Lessons Sought in the Origin of AIDS

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(Review of The River: A Journey to the Source of HIV and AIDS)

Writer says the disease may have jumped from chimps to humans via an experimental polio vaccine--and he warns that cross-species transplants could likewise backfire. But the man who led the African inoculation research calls the theory outrageous, and the scientific community has expressed little interest.

By MARLENE CIMONS, Times Staff Writer

Los Angeles Times, Thursday 23 December 1999

 

WASHINGTON--In the mid-19th century, Londoners were dying by the hundreds from cholera, then a mysterious disease whose origins were unknown. British physician John Snow correctly deduced that the source was the water supply. In one simple action--removing the handle from the Broad Street water pump so residents could not obtain the tainted water--he contained the deadly epidemic.

This lesson, one of the earliest examples of medical detective work, haunts British writer Edward Hooper. The author of a new book on AIDS, Hooper is on a campaign to persuade the medical world that the deadly HIV virus may have been unleashed more than 30 years ago by well-meaning Western doctors giving experimental polio vaccines to African children.

In "The River," a 1,100-page examination of the history of AIDS that took him nine years to research and write, Hooper says an oral vaccine given to about a million people in central Africa from 1957 to 1960 was cultured from the cells of primates. Scientists have concluded in recent years that AIDS originated in a primate: the chimpanzee.

Most scientists believe that the transfer from chimps to people came from slaughtering and eating butchered chimps. Hooper argues instead that cells from infected chimpanzees could have been part of the polio vaccine.

He reasons that although Africans have been killing and eating the meat of primates for centuries, the earliest known sample of the human AIDS virus is from 1959--after the polio vaccine had been administered. He writes that areas in which the polio vaccine was administered later became the epicenter of the African AIDS epidemic. And he says the researchers giving out the polio vaccine were also engaged in medical experiments on several hundred chimps in an African camp.

"It is, in short, not unreasonable to propose that some of the [vaccine] batches fed in Central Africa between 1957 and 1960 could have been prepared in chimp tissue, and that some of this tissue may have been infected with the . . . precursor of HIV," he writes.

If that is true, Hooper's case history on AIDS could serve as a cautionary tale for researchers today, a warning that the crossing from animals to humans is fraught with peril.

Within the next few years, scientists are expected to accelerate research using cells and organs transplanted from animals into human beings. Pigs are being bred for their genetic parts. Companies in Britain and the United States are competing to perfect the procedures that will prevent humans from rejecting the organs. Given long waiting lists for human organs, many recipients might well have no choice but to risk getting a baboon's heart or a pig's liver if it would prolong life.

Hooper is trying to raise a red flag, concerned that using animal cells, tissues and organs in humans could spread the same kind of deadly infectious agent that led to the AIDS epidemic. He thinks the medical community should take note.

"If the genesis of AIDS involved avoidable events, or human error, then perhaps we can . . . avoid similar disasters in the future," he said in an interview in Washington, where he stopped to do some book interviews before returning to his home in Somerset, a rural area in the west of England. "When the stakes are as high as this, scientists need to exercise extreme caution before introducing procedures we may regret for generations to come."

The Cold Shoulder

Despite the book's favorable reviews in prominent scientific journals, few in the scientific world have shown much interest. Disdain would be more like it.

"He does the field a service by raising the question," said David Ho, a leading AIDS researcher who directs the Aaron Diamond AIDS Research Center in New York. "But we all have more pressing things to attend to."

"It is enough trying to keep the research effort going and providing patient care [without spending] any time on this," agreed Dr. Robert T. Schooley, head of infectious diseases at the University of Colorado Health Sciences Center. "Life is short. This is not the way I want to spend mine."

Hooper is baffled by the collective cold shoulder, but he persists. "People don't want to know about this, that it could be a physician-caused catastrophe," said Hooper, a former BBC correspondent in Africa and one of the first to cover the AIDS epidemic there. "But I don't think this thing is going to go away."

Not everyone is dismissive.

Texas author Tom Curtis first aired the polio vaccine theory in a Rolling Stone article in 1992. Now an editor at the University of Texas Medical Branch in Galveston, he applauds Hooper's efforts and echoes his warning that the unleashing of AIDS could be a harbinger of even worse occurrences.

