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Anonymous
Unregistered

Help!
      #2771 - 04/05/00 12:16 PM

I just found out 5 weeks ago I had AIDS. My viral load was
490,000 and CD4 count was 190. My doctor started me on Norvir,
Invarase, and Zerit. After hearing about all the side effects, I
decided not to take any of the drugs to see what my next count
would be. My tests came back today with a viral load of 240,000
and a CD4 of 210. Without taking the drugs, how did my viral load
drop that much? Just how accurate are these tests? My doctor said
that the meds must be working until I told him I haven't taken
anything. He said the lab must have made an error. Any help would
be appreciated very much.



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Anonymous
Unregistered

Re: Help! new
      #2772 - 04/05/00 12:18 PM


Wait on, I hear some ask, what about the polymerase chain reaction
or PCR? For those who don't know, this is a new and very sensitive
technique for finding genetic blueprints. Surely this can put us
straight about the antibody tests? Not so I'm afraid. To perform the
PCR you need to begin with a piece of RNA or DNA which you can
say for certain belongs to the HIV genome. To obtain the HIV
genome first you need to isolate an HIV particle. That's where the
HIV genome comes from and that is the only way to know the RNA
or DNA actually belongs to the virus. Even the most charitable
interpretation of the data available to date does not show that a
unique retrovirus, HIV, has been isolated. Furthermore, even if one
assumes that the process of selecting the RNA and DNA molecules
(molecular probes) used in the PCR are from the HIV genome there
are still many problems with the use of the PCR to prove HIV
infection. For a start, at best, the PCR detects single genes and most
often, only bits of genes. If your PCR finds two or three genetic
fragments out of a possible dozen complete genes is this proof that
you have all the genes? The whole genome? No it is not, and in fact
HIV experts admit that the majority of HIV genomes studied are
defective. This means they are incomplete and could never
orchestrate the synthesis of a viral particle. Even if all genomes
were complete let's not imagine for a moment having the plans
means you've built the house. Basic retrovirology long teaches us
you can carry a whole retroviral genome around inside your cells
all your life without ever making a viral particle. And in 1992, in
the only study of its type, French researchers found the HIV PCR
non-reproducible and the agreement between the PCR and the HIV
Western blot was found to vary between 40-100% and was
especially poor when fragments of more than one gene were sought
[7]. In this study there were several PCR negative/HIV positive as
well as several PCR positive/HIV negative samples. In other
words, the two tests don't fit. As far as which test proves HIV
infection, you pay your money and you take your pick.


Here is the whole article. I hope this helps you to become informed
about these critical choices you must make regarding your health.


RETHINKING AIDS HOMEPAGE



DO HIV ANTIBODY TESTS PROVE HIV INFECTION?
By Valendar Turner

Department of Emergency Medicine, Royal Perth
Hospital, Perth, Western Australia



What evidence authenticates a positive HIV antibody test as proof
of HIV infection? This question has greatly interested me because
those of us who work in Emergency Medicine spend a considerable
part of our lives exposed to other people's blood and body fluids, a
circumstance which, according to the experts, places us under
constant threat of death from AIDS. Ironically, if the experts are
right, the life we save may cost us our own and it's little wonder
that some of us have pursued the question of proving HIV infection
to the very limits. From the early days of AIDS I was fortunate to
collaborate with Eleni Eleopulos, a Biophysicist at the Royal Perth
Hospital, John Papadimitriou, Professor of Pathology at the
University of Western Australia, and other colleagues, and in one of
our papers, published in June 1993 in the journal Bio/Technology
[1], we were compelled to confront many unsettling conclusions
about the HIV antibody tests, none of which accord with current
wisdom. Some of these I would like to share with you today.

