San Francisco Chronicle - The Voice of the West, 901 Mission Street, San Francisco, CA 94119 - Sunday, September 7, 1997 - Page 8

VIRAL SEX: The Nature of AIDS

By Jaap Goudsmit

Oxford University Press; 260 pages; $27.50.

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Jaap Goudsmit, a physician and virologist at the University of Amsterdam, has been an international leader in battling the AIDS epidemic since its beginning. His adventurous research has sought to understand just how the plague began and where the deadly AIDS virus is headed.

At this moment in the history of the disease, when successful new drugs called protease inhibitors have created a false and dangerous euphoria among many at the highest risk of AIDS, Goudsmit's story is at once a powerful warning that the future may prove even more catastrophic than the past, and a bold speculation on the nature and evolution of the virus we call HIV.

To Goudsmit, the phrase "Viral Sex" is a metaphor for the manner in which varying strains of HIV can couple with each other and exchange genetic information to create new strains that seem inevitably to defeat researchers who try to combat them.

With a swift sense of narrative and ideas that many experts will surely find controversial, Goudsmit traces the history of HIV back to benign precursors of simian AIDS viruses whose ancestry may lie in ancient cats and rodents -- and perhaps even in the mummified remains of Barbary apes whose DNA Goudsmit has tried to analyze from the graves of Egyptian pharaohs.

From his research in Egypt and sub-Saharan Africa, Goudsmit believes that variants of those once-harmless viruses may well have co-existed peacefully for thousands of years within generation after generation of apes and monkeys deep in the African rain forest.

The simian viruses, he argues, using Darwinian principles, must have mutated over and over again until one unique strain -- still harmless to its hosts in the primate world -- found its way into humans. This strain turned episodically virulent and within the past century spawned a succession of lethal variants that by now have invaded the world.

"Why us and why now?" is the quintessential question for AIDS researchers, Goudsmit says, for today's HIV strains are many, and in his view more new drug-defying strains are bound to evolve in the near future.

Goudsmit classifies the viral strains in detail, and the scientific information in these pages may be daunting to lay readers. But a clear glossary is exceptionally helpful, and Goudsmit's story is too compelling to miss. His account of the "race" between Robert Gallo of the United States and Luc Montagnier of France to isolate HIV-1 may be familiar to some, but it's a fast-paced insider's tale here, and a fascinating one.

So are his speculations: The virus, he proposes, may first have emerged from monkeys to infect humans in the German West African colony of Cameroon as far back as 1900. Later the virus became increasingly deadly as it was spread across Africa by "soldiers, sailors, adventurers or servants." Exactly when it escaped from Africa and reached Europe remains a mystery, but Goudsmit's investigations reveal that it could have emerged in Germany even before World War II.

The epidemic we know today began well before the late 1970s, for there is evidence that a Norwegian sailor, whose frozen blood was diagnosed as HIV-infected long after his death, could have carried the virus to Europe more than a decade earlier; and a British sailor, who died with all the symptoms of AIDS in 1959, had also been exposed to disease in Africa, and he too may have been an "index case."

But though the virus emerged from its harmless strains in monkeys and apes to become deadly in humans, new variants continue threatening to trigger very different epidemics in Asia and Latin America, Goudsmit warns. Nor are those new epidemics likely to end unless human behavior changes or some universally safe, effective and cheap vaccines are developed. Perhaps, he proposes, scientists may even learn to alter the evolutionary course of the AIDS virus itself through genetic engineering and thus transform HIV back into harmlessness.

That's a big perhaps, and Goudsmit is not hopeful: "Now that the HIV family has found the human family," he writes, "it will always be with us in some form. All people must know HIV and work to control it. All people must know that HIV is only the first of a terrible series if we do not radically rethink our place -- and our responsibility -- in the world ecosystem."
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Always watch for outdated information. This article first appeared in 1997. This material is designed to support, not replace, the relationship that exists between you and your doctor.

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