Patricia Nell Warren

New Cousin to HIV?

Filed By Patricia Nell Warren | July 03, 2011 10:00 AM | comments

Filed in: Living
Tags: HIV/AIDS, MS, retroviruses, RNA

DoctorIllustration.jpg"OMG! An HIV-like virus that is easily transmissible," was the email I recently got from a gay friend. He was forwarding a rumor about a new virus spreading like wildfire in China. Supposedly it causes AIDS-like symptoms, along with debilitating depression, but it incubates as rapidly as flu. The rumors started flying last summer; by now, news media all over the world have carried the story. Reportedly, researchers are working to see if a new pathogen - possibly a retrovirus - can be cultured from samples provided by some of these patients.

But when the BBC weighed in, it pooh-poohed the story. From Shanghai, BBC commentator Chris Hogg wrote:

Hundreds of people in China believe they might have a new disease with HIV-like symptoms, but doctors suggest their illness could be the result of a mental rather than a physical condition. ... Doctors are blaming a breakdown in trust between the medical profession and patients, who fear they are being lied to when their diagnostic tests come back negative.

Hogg went on to describe a few cases where a Chinese person came up HIV-negative on several tests, only to continue frantically reporting an array of symptoms.

This isn't the first time that the medical establishment has pooh-poohed a growing cohort of patients, telling them that the pain and agony they're experiencing is just a figment of their imagination.

The CFS Controversy

Witness the stand-offish posture that the CDC and most doctors still maintain towards chronic fatigue syndrome. For decades now, because of the deep depression that often impacts people with CFS, some authorities view CFS as a mental illness. Today the CDC still classifies CFS as a "disorder," not an infectious disease, saying, "The cause or causes of CFS remain unknown." As recently as 1993, a Lancet article characterized CFS as a psychiatric condition. Yet some observers still have the opinion that CFS will be found to have a viral cause - possibly a retrovirus.

Some doctors even pooh-pooh diseases that are proven to have a pathogenic cause, like Lyme disease - whose cause (insect bites that transmit infection by a nasty bacteria) has been scientifically proven beyond a shadow of a doubt. Yet amazingly enough, there are still doctors around the United States who won't treat Lyme disease as such because they insist that the depression that often accompanies Lyme makes it a "mental illness."

If some alert researcher does spot a new "HIV-like" virus in a Chinese lab culture, it will add another name to the growing family of known retroviruses. So it's a good moment for an overview, since the retroviruses have such an intriguing history with the human race.

A Family of Killers

Retroviruses are RNA-based, not DNA-based. "Retro" means that their reproduction MO is exactly the opposite to that of DNA viruses. When an RNA virus penetrates a host cell, it has to transcribe its RNA into DNA before it can replicate itself into millions of copies.

The many-branched RV family is currently divided into seven genuses: alpha, beta, gamma, delta, episilon, lentiviruses and spumaviruses. They all affect vertebrates (i.e. creatures with backbones), and they all cause some sort of cancer or immune-system disorder. Once these RVs have entrenched themselves in a living body, they can even become endogenous, meaning that the host's infected sperm and ova carry them into the reproductive process, so they're inherited by the host's offspring. Possible example: multiple sclerosis, which has recently been linked to retroviruses. European researchers have detected particles of the human endogenous retroviruses (HERV)-W in MS patients. So these researchers now talk about an MS-associated retrovirus (MSRV).

Retroviruses were first discovered in the early 1900s by scientists studying leukemia in chickens. But it was not till the 1960s, with growing understanding of how DNA works, that the retroviruses' up-the-down-staircase RNA mode was discovered. Clear till the 1980s, these unique viruses were thought to infect only animals. Among the known variants were equine infectious anemia virus (EIAV) and feline leukeumia virus (FeLV). In the 1970s, as both a show-horse owner and a purebred cat owner, I remember the first rush to testing when these two diseases were identified as retrovirus-caused. There was the shock of horror and despair when you learned that one of your prized animals was infected.

Still other retroviruses were found to affect cattle and mice. And, notably, there was the simian immunodeficiency virus (SIV) found in primates.

An Ancient Epidemic

Not till 1977 did researchers began fingering the first retroviruses in humans. That year, in Japan, a researcher noted a sizable cohort of Japanese adults who suffered from a lethal form of T-cell lymphoma. By 1979, U.S. scientist Robert Gallo and his associates identified the cause of this lymphoma as a human retrovirus, dubbed HTLV-1. Next came discovery of a similar virus, HTLV-2, which has since been linked to human hairy-cell leukemia.

