HIV link to Aids proved in last blow to sceptics

STEVE CONNOR

Science Correspondent

The world's largest study of haemophiliacs has proven categorically that HIV causes Aids, a link disputed by a small number of maverick scientists who enjoyed extensive publicity in Britain.

The 15-year study followed all the 6,278 haemophiliacs living in the UK between 1977 and 1993. It found that haemophiliacs infected with HIV were 10 times more likely to die than uninfected sufferers of the blood-clotting disorder.

Although the vast majority of scientists and doctors have had no doubts over HIV causing Aids, the new research is seen as the final refutation of the views of Peter Duesberg, a Californian virologist who has for years claimed that HIV is harmless. The Duesberg theory received widespread publicity in Britain first through a series of documentaries for Channel 4's Dispatches programme. The Sunday Times then ran a number of major articles on it by its former science correspondent, Neville Hodgkinson.

Death rates for those with severe haemophilia were stable between 1977 and 1984 at 8 deaths per 1,000. But between 1985 and 1992, after blood products contaminated with HIV were unwittingly given to patients, death rates for HIV-positive haemophiliacs rose progressively to 81 per 1,000. However, the death rate of HIV-negative haemophiliacs remained at 8 per 1000.

Duesberg followers have claimed that if haemophiliacs are more likely to die it is because of their disease and treatment rather than HIV, but the study again refutes this.

It found that the same sort of increase in death rate occurred even for patients with milder haemophilia. Between 1977 and 1984 their death rate was 4 per 1,000. This rose to 85 per 1,000 for those infected with HIV. It stayed stable for those who remained HIV-negative.

The research, published in the journal Nature, was carried out by Medical Research Council scientists at the Oxford Haemophilia Centre, which keeps a national register of patients, and the Imperial Cancer Research Fund, which carried out the statistical analysis.

Paul Giangrande, a clinical scientist at the centre, said the figures "speak for themselves". There were 403 deaths in the infected group of haemophiliacs between 1985 and 1992 compared with an expected 60 calculated from the death rate in non-infected patients, he said. "This implies that 85 per cent of deaths in the infected group were due to HIV."

Sarah Darby, the statistician in charge of the study, said: "There is no doubt in our minds that this research has proven the link between HIV and death from Aids. HIV-positive haemophiliacs were 10 times more likely to die than those who had not contracted the virus.''

Dr Giangrande said a follow-up of patients will continue to see what happens to the third of the HIV-positive haemophiliacs who do not yet show symptoms of Aids. He warned, however, that it is unlikely that they will continue to remain healthy because the data showed no decrease in death rates over time.

The research undermines one of the last remaining arguments of the Duesberg lobby. In one Sunday Times article in 1993, Mr Hodgkinson wrote that the immune system of haemophiliacs recovers when they are given new types of blood-clotting products. "There now seems no reason why they should not live a normal lifespan, regardless of their HIV status," he wrote.

An editorial in Nature said that those who argued the Duesberg case owed the public an "acknowledgement of error".