"Wherever AIDS came from, we know we had a species jump," Curtis said. "There is no reason to think this could not happen again with another virus we know nothing about. We put these cells into people, suppress their immune systems to prevent rejection, and turn them into human petri dishes" for other unknown viruses.

The main target of Hooper's suspicions, Dr. Hilary Koprowski, who led the experiment, is now in his 80s and living in Philadelphia, where he still conducts medical research.

A Polish emigre who came to America in 1940, Koprowski dismissed the book in an interview as "outrageous," saying Hooper "got a preconceived notion that is simply not based on facts. I lived through it--and Hooper only imagines what happened."

Koprowski admitted that scientists at the Wistar Institute, a Philadelphia facility, used cultures from primates, but he denied that any of those animals were chimpanzees. Mostly he remembered the pressure to do something about the scourge known as polio.

During the late 1950s, Koprowski and other researchers were desperately trying to put an end to that disease, which crippled or killed many of its victims and terrified the world.

They administered an experimental live-virus polio vaccine known as CHAT throughout a region that is now Rwanda, Burundi and Congo--areas that ultimately became a hotbed of AIDS.

Hooper suggests that kidneys from chimpanzees may have been used as a medium in which to grow some batches of the live-virus vaccine. Cells from animal organs are now--and were in the 1950s--often used in this way.

To be sure, Koprowski was involved in the establishment of a large chimpanzee colony near Stanleyville called Camp Lindi, where the animals were used for various medical experiments. Stanleyville, now named Kisangani, was in what was then the Belgian Congo. Hooper believes that among the experiments that may have used chimpanzee cells was that involving the polio vaccine.

But even Hooper admits that there are no available records, and much secrecy surrounded the camp when it was operating.

As for Koprowski, while acknowledging the existence of the chimpanzee colony, he insists that only Asian monkeys were the basis for his experimental polio vaccine. Chimpanzees "were never used," he said. "I used only Asian monkeys. Not even monkeys from Africa."

Hooper says that last summer--too late to be included in the book--he met with an African who worked at Camp Lindi between 1956 and 1959. The man described to him how Koprowski's Belgian medical colleagues would come to the camp, anesthetize the chimps and extract their organs, taking them away.

"It was a routine procedure, which supports my contention that the major reason for the camp was to provide chimpanzee kidneys," Hooper said.

"Starter" samples of the vaccine are still stored in a locked freezer at the Wistar Institute, where they have been for more than 40 years. Hooper and others--including a scientific panel that investigated after the Rolling Stone article appeared--say the samples should be tested for the presence of simian immunodeficiency virus, which in chimps is similar to HIV in humans--although no one knows whether this material was used to develop the same stocks administered in Africa.

"Wistar looked for competent and objective labs to do the work," said Ho, who served on the panel that investigated. "There was little enthusiasm. Since no one was pressuring the situation, they simply dropped the issue after some time."

Dr. Clayton Buck, Wistar's chief administrative officer, said the institute is willing to make the samples available for testing, although he said there is little impetus from outside scientific bodies to do so.

"We aren't going to learn anything that will shed any light on the disease itself, but serious questions have been raised, and we have a credibility problem," Buck said. "We owe something to the public and to science."

'The Case Is Not Proven'

Most of those involved in the African experiments have died. Koprowski is still doing research, now with Thomas Jefferson University in Philadelphia. He fears that resurrecting this controversy "will make people afraid of polio vaccines and hurt the global eradication effort."

He sued Curtis and Rolling Stone after the 1992 article appeared--a suit that was settled for $1 with a published "clarification" saying the scientific panel that investigated concluded that the polio scenario was unlikely.

Koprowski does not appear as quick to sue Hooper as he was Rolling Stone. "I have left it in the hands of my lawyers to decide what, if anything, to do," he said.

Even Hooper acknowledges that "the case is not proven." Yet he hopes to attract the best scientific minds to convene a meeting--perhaps in London--to discuss some of the issues he raises.

"There is no concrete physical evidence, as yet, to prove the theory, even if the anecdotal and circumstantial evidence is highly persuasive," Hooper said. "What I hope is that the scientific establishment, and in particular its AIDS researchers--many of whom have, until now, shown an unseemly desire to brush the theory under the carpet--will now be encouraged to initiate an independent investigation."

Hooper says it is not enough to pursue new advances in AIDS therapy--that now is the moment to pause and take a long look back. "It's the appropriate time to return once more to that vital question about origin, and see where the answers lead us," he said.