Origins of HIV/AIDS

By: Alex Kituli
Submitted: 2007-01-17 16:26:36
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Where did HIV come from? This question has been one of controversy since the outbreak of the epidemic, and many maverick and even lunatic theories have been aired, including it being a virus from space deposited by a passing comet or aliens, or God’s revenge on a sinful world. The origins of the virus pale into insignificance compared to the battle of fighting it. With HIV spreading through poor populations and in particular in Africa, and despite the availability of antiretroviral medication in the West, it is a global problem of gargantuan proportions with 2.4 million deaths due to, and over 25.3 million people continuing to live with, HIV infection in sub-Saharan Africa alone in 2000.

Indeed, investigation of the origins is a sidelined study in the field of HIV research, deemed somewhat unimportant in the face of such an overwhelming task of fighting the infection. The British National Aids Manual (NAM) 1998/9 states “Scientific investigation of origins may help us understand how to combat HIV most effectively. However, it is extremely important to distinguish this from irresponsible speculation about ‘where it came from’”, before adding, somewhat cryptically, “origin does not equal cause”.

However the NAM warning seems to be guarded against the fact that speculation about the origins of the virus have a particular use in the popular press, and that it is used to blame particular individuals or social groups. These typically have been those most affected by the virus: the marginalized and poor of the world, its association with sex, prostitution and drug use emphasises this. Thus, as it was first identified in American homosexuals, they were also blamed for bringing it into the world, and blamed for their own misfortune. This was quickly deflected into Haiti, a very poor country dependent on tourism for its public revenue, and thence into Africa, the poorest and most marginalized continent.

Where the virus came from is important to understand in terms of disease prevention. While the prevention of onward transmission of the virus has currently failed, knowing the origins of the virus may prevent further agents becoming widespread in the population. What makes the origin issues hard to resolve is that the HIV virus has a long incubation period. Diseases such as Ebola haemorrhagic fever are easier to transmit, but also have a very short incubation time: an epidemic is easy to identify due to horrifying and identifiable symptoms, and easy to isolate. HIV, on the other hand, incubates for about nine years. There are few symptoms until the immune system starts to collapse. Thus with a delay of nine years, tracking the ‘source’ is difficult.

A number of theories have been proposed and, indeed, hotly contested. Firstly, however, there is some agreement on the ancestor of the HIV virus. HIV-1 is related to a Simian retrovirus found in some chimpanzees. This virus, called SIVcpz, is generally agreed to be the ancestor of the HIV-1 virus. Indeed, genetic information on the virus is collected in Los Alamos in the United States in a specific public access database (http://hiv-web.lanl.gov). Curiously, the ancestor if HIV-2 also has a simian ancestor, SIVsm – the SIV that is found in sooty mangabeys. SIVs have been observed to cause a collapse in the immune system of certain primates, however, in others, they appear to be asymptomatic (resolving in no immune damage and the host and virus appear to be attenuated to each other).

Given this general consensus on the ancestor of the virus, the question has largely become: how did SIVcpz enter into humans? There are roughly two explanations: the natural transfer theory, and two more controversial theories that propose human intervention as unwittingly introducing the virus.

Firstly, however, I would like to examine a counter-consensus and early theory proposed by Richard and Rosalind Chirimuuta in their book AIDS, Africa and Racism. This early work is important primarily in that it highlights issues of interpretation specifically from western cultural perspective, and challenges typical transmission hypotheses. Their central point is that racist ideology is a core element of the Western psyche: “When a new a deadly sexually transmitted disease… emerged in the United States… it was almost inevitable that black people would be associated with its origin and transmission”. The attack of the Chirimuutas is based upon a case-by-case study of the early origins of the epidemic. They note the presence of AIDS symptoms (KS and PCP) among Americans in 1978. AIDS was then noticed in Haiti, which was, in the 1970s a popular resort for American homosexuals. The first Haitian case was reported in 1982, although Africa had been posited as a source about this time. American homosexuals in the meantime, however, were being blamed by the popular rightwing press for the introduction of the disease. Many researchers were themselves homosexual; this suggests a conflict of scientific objectivity: “they uncritically accepted and propagated suggestions that AIDS had originated in the black people”. In other words, the buck had been passed. Finally, African cases appeared in the literature in 1983 – interestingly in Europeans presenting with AIDS symptoms either in or returning from, Africa. The Chirimuutas contend that the instant assumption of African to European transmission was such a case of racist assumption. Indeed, they are correct that the possibility of a European to African transmission was not seriously investigated.

