이름:궁금 2002/5/27(월)

HHV - 6A 가 원인이라는 ,,,,,,,   How Robert C. Gallo could seize victory  from the jaws of HIV defeat By Charles Ortleb In just a few weeks, "Science Fictions," a detailed account of the discovery of HIV written by Pulitzer Prize winner John Crewdson, will reach bookstores. Ten years in the making, this book virtually skins AIDS researcher Robert C. Gallo alive. The Little Brown book is a page-turner that finishes the job that Crewdson started as a journalist many years ago at the "Chicago Tribune." It leaves little doubt that Gallo and his American colleagues appropriated the discovery made by French researchers of a retrovirus in AIDS patients. The retrovirus eventually became known as HIV and is virtually synonymous with AIDS. "Science Fictions" is so thoroughly researched and well written that it’s hard to believe it won’t win most of the major nonfiction awards for 2002. As a veteran Gallo-watcher, I know that Gallo’s first response will be to go after Crewdson and "Science Fictions" like a pit bull. And yet, should Gallo have an uncharacteristic bout of coolheadedness, he has a unique opportunity to play one last card that could not only redeem his reputation, but could also save millions of lives. I’ve tried to explain what that strategy would be in the following "fictional letter from Gallo" to the rest of the scientific community. Dear Colleague, By now you have heard that a new book about me by John Crewdson, "Science Fictions," will soon be published. While "Science Fictions" raises the old question of who really discovered HIV, and is extremely critical of both me and many of my colleagues, I would like to take this opportunity to raise my own new questions about AIDS. While "Science Fictions" focuses on HIV, the controversies surrounding its discovery, and the creation of a blood test, it has become increasingly clear to me that the whole discussion of HIV discovery and testing is actually now quite moot. HIV, it turns out, is not the central figure in the AIDS epidemic that we all thought it was. We as scientists know that research is full of surprises. Why should AIDS research be any different than any other kind of science? For any of us to say that everything we know about AIDS is carved in stone is for us to deceive ourselves about the evolving nature of knowledge. I’m in a very peculiar position in the AIDS research establishment. Not only was I involved in the work done on HIV, but I am also credited with the discovery of HHV-6. A virulent strain of this virus, HHV-6A, now seems to be a far more important factor in AIDS than HIV. The biggest error in John Crewdson’s book may turn out to be his cavalier dismissal of the importance my discovery of HHV-6. I’m writing to you to suggest that our attention should now turn to HHV-6A as the real problem in AIDS and other diseases, like the immune dysfunction syndrome euphemistically called "Chronic Fatigue Syndrome." The virus may also be a key to our understanding of multiple sclerosis. Many times during the last decade, I have suggested that HHV-6 may be a co-factor in AIDS. My colleague Peter Duesberg often publicly warned us that co-factors often raise new questions about causality. If HIV and HHV-6A are partners in the crime of AIDS, then it now looks like HHV-6A is the senior partner. And I would be lying to you if I did not also suggest the possibility that HHV-6A can cause serious immune dysfunction without HIV. All of this needs to be sorted out, which is why I am writing to you. John Crewdson’s book will raise serious questions about the work we have done on AIDS. Rather than turn this into a bitter time of recriminations, and rather then obsessing over the past, for the sake of public health I urge you to help me focus our questions and research on HHV-6A, the other virus I claim to have discovered. While HIV may turn out to be less important than we thought, HHV-6A turns out to be far more important than we thought. I would hate to see the battle over HIV overshadow important work we must now do on HHV-6A. I would hate to see a controversy about my role in the discovery of HIV prevent us from trying to stop HHV-6A from destroying the immune systems of AIDS patients and many others. If I had known in 1983 what I now know about HHV-6A, I would probably have suggested that it is the cause of AIDS. Early on, the Centers for Disease Control may have been looking at HHV-6A in AIDS patients and assuming it was CMV, which may turn out to be one of the most tragic mistakes in the history of science. Another tragic mistake may be the much too narrow definition of AIDS as T-cell depletion that the Centers for Disease Control gave us. A third tragic mistake by the CDC seems to be their inability to see the relationship between the immune dysfunction in AIDS and "Chronic Fatigue Syndrome." In some ways we virologists were sent on a wild goose chase by a bad CDC definition of AIDS that resulted in the political mess that HIV seems to have become. I know that most of you will read John Crewdson’s "Science Fictions" because it will receive enormous media attention and it paints a very disturbing picture of the AIDS research community. But rather than spend my time defending myself against this book, I would like to take this new opportunity to urge that we all reexamine the AIDS paradigm. All the new research on HHV-6A suggests that we consider working with a model of immune dysfunction that we could call HHV-6A disease. Given how destructive this virus is, we need to make sure the blood supply is screened for it, and that clinicians are keenly aware of what it is doing in a variety of conditions that involve immune dysfunction. We need to ask Congress and philanthropists like Bill Gates to begin redirecting their resources and philanthropy at this important AIDS pathogen. I know I have caused a great deal of grief among my colleagues in the HIV matter. I am sorry for that, but as the discoverer of HHV-6, I feel I now have an opportunity to show the public how science works best. By demonstrating that we can recognize our mistakes and can move in a positive direction, we reveal what a wonderful self-correcting enterprise good science can be. I urge you to now redirect your attention to HHV-6A so that we can put AIDS research on the path not to "Science Fictions," but to truth. Sincerely yours, [Robert C. Gallo] Charles Ortleb is the former publisher of "New York Native" and is the author of "The Closing Argument," a novella about HHV-6A, race and civil liberties