One of my main motivations in college and grad school was to work in drug discovery, specifically for HIV. At the time (~1995-2000) we were just starting to see positive results from protease inhibitors and reverse transcriptase inhibtors came somewhat later leading to the current "managment of HIV through HART" https://en.wikipedia.org/wiki/Management_of_HIV/AIDS
All of this came slowly - decades between significant new technologies/improvements in treatment. many sources of infection such as blood transfusions are now much less risky (people in the 70s and 80s were getting hep C and HIV from blood taken from HIV-positive donors). And the disease presents very differently in the US vs. other areas such as Sub-Saharan africa. But with extensive effort, prevention has gotten better and treatments have gotten much better. If there are truly usable preventatives for at-risk populations, and those medications are affordable, it will be a huge boon to the recipients.
Some interesting things to note:
- there was a lot of controversy about the source of infection and a lot of people used this to criticize gay people and injected drug users.
- one of the world's most famous virologists, https://en.wikipedia.org/wiki/Peter_Duesberg actively denied that HIV caused AIDS and instead thought it was transmitted by drug use. Note "Duesberg entered a long dispute with John Maddox, then-editor of the scientific journal Nature, demanding the right to rebut articles that HIV caused AIDS." which I think presages the current arguments about what scientists can say regarding the origins of COVID. The impact of his statements in South Africa was significant. From what I can tell he was completely off base and never made any truly convincing arguments for his position.
- Fauci, of COVID fame, played a big role in getting NIH and the various AIDS community organzations working together and making large improvements to HIV/AIDS treatment. Before that, Fauci was heavily criticized by various LBGTQ orgs (see https://www.nytimes.com/2022/12/31/opinion/anthony-fauci-hiv...) "Larry Kramer, one of the group’s founders, wrote an open letter to Dr. Fauci in The Village Voice calling him a murderer and comparing him to the Holocaust organizer Adolf Eichmann." Again, all this presages the later treatment of Fauci by various political groups during COVID. I often think back to Fauci during HIV/AIDS while reflecting on the current situation around COVID and I think we got lucky to find somebody like him, even if he said a few dumb things, and we'll be lucky if any public servants are willing to take up his role in the future.
- modern gene therapy often uses variants on HIV as the vector. That's right: it's so good at getting into cells and modifying the genome, that we use it as the preferred method. it took quite some time before the vectors were made safe enough (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5152689/)
You get new evidence and you update your beliefs. This is literally how science works and progress is made. If you had to put every student of science on the spot for everything wrong they said/did, there wouldn't be as much progress.
The plus side of that in a pandemic scenario is that when you say something is necessary, people do it. The downside is you ruin the credibility of everyone you're leading if you're wrong.
Fauci isn't the average scientist. The cost-benefits to him speaking on an issue are different than a researcher coming up with a new theory on how COVID spreads.
Fauci changed opinions, a lot of experts do. It's only the lay people with no idea how science works who will call it a "mistake".
Actually it's worse than that, people have openly harassed and threatened Fauci and his family for doing what he did. That's unfair and borderline evil.
That's all well and good but then don't shout down people who question your beliefs made on incomplete data as being against the science. Herd immunity was not just a scientific theory but presented as a fact and used to deprive people of their bodily autonomy at the threat of significant loss of other freedoms. And now that The Science(tm) has been updated intellectually bankrupt people like you just go "oops, no one could have known" when you know for a fact that there were people warning you.
I'm curious about his claim that retroviruses (retrovirii?) must be harmless to survive and multiply. What is the mainstream consensus on this?
To be clear: I know next to nothing about viruses (virii? I mean I don't even know how to call them) and I have no idea whether it really supports Peter Duesberg's claims about AIDS in general. I'm just wondering whether he's pointed out an interesting peculiarity of HIV that is not further investigated by others for fear of being accused of denialism.
Scientists can get very like that.
>> (...) the current arguments about what scientists can say regarding the origins of COVID.
It reminded me most about John Ioannidi's polemic against the way COVID was dealt with, rather than its origin. Ioannidis is a leading epidemiologist so he had to be taken seriously, although of course his opinion was rejected by most everyone else.
The mainstream consensus is the he was wildly wrong about HIV specifically, that HIV causes AIDS, and that his influence in South Africa to not deploy anti-viral medications killed hundreds of thousands of people before the policy was reversed.
Part of his hypothesis was that viruses in general, not just retroviruses, were not connected to cancers, the consensus view is that this is completely wrong. We have a very large body of evidence on many virus caused cancers now.
