AEGiS-08IAC: HIV causes AIDS: a controlled study.

8th International AIDS Conference

Amsterdam, Netherlands — July 19-24, 1992

HIV causes AIDS: a controlled study.

Int Conf AIDS 1992 Jul 19-24; 8:We49 (abstract no. WeC 1027)
Craib KJ, Schechter MT, Le TN, O'Shaughnessy MV, Montaner JS; Vancouver Lymphadenopathy-AIDS Study (VLAS) Group, UBC & BC Centre for Excellence in HIV and Related Viral Diseases, Canada.

ISSUE/PROBLEM: A considerable number of people continue to question the role of HIV in the pathogenesis of AIDS. One of the main proponents of this school of thought, Prof. P. Duesberg, wrote in 1988 (Science 1988; 242: 997-8) and repeated in a public address in 1991 that the necessary comparisons in controlled cohorts were not available to address this question. The purpose of this analysis was to conduct just such a controlled analysis within a cohort of homosexual men.

DESCRIPTION OF PROJECT: The VLAS is a cohort study which has followed HIV- and HIV+ homosexual men since 1982. This analysis involves 350 persistently seronegative men (SN), 237 seroprevalent men (SP), and 128 seroincident men (SI) followed for a median of 103 months. A total of 134 cases of AIDS-defining illnesses have occurred in these men. We studied the incidence of AIDS-illnesses by HIV status, by exposure to psychoactive drugs, and by other risk behaviours. The latter are popular counter-hypotheses to HIV. We also studied changes in CD4 count in HIV+ and HIV-men through time.

RESULTS: The SN group continues to be exposed to a number of risk factors. As many as 49% of the SN group reported using psychoactive drugs during follow-up. About 25% of the SN group reported receptive anal intercourse with causal partners. Of 134 AIDS illnesses in the cohort, every single one occurred in men with pre-existing evidence of HIV infection (52 PCP, 33 KS, 24 other OI, 10 candidiasis, 10 lymphoma, 4 wasting syndrome, 1 neurologic disease). No evidence of any immune dysfunction has occurred in the SN group. The figure illustrates that CD4 counts have remained stable in the SN group while they have fallen steadily in the SI group after seroconversion. LESSONS LEARNED: Claims that AIDS is caused by other exposures and not by HIV are clearly not borne out by these data. Part of the problem may be semantics. No one has ever disputed that cofactors play a very important role in determining the rate and type of clinical progression just as cofactors must determine why some smokers develop lung cancer, why some develop bronchitis and why still others remain well. The search for cofactors must continue but it is a disservice to the many persons infected with HIV and a hindrance to public health initiatives for responsible scientists to claim that HIV is harmless. TABULAR DATA, SEE ABSTRACT VOLUME.

Keywords: AEGIS, HIV, Acquired Immunodeficiency Syndrome, HIV Infections, CD4 Lymphocyte Count, Homosexuality, Cohort Studies, Risk-Taking, HIV Core Protein p24, HIV Antibodies, Human, Male, etiology, ICA8
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WeC1027