[Letter to Colleagues from Peter Duesberg]

Comments on "The Role of Drugs in the Origin of AIDS"
by Peter Duesberg
Dr. Duesberg's thesis that the long term use of psychoactive and
medical drugs is responsible for AIDS diseases in the USA is not persuasive.
The paper raises interesting speculations on the potential importance of
psychoactive drugs as possible cofactors in accelerating immunodeficiency
but goes far beyond the scientific and epidemiologic evidence to make poorly
substantiated and, in some cases, misleading assertions.
Dr. Duesberg refers to CDC data that overall about 30% of American
AIDS patients have used i.v. drugs. He then virtually ignores the remaining
70% of patients with no history of drug use and offers no convincing theory
as to the etiology of their immunodeficiency, while denying that the HIV
virus has a role other than as a marker of a group at risk for AIDS.
There is little controversy regarding the important contribution of i.v.
drug use to morbidity and mortality even in the absence of HIV infection.
Duesberg would deny that HIV infection instills an added risk. He refers to a
New York study that demonstrated a marked increase in mortality in i.v.
drug users in the 1980's. (Science, 22.3988, p916).He not only
misquotes the figures for HIV associated deaths (22/50 not 26/50 from
pneumonia; 7/22 not 15/22 from endocarditis; 11/16, not 5/16 from TB),
but ignores the main point of the article which demonstrated a marked
increase in deaths from several infectious diseases in HIV infected i.v. drug
users during a period when the total number of addicts in NYC was stable.
Much of the excess mortality could be ascribed to HIV infection even though
the, diseases did not fit into the official CDC definition of AIDS, implying that
HIV induced immunosuppression contibuted to the poor outcome in drug
users even with bacterial infections.
The fact that an average of ten years elapsed between the onsetof
thrombocytopenia and immunodeficiency and the time a group of i.v. drug
users (13/15 HIV positive) began to use drugs is given as evidence for the
drug use leading to hematologic abnormalities with a similar time course as
AIDS. On the contrary, it is,evidence for the importance of HIV infection
over time. Moreover, hematologic abnormalities such as thrombocytopenia
are seen frequently in HI V infected homosexual men and are highly
correlated with HI V infection and not drug use.
Duesberg notes that similar neurologic abnormalities can be seen in
HIV infected and uninfected infants of drug-addicted mothers. There is little
doubt that narcotics are harmful to the developing fetus. Dr. Duesberg does