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SPECIAL NEWS REPORT

The Duesberg PhenomenonA Berkeley virologist and his supporters continue to argue that HIV is not the cause of AIDS.

A 3-month investigation by Science evaluates their claims

On 28 October, Robert Willner held a pressconference at a North Carolina hotel, duringwhich he jabbed his finger with a bloodyneedle he had just stuck into a man who saidhe was infected with HIV. Willner is a phy-sician who recently had his medical licenserevoked in Florida for, among other infrac-tions, claiming to have cured an AIDS pa-tient with ozone infusions. He is also theauthor of a new book, Deadly Deception: TheProof that SEX and HIV Absolutely DO NOTCAUSE AIDS. He insists that jabbing him-self with the bloody needle, which he de-scribes as “an act of intelligence,” was notmeant to sell books. “I’m interested in prov-ing to people that there isn’t one shred ofscientific evidence that HIV causes any dis-ease,” Willner says.

Willner’s unsettling self-injection isamong the more bizarre manifestations of aphenomenon that many in the AIDS re-search and treatment community find in-creasingly troubling: a vocal group of skep-tics who continue to grab headlines withtheir contention that HIV, the retrovirusidentified as the cause of AIDS more than adecade ago, doesn’t cause the disease. Likealmost all “HIV dissenters,” Willner reliesheavily on the ideas of Peter Duesberg, aretrovirologist at the University of Califor-nia, Berkeley, who in 1987 published a paperarguing that HIV is harmless. Duesberg hasgone on to argue that, rather than HIV, fac-tors such as illicit drug use and AZT, theanti-HIV compound, actually cause the dis-ease. Willner dedicates his book to Duesbergfor the California virologist’s “courageousexposé of the unconscionable deadly decep-

tion known as the AIDS epidemic.”Although mainstream AIDS researchers

dismiss Duesberg’s ideas as unsupportable,his challenge to the conventional wisdom isstill winning converts. The “Group for theScientific Reappraisal of the HIV/AIDS Hy-pothesis,” a loose-knit coalition of whichDuesberg is a member, has organized an in-ternational symposium to be held in BuenosAires in April. The London Sunday Timespicked up Duesberg’s cause and has run aseries of articles questioning HIV’s link toAIDS and calling the African AIDS epi-demic “a myth.”

Kary Mullis, winner of the 1993 NobelPrize in chemistry for discovering the poly-merase chain reaction, has joined in, sayinghe has seen “no scientific evidence” provingthat HIV causes AIDS. In June, the PacificDivision of the American Association forthe Advancement of Science (publisher ofScience) sponsored a daylong meeting atwhich the dissidents offered their points ofview. Duesberg was the guest editor of anentire upcoming issue of the genetics journalGenetica that will be devoted to alternativeAIDS hypotheses. A recent issue of Yale Sci-entific, which is published by Yale under-graduates in the sciences, carried a coverstory by mathematician Serge Lang titled“HIV/AIDS: Have We Been Misled?”

All this controversy confounds AIDS re-searchers who think HIV has been decisivelyestablished as the cause of AIDS. DescribingHIV as harmless is “irresponsible, with terri-bly serious consequences,” says WarrenWinkelstein Jr., a Berkeley AIDS epidemi-ologist who has known Duesberg for morethan 20 years. Duesberg’s message, Winkel-stein and others say, undermines the value ofcampaigns for the use of condoms and cleanneedles. What is more, says Helene Gayle,associate director of the Centers for DiseaseControl and Prevention (CDC) office inWashington, D.C., that message is “verydamaging” in the attempt to persuade othernations to stem the spread of AIDS, because“people already want to deny” the presenceof HIV and AIDS in their countries.

Yet although the scientific communityseems concerned about the effects of Dues-berg’s message, with few exceptions—such asNature editor John Maddox, who took on theLondon Sunday Times for its AIDS cover-age—the scientific community has largelyignored Peter Duesberg. But because the Dues-

berg phenomenon has not gone away andmay be growing, Science decided this was a goodtime to examine Duesberg’s main claims. In a3-month investigation, Science interviewedmore than 50 supporters and detractors, ex-amined the AIDS literature, including Dues-berg’s publications, and carried out corre-spondence and discussion with Duesberg.

