The discovery of the AIDS virus in 1983-1984 became exposed to a lot of international controversy and contention, which is perhaps one of the reasons that HIV denialism developed in response. Legal disputes, scientific inconsistencies, political motivations, and even personal grudges all played a part in deciding who got credited for isolating HIV. Many historians both during and after the AIDS crisis have criticized this ensuing controversy because it deflected attention away from the actual problem of AIDS. This became one of the key reasons for the wave of activism in 1987.
Two research teams were at the forefront of this controversy: Dr. Robert Gallo’s team at the National Institute of Health, and Dr. Luc Montagnier’s team at the Pasteur Institute. Both were studying cancer-causing retroviruses at the dawn of the AIDS epidemic and both became invested in the search for the cause: they simultaneously began analyzing samples from patients with AIDS. Dr. Gallo’s team had been doing research on a class of retroviruses called Human T-cell Lymphotrophic Virus (HTLV), and he theorized that the viral cause of AIDS would be a retrovirus related to HTLV-I and HTLV-II. Many scientists adopted this perspective, including Dr. Montagnier. As he recounts in a reflective article from 2002, his team started using Dr. Gallo’s methods of isolating retroviruses in order to obtain samples from the biopsies of AIDS patients. In 1983, Montagnier’s researcher Dr. Françoise Barré-Sinoussi isolated a virus from a patient with lymphadenopathy in the neck which was not an HTLV but was similarly retroviral, and so their team dubbed it Lymphadenopathy Associated Virus (LAV). They obtained a patent on the virus which made it their intellectual property, so that any vaccines or diagnostic tests would provide them and their government with royalties.
Meanwhile, Dr. Gallo’s team was also attempting to isolate this retrovirus from AIDS patients: while he also published a paper in May 1983 about finding one such virus, he admitted in a reflective article from 2002 that his team weren’t actually successful. He requested to exchange some samples with Montagnier’s lab. Around the same time that his lab received these French samples, Gallo announced that his team was successful in creating an isolate of the AIDS retrovirus. Gallo’s isolate had different properties to Montagnier’s in that it grew in permanent T-cell lines and not just fresh cultures. Continuing from his initial hypothesis about HTLV’s and AIDS, Dr. Gallo published in May 1984 that he had found another kind of AIDS retrovirus which he called HTLV-III. Secretary of Health and Human Services Margaret Heckler announced that Dr. Gallo discovered the cause of AIDS at a press conference in April 1984, and Dr. Gallo applied for a patent on the virus and the blood-test he developed soon after.
She would later blame herself for misrepresenting both the discovery and the potential for vaccines. In his 2002 reflective article, Gallo said that this press conference was the result of leaked information which runs contrary to the “constant briefing” between them that Heckler cited in her interview. No matter which account one believes, a press conference did happen and Dr. Gallo was the only scientist credited.
The controversial part came when scientists tested the sequence of Dr. Gallo’s retrovirus sample: they found it to be nearly identical to Dr. Montagnier’s LAV isolate, with less than 1% difference in their genetic structures. This is bizarre because HIV is known for its high mutation rates, with an expected level of variation around 8%. It was almost unprecedented to find such similar samples in two different patients. The results of the sequencing lead to much bitterness and allegations between the French and American teams of researchers, both of whom were invested in obtaining the scientific and legal credit for discovering the virus. Not only did their scientific reputations depend on this attribution, but the legality of their country’s claim to royalties did as well. It also lead to the questioning of Dr. Gallo’s scientific integrity, which would be investigated by the NIH in 1989: the inquiry was concluded in 1993, officially clearing his name.
It took two to three years to settle all the legal suits and media outrage over this controversy. During that time, the virus was referred to as “HTLV-III/LAV” or “LAV/HTLV-III” interchangeably. In 1986, chairman of the Retrovirus Study Group of the International Committee on Taxonomy of Viruses (ICTV) Harold Varmus held a conference to decide the name of the AIDS-causing virus. While both Gallo and Montagnier made their cases to keep the names that they chose, HTLV-III and LAV respectively, the name that the panel settled on was HIV, which has been its name ever since.