On the heels of these revelations came the historic discovery, in 1983, of a third human retrovirus that was originally called LAV, then HTLV-3, by Luc Montagnier and his associates in France. Shortly afterward, in the United States, Gallo and his team linked this newly noted retrovirus to a mysterious and usually fatal immune-related disease that had been emerging in Africa, the Caribbean and the United States.

In due course the newcomer was renamed as the human immunodeficiency virus, or HIV, because some of its characteristics differed from those of HTLV-2 and -2. Today HIV is classified in the lentivirus ("slow virus") genus, along with FeLV and EIAV, while the two HTLVs are placed in a different branch, the delta genus.

Controversy rages over just how long the retroviruses have been making life miserable for living things with backbones. Researchers who insist that HIV emerged only recently in Africa have argued that SIV must have mutated and leaped to African humans through the eating of monkey meat. Others disagree, pointing to northern Europe's high incidence of a mutant gene called CCR5 delta 32, that confers an inherited resistance to HIV. Ten percent of northern Europeans carry this mutant gene. In the study of population genetics, it's generally agreed that a high gene frequency will only be found where a disease has been around for many centuries, prompting the appearance of a resistance mutation that has to spread slowly through a population, generation by generation, for many hundreds of years, before it attains that high frequency.

Interestingly enough, HTLV-1 has an ancient pedigree. Genetic traces of it have been found in 1500-year-old Indian mummies in Ecuador. Adding to this significance is the fact that ancient pottery found in that part of South America is similar to certain ancient Japanese pottery. So some historians suggest that there were ancient contacts between Ecuador and Japan, where HTLV-1 was first discovered in 1977.

Springboarding From Animals

Controversy also rages over how many of these animal retroviruses can be transmitted to humans.

The possibility that HIV-1 mutated into humans from primates is not the only one. In 2005, researchers in Africa's Cameroon collected blood samples from bush-meat hunters and identified two new HTLVs, dubbed -3 and - 4. As hunger hits ever harder in developing countries with their exploding populations, there is an ever more frantic rush to kill wild animals as a source of meat-market protein - including monkeys. Lead author of the study, Nathan Wolfe of the Bloomberg School of Public Health, said later, "The discoveries of HTLV-3 and HTLV-4 show that, far from being rare events, retroviruses are actively crossing into human populations."

Another possible case of animal-to-human jumping might be found in chronic fatigue syndrome. Some researchers claim that CFS is linked to a newly identified mouse virus, XMRV (xenotropic murine leukemia virus-related virus). XMRV belongs to the gamma genus and is related to longer-known mouse leukemia viruses. As I said before, many in the medical establishment still dismiss CFS as one of those "mental diseases," and nobody is sure yet how XMRVs might be transmitted.

But the CDC recently admitted, "Researchers from the Food and Drug Administration (FDA), the National Institutes of Health (NIH), and Harvard Medical School reported evidence of MLVs in about 87% of CFS patients and 7% of healthy blood donors." So XMRV's possible presence in the U.S. blood supply has become a troubling question -- one that researchers are trying to answer.

Ongoing Questions

Back to the Chinese panic about that "AIDS-like disease."

As I write this column, Beijing is doing the now-familiar "imaginary disease" dance. In The Epoch Times, staffer Chen Yillian writes:

Official media have stepped in to put the matter to rest: there is no such disease, and people claiming to be sick from it need psychological help.

But the fact that Beijing previously denied the existence of SARS has only fed the fires of rumor. It will take time - and dogged ongoing work by researchers with open minds - to tell us more.

All in all, the emerging story of human relationships with the retroviruses is a complicated one, and far from perfectly understood. In his bestselling book Guns, Germs and Steel, Jared Diamond put it this way:

The major killers of humanity throughout our recent history are infectious diseases that evolved from diseases of animals. ... Because diseases have been the biggest killers of people, they have also been decisive shapers of history.

____________

A shorter version of this piece appeared previously in my "Left Field" column in A & U Magazine. I've been reporting on AIDS politics and public-health politics in this column for 12 years.

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Laurie Edwards | July 3, 2011 10:11 AM

I don't know whether I'm dim or simply badly educated, but I've now read this article four times, and it makes damned near no sense to me. I got confused about two paragraphs in, and no matter how carefully I think I'm reading, I suddenly realize I don't get it. This is important; I wish iall the information would sink in.