This investigation reveals that althoughthe Berkeley virologist raises provocativequestions, few researchers find his basic con-tention that HIV is not the cause of AIDSpersuasive. Mainstream AIDS researchersargue that Duesberg’s arguments are con-structed by selective reading of the scientificliterature, dismissing evidence that contra-dicts his theses, requiring impossibly defini-tive proof, and dismissing outright studiesmarked by inconsequential weaknesses.

The main conclusions of Science’s investi-gation are that:■ In hemophiliacs (the group Duesbergacknowledges provides the best test case forthe HIV hypothesis) there is abundant evi-dence that HIV causes disease and death (seep. 1645).■ According to some AIDS researchers,HIV now fulfills the classic postulates of dis-ease causation established by Robert Koch(see p. 1647).■ The AIDS epidemic in Thailand, whichDuesberg has cited as confirmation of histheories, seems instead to confirm the role ofHIV (see p. 1647).■ AZT and illicit drugs, which Duesberg ar-gues can cause AIDS, don’t cause the im-mune deficiency characteristic of that dis-ease (see p. 1648).

From notable to notoriousAlthough Duesberg’s is the first name thatcomes to mind when HIV skeptics are men-tioned, he was not the first to question theHIV/AIDS connection, as he acknowledges:“I’m generously now credited by lots ofpeople for hypotheses which I’m embarrassedto admit are not my own,” says Duesberg. Butunlike his predecessors, “Duesberg carriesvisible credentials,” as Robert Gallo of theNational Cancer Institute (NCI), whose labwas the first to offer convincing evidencethat HIV causes AIDS, puts it. Duesberg is arespected virologist and cancer researcherwho in 1985 was awarded a prestigious Out-standing Investigator Grant by the NCI. Thenext year, Duesberg’s colleagues made him a

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Making a point. Robert Willner (right) drawsblood from a self-described HIV-positive manin preparation for Willner’s self-injection.

SPECIAL NEWS REPORT

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member of the elite National Academy ofSciences (NAS).

In addition to being an established scien-tist, Duesberg had another important featurethat distinguished him from earlier skepticsof the HIV-AIDS link: scientific combat ex-perience. Duesberg’s views about the “AIDSestablishment” are strikingly parallel to argu-ments he first leveled at cancer researchers.

In the early 1970s, Duesberg was amongthe first to demonstrate the exis-tence of cancer-causing oncogenesby showing that animal viruses ofthe type called retroviruses carrygenes that can transform normalcells in culture into cancerousones. Ironically, by 1983, Duesberghad turned against the field hehelped to found, publishing aneight-page paper in Nature savag-ing the idea that the related proto-oncogenes in normal human cells,once activated, behave like retro-viral oncogenes and cause cancer.Science ran a similar nine-pageDuesberg critique 2 years later.

In 1987, Duesberg upped theante in a 22-page article in CancerResearch. In it, Duesberg argued thatthe mainstream cancer researchcommunity was wrong about retro-viruses (the group to which HIVbelongs). Some of those viruses, hewrote, which were being thought ofas “evil,” were, in fact, harmlesscreatures that were incapable ofcausing cancer. At first, cancer re-searchers tried to persuade Duesberg that hewas wrong. But soon they began to ignorehim. In doing so, they were motivated by twofactors. One was the large and growing bodyof evidence that Duesberg was wrong: Muta-tions in proto-oncogenes do contribute tosome cancers. The second factor was frustra-tion with Duesberg’s style, which was widelyperceived as inflexible in the face of data thatdidn’t support his views. But because the is-sue was highly technical and the publichealth implications indirect, the debate re-mained in the pages of technical journals.

