My medical career has essentially spanned the same time frame as the AIDS “epidemic”. When I entered medical school in 1980, we began to hear of this new illness showing up in gay men in New York and San Francisco. When I graduated in 1984, many deaths had resulted from this mysterious new illness. By the time I finished residency, it was announced that the cause had been discovered, a major first step in the path to controlling this devastating illness. Even then, though, some things didn’t seem to make sense.Throughout my medical training we were taught that, with viral infections, two “arms”of the immune system get involved, the cellular and the humoral. The cellular immune system is based on white blood cells and rids of us of invaders by engulfing and digesting micro-organisms such as viruses and bacteria. The signs of activation of the cellular immune system include fever, mucus, and often rash, as the white blood cells digest and excrete unwanted foreign substances. The consequences of the cellular immune system are the signs of illness that we see and that make us feel sick. The humoral immune system is the memory part of our immune response. It is the part that makes antibodies tailored to specific invaders that tag and remember these substances.
In the normal course of a viral infection, both arms of the immune system are involved. As an example, with chickenpox we see signs of activation of the cellular arm with the fever, mucus, cough and rash that characterize this illness. As with most viral infections, the signs of the illness are almost identical in type, if not in severity, across all people. In other words, chickenpox almost always gives the same type of rash, lasts the same length of time, etc., no matter who gets the illness. Next, the humoral immune system is activated, and six weeks later antibodies are produced which impart life-long immunity to the illness.
With this new disease of AIDS, the interpretation of how the viral immune system works seemed to change. For the first time we were being told that, even though every case of AIDS was caused by the same virus, there were many possible manifestations of this viral disease. And, shocking to me at the time, I remember distinctly finding out that the diagnosis of the illness was based on a test that detected antibodies in the blood to the HIV virus. What?! I had been taught for years that when we produce antibodies to a virus, this means we are immune to that virus. Why now, all of sudden, does detecting antibodies to a virus mean it is the virus making us sick? For me, this would be akin to saying that the German measles virus, when contracted by adults, can cause a kind of arthritis. With that line of “logic” when a middle-aged person comes in complaining of joint pains, we would do an antibody test, discover the antibodies (because the person did have German measles as a child) and then pronounce that it must be the German measles virus that is causing the illness. This is a mis-interpretation. We generally assume that the fact that we have antibodies mean we are immune. Why would it be different for HIV?
Subsequently other unusual facts and diagnostic discrepancies started to emerge from the AIDS crisis. We were told that the HIV virus was contracted through sexual or blood born contact. This was not the first such micro-organism to have this characteristic. All sexually-transmitted diseases are, of course, transmitted only through direct sexual contact, including herpes, Chlamydia, syphilis, gonorrhea, and many others. However, unlike AIDS, all of these illnesses share the characteristic of being almost equally present in both males and females. With AIDS, at least in the US, for the first time a sexually-transmitted illness has stayed almost predominantly within one sexual group, that is gay men (over 90% of the deaths in the US have been in gay men).
Additionally, with other blood-born illness such as hepatitis C, many cases are eventually found among the medical profession, due to the risk of inadvertently spreading the virus through needle sticks, a risk predominantly born by medical and dental workers. Inexplicably, with AIDS, as far as I know, only two dentists in the entire 25-year history of AIDS have contracted AIDS with no other risk factors (gay male, IV drug abuser, etc.). This, of course, might lead us to the question whether these two dentists were completely forthcoming in their answers about their risk factors.
The final unusual diagnostic discrepancy of the AIDS epidemic was that over the years, numerous patients, supposedly numbering in the thousands, who were found to suffer from the full blown AIDS illness, had no detectable levels of antibodies in their blood. In fact, they had no evidence of any sort of having a viral infection, even antibodies, but because they had all the AIDS symptoms, it was assumed that they must have had the virus at least at some point. This was an unprecedented conclusion.
Sometime in the late 1980s and early 1990s, the safe sex campaign began, and at the same time we saw as the introduction of the different categories of AIDS drugs, each supposedly targeting different aspects of the virus’s life cycle. What was once considered an early death sentence became a manageable disease, albeit with many unpleasant and even life-threatening consequences. This brings us to the present, where the dire consequences of the AIDS epidemic predicted in this country have largely proved to be unfounded. Back in the 1980s we were told that unless a vaccine was quickly discovered, we were basically doomed as a species because the virus would quickly spread throughout the heterosexual population, as had other sexually transmitted diseases. Twenty-five years later there is no vaccine in sight, there have been rare illness in those without risk factors (i.e. gay men, IV drug use, co-existing other sexually transmitted illness, malnutrition, etc) and, even today, fewer people die of AIDS in this country than in car accidents or of alcoholism.
But what about Africa? Don’t the AIDS experts tell us that unless massive action is taken the HIV virus will soon wipe out the economies and viability of different cultures in many African countries? Again, some inconsistencies exist in these predictions. For starters, people in Africa are rarely actually tested for the HIV virus when they are either screened or diagnosed with AIDS. The cases, as in this country, almost uniformly occur in people with other risk factors for illness. These include the some of the same risk factors of gay male sex, IV drug abuse, malnutrition, co-existing sexually transmitted illness. But they also include the specifically African issues of TB, malaria, as well as many other unchecked infectious illness existing in people highly exposed to environmental toxins amid a huge burden of poverty and social unrest. As with most illness, if one examines the epidemiological data, the best conclusion one can draw is that the poorer, the more malnourished, the more exposed to TB, malaria, toxic waste, and social disharmony that a person or culture experiences, the more likely they are to get sick with AIDS. This is highly unusual way for a virus to behave, one from which we supposedly have no natural defenses. These and many other issues surrounding the AIDS controversy have been extensively documented in all sorts of sources over the past twenty years. I would refer all my readers to the book by Christine Maggiore, What If Everything You Thought You Knew About AIDS Was Wrong?, the website www.virusmyth.org, and the article in the March 2006 issue of Harper’s magazine about the inconsistencies of the AIDS-HIV connection and the problem with the HIV drugs (available online at www.harpers.org/OutOfControl.html).
This is not a closed case. Many questions remain that need to be answered, and more to be asked. As we gear up to spend almost unlimited resources fighting this virus, it behooves us all to find out more about the facts behind this perplexing epidemic.
Full Moon Feast: Food and the Hunger for Connection — book by Jessica Prentice