The HIV antibody tests do not detect a virus. They test for any
antibodies that react with an assortment of proteins experts assure
us are unique to HIV which, almost everyone agrees, is a retrovirus
and the cause of AIDS [2]. What happens is this: A sample of blood
serum is incubated with a mixture of these proteins in a test called
an ELISA, an acronym for Enzyme Linked Immunosorbent Assay.
The ELISA is positive if the solution changes colour thereby
indicating a reaction between the proteins in the test kit and the
patient's antibodies. However, according to many experts, the
ELISA is not specific meaning it may react in the absence of HIV
infection. In response to this, testing authorities have developed
strategies such as repeat testing of all positive ELISAs and
following up those twice positive with a third but different antibody
test known as the Western blot. In the Western blot the "HIV"
proteins, about ten of them, are located at discrete spots in a paper
strip, rather like the one your doctor uses to perform multiple tests
on your urine. Serum is added and wherever there is a reaction a
colour change occurs which shows up as a dark band. The test is
read by noting which bands show up, in other words, which
proteins react. Certain combinations of bands are defined as a
positive test. It is enigmatic that the location and number of bands
required for a positive Western blot varies around the world. They
may even vary between laboratories within the same city. In
Australia four bands are required, in Canada and much of the
United States, three bands suffice. And in Africa two will do. In the
US Multicenter AIDS Cohort prospective study involving several
thousand gay men, one "strong" band was deemed sufficient. If each
of the above indicates HIV infection then HIV must cause different
populations of antibodies to appear in different places. I don't know
about you but to me that sounds very odd. But at least it gives some
Africans a way out. All an African has to do is have a test in
Australia because two bands would not be considered positive
here. Nevertheless, in spite of lack of standardisation and other
problems such as reproducibility, the Western blot is accepted to
be in excess of 99.9% specific and if positive is regarded
synonymous with HIV infection. In some countries similar claims
are now made for the HIV ELISA without recourse to the Western
blot.

The rationale for the use of antibody tests is as follows: The
immune system has the ability to detect foreign agents and to
respond by producing antibodies which react with those agents.
However, this does not work in reverse. By that I mean the
observation of an antibody reaction with a particular agent is not
automatic proof that the antibody was produced in response to that
agent. The problem is that antibodies indulge in casual and
indiscriminate relationships. They are in fact promiscuous.
Antibodies meant for one agent may react with another agent, a
perfect stranger. Or, if you want it put technically, there is ample
evidence, some of the best in fact comes from the Pasteur Insititute,
that antibody molecules, even the most pure, the monoclonal
antibodies, are not monospecific and cross-react with other,
non-immunising antigens. Here are some examples to illustrate this
most crucial fact. Firstly, in a study of 1.2 million applicants for US
military service [3], of the 1% or 12,000 who had first time
positive HIV ELISAs, only 2000 were ultimately shown to be also
WB positive and thus, according to the authors, HIV infected. That
left 10,000 positive ELISAs which must have reacted for reasons
other than "HIV antibodies", a fitting testimonial to the problem
caused by cross-reacting antibodies. Secondly, there is the
tantalising data reported in 1990 about dogs. Writing in the journal
Cancer Research, Strandstrom and colleagues reported that 72/144
(50%) of dog blood samples "obtained from the Veterinary Medical
Teaching Hospital, University of California, Davis" tested in
commercial Western blot assays, "reacted with one or more HIV
recombinant proteins [gp120--21.5%, gp41--23%, p31--22%,
p24-- 43%]" [4]. Assuming Californian dogs are not infected with
HIV (as did the authors) one must conclude these data are further
proof of antibody cross reactivity to many of the "HIV" proteins.
What all this means is that you're not necessarily infected with what
your antibodies appear to tell you. This can be brought home by two
further examples. Firstly, some AIDS patients have antibody
reactions with laboratory chemicals but no one claims AIDS
patients are infected with laboratory chemicals. Secondly, as an
example removed from AIDS, the antibody test for glandular fever
relies on the fact that patients with glandular fever make antibodies
that react with the red blood cells of sheep and horses. But these
patients are not infected with animal blood and animal blood does
not cause glandular fever. Bearing all these examples in mind it is
painfully obvious we cannot pronounce someone infected with what
is regarded as a lethal human retrovirus merely because we observe
an antibody reaction. Before we pronounce any such reactions
indicative of HIV infection and long before we introduce the test
into routine clinical practice, we must exact solid proof of
precisely why these reactions take place. In doing we must not
forget that biology is not mathematics and despite our clever
technology, in biology still we must stoop to the relative ignominy
of empirical proofs. Or, as Plato said, "experiential data must
always be interpreted in the light of what Nature has revealed".