In the public arenaThat wasn’t what happened with AIDS.When Duesberg turned his attention toHIV, his objections quickly became a pub-lic cause. In the same 1987 Cancer Researchpaper, he made his first strike against thetheory that HIV causes AIDS. His conclu-sion: HIV was nothing more than a benign“passenger virus.” Much of the substance ofhis argument was derived from the fact thatthere were many unknowns about how HIVcauses AIDS—a gap in knowledge that stillholds true and still fuels the supportDuesberg receives outside the community ofAIDS researchers.

AIDS other than HIV offers an upbeat out-look. “To some extent, going back to thebeginning and looking for another cause pro-vides a hope for finding a cure and a vac-cine,” says Curran.

Duesberg’s hero’s welcome in the gaycommunity quickly wore out when he beganespousing the theory that AIDS was the re-sult of lifestyle choices—in particular, illicitdrug use—implying that people with AIDS

were in some sense responsible fortheir disease. But although thismessage didn’t play well in theCastro, says UCSD’s Epstein, it didamong some political conserva-tives, including Bryan Ellison, aBerkeley graduate student who be-came Duesberg’s main collabora-tor; conservative journalist TomBethell; and Charles Thomas Jr., aformer Harvard University bio-chemistry professor who has ar-gued that AIDS is a “behavioral”rather than an “infectious” disease.

Epstein cautions that “politicalconfigurations in the Duesbergcontroversy are more complexthan simple labels can suggest.”Yet he also concludes that “theparticular appeal of Duesberg’sviews to conservatives—certainlyincluding those with little sympa-thy for the gay movement—can-not be denied.”

A willingness to attribute AIDSto specific lifestyle choices wasn’tthe only reason Duesberg’s mes-

sage found receptive audiences outside thescientific community. Another is that his at-tacks on AIDS researchers as greedy self-in-terested mythmakers clicked into a growingdisenchantment with the medical establish-ment. Don Des Jarlais of New York’s BethIsrael Hospital, who works with users of in-jectable drugs, suggests Duesberg’s thesesmeet many people’s “emotional needs” tomake the establishment look bad. “You’renot going to argue people out of those [needs]based on footnotes,” says Des Jarlais. HaroldJaffe, head of the CDC’s Division of HIV/AIDS, also senses disenchantment with theestablished order. “In the beginning, it mayhave represented honest scientific argument,”says Jaffe. “Now it has assumed some kind ofcult status. It’s attractive to people who be-lieve the establishment is always wrong. Thiswould be the biggest example of all.”

The battle for credibilityDuesberg’s followers not only suggest thatthe “AIDS establishment” is wrong aboutthe cause of the disease; they also argue thatmainstream researchers have suppressedDuesberg’s search for the truth. The conten-tion of censorship has been given credibilityby a half-dozen prominent scientists who

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NHis own slant on things. Virologist Peter Duesberg.

Most AIDS researchers thought Duesbergwas exploiting uncertainties about the pre-cise mechanism of disease causation to dis-count a mountain of compelling epidem-iologic, laboratory, and animal data support-ing the conclusion that HIV causes AIDS.But the press was less skeptical. StevenEpstein, a sociologist of science at the Uni-versity of California, San Diego (UCSD),who has charted how Duesberg’s initial Can-

cer Research article wound its way throughthe media, says “What seems to gives thiscontroversy a lot of its motive force and itspeculiar twists and turns is the way in whichit’s enacted in very public arenas.”

Through the press, Duesberg found en-thusiastic audience for his attack on an“AIDS establishment” that he depicted aspushing a false theory. In Epstein’s study, hedescribes how the San Francisco Sentinel, agay newsweekly, reported that when Dues-berg attended an AIDS forum held in thecity’s largely gay Castro District in January1988, he “received a hero’s welcome.”