Laurie, it is not just you. I know I'm only working with 2 hours sleep right now, but this article just seems all over the place. I get the jest, but it is too mottled for my taste and it failed to engage me as a reader. I really wanted to know more about the supposed virus or lack there of.

To sum, retroviruses have a history, more have been discovered, some are thought to be old, and there is a question whether HIV, based on a genetic mutation for immunity, indicates whether HIV or some form of it, has been around before.

There is also fear, although it is not a strong argument, that China is withholding data, that there may be an HIV-like disease affecting their population. This fear is based on the fact that because the Chinese lied about a past serious disease, they will lie about a current one. This logic is valid and sound, yet neither proves nor disproves that a virus exists.

In short, the article is about a controversy over whether a particular retrovirus may currently exist, and the questions surrounding it. It uses other areas where there are controversy in the medical community, to bolster this view. Although, I agree with the author that the issue is a complicated one.

If I didn't get the author's gist, the perhaps we are either just to stupid, or the article is poorly written. At any rate, I thank the author for providing a springboard into the history of retroviruses, for which I've not given much thought.

Fear is a good motivator if something exists, and an insanity device if something does not.

In short, however, the article could say, Disease may exist, but no one, for myriad reasons, knows for sure. Just like whether alien life exists, but with a bit more historical evidence.

If the article urged action and a call for research by other governments, that would be useful. I agree with the preceding readers that the article is a bit hard to follow, and not due to the technical level of the writing.

jjcazares | July 3, 2011 11:58 AM

I've been living with AIDS for some time now. Along with the lingering effects of AIDS related diseases, including a debilitating bout with pneumocystis and my current struggle with the side effects of three HIV medications I have to take everyday, my ability to comprehend complicated medical information has been a source of considerable frustration. However, I feel I must respond to some of the comments posted so far.

I've read this piece only once (so far) and I found it not only very informative, but not at all difficult to understand. Warren has written extensively on AIDS/HIV and I have always found her information accessible and very helpful.

This is not to say I agree with all of her points in this piece, for instance while XMRV is present in the general population, the link between that retrovirus and CFS remains tenuous at best (which means, of course, that more research is needed in this area rather than simply dismissing the possibility that a retrovirus may be the cause of CFS).

In any case, given the complexities retroviruses have revealed both in the existence and transmission of various immunosuppressant diseases, Warren's piece provided (me, at least with) a much more effective understanding of what is going on. More importantly, her article is a great resource for further investigation.

An excellent article well written and well considered but then I am no stranger to the XMRV debate. For those who have never heard of XMRV retrovirus then a google search will soon bring up a plethera of information but perhaps the best place to start would be the Whittemore Peterson Institute through their website you can read how they found a high number of patients with ME/CFS to have XMRV previously XMRV was linked to some patients with prostate cancer. The controversy began when many negative studies were published in rapid succession not one single one of which replicated the original study. However as this article says the FDA with NIH did do a study which found MLV's from the same family of human gamma retrovirus as XMRV.

If this work is properly replicated and confirm the original findings this will have very significant impact on many neuro immune illnesses and possibly cancers so a huge impact outside the world of ME/CFS.

I found this article fascinating, and I thought the narrative thread was well formed -- but I try to follow things in this area, and have some background knowledge that helps me take it in.

Patricia also mixed science facts with political considerations, and while she did jump back and forth between science and politics a few times, I thought she did so with clarity.

I thank Patricia particularly for mentioning in passing the CCR5 delta 32 mutation. For years I have heard it repeated that some Americans are immune to infection by HIV, and they tend to have Polish ancestry. I also heard snippets about the mutation itself (and the info reached me stripped of the actual scientific designation for it) and that it is believed that it originally conferred resistance or immunity to smallpox (in other words, small pox was the selection pressure that caused it to evolve and gain in population frequency). But now, thanks to Patricia, I have a label -- CCR5 delta 32 -- so that I can research this further. (Earlier in my life, I had a partner who stayed negative despite multiple suspected exposures to HIV -- and now it is less of an enigma since he is indeed of Polish descent. Needless to say, I am both envious and delighted at his good fortune.)

