Document:Campbell reviews Adams
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6 May 1989
The publication of this book is an unfortunate event. Jad Adams claims that AIDS is not caused by infection with HIV. What does cause AIDS, say Adams, is something he isn't obliged to work out. It could be "lifestyle" or "anything"; anything, that is, except the virus now firmly established through an urgent programme of medical research as the infectious agent causing AIDS. The claim that HIV is not the cause of AIDS is neither new nor Adams's own. As a nonscientist (who admits that he does not "pretend to objectivity") Adams relies almost entirely on the arguments against HIV previously advanced by the Berkeley biochemist, Peter Duesberg.
That Duesberg's criticisms have repeatedly and effectively been refuted deters Adams not at all. His reporting is staggeringly inaccurate, scientifically inept, and continually blighted by the misinterpretation or distortion of the minimal scientific sources that he has consulted. He has constructed his book in such remarkable ignorance of so much widely available recent research and information on AIDS and immunology that it is very hard to believe that his ignorance is not deliberate.
None of this would matter particularly were it not that a British publisher of erstwhile high repute, Macmillan (Macmillan Journals are the publishers of Nature) has put its imprimatur on the book; or were it not that the Royal Television Society, in its wisdom of matters medical, placed its imprimatur of the award of the "Best International Current Affairs Documentary" for 1987 on a film Adams made on the subject. Screened by Channel 4 in the series "Despatches" late in 1987, the film was, Adams now admits, "not balanced".
This book follows in exactly the same vein. Macmillan admits that it did not have Adams's manuscript checked for accuracy before publication, and ignored a warning received from an expert working for another Macmillan pubication [sic], Nursing Times. Adams himself did none of the necessary fact-checking. In direct consequence, grotesque and dangerous errors abound.
The Adams/Duesberg claims have already done serious harm. AIDS is a debilitating and still-lethal disease afflicting an increasing number of otherwise healthy adults. The primary sales target for this book are the tens of thousands of people in Britain who have personally, directly or indirectly, to deal with problems of HIV infection and/or AIDS. For them and their carers, scientific and medical information is a much-sought lifeline, and a guide on which they are likely to base literally life-and-death decisions. Such a situation places considerable responsibility on the shoulders of any serious author or publisher.
Disregard the evidence about the nature of HIV, and you urge HIV and AIDS patients to distrust entirely the basis on which they now receive medical care. Already, this effect of Adams's work has brought one of Britain's most renowned AIDS physicians, Charles Farthing, to condemn his efforts as "evil". So on what scientific basis does Adams (and behind him, Duesberg) advance the argument that HIV does not cause AIDS?
This critical passage spans only 24 pages, less than 10 percent of the text. Adams offers two primary arguments against the HIV/AIDS theory. First, he asserts that the virus itself cannot be shown to be present in many AIDS patients. Secondly, he claims that neither in the US nor anywhere else are AIDS patients even tested for HIV antibodies. "There is no check for HIV," he writes, because "it is so fully accepted as a matter of faith that HIV causes AIDS, no supporting information is required". In summary, Adams says, "so few AIDS patients now receive even an antibody test that we cannot be sure what they are carrying. Virtually anything could be causing their disease."
These contentions are all absurdly wrong, as the author would have found out had he once bothered to contact any of the world's major centres for AIDS treatment.
Adams's claim that HIV virus cannot easily be recovered from most people with AIDS is several years out of date. The claim that most patients are never tested for HIV antibodies is completely spurious.
"Paradoxically", Adams asserts, "people with a low level of antibodies to HIV are considered to be at low risk from AIDS." But this is no paradox, just another error. The 1984 paper Adams cites in support of this claim states the opposite to be true. People with "advanced AIDS" have "significantly lower" levels of HIV antibodies than "newly-diagnosed" cases. The paper on which Adams relies does report finding "a high incidence" of HIV antibodies among patients at risk of developing AIDS (that is, many of them had been found to have antibodies). The author has become confused and reports this as meaning "a high level" of concentration of antibodies in their blood. In publicity material, Macmillan has given high prominence to this error.
The book also asserts that homosexual men are "immune-suppressed" because of their sexual practices. Adams alludes to reports that in some gay men, the normal ratio of helper cells to killer cells in the immune system has been found to be inverted as compared to similar heterosexual men. But the studies referred to by Adams were all completed before 1985. When HIV tests became more available, researchers found that the inversion applied only to gay men who were HIV antibody positive. Gay men, who were antibody negative, were found to have the same immune system parameters as heterosexual men.
The "paradox" which he and Duesberg see as central to their argument is that even in "full-blown" AIDS the level of HIV in the blood is but a fraction of what can be found in some other virus-caused diseases. The rate of destruction of the key T4 "helper" white blood cells by HIV is a million times too slow to cause any effect, they suggest. Most bizarrely of all, they say that HIV has too few genes and "the wrong structure" to cause a fatal disease.
Each of these claims is either false or irrelevant. Low levels of viruses in the blood are characteristic of retroviruses; and high concentrations of viruses (viral titres) are never necessary where autoimmune phenomena are likely to play a large role in the development of a disease. Tests for the active HIV infection of T cells in the blood are not tests for the level of infection in other tissues, particularly lymph nodes. There is no "paradox" that very few of a patient's T4 helper cells can be found expressing HIV at any one time, because any that do are likely immediately to be destroyed by the immune system of which they are part. Adams's claim that HIV has "too few genes" to be pathogenic does not even merit serious attention.
Another repeated assertion is that "in all other diseases the virus titre becomes active and rises in those...who are going to get the disease. Not so with HIV". Actually, it's precisely so with HIV. Pioneering work during 1986 and 1987 identified the re-appearance of HIV antigen in the blood of someone who was HIV-antibody positive as indicating the early onset of AIDS. Over the past 18 months, the level of concentration of antigens has become established as a key laboratory marker of whether anti-AIDS drugs are effective. Of all this research, as well as the many "cohort studies" (which are now following the long-term development of HIV disease) the author has kept readers in ignorance.
To explain why the entire scientific world disagrees with him and Duesberg, Adams perjoratively brands his opponents as members of a homogeneous "AIDS establishment", whose scientific prestige and personal prosperity now depend on maintaining the HIV myth. Extensive quotations from Paul Feyerabend about the nature of scientific discovery decorate the book, but fail to disguise the author's basic ignorance of science and scientific method. There are periodic allusions to the author's concern for those afflicted by AIDS, but these fail to mask his often-stated view that "AIDS is a behavioural disease". Such a claim is not merely offensive to AIDS sufferers; it flies in the face of the well-established patterns of transmission via blood and its products to transfusion recipients, haemophiliacs, and their partners.
Adams claims that everyone who gets AIDS is behaviourally to blame. Even babies, he has contended, had engaged in "a form of behaviour" by being in the womb of an HIV-infected mother. Health-care workers who are victims of needlestick injuries are also to blame.
In his preface, Adams writes: "I see no need to apologise for the subjective style in which this book is written." As news reports in New Scientist have already indicated (28 April), Adams has made it clear that he sees no need to apologise for getting his key facts wrong.
But Macmillan, the publisher, is in a different position. It has belligerently refused to check the accuracy of the book. Appeals to do so have repeatedly been rejected. It is now many weeks since Macmillan became aware of the book's major errors. It is difficult to contemplate any motive, other than arrogance or greed, which can make a serious publisher so recklessly indifferent to accuracy in reporting.
© 1989 by Duncan Campbell
Originally published in New Scientist