It isn’t difficult to understand why peopleat high risk of AIDS might be sympathetic tohis revisionist views. Not only are there un-certainties about the pathogenesis—the pre-cise way HIV causes disease and death—butalso there isn’t yet a cure or a vaccine. Asvirologist Joseph Sodroski of the Dana-Farber Cancer Institute in Boston acknowl-edges, “the ways for dealing with the virushaven’t worked that well. … Affected peoplethink maybe science, with all its powers,hasn’t been able to solve it” because thetheory’s wrong. AIDS epidemiologist JamesCurran, who coordinates the CDC’s AIDSprograms, adds that thinking about causes of

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sion that the evidence [about HIV causingAIDS] was dubious,” says Thomas, who stud-ies molecular biology at his own researchfoundation, Helicon, in San Diego. Just astroublesome, says Thomas, “nobody wascoming to his rescue. Everybody turned theirbacks on him. I figured, hell, if no one elsewill talk to him, I will. He kind of fell into myarms. He didn’t have too many friends inthose days.”

And some researchers who are frequentlycited as Duesberg supporters are not per-suaded he’s correct about HIV and AIDS—

but do support his right to dis-sent and to be taken seriously bythe scientific mainstream. HarryRubin, a Berkeley retrovirolo-gist and member of NAS whoshared Duesberg’s misgivings inthe cancer debate, says he“doesn’t deny” that HIV couldplay a role in AIDS. Rubin evencites a recent paper dismissingthe drugs–AIDS hypothesis thathe calls “fairly convincing.” Yet

Rubin supports Duesberg’s right to voice hisscientific opinion. “I respect what he’s doneand what he stands for,” says Rubin.

Berkeley’s Richard Strohman, a professoremeritus of cell biology, has doubts aboutHIV’s role in AIDS but stops short of endors-ing Duesberg’s view that it can’t cause dis-ease and that drugs and AZT do. Instead,Strohman says his main interest in the de-bate has been supporting Duesberg’s right todissent. Nobel laureate Walter Gilbert, aHarvard molecular biologist, has taken asimilar stance.

Also unpersuaded of Duesberg’s ideas—but persuaded he shouldn’t be shut out ofscientific resources—is Daniel Koshland Jr.,editor-in-chief of Science, who has writtenletters to the National Institute on DrugAbuse supporting Duesberg’s recent grantproposals. Those proposals focus on animaltests of Duesberg’s hypothesis that drugs—inthis case, nitrite inhalants like the “poppers”sometimes used by gay men—cause AIDS.“[Duesberg] has been considered far-out be-cause of his insistent denunciation of thegeneral conclusion in regard to AIDS,”

wrote Koshland, who has been critical of hisBerkeley colleague for not doing experimen-tal work in AIDS. “But his willingness to dothis experiment is important.”

But as he’s garnered support from thosenotables, Duesberg has begun losing supportfrom some early allies, including RobertRoot-Bernstein, a physiologist at MichiganState University, and New York AIDS clini-cian Joseph Sonnabend, who both criticizeDuesberg for being too inflexible in his asser-tions that HIV isn’t the cause of AIDS.

Whatever the opinions of others, Dues-berg says he will persevere—despite personallosses. “The one thing I’m doing here is al-most destroying my own reputation by ques-tioning whether HIV is the cause of AIDS.”If he had accepted the HIV argument, hesays, “I would not have to worry about a grantfor a second; the lab would be humming; Iwould be in the Journal of AIDS. … I wouldhave a tremendous life, and I will see my 30years of retrovirus work had paid off hand-somely after all.” He insists that if he read asingle scientific article that suggested to himhe was wrong, he would alter his views. “I’mlooking for that article,” he says. “I wouldlove to see it.” But for now, nothing he’s seenhas changed his mind.

–Jon Cohen

For the HIV skeptics“going back to thebeginning and lookingfor another causeprovides a hope forfinding a cure. …”

—James Curran

maintain that AIDS researchers have be-haved like an establishment, treatingDuesberg shabbily for challenging conven-tional wisdom.