Thanks Patricia -- although others may have had trouble with it, perhaps for good reason, I found this article engaging and very useful.

bigolpoofter | July 3, 2011 5:00 PM

Ms. Warren lost credibility with me upon discussing the CCR-5 delta-32 mutations among Northern Europeans. I have one copy of delta-32, one of three known favorable genetics traits of mine that allow my immune system to effectively control HIV, even after almost 29 years living with the virus. Even before being tested for delta-32, I was aware of its connection to HIV immunity and, more importantly, immunity to "the Black Death" centuries ago. The higher prevalence of delta-32 among Northern Europeans (and in other areas extending into Central Asia) is due to the historic plagues taking an extraordinary toll on those persons who did not carry delta-32, not some random occurrence.

OK, I understand your prior knowledge of delta-32, and that it was clearly more complete than mine. (Above, I mentioned small pox, but the European Black Plague makes more sense.)

But I don't understand how Patricia's remarks about delta-32 resulted in her "lost credibility" with you ... can you explain?

Bubonic plague is not conclusively proven to have prompted the CCR5 mutation. It has been "suggested" as a possibility, and is being evaluated as such.

Bob Roehr | July 4, 2011 11:33 AM

While midieval plague was an initial hypothesis to explain the survival of delta-32, subsequent genetic analysis has pushed the date back a lot further; the thought now is that it occurred 15-20,000 years ago.

Oh no, not XMRV, no, no, no, no no. That does not cause CFS. It has been debunked in the scientific community. Only one lab has ever found a connection, no other has been able to confirm it, and it only exists regionally. It does not explain it at all. Oh, and the lab that did detect it, it was at such a low level that it is dismissable as an artifact.

If what Vene says is true, then the CDC would not be worried about the proven presence of MLVs in 87% of CFS patients. So the "scientific community" is not in unanimous agreement about this.

Chronic fatigue syndrome: life after XMRV

"The hypothesis that the retrovirus has a role in chronic fatigue syndrome (CFS) has been dealt a serious blow by the publication of two damning papers in Science"

"'It's a bust,' says Jonathan Stoye, a retrovirologist at the National Institute for Medical Research in London, part of the UK Medical Research Council (MRC), who was one of the fiercest critics of the association between XMRV and CFS. 'People who are interested in this condition will have to move on.'"

This is also ignoring the conduct of the "TrueBelievers™"
"This will convince another large group of decent scientists to say: oh no, I would rather go find the gene for homosexuality or do work on images of the prophet Mohammed than do this."

Oh, by the way, MLV is not XMRV, it is related, but not the same. I never said that a retrovirus couldn't possibly be the cause of CFS, I said that the link between XMRV and CFS is bunk.

Oh, and what do you say about the many independent labs who have no found any XMRV*? Are they all incompetent? False positives happen in science, it's not really a big deal (this is what happens when you only need a P-value of

*Have some papers published by said labs
1
2
3
4
5

Correction: The bacteria that cause Lyme disease are spread by ticks, which are arachnids, not insects.

Another few things:

1) Similarities between pottery in Ecuador and Japan and the emergence of the HTLV-1 virus in Japan in 1977 don't mean there were ancient contacts between the two cultures (here's one problem with that idea: How would Japanese people 1,500 years ago have gotten there?); those Japanese patients could just as easily have gotten it from an Ecuadorian visiting Tokyo on business.

2) There are numerous cases of widespread panic of "epidemics" that turn out to be psychological. Morgellons is a good example.

3) Hysteria based on rumor happens a lot in China; a recent example was when people were buying up iodized salt because they thought it would protect against radiation from the nuclear plant in Japan, even though they were told by authorities it wouldn't.

4) There's widespread ignorance in China about HIV and reproductive health in general, which is a major reason why actual HIV has been on the rise there.

Re Japan and Equador -- I did point out that the experts use the word "suggest" when discussing this possible link. Nevertheless, if you take a more detailed look at the subject of possible transoceanic Asian/American contact in ancient times, you'll find that this is not the only example that is being discussed. In North America, human remains have also been found whose characteristics suggest the Ainu, an indigenous people of Japan in ancient times. One of the many currents in the Pacific flows from Japan to North America. Vital Alsar, Spanish explorer who came along after Thor Heyerdahl, showed more conclusively than Heyerdahl that it was possible to navigate these different currents back and forth with the types of seagoing crafts used by ancient peoples. (Unlike Heyerdahl, Alsar actually got all the way across the Pacific on his Ecuadorian-type balsa raft, which he was able to steer using an ancient technique.) With all the new discoveries being made by archeologists, I think it's important to keep an open mind on this subject.

I used the term "insect" as a convenient generic, since the trend is exploring spread of this bacteria by fleas, mosquitos, biting flies, etc as well as ticks. At least one scientist that I've read about has documented live Borrelia in fleas, etc.

