It was MaeWan Hos 1998 book Genetic Engineering: Dream or Nightmare that convinced me that the central dogma of genetics (that information flows only from DNA to the cell via RNA) was wrong and that the relationship between genetics and virology was close. Both sciences share many flaws, both ignore other causes for disease, and both compete to be top dog in health funding. I even wrote to Ho after finishing the book to persuade her that if she performed the same analysis on HIV science, she would reach conclusions that were just as shocking.
This new book Unravelling AIDS (Vital Health Books, 2005) by editor and senior author Ho, with assistance from Sam Burcher, Rhea Gala and Vejko Veljkovic, is my answer. Because the authors are not afraid to question every aspect of HIV and AIDS it will be controversial.
MaeWan Ho is a well known critic of genetic engineering. She received a PhD in biochemistry in 1967 and taught genetics and biology until she retired in 2000, to devote herself fully to ISIS (Insitute of Science in Society), mostly opposing genetic engineering. Her coauthors Sam Burcher and Rhea Gala also work for ISIS, Burcher as a writer and Gala as assistant editor of the ISIS magazine Science in Society. Vejko Veljkovic is director of the Center for Multidisciplinary Research at the Institute of Nuclear Science Vinca in Belgrade and an HIV/AIDS immunology researcher with eight vaccinerelated patents.
The Book OverallA chain of logic holds the HIV/AIDS hypothesis together. Questioning a fundamental link can radically change how other parts should be examined, or even disconnect the whole. For the central discussion of this book, HIV Vaccines, to have any meaning HIV tests have to be accepted as meaningful and accurate, the radically different definitions of the syndrome AIDS have to be taken as one, and the surrogate markers used to measure the stage of the disease have to be accepted instead of clinical evidence of health.
This leads to the book appearing to accept axioms in one place that it elsewhere rejects. This will force persistent readers to think through each point, weigh the evidence and do some of their own research. This is not the book for people who want a simple Yes or No answer to the question of whether HIV vaccine research is useful.
The writing style is mostly readable although not always elegant. The first sentence, instead of being one of the best in the book, is too convoluted to hook casual readers: Figures from the joint United Nations Program on AIDS (see box) released at the end of December 2003 claim 40 million affected with HIV or AIDS worldwide, and within the year, 3 million people have died while 5 million new cases were recorded, the vast majority in subSaharan Africa.
Defining HIV and AIDS
Ho starts by questioning the meaning of the term AIDS, especially the Bangui definition, used in most third world countries since it was first published by the World Health Organization in 1986. Ho only provides a truncated version, but everyone should be aware that: AIDS in an adult is defined by the existence of at least 2 of the major signs associated with at least 1 minor sign, in the absence of known causes of immunosuppression such as cancer or severe malnutrition or other recognized etiologies. and that the Major signs are (a) weight loss >= 10% of body weight, (b) chronic diarrhoea > 1 month; (c) prolonged fever > 1 month (intermittent or constant). and the longer list of Minor signs starts with (a) persistent cough for >1 month. [WHO, 1986]
It is not just the definition of AIDS that can be critiqued. HIV tests are essentially the definition of HIV infection, and they also produce inconsistent and questionable results.
Antibody tests are still the method by which most people are diagnosed as HIVinfected. Hos understanding of antibody tests is apparently shallow, as her description is not very accurate. The basic antibody test is ELISA, yet her criticisms of these tests are applicable only to the Western Blot test, used to confirm the results of ELISA tests. With only a few pages devoted to this subject, her review is incomplete.
Ho glosses over problems with HIV isolation, often used as validation of antibody test methodologies, and occasionally as a test itself. She only states that the HIV virus, unlike ordinary viruses responsible for disease, cannot readily be isolated from AIDS patients. She does not point out that isolation is only a euphemism for cell culturing and has nothing to do with virus purification. It does not start by adding pure virus to a cell culture and it ends by detecting a nonspecific marker such as the p24 antigen or the reverse transcriptase enzyme, not by obtaining and characterizing pure virus. This may be the fundamental flaw in HIV science and deserves more attention.
