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The Harold Varmus Papers

Letter from Max Essex, Harvard School of Public Health to Harold Varmus pdf (117,732 Bytes) transcript of pdf
Letter from Max Essex, Harvard School of Public Health to Harold Varmus
Number of Image Pages:
2 (117,732 Bytes)
1985-08-12 (August 12, 1985)
Essex, Max
Harvard School of Public Health
Varmus, Harold
Original Repository: University of California, San Francisco. Archives and Special Collections. Harold E. Varmus Papers
Reproduced with permission of Max Essex.
Medical Subject Headings (MeSH):
Terminology as Topic
Exhibit Category:
AIDS and HIV: Science, Politics, and Controversy, 1981-1993
Box Number: 2
Folder Number: 15
Unique Identifier:
Document Type:
Letters (correspondence)
Physical Condition:
Series: UCSF Collections
SubSeries: Collection Number MSS 88-47
SubSubSeries: Human Retrovirus Study Group, 1981-1987
Folder: Human retrovirus subcommittee correspondence, 1985-1986
August 12, 1985
Dear Harold:
Aside from our conversation in June, I have remained relatively silent concerning my opinion on the nomenclature. I have thought long and hard about the issue. As one of the few members of the committee who has been heavily involved in research with the agent(s) but was not involved in the introduction of any of the terms, I decided to wait and weigh as many proposals as possible before forming an opinion. I also solicited several. Some were forwarded to you at the time. The two that were not (Pagano, Kirsten) are enclosed.
Having been through the successful nomenclature committee experience in the case of the onc genes, I was probably unduly optimistic. It now seems extremely unlikely that we will reach a consensus on a specific term. Perhaps the only reasonable course is to table the issue for a year or so and to try again then or to simply give up entirely.
This said, I have filed my ballot with the term HTLV-3/LAV (or HTLV-III/LAV). I recognize that it is cumbersome. Although this term is also vigorously opposed by some, most of the opponents are virologists who do not work with the agents. Their impact is thus likely to be lessened.
It seems to me that several issues come into play to negate the possibility that a meaningful consensus can be reach for any other term. These are:
(1) There is already a substantial literature that has accumulated, almost all with the terminology HTLV-111, LAV, or HTLV-III/LAV. Research using these terms represents almost all of the work already published. Further, a very substantial majority of the published work has come from only a few labs (Gallo, Wong-Staal et al; Haseltine and ourselves; Montagnier, Chermann et al.; Weiss; Fauci; Bolognesi). Unless all were to agree to switch en masse, it seems unlikely that any will.
(2) The respondents who have clinical responsibilities (Safai, Gottlieb, Broder, Kaplan, Fauci) seem very concerned about any use of the term AIDS to describe the agent. I believe we should consider their dilemma more carefully and thus would not endorse the term HALV. They represent the many who must inform the million or more that are already infected about the meaning of a subclinical infection with this agent.
Certainly no agent/disease has created such a clamor in the general population in the era of modern virology. Within a year or two after the identification of the agent there is almost universal dissemination of information with daily articles in the lay press, frequent policy pronouncements by governmental agencies, commercialization by many large corporations, etc. The FDA, Abbott, and the CDC have printed brochures for physicians and blood donors using the term HTLV-III (or HTLV-III/LAV). To try to change all that at this point seems futile.
When I first began our modest program with HBV I simply couldn't understand how virologists could tolerate terms such as hepatitis A and hepatitis B when the agents have nothing whatsoever in common except that they cause liver disease. By my second or third year of working with HBV I realized there was nothing that could be done with terms that, albeit totally uninformative or misleading to the student of virology, have become firmly entrenched.
M. Essex
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