"Bugs" might be a better word, then...

Regarding pre-Columbian travels to the Americas (excluding Leif Ericsson), it's certainly possible, but there has never been any definitive proof found. A lot of claims have been made, but the evidence has always turned out to be circumstantial, misinterpreted or fabricated.

You also have to admit to the well-documented Norse settlement that was recently excavated in Newfoundland, much later than Leif Erickson.

Bob Roehr | July 4, 2011 11:27 AM

You're a little behind on your research. A major paper on the Chinese disease was published in the New England Journal of Medicine on April 21. Full text if freely available at http://www.nejm.org/doi/full/10.1056/NEJMoa1010095

The NEJM article you mention does not come to any hard-and-fast conclusions and says that more research is necessary. In any case, the purpose of my article was to look at the subject of controversies about viruses, especially those related to the retrovirus family.

Bob Roehr | July 6, 2011 12:36 PM

How often does one read a scientific paper that does not say "more research is needed?"

At the start of the Discussion section the authors write: "Although we have not fulfilled Koch's postulates for establishing a causal relationship between a microbe and a disease in their entirety, our findings suggest that SFTS is caused by a newly identified bunyavirus. These data include epidemiologic, clinical, and laboratory findings and several lines of evidence that include virus isolation, viral RNA detection, and molecular and serologic analyses. SFTS has been identified in Central and Northeast China, which covers all six provinces where surveillance for SFTS was carried out."

Those multiple lines of evidence provide a very strong case; about as hard-and-fast a conclusion as one is likely to find in an initial paper. But of course more research is needed -- it is the lifeblood of science.

SFTS bunyavirus is not the same as the new "HIV-like" virus in China.

The "HIV-like" virus in China passes very easily from person to person (via saliva) by normal household or workplace contact.

By contrast, Wikipedia says of SFTSV: "The transmission routine of SFTSV is unknown, but person-to-person transmission either plays no role or at least is not an important routine of transmission of SFTSV". Bunyavirus are generally vector-borne (carried my ticks, misquotes, etc), so you can't catch them from another person.

If you want info in English about the new "HIV-like" virus in China, see here:

http://sites.google.com/site/newhivaidslikeviruschina/

I caught a very nasty sore throat virus myself (just from kissing) that later soon spread to my family and friends, via normal social contact. The virus I caught has very similar systemic symptoms to the "HIV-like" virus in China - but also some differences in symptoms, so I am not sure if I have the Chinese "HIV-like" virus or not.

I have a website where I describe my particular virus; it can be found here:

http://chronicsorethroat.wordpress.com/

Moral of all this: take care out there.


Mary Scriver | July 29, 2011 12:18 AM

This sort of subject is hard to think about because it IS emotional and sort of shiftingly nebulous to many of us. When I was working for animal control in the Seventies, we spent a lot of time thinking about rickettsias, debilitating tiny entities, "non-motile, Gram-negative, non-sporeforming, highly pleomorphic bacteria" according to Wikipedia. (I do NOT believe much of what Wikipedia says.) The veterinarians told us not to be blood donors.

As Jared Diamond says, the history of the North American continents and Polynesia was forever changed by smallpox, measles, and whooping cough. The original inhabitants of NA were wiped out by contagion from the first Europeans, who had developed relative immunity in the ten thousand years after cows and pigs began to be domesticated, allowing their diseases to jump to humans, This phenomenon has a sharp edge for me since I taught Blackfeet for many years and know their story very well. The loss of so many people at once was much deeper than an individual death just as AIDS is destroying so much. Families, culture, tradition, order itself.

A few years ago I worked at a local nursing home as a ward clerk and was told a terrifying tale about a hep C mutation that was dubbed "galloping." A little circle of a couple of dozen iv drug users and sexual partner sharers was wiped out in less than a month. They "caught cold," in a few days they thought they might have pneumonia or something, and then they were dead. The mutation died with them.

What I'm saying is that ALL life is a great shifting web of entities weaving in and out of each other. The cutting edge research now is extremely technical and hard to follow, but we are going levels and levels deeper than saying "this disease is X and this is X I, and then there's 2 and 3 and 4." Now we're talking about the interactions of atoms and molecules in cells. I hope and believe that this will lead to major breakthroughs on HIV, cancer, MS, CFS, and a host of other things in the not distant future.

Those of us who are not scientists must make sure that the social climate does not block their work.