[Letter to the Council of the National Academy of Sciences from Serge Lang]

Science, Gutknecht and Shalala

Cohen quoted one of the co-authors of the scientific paper, Patrick Moore, as saying that "this virus is
probably playing a central role." Cohen then added: "That thesis will be intensely scrutinized over
the coming months. But if it stands up, solid headway will have been made toward solving a vexing
riddle that arose more than a decade ago when an old tumor began popping up in new places, with
deadly results."
These Science and New York Times articles are questionable on several grounds.
(a) What is "AIDS"? No definition of "AIDS" was given in either article. KS is listed among the 29
diseases which define AIDS in the presence of HIV according to the CDC.2 Expressions such as
"Kaposi's sarcoma in people with AIDS" (New York Times), and "Kaposi's sarcoma...is a scourge in gay
men with AIDS" (Science), represent shifting terminology, compounding the confusion about HIV and
AIDS, and possibly representing the beginning of a rewriting of history concerning "AIDS" and what it
means.
(b) What virus? Furthermore, no virus had been found. The New York Times article subsequently
stated that the scientists found sequences of DNA which an "expert in herpes viruses at Yale
University" said were "consistent with a new herpes virus". But the "expert" who said that also
cautioned: "There is a long step between finding DNA sequences and having a virus."
(c) What cause? There is also a long step between finding yet another latent virus, and showing that
it causes various forms of cancer, especially while it is dormant. The Times article contained one
sentence to the effect that "even if the virus turns out to be a previously unknown one, they said, much
research needed to be done to prove that it was the cause of Kaposi's sarcoma. The possibility exists
that the virus is present in Kaposi's sarcoma only after the cancer develops." According to Duesberg,
the fact that the DNA sequences were discovered only by amplification via PCR indicates that
whatever is there, virus or not, is inactive and sparse. Duesberg added that there is no precedent for a
virus causing cancer or another fatal disease while it is latent.
Harold Jaffe was quoted in the New York Times as saying: "It's a strong candidate to be the Kaposi
sarcoma agent." So Jaffe was up to his usual rhetoric, since first, there is no candidate yet, and second
the definite article ("the" Kaposi sarcoma agent) is unwarranted since Kaposi's sarcoma could be
caused by several different agents, depending on the time, place, risk groups, various practices, or
whatever, as I have repeatedly emphasized in my Yale Scientific article. Jaffe was similarly quoted
in Science: "I think it's a tremendously exciting result. At this point, we can't say it's the etiologic
agent, but I think it's a very good candidate."
2For instance, in the publication Confronting AIDS Update by the Institute of Medicine (1988), we find:
p. 207: 'The following revised case definition for surveillance of acquired immunodeficiency syndrome (AIDS)
was developed by CDC in collaboration with public health and clinical specialists...The objectives of the revision
are a) to track more effectively the severe disabling morbidity associated with infection with human
immunodeficiency virus (HIV)...
p. 208: "For national reporting, a case of AIDS is defined as an illness characterized by one or more of the
following "indicator" diseases, depending on the status of laboratory evidence of HIV infection, as shown below."
The updating occurs in the CDC publication Morb. Mort. Weekly Rep. 41 No. RR17 (1 December 1992), giving
"the revised classification system for HIV infection and expanded surveillance case definition for AIDS...". This
document asserts:
p. 1. "The etiologic agent of Acquired Immunodeficiency Syndrome is a retrovirus designated Human
immunodeficiency virus (HIV)..."
p. 2. "Persons with AIDS-indicator conditions (Category C) as well as those with CD4+ T-lymphocyte counts
<200OtL (Categories A3 or B3) will be reportable as AIDS cases..."
p. 4. "Diagnostic criteria for AIDS-defining conditions included in the expanded surveillance case definition are
presented in Appendix C...", which contains the 29 diseases, including Kaposi's sarcoma