert on retroviruses (the family of viruses to which HIV belongs), and once a colleague of Dr. Robert Gallo, the U.S. researcher credited with the HIV thesis. Readers are treated to a faithful chronology of Duesberg's decade-long battle with medical orthodoxy, along with that of other HIV skeptics, including Greenwich Village physician Joe Sonnabend and a team of scientists from Perth, Australia.

But if not HIV, then what else could possible bring the downfall of the normally robust network of cells and chemicals that protect us from infections and cancers?

Duesberg's answer is simple, albeit somewhat extreme: he dismisses the notion of AIDS as a transmissible condition altogether, blaming the condition instead on recreational and pharmaceutical drugs, including the very medicines used to attack HIV, calling condoms and safe sex "irrelevant" to the spread of AIDS. This view of AIDS as non-infectious, shared by most "AIDS dissidents", has been held up by media and science alike as "the" alternative view, effectively obscuring those advocating other, possibly microbial, causes.

That's why it's refreshing to see Regush bring infectious agents back in the AIDS co-factor spotlight, in this case a member of the human herpes virus family known as HHV-6, which he says may play a role in not only AIDS, but a variety of other illnesses as well, from chronic fatigue to multiple sclerosis. He traces the careers of two obscure Wisconsin scientists on the hunt for HHV-6, illustrating his narrative with dramatic, at times disquieting, clinical case descriptions.

Regush acknowledges the missing gaps in assigning a role for HHV-6 in AIDS, especially the fact that 90% of the world's people have been exposed to this organism, making it unclear why it should play a central role in the syndrome. Many infections become reactivated in people with immune dysfunction, and HHV-6 is no different in this regard.

Interestingly, neither is HIV: Mounting evidence suggests people can resist the supposedly deadly virus with strong immune responses, at least in the absence of other contributing co-factors.

One of these co-factors - completely ignored by Regush - may well be inadequately treated syphilis which, unlike HHV-6 or other postulated AIDS co-factors, remains conspicuously absent as an opportunistic complication in AIDS. Odd, given the once deadly disease ran rampant and unchecked at epidemic levels in both the gay men in the West and heterosexuals in Africa at the onset of the AIDS era, while doctors placed their trust in cheap, outdated blood tests now acknowledged to be inadequate for detecting re-infection.

Experts acknowledge millions of untreated syphilis cases on the loose by the early 1980s, especially in Africa, yet the classical later presentations of the disease seem to have mysteriously vanished - among the very same populations that later went on to develop AIDS in large numbers.

In contrast to the widely distributed HHV-6, syphilis is concentrated mostly among gay men in the West, and there's an overwhelming statistical association between having had a past history of syphilis and subsequently turning HIV-positive.

The usual explanation for the correlation is that the open sores of early syphilis allow HIV to penetrate the body more easily. But some European STD experts suggest chronic syphilis infection - compounded by undetected re-exposures - may well hasten the development of AIDS itself.

While Regush sidesteps these fundamental questions about the possible hidden role of syphilis in AIDS - a glaring omission, in my mind - he still performs a valuable service by noting HIV is only one of several equally plausible candidates worthy of scrutiny by AIDS researchers. While he may have erred in his choice of alternative theory, his persistent refusal to accept easy answers to this complex health problem is one reporters descending en masse at the Durban conference would do well to take a cue from.

Colman Jones's 1996 radio documentary, Déjà Vu: AIDS in Historical Perspective, won a Science in Society Journalism Award from the Canadian Science Writers Association. Jones writes for Toronto's NOW Magazine.