In Science we must constantly resist the temptation to stray beyond
our data and in that spirit I put it to you there are only two pieces of
information which can be gleaned from an antibody test (for
mathematical purists it's only one piece of information). Either you
see a reaction or you don't. That's all. You don't see antibodies with
labels attached saying what produced them. You cannot construe the
genesis of antibodies by observing changing colours in a test-tube.
The cardinal problem scientists face when ascribing meaning to a
set of antibody reactions is how can they tell whether the reaction is
caused by a real antibody or a ring in? One whose proper partner is
something else but caught in a compromising act? In this context it
is proper for a disinterested scientist to allow for the possibility
that there are no real HIV antibodies whatsoever, that they're all
pretenders. When the only information is a reaction, and that
reaction has more than one possible cause, as is the case with an
antibody test, you need extra information before you can ascribe a
particular outcome. So, if you want to claim an antibody reaction
signals a particular outcome, such as HIV infection, first you have
to prove it. And just before we get to crunch time consider this little
morsel. AIDS patients are exposed to many foreign agents are
known to have antibodies reacting with dozens of different
substances and it makes perfect sense that the more antibodies there
are the more chance there will be some that will spoil the test. What
this means is that in the very patients you suspect of harbouring a
virus there exists the precise circumstances, lots of potentially
cross reacting antibodies, which make it imperative to sort out what
is really going on.

What's the solution or, more to the point, what's the problem? The
problem is how do you know, when you witness an antibody
reaction, that is, a positive test, HIV is present too? After all, that's
what you really want the test to tell you and the question on the
patient's lips is bound to be "Is HIV infection the only cause of a
positive test? If's there's something else I'd rather have that, thank
you very much". In technical terms the patient's hopes are hanging
on the specificity of the test. Let me first explain what is meant by
100% specificity. One hundred per cent specificity means that
positive tests only occur in HIV infected people. That's the same as
saying positive tests never occur in uninfected people. And that's
the same as saying all uninfected people have a negative test. This
leads us to the formal, mathematical definition of specificity which
is the number of negative tests in a large group of individuals who
do not have HIV infection. If 100% of one thousand people who do
not have HIV infection are seronegative the specificity is 100%. If
one uninfected person is seropositive the specificity is reduced to
999/1000 or 99.9% by virtue of a lone false positive. Thus, to
determine the specificity of an antibody test we need two pieces of
data. The numbers of persons with negative tests and the numbers of
persons with no HIV infection. By the way, and I'm sure it's
obvious, the false-positive rate is (1-the specificity). An experiment
to find the specificity also gives the false positive rate and vice
versa. How should we design an experiment to discover this
important data?