Even at the time he was arguing this, it was clear that the retrovirus HTLV was disease causing in humans https://en.wikipedia.org/wiki/Primate_T-lymphotropic_virus
So, the two known human retroviruses both cause disease and retroviruses cause diseases in animals. Duesberg held on to and promoted this concept long after it should have been clear to him that there was zero empirical support for his idea.
See https://www.nytimes.com/2024/05/20/world/europe/britain-cont... for some recent discussion of the scope and scale of HIV contamination.
Yet apparently to this day he draws over 200k/yr in salary from Berkeley. I believe they are not entirely funded by tuition/endowments which means California tax payers support him at least in part.
IIUC he's been isolated- doesn't get any real funding from NIH, or from the university (beyond the standard salary), and doesn't have an active lab.
It would likely cost the university more in legal fees to get rid of him than keep him until he goes away.
He was investigated but it was dropped as being protected by his academic freedom: https://www.science.org/content/article/berkeley-drops-probe...
He also, that I know of, still supports this position. To this day, you will find people getting into this particular conspiracy and rejecting treatment. It doesn't go well for them.
I do think that freedom of speech is important, and that many attempts to squash "misinformation" are misguided, but some speech has consequences. Personally I find Duesberg utterly reprehensible and morally culpable.
On the "retroviruses must be harmless" virology: He's a denier of viral involvement in cancers in general, not just that HIV must be harmless. He is way outside mainstream consensus on all kinds of things.
For instance, he argues that Kaposi sarcoma, a very common AIDS related cancer was caused by drug use and not opportunistic infection. It is now very well established that all KS, which also affects (typically older) HIV- people, is caused by HHV-8 infection.
He claims that Hep-B/C can't cause liver cancer.
He claims that HPV doesn't cause cervical cancer (https://www.academia.edu/31617237/What_if_HPV_does_NOT_cause...)
The core thing he does on all of these topics is just to ignore or deny anything that doesn't agree with him, eg: Hemophiliacs treated with tainted blood get AIDS, HIV viral load directly corresponds to disease progression which is clearly halted by dropping HIV load with treatment, the HPV vaccine demonstrably prevents cervical cancer, etc. He is far off in quack territory.
That's the question I couldn't answer by reading the wikipedia article. But I think thanks to some of the comments here my question is at least partly answered: at least some retroviruses -including HIV- seem to not kill off their host immediately, which I guess gives them time to reproduce and infect more hosts.
Moreover, why would a disease even 'care' about the host? As long as it can jump hosts quickly, it can afford to kill many of them. If achieving fast transmission is tough on the host, so be it. Other diseases may select for the opposite approach, of course.
I don't know enough (my retrovirus knowledge is out of date), but if you look at authoritative knowledge (IE, textbooks), you will see many non-harmless retroviruses:
- oncoretroviruses: as a side effect of how they integrate, they often cause cancer in patients. There is lots of time between infection and death for the virus to be transmitted.
- lentiviruses (this is also known as a "slow virus"). There is often lots of time between infection and death for the virus to be transmitted.
It's possible that scientists are avoiding directly attempting to argue with Deusberg's observations, but in general, the consensus seems to be that he brought nothing useful to the debate except irrational claims that were inconsistent with the evidence. We don't live in an ultrarational world where every fringe theory can be investigated.
As for Ioannidis... not sure what to say. I think his big mistake was going to the white house and trying to make Trump an ally and not shut down everything because he predicted the virus wouldn't spread and wouldn't be fatal at the rates that were later observed. Diseases like COVID are multidimensional problems with partial information and a high level of politics, corp, and media involvement. I think fauci and others have finally admitted that they may have made some mistakes in the specific details of the shutdowns, in particular, it took people a while to realize that the impact on children (who by and large are not at risk from COVID) was enormous.
If your goal is to affect public health policy, you have to be a truly 4D thinker, and even that's not enough dimensions.
You reminded me hat Ioannidis made very specific predictions that turned out to be false (about the number of deaths we could expect). And that, while measures were adopted that he claimed were useless. I agree Fauci saved lives - and last time I saw him in the news he was being attacked by Republican trolls, I don't have any other word for those people.
As you probably know, it can stay dormant for 10 years or more, but then gets into active stage, causes AIDS, and relatively quickly kills the host.
Sadly, there will be plenty of people desperately wanting that job. It is definitely a prime example of the saying those that want the job would not be good at the job and those that would be good at the job do not want it. Especially in today's environments where it will become a bully pulpit to push whatever agenda of whoever is in charge
We need somebody who takes on the pivotal role that Fauci played in the HIV and COVID epidemics, not just a career-motivated seat warmer.
Hopefully, the next administration doesn't come up with Schedule F once again and make all health-related government jobs political.