Although AIDS researchers have chal-lenged Duesberg’s arguments in scientificjournals, public forums, and the media, theserebuttals by and large have been breezy. Theconsensus strategy has been benign neglect.Duesberg’s 76-page AIDS opus published 2years ago in Pharmacology and Therapeuticsmade nary a ripple in the scientific commu-nity. When the mainstream AIDS commu-nity does reply, the responses sometimeshave an ad hominem edge. In a 1988 Sciencearticle, Gallo compared Duesberg to “a littledog that won’t let go”; Nobel laureate DavidBaltimore called his ideas “pernicious.”

Journals have also had difficulty dealingwith Duesberg’s unconventional theories. In1989 and 1991 the Proceedings of the NationalAcademy of Sciences subjected his AIDS pa-pers to unusual multilayered peer reviews,although the journal did ultimately publishthem. In 1993, NCI decided not to renewhis Outstanding InvestigatorGrant, an act Duesberg claimswas politically motivated. NCIofficials strongly disagree. “TheNCI makes decisions based onscientific merit,” says MarvinKalt, head of NCI’s extramu-ral activities. In addition,Duesberg has been turneddown by funding agencies onseveral new proposals to studyboth AIDS and cancer. Dues-berg paints himself as a manpaying the price for holdingunpopular views. “I would liketo do experiments, but I can’t do them any-more because I won’t get a grant anymore.”

In the eyes of sociologist Epstein, thesestruggles are largely over a very preciouscommodity: credibility. “Some of the mostpowerful weapons available to the defendersof the dominant position in scientific con-troversies are the sanctions they can exerciseagainst dissidents,” Epstein suggests.

But Duesberg has his own resources forsustaining credibility—including some prom-inent scientists who have circled the wagonsaround him. In the popular press, these sci-entists are often cited as Duesberg supporters.But that description overlooks some crucialdistinctions. Some of Duesberg’s sympathizersstrongly support his contention that HIVdoes not cause AIDS, among them NobelistMullis and self-injector Willner.

But others seem equally, if not more, con-cerned about the treatment Duesberg has re-ceived at the hands of the establishment.Former Harvard biochemist Thomas orga-nized the Group for the Scientific Reap-praisal of the HIV/AIDS Hypothesis. “WhenI read his paper in 1987, I came to the conclu-

Additional ReadingM. Ascher et al., “Does drug use cause

AIDS?” Nature 362, 103 (1993).W. Blattner et al., “HIV/AIDS in laboratory

workers infected with HTLV-IIIB,” IXth Interna-tional Conference on AIDS, PO-B01-0876(1993).

W. Blattner, R. C. Gallo, H. M. Temin, “HIVcauses AIDS,” Science 241, 515 (1988).

T. Chorba et al., “Changes in longevity andcauses of death among persons with hemo-philia A,” American Journal of Hematology 45,112 (1994).

P. Duesberg, “Retroviruses as carcinogensand pathogens: Expectations and reality,” Can-cer Research 47, 1199 (1987).

P. Duesberg, “HIV is not the cause ofAIDS,” Science 241, 514 (1988).

P. Duesberg, “AIDS epidemiology: Inconsis-tencies with human immunodeficiency virus andwith infectious disease,” Proceedings of theNational Academy of Sciences 88, 1575 (1991).

P. Duesberg, “AIDS acquired by drug con-sumption and other noncontagious risk factors,”Pharmacology and Therapeutics 55, 201 (1992).

A. Evans, “Does HIV cause AIDS? An his-torical perspective,” Journal of AIDS 2, 107(1989).

J. Hassett et al., “Effect on lymphocyte sub-sets of clotting factor therapy in Human Immu-nodeficiency Virus-1 negative congenital clot-ting disorders,” Blood 82, 1351 (1993).

R. Kurth, “Does HIV cause AIDS?” Intervir-ology 31, 301 (1990).

M. Schechter et al., “HIV-1 and the aetiol-ogy of AIDS,” The Lancet 341, 658 (1993).

R. Weiss and H. Jaffe, “Duesberg, HIV andAIDS,” Nature 345, 659 (1990).

B. Weniger, “The epidemiology of HIV infec-tions and AIDS in Thailand,” AIDS 5, S71 (1991).