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Dr. Bob: Plz answer, you never answer me: Journal of irreproducible results
Oct 12, 2007

Hi doctor, Please answer me. As you said that Journal of ireproducible results statements are funny and inaccurate. I have two questions:

1) Then why did Dr. Pierone Jr. once said in his forum to a patient when he asked something about CD4 when crystal methamphetamine, then he answered Let's see rising CD4 cells on crystal methamphetamine monotherapy that study was published in the Journal of Irreproducible Results, March 2003.(You can check his forum for nov 12, 2005) When JIR is inaccurate, funny, and humourous then why did he say about an article in JIR. So this means JIR is correct and have right information OR was he trying to say that JIR funny report about CD4 because of crystal methamphetamine is funny, inaccurate, and wrong. I am so worried because JIR does have some funny and weird stuff for HIV.

2) If JIR is inaccurate and funny then why did thebody.com kept its published article in its database like THE CRISIS IN CLINICAL AIDS RESEARCH on december 1993. If JIR doesn't give accurate information then why did thebody.com kept its article in its database.

Please be clear as I am very worried after reading JIR stuffs regarding HIV. First I never used to bother about its stuff but finding it on thebody.com, I am worried.

My case is i read on JIR that maximum window period for HIV is 6 months by CDC but a publication on JIR and one doctor told me that 6 months is the average and takes few years. He said CDC/HIV experts talk bookish language but in real clinical practice, 6 months is the average and may take few years. I cannot sleep and eat properly. If you clear the confusions, I will be relieved a lot. Wishes for you. Waiting for reply. Please reply soon.

Thanks and regards

Response from Dr. Frascino

Hello,

You are "very worried after reading 'Journal of Irreproducible Results' stuff regarding HIV"?????? Oh my . . . . Dude (or Dudette), clearly a sense of humor is not one of your strong suits. (Let alone irony, sarcasm or common sense!)

To specifically answer your questions:

1. If the Journal of Irreproducible Results is inaccurate, funny and humorous, why did Dr. Peirone mention it in his responses? Well, my keen sense for the obvious tells me he was attempting to be humorous and funny, because the question was so outlandish. (Indeed this is the case. See below.)

2. Anyone claiming to quote or utilize the JIR is making a joke, OK? (See below.)

As for "the CDC/HIV experts talk bookish language" . . . hmmm . . . it's always entertaining when a clearly less experienced individual claims to have more experience than certified experts. Believe your inexperienced "one doctor" and/or the completely fictional JIR if you so choose. The choice is obviously yours to make. However, I can assure you my board certification as an immunologist and over a quarter of a century of treating thousands of folks with HIV/AIDS plus my personal experience of being HIV positive for the past 16 years might, just might, qualify as "real clinical practice."

Dr. Bob

Extended Holiday Surprises Nov 12, 2005

It seems like everywhere I turn, there's someone else who's taking an endless drug holiday with surpring results. While viral loads fluctuate and respond differently, it seems consistent that their CD4 cell counts are rising, especially for those who have been using crystal methamphetamine but don't smoke cigarettes or consume other drugs. I know there were studies on this at UCSF and Stanford two years ago, and, of course, it would be expected that any stimulant might produce temporary spikes in a CD4 cell count, but it seems that after more than 5 years on meds, and 5 months on a drug holiday, CD4 cell counts are steadily increasing and staying there. Where can I locate the studies that provide information regarding these results? Also, I had been experiencing serious side effects associated with the Travada/Viramune cocktail. The symptoms I had while taking this regimen were similar to those I experiened when I contracted hep A. Is there any correlation?

Response from Dr. Pierone

Let's see rising CD4 cells on crystal methamphetamine monotherapy that study was published in the Journal of Irreproducible Results, March 2003.

On a more serious note if you are having side effects suggestive of hepatitis on this regimen then you may drug-induced hepatitis. Even if you don't, you may have to change this regimen if the symptoms don't resolve.

Some interesting Info and a question for the good doc Nov 18, 2003

Hi Doctor Bob, I had had a low risk encounter (stripper's groin came in contact with my with my face, concerned for any possible open wounds i may have on/in my nose,followed by cunnilingus for 10 seconds)with someone of unknown status on July 11, 2003. I had an ELISA/Western Blot test 5 days later (Negative) and on October 15 (Negative). I know that you have said many times that this test after 3 months is considered definative for HIV, but my doctor says no. He said that 3 months is only 40 definative, 6 months 70 and 1 year is 99. I had mentioned to him that the CDC told me that 3 months is definative for low risk exposure and 6 months for greater risks, he said I was misinformed. He said that was the "textbooks" information. Please tell me your thoughts on this. Should I wait longer or go on with my life?

Secondly, a friend of mine is in the insurance industry. He has spoken to an underwriter at a large life insurance company. The underwriter said that the ELISA/Western Blot test is so sensetive that it can detect HIV within 24 after hours of exposure. They are so confident in that test that they can write a 1 million dollar policy based upon that test, without having to wait for any time frame window. He also said that in the last 10 years, they have never had to pay a cent based upon the test giving a false negative. He also said that the medical community will never release this information for fear of liability. Please let me know your thoughts. Thank you for your time and good work to us hopefully worried wells.

Response from Dr. Frascino

Hello,

I find it quite amazing that your doctor told you that the CDC (and virtually all HIV/AIDS experts) are "misinformed!" And that apparently he doesn't believe the information in "textbooks." I have to wonder where he gets his information. Perhaps "The Journal of Irreproducible Results." I think your doctor is in dire need of a very basic textbook. Perhaps you could buy it for him. It's called "Medicine for Dummies." My dear friend, it's your doctor who is misinformed. You don't need additional HIV tests. You do need a new, more competent doctor -- preferable one who learned his basic medical knowledge from textbooks.

Your insurance industry friend is also woefully misinformed. The immune system just doesn't work that way. Insurance companies know the sensitivity and specificity of antibody tests and are very cognizant of the "window" period. However, having you take more than 1 HIV test wouldn't make a whole lot of sense, because if you are negative on day 1, and they come back to test you 3 months later on day 90, they still wouldn't pick up an infection from unsafe sex on day 80. Right? All insurance rates are structured to take into account the very small number of folks who might test negative due to being in the window period.

Hope that clarifies things for you.

Dr. Bob



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