Nevertheless this is an interesting theory, which ultimately relies on the crucial dates above: America 1978, Haiti 1982, Africa 1983, and the numbers of cases reported, which shows increasing prevalence of infection in the West, whereas steady levels amongst Africans. The presentation of symptoms would suggest that the disease had begun in America and been transmitted directly, or via Haiti, to Africa. The Chirimuutas case falls down on a number of facts. The first is that they conflate absence of evidence with evidence of absence. While they did defend African healthcare systems it is not realistic to compare surveillance units such as the CDC and the state-of-the-art Western systems with that in most areas of Africa. The second reason why we can discount their interpretation of origin is that earlier samples were identified in retrospective analyses of stored African blood samples as early as 1959. However, this work does have a real value in that it emphasises that discussions of AIDS have often been tainted with prejudice.

The 1959 African blood sample was isolated in 1998, and found to be near the ancestor of the virus, the words of the researchers: “Multiple phylogenetic analyses not only authenticate this case as the oldest known HIV-1 infection but also place its viral sequence near the ancestral node of subtypes B and D in the M-group viruses, suggesting that these HIV-1 subtypes, and perhaps all M-group viruses, evolved from a single introduction into the Africa population in a time frame not long before 1959”. The sample came from a Bantu man who lived in Leopoldville, Belgian Congo -- what is now Kinshasa, Democratic Republic of the Congo.

The natural transfer theory suggests that the Leopoldville man was one of the earliest infectees. It is suggested that the Leopoldville man or his immediate contacts – was a monkey hunter, and had become infected via a monkey bite. On his return to Leopoldville the infection was transmitted forward sexually, gradually spreading through the continent, thence into Haiti and the homosexual population in America. The virus mutated and become more pathogenic in its continued transmission through various hosts and evolved into the various subtypes now known in the world. This theory appeals in a number of ways in that it is somewhat un-researchable beyond this speculation, and leaves the virus’ introduction a matter of chance. Chief objections to this theory are the same as its appealing factors. It is also incredibly bad luck for humanity as a whole, and raises the question that if this method of transmission had happened once, why had it not happened before, and other animal retroviruses not been isolated in human populations? Furthermore, there is the second human retrovirus HIV-2 that would appear to have been introduced from the sooty mangabey (SIVsm) at about the same time? This is incredible chance for two simian retroviruses to be introduced in the same period.

If natural transfer is not the truth, the remaining theories argue that human intervention must have been involved at some level. Edward Hooper has suggested in The River that the source of HIV – the transmission of SIVcpz into humans – occurred as an unforeseen side effect of oral polio vaccine (OPV) campaigns that took place in Africa in the 1950s. Hooper’s case amounts a huge quantity of circumstantial evidence written in over 1000 pages.

Vaccination is the process where small amounts, weakened or dead viruses are introduced into the human body in order to produce an immune response. The immune system thus ‘remembers’ the virus, and when a person becomes infected with a ‘wild’ virus the immune system can respond effectively. Via this method, a number of afflictions and diseases worldwide have been effectively eliminated. However, in order to vaccinate a large population, one needs to grow a lot of viruses, and also a particular culture to grow them in. One highly successful culture is monkey kidney tissue culture (MKTC) which provides a rich reproductive environment for the poliomyelitis virus. This tissue culture was used by a number of vaccine producers, primarily Hilary Koprowski, who established a camp in Lindi, Zaire (now the DRC). This camp kept a number of chimpanzees and other primates, and they used MKTC there to produce virus cultures. Koprowski now denies that he used chimpanzee MKTC, although nothing in anything published at the time specified which particular MKTC was used. Koprowski claims that the chimpanzees were used to test the efficacy and virulence of the vaccine., and were not sacrificed to produce MKTC. However, there was nothing at the time which suggested which particular primates should be, or should not be, used to produce MKTC, indeed, the possibility of retroviral infection was unheard of at the time. It is likely at the time that any primate was considered as good as another for MKTC, and thus there was no reason not to use chimpanzees to supply MKTC.

