Kaposi's Sarcoma and the Perth Group 5 August 2004
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Christopher J Noble,

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Re: Kaposi's Sarcoma and the Perth Group

On the subject of Kaposi's Sarcoma the Perth Group have previously written (BMJ Rapid Response):

The difficulty we encounter in our attempts to publish in peer reviewed journals can be best illustrated by an example. In 1988 we submitted to The Medical Journal of Australia a paper entitled "HIV and Kaposi's Sarcoma - a questionable relationship", in which we had argued that HIV could not be the cause of KS.

This is the first, hmmm, misrepresentation. For a start few if any researchers have claimed a direct role of HIV in the causation of KS since 1984 when it was found that KS cells did not contain HIV DNA. The Perth Group also misrepresent their own claims. They actually claimed that KS was not caused by any infectious agent but rather that it was caused by nitrite inhalants and semen. If the Perth Group want to claim that they have been vindicated they are sadly deluded. An infectious agent KSHV/HHV-8 was subsequently discovered which is found in all four types of KS and the evidence for its involvement in KS is overwhelming if not conclusive.

On the reviewers' advice the paper was rejected. One of them wrote: "Unfortunately I believe that the tenants of the argument presented have not been carefully constructed from study of current literature?".

Sound familiar?

Another wrote: "The arguments forwarded by the author are quite unsatisfactory, and are not supported by even desultory reading of the literature quoted?In addition, the author fails to examine the body of epidemiological, immunological and cellular literature concerning the Pathology, Pathogenesis and Clinical association of this fascinating manifestation of HIV infection".

Yes, it seems unanimous. Everybody thinks the Perth Group misrepresents the available literature (including the very papers they cite).

Between 1988-1992 we had many exchanges with the editors regarding our paper and submitted updated versions. Again, on the reviewer's advice the paper was rejected. "Unfortunately, their hypothesis is now completely untenable. We are fortunate that new information discussed at the recent International AIDS Conference in Florence gives us a much better idea of the pathogenesis of Kaposi's sarcoma in HIV infection?evidence demonstrating that activation of the tat gene with subsequent effects on the production of IL6, produces both the proliferation of endothelial cells responsible for KS and the elicitation from those cells of an angiogenic factor as well as the polyclonal gammopathy seen in the disease, takes us very far down the path towards an understanding of these problems and far away from the hypothesis suggested by the West Australian scientists. Under the circumstances, it is not suitable for publication in the Journal".

Yep, unanimous!

Our paper was rejected even after the 1992 publication, in Lancet, by the CDC researchers where they presented evidence against the claim that the cause of KS is HIV [1].

Again they misrepresent history. This paper Beral et al argues that KS is caused by an as yet unidentified sexually transmitted infection whereas the Perth Group claim it is caused by poppers and semen. The current evidence supports Beral et al (HHV-8 was later identified) not the Perth Group.

At present it is generally accepted that HIV plays no role, either directly or indirectly, in the causation of KS.

Hello, anyone there? Have you read the literature lately? Just try a search at pubmed with the terms "HIV tat KS". I don't know where the Perth Group get their ideas about what is generally accepted.

This is one of many other similar examples.

Well at least they got something right here. It is just another example of the Perth Group misrepresenting the literature. The Perth Group claim that they critically analyse the scientific literature. You would then expect that they systematically cover all the literature rather than selectively quoting from isolated papers. Try looking on their website for any mention of KSHV/HHV-8.

site:www.theperthgroup hhv8 OR hhv-8 OR kshv

Yes, the Perth Group totally ignore the latest findings (actually ten years worth of results) but want to convince their supporters that their theory that nitrite inhalants and semen are the causes of KS has been vindicated. I would claim that any problems that the Perth Group have had getting published is due entirely to the quality or lack of it in their work.

Competing interests: None declared