In a chapter on the African AIDS epidemic Ho recognizes some techniques used to inflate the publics view of the HIV/AIDS problem: Run HIV tests with lower standards than in the rich West, and then only on a small sample of the population. Extrapolate this laxer definition of HIV to the entire population and, Presto!, a nightmare scenario has been conjured up. The Bangui definition of AIDS does the same thing for the AIDS head count, counting millions of people with Tuberculosis, Malaria, parasitic infections or simply malnutrition as AIDS victims.
Ho starts her discussion of drugs with a chapter deploring their high price and inaccessibility, implying that they are highly beneficial: Thanks to modern combination drugs, more and more people suffering from AIDS in Europe and North America are now surviving the disease, so it is often said. Shouldnt this benefit be extended to AIDS sufferers in Africa and other countries in the developing world? It is easy to overlook the small caveat that Ho coyly inserts (so it is often said).
Ho waits until the next chapter, AntiHIV Drugs Do More Harm Than Good, before describing some of the severe side effects of AIDS drugs anemias, lactic acid buildup, liver damage and lifethreatening skin reactions (such as the often fatal Stevens Johnson Syndrome, when your skin dies and flakes off leaving your entire body as an open sore).
If the drugs are so dangerous, I am confused by Hos earlier stance. Shouldnt George Bush and the greedy drug companies be given medals for pricing these dangerous drugs out of the bodies of millions of Africans?
Ho shines in her detailed critique of HIV vaccine experiments, attempts to stimulate antibodies against HIV, mainly using the gp120 or gp160 proteins believed to be important constituents of the HIV envelope.
There is no evidence that any of these vaccines have had any significant benefit, although there have been attempts to massage the data to claim a minor success. For example, data on the 13 black people in the VaxGen trial showed a 78% vaccine success rate. Apart from promoters of this company, everyone has agreed that this is a statistical fluke.
Being an expert on genetic engineering, Ho is rightly concerned about the transmission of genetic material from these vaccines (some of which are delivered in live bacteria or viruses) into the human target.
Even more dangerous, because it could affect people who arent vaccinated as well as those who are, is the genetic engineering of plants such as maize to incorporate HIV proteins. What if these genes escape into other corn fields and become part of cobs that are not supposed to be an edible vaccine?
One of the problems with the section on vaccines, which forms the heart of this book, is that it is argued almost entirely from a mainstream perspective. Some of her criticisms are meaningless if major aspects of the HIV/AIDS dogma are challenged. Ho criticizes gp120 vaccines because they might stimulate an immune reaction against the proteins in the vaccine. This, the authors fear, might dull the detection of this protein from a wily HIV that mutates to produce a slightly different gp120. This is irrelevant if the provenance of gp120 is challenged.
Ho cannot plead ignorance. Earlier in the book she describes how scientist and businessman Howard Urnovitz questions the existence of HIV: Urnovitz is not even sure that the virus HIV exists. He thinks it may simply be a piece of RNAcontaining reshuffled gene sequences similar to those found in people exposed to a variety of environmental toxic agents, as in veterans suffering from Gulf War syndrome. In other words, what many scientists have been calling HIV may be a marker for having been exposed to toxic agents that are likely to lead to AIDS disease, but may not be the actual agent that causes the disease.
The only vaccine that Ho is enthusiastic about is V1 Immunitor from a private Thai biotech company. This oral vaccine is manufactured from HIV antigens from pooled clinical isolates from HIV infected donors. The manufacturer claims many Lazarus stories, dying AIDS patients who have recovered their appetite, gained weight, increased their CD4 cell counts and risen out of bed.
V1 is controversial, and it is easy to believe that multinational drug companies would undercut a cheap and accessible treatment for AIDS. The suggestion by some proponents that patients stop taking AIDS drugs is a good excuse for a backlash. Denying patients proven treatment has long been one of the gnarliest sticks used to bash alternative health practitioners.
The problem is that the discussion of V1 is uncritical. For example: Increase in body weight was 2.2 kg on average. But some patients weight increased by as much as 30 kg, which is an important gain in the treatment of AIDS. The bias in this statement is the segue from the 2.2 kg gain to 30 kg, leading the casual reader to end up remembering the larger weight gain, which might have only occurred in one person. Weight gain can also be misleading. Protease inhibitors, for example, often result in major disturbances of fat metabolism. By this measure a buffalo hump forming on the back of a patient is a good thing.