Hooper’s evidence is meticulously researched and also demonstrates a high correlation to the application of the vaccine in geographic areas with early presentations of AIDS or AIDS-like cases. The use of MKTC as the agent that passed the SIV into a human also explains the anomaly of HIV-2.

OPVs were applied to about a million people in sub-Saharan Africa. If only 1% of these became infected with ancestors to HIV then we are looking at a base infection of not one individual, but about 10,000 individuals. This allows explaining the current prevalence of HIV infection in Africa that is hard to explain by appealing to widespread promiscuity amongst the population. If the single Leopoldville case is to explain the beginning of an epidemic – especially given the very unlikely possibility of transmission of the infection except at the beginning and at the end of the course of the disease – then one has to assume very high levels of promiscuity across the continent, which – as we have been warned by the Chirimuutas – maybe prejudicial interpretation in the face of little or no evidence. On the other hand, if 10,000 had been infected then there is enough of base rate infection to explain the current epidemic.

However, in recent years a second theory has come to light. This was explored by Hooper in The River and admitted as a secondary causal factor along with the initial transmission of the SIV to humans via OPVs, but now has been proposed as a theory in its own right. Preston Marx and Ernest Drucker have suggested that the massive injection health campaigns in the 1950s also could have spread the disease onwards. The 1950s not only saw OPV campaigns in Africa, but huge co-ordinated injection campaigns to eradicate a number of diseases across Africa, largely run by the World Health Organisation. There was a massive demand for syringes after the war, and expensive glass syringes were rapidly replaced with cheap plastic ones. However, Marx and Drucker have evidence that many of these syringes were reused, indeed, “health officials in Egypt had waged a mass-injection campaign to treat an illness called schistosomiasis. One result of the campaign was a massive outbreak of hepatitis C, spread through the reuse of contaminated needles”. More worryingly, the rapid reuse of contaminated syringes has been shown to increase rapidly the pathogenic nature and evolution of viruses – thus regardless of whether the virus was transferred naturally only once or a number of time, or had been introduced via OPVs, the reuse of contaminated needles may have lead to the current scale of the problem with HIV infection in Africa.

These latter theories explain a number of anomalies that are not easily explainable with a disease that is hard to transmit. Firstly, human intervention explanations clarify how what should have been a localised epidemic in some parts of Africa, is in fact a worldwide problem, when one takes into account the number of base infections, which sexual promiscuity cannot account for alone. This also explains that despite the virus favouring women, the infection rate in Zambia, for example, is not 2 women for each man, but in fact 1:1.

Understanding the origins of the HIV virus is a very complex and controversial business. Indeed, the OPV theory above is one of the more controversial of explanations of the origins, and is certainly not, at this stage, orthodox knowledge. However, I do find it very hard to account for incredible disparity and high infection rate in Africa by appealing to sexual behaviour alone. The simultaneous appearance of the HIV-2 virus is also cause for concern, as is the ratio of infectees. It seems too much of co-incidence for two simian retroviruses to enter humans at the same time (without any precedent) without there being human intervention. At this state there is not enough evidence to either prove or disprove any theory of HIV origins. It may never be the case. However, it is very difficult to accept that a lone chimp hunter in central or western sub-Saharan Africa began the pandemic with a chimp bite at the same time that a colleague further north had exactly the same happen to him, thus producing two epidemics of HIV-1 and HIV-2.

There’s a documentary about Hooper’s theory is available here: http://www.documentary-film.net/search/video-listings.php?e=5

Alex Kituli, Intellectual Gangster and Webmaster of Afrika Dating

Article source: Expert Articles