[To read more about the naming of the virus, check out Dr. Leonard M. Norkin’s blog post on the subject.]
Meanwhile, the patent issue was only settled on March 31 1987, when President Reagan and President Chirac agreed to share the credit for discovery of the AIDS virus. They decided to split the patent rights to the blood test as well, donating most of the royalties to AIDS foundations. Even still, in the 1990’s it was found that French health officials had deliberately decided not to utilize this blood-test back in 1985 on the basis that French scientists would create a test of their very own: as a result, hundreds of people contracted HIV through tainted blood products.. Similar scandals were discovered in Japan and Germany, where blood contamination and improper testing during the 1980’s lead to the spread of HIV in hundreds of hemophiliac patients.
In 1995, Dr. Gallo found that chemokines inhibit the HIV virus which shaped the understanding of HIV/AIDS in the medical community: his research spawned a class of drugs, the entry inhibitors, that became part of the growing body of HAART. Indeed, it was not enough to clear his record: in 2008, Dr. Montagnier and Dr. Barré-Sinoussi received the Nobel Prize in Medicine for their work on HIV while Dr. Gallo was noticeably excluded. Both Montagnier and Gallo expressed some shock over this decision. In his book A Plague on All Our Houses Bruce Hillman explains this decision on the part of the Nobel Committee as an attempt to avoid any future revealings of misconduct on the part of Dr. Gallo.
Health historian Michael Oldstone said this about these blood-testing scandals in his book, Viruses, Plagues, and History:
“When scientific research approaches the borders of political debate and economic interests, the issue of who has access to data takes on critical dimensions.”
— Michael Oldstone, p. 156
And in 1987, Randy Shilts brought public attention to this scientific data when he published his second book, And the Band Played On, which was a history of the early years of the AIDS crisis. In this book he was heavily critical of the institutional and governmental responses to the AIDS outbreak, calling attention to President Reagan’s silence on the issue as well as the inwards mismanagement of governmental departments like the NIH and the CDC as they squabbled over funding and credit for the discovery of HV. Shilts reported that Gallo’s isolate got swapped by someone in the lab who held a grudge against the Pasteur Institute, resulting in a controversy that put off AIDS research for almost a year.
Indeed, many people took issue with the way that the world’s scientists and governments seemed more invested in the patenting of HIV than in helping actual people with HIV/AIDS. In the same year as the publication of this book, activist groups like ACT UP began fighting for people with AIDS. Cleve Jones created the first panel of the AIDS quilt which would eventually become the NAMES project, the largest memorial for people who died of AIDS-related causes. There was a general consensus among the people most affected by AIDS that the powers of authority were not properly handling this crisis, and so they started representing their own interests.
But in spite the scandalous circumstances that surrounded the discovery of HIV, its isolation was monumental in the eventual conclusion of the AIDS crisis. It provided the basis for increased political action, increased medical attention, and increased scientific research. The first commercial blood-tests were released in 1985, and the first antiretroviral drug (AZT) was released in 1987. In his reflections, Dr. Luc Montagnier prides the medical communities on their relatively quick action in the onset of disaster.
As such, the discovery of HIV was a critical moment in the history of the AIDS crisis as it demonstrated both the progress and non-progress of the management of disaster. While the discovery of HIV clearly fits into a narrative of technocratic achievement, the event itself became so fraught with controversy and political claims that it lost its meaning to the actual victims of AIDS. Once again, the AIDS crisis challenged the traditional model of disaster.
Featured Image Credit: Rosettasister’s Weblog, “Dr Robert Gallo and Luc Montagnier getting the Lasker prize together many years ago,” (note: this picture was taken in 1986). https://rosettasister.wordpress.com/2011/09/01/len-leonard-horowitz-the-book-of-528