-Caveat Lector-

http://www.newscientist.com/ns/19990904/editorial.html

The cruellest irony
We may have to think the unthinkable about HIV and AIDS
COULD DOCTORS TESTING a polio vaccine in Africa in the late 1950s have
unintentionally started the AIDS epidemic?

Seven years after this conspiracy-style theory was first floated, the
publication of The River, a new book by the writer Edward Hooper, is forcing
scientists to take this disturbing possibility seriously again. Hooper spent
nine years researching the book and has paid great attention to detail. Few
experts doubt that he has done his homework. So how seriously should we take
the theory?

It's widely accepted that humans became infected with HIV-1, the main AIDS
virus, through contact with chimpanzees. When and how the chimp version of the
virus jumped into humans, however, is much less clear. Epidemiologists' best
guess is that hunters became infected with blood as they cut up chimp
carcasses for meat.

By contrast, Hooper's theory centres on a polio vaccine that was tested on
about a million people in central Africa between 1957 and 1960. Because the
vaccine was produced in cultures of kidney cells from various primate species,
Hooper argues that some of it could have been contaminated with the virus that
was later identified in humans as HIV-1. All that was needed to seed the AIDS
epidemic was a few contaminated batches.

If Hooper is right, it would mean 14 million people have so far died and 33
million been infected because of a well-intentioned--and ultimately
successful--attempt to stem the tide of polio. That's some tragic irony. But
discomfort is no reason to ignore the possibility.

When the vaccine theory of AIDS first surfaced, scientists could be
justifiably dismissive. The word then was that the kidney cells used to make
the polio vaccines came from macaque monkeys, not chimps. Also, scientists
believed that the first recognisable case of AIDS involved a British seaman
whose travels were over before the vaccinations began.

We now know that this was not a genuine HIV infection. More importantly,
Hooper provides the first evidence that chimp kidneys may have been used to
culture the vaccine and he identifies a geographic match between the vaccine
trial sites and what are now regarded as the first known cases of HIV
infection, including the earliest in 1959.

But if the vaccine theory has become less obviously far-fetched, it still has
problems. For example, the vaccine was also tested on thousands of individuals
in Poland but there's no evidence of early HIV infection there. Secondly,
different subspecies carry different forms of the chimp virus and, if current
research is correct, the subspecies of chimp from the Congo whose kidneys
might have been used is the "wrong" one: it harbours only a distant relative
of HIV-1.

And if vaccine trials were responsible for HIV-1 in central Africa, where does
that leave HIV-2, the sister virus that emerged in West Africa? HIV-2 seems to
have "jumped" species from the sooty mangabey in at least four separate
incidents. Were vaccines involved in these leaps too? Or did HIV-1 need help
to jump species even though HIV-2 didn't? Either version requires excessive
special pleading. Especially since biologists who have studied different
strains of HIV-1 are confident that they began to diverge from a single viral
ancestor no later than 1940.

But even if there is only the tiniest chance that Hooper is right, the
implications of his theory demand that it should be investigated. The obvious
next step is to test the remaining frozen stocks of the vaccine for the
presence of the chimp virus. Of course, negative results will not resolve the
controversy, because other batches, now used up or lost, might have been
contaminated. But this is no excuse for doing nothing.

So far, few of the players have shown any sense of urgency. An expert
committee that looked into the vaccine theory in 1992 called for tests on the
remaining stocks and an end to using monkey tissues to make vaccines. Well,
the stocks have still not been tested, and although most manufacturers have
switched to using human cells to culture the vaccine, some still have not.
Production methods are far more stringent than they were 40 years ago. But the
fact is that any vaccines cultured in monkey tissues could still carry a risk
of unknown primate viruses.

For this and other reasons, it is now up to the WHO to try to answer Hooper's
questions as quickly as possible. A refusal to test the leftover vaccine
stocks will simply fuel conspiracy theories everywhere.



>From New Scientist, 4 September 1999



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