Ho does not consider that V1 might be effective not against HIV, but against belief in HIV. The psychological impact, the voodoohexing, of being told to go away and die by doctors, family and friends, can be fatal. Belief in V1 could act as a powerful antidote to the fatal belief in HIV as well as persuading people to stop taking toxic antiretrovirals.
V1 Immunitor is on the boundary between a mainstream AIDS treatment and an alternative. The last major section of Hos book describes more classic alternatives: herbs, minerals, mushrooms, probiotics, exercise and even simply better nutrition. She also discusses some generic pharmaceuticals that have some antiviral activity, but are more commonly used for other conditions.
Her treatment of these supplements is similar to that of vaccines. It is based upon a belief in the reality of HIV and AIDS, on the accuracy of surrogate markers for HIV and AIDS progression, and on the truth of the many anecdotal stories about these compounds.
In some cases the benefits she claims are virtual, such as inhibition of the reverse transcription enzyme in a test tube. These, of course, depend on the accuracy of the HIV theory of AIDS and the translation from lab measurements to health benefits in a human.
Even when the claims are of actual clinical benefit it is difficult to separate the benefits of the remedy from the placebo effect or from people deciding to take control of their health in a number of different ways at the same time, perhaps cutting down on drugs and junk food as well as taking herbs or supplements.
Ho devotes a whole chapter to the theories of Canadian professor Harold Foster who coined the term the SeleniumCD4 tailspin, the idea that HIV can outcompete the human body for Selenium, exacerbating the effects of of the deficiency. [Foster, 2002] Foster treats Africans with Selenium as well as Cysteine, Glutamine and Tryptophan so it is not clear whether the positive results from his treatment are due to its direct effects on HIV, or whether his patients were really just suffering from malnutrition, perhaps from a diet that had sufficient calories, but insufficient quantities of critical nutrients.
Members of the socalled Perth Group, probably the first scientists to question the existence of HIV, have correlated both the diagnosis of AIDS in Africa and positive HIV tests with protein energy malnutrition and oxidative stress. [Papadopulos, 2001]
Ho comes close to recognizing this link. In a discussion on positive results from a trial that used Vitamin A supplements in combination with antiretroviral drugs she quotes an African saying If you give us ARVs [antiretroviral drugs], please give us food, just food. Ho wonders if the results would have been better if these people had been given food as well as these supplements, but doesnt turn it completely around to ask whether adequate and nutritious food might be the most important factor in curing the symptoms that are called AIDS in Africa, and that AIDS drugs and supplements might play a minor role at best.
Perhaps if Ho had studied the work of the Perth Group more thoroughly she would have expanded more on this connection. She only cites one of their papers to support one small point in the book, an unfortunate omission. [Perth, 2005]
I would have expected that Ho, a veteran antiGMO campaigner, would question whether globalization of food production might not be at the root of AIDS in Africa. As Africans are being moved from their traditional foods to higher productivity, more easily processed foods such as maize, it is possible that nutrient deficiences from a less varied diet are causing the vitamin and mineral deficiencies, just as a cornbased diet was at the root of the pellagra epidemics in the US South.
Supplementation and other alternative and traditional remedies may well play a role in recovery from nutrient deficiencies and from the diseases that are common in Africa. Their benefits may be much easier to see in the context of malnutrition, separated from their effects on surrogate markers or on artificial systems in test tubes.
Her discussion of pharmaceutical generics suffers even more from the surrogate marker problem. Recommending the blood thinner warfarin because of test tube activity against viruses and because a trial showed it restoring the immune function in 33 AIDS patients (raising CD4 cell counts?) might prove dangerous. The use of the intestinal worm treatment Levamisole might benefit the many AIDS patients who have Bangui AIDS due to parasitic worm infections but not those whose symptoms have other causes. A study in Ethiopia showed that worm medications decreased viral load, but does this show some interaction between worms and HIV, an antiviral activity of the drugs used or that viral load is not an accurate marker for HIV? [Wolday, 2002]
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