Firstly, since the underlying problem is largely one of deciding
between bona fide and cross-reacting antibodies we must include in
our sample persons who are likely to have a large repertoire of
antibodies to agents other than HIV. The more the merrier. Thus we
must include persons who are sick and who have diseases similar
to AIDS but not AIDS. Secondly, we need a way of determining the
presence or absence of HIV infection. Obviously, this can't be the
antibody test itself because that's what we're trying to validate.
When we measure specificity we are trying to find out how often
reactions occur in individuals who do NOT have HIV infection.
Rather surprisingly, in the AIDS literature, the specificity of the
HIV antibody tests has been evaluated by testing for reactions in
healthy individuals such as blood donors. These persons are chosen
as de factos for the absence of HIV infection. Under these
circumstances few if any positive reactions are found but this is not
necessarily, as the HIV/AIDS experts claim, because the tests are
highly specific. In fact, this is the wrong experiment and wrong for
two reasons. Firstly, healthy people do not have large number or
variety of antibodies to react in the first place. That goes with being
healthy. That's why we put them in the Army and let them donate
blood. There are simply not enough antibodies available to measure
the propensity for unwanted reactions. It's like going to a party
where hardly anyone is hogging the Guinness because there's hardly
any people. Secondly, good health cannot be used as a de facto for
the absence of HIV infection any more than good health can be used
as a de facto for the absence of gall stones, kidney stones,
pregnancy, hydatid cysts, deep vein thrombosis, cerebral
aneurysms, pathogenic bacteria or coronary artery disease. The
practice, widely adopted by HIV/AIDS experts, of appraising HIV
antibody tests by testing thousands of healthy blood donors, also
creates an enormous dilemma. If healthy people are regarded as a
de facto gold standard for the absence of HIV infection, counting the
occasional one or two who do react as false-positives, by what
criteria can similar or even the same individuals be regarded as
infected at some future date? One week the same individual may be
tested as member of a cohort of healthy blood donors and the
following week when he or she requests an examination for Life
Insurance or attends a doctor for a checkup. Is this person HIV
infected or not? Does the outcome depend solely upon who you are
and which door you knock on?

Back to the problem of validation. We select our thousand people
who are sick and let's make sure we include some who have
diseases similar to AIDS and let's include a few healthy persons
and some cases of AIDS as well. You never know, we might be in
for a big surprise. We might find some AIDS patients too are
antibody positive in the absence of HIV infection. In fact, if you
read Gallo's May 1984 Science papers, where it is claimed HIV
was proven to be the cause of AIDS, HIV could be "isolated" in
less than half the AIDS cases. Let us return to our experiment. Most
of the people selected will have lots of antibodies and this will
give the test a fair run for its money. There'll be a lot more people
at this party. But hold on, if HIV causes AIDS, and some of our
patients have AIDS-like diseases or even if they don't, even those
who are healthy, how do we get past the sticky problem of knowing
who is or is not infected with HIV? We don't want to include them
in our analysis because we want to evaluate the test when there is
no HIV infection. I know by now many of you will have the correct
answer. It's obvious isn't it? You have to use HIV itself. You simply
divide your blood sample in two. One to test for the antibody
reactions and the other to try and isolate HIV. If you want to know
what the HIV antibody tests tell you about HIV infection you
compare the reactions with what you are trying to measure. Not
with pumpkins. The only way to distinguish between real reactions
and cross-reactions is to use HIV isolation as an independent
yardstick or gold standard.

What are the results of such an experiment? How many of an
appropriately chosen, thousand patients from whom HIV cannot be
isolated at the same time have an antibody reaction? I can't tell you
that because, bizarre as it may sound, twelve years since the
discovery of HIV and ten years since the development of the HIV
antibody tests, this experiment has not been done. We don't know
how many positive tests occur in the absence of HIV infection, it
might be none or it might be all of them. Nobody knows. There is no
proof of the specificity of the HIV antibody tests for HIV infection.

What if someone decided to do this experiment? Is it feasible?
That's hard to say because it depends on how much importance you
place on the precision of defining HIV infection. Ultimately this can
only be defined by the isolation a unique retrovirus. The word
isolation comes from the Latin word "insulatus" meaning "made into
an island". It refers to the act of separating an object from
everything else that is not that object. Like solitary confinement.
The rules of retrovirus isolation are now old. All the HIV experts
should know them. They were developed in the several decades
preceding the beginning of the AIDS era in 1981 and were
thoroughly discussed at a meeting held at the Pasteur Institute in
1973 and attended by now leading HIV/AIDS researchers including
Barre-Sinoussi and Chermann. These are a set of rules which
credibly achieve the aim of separateness. The problem is that no
claim of HIV isolation yet presented fulfils either the island concept
or follows these rules. None of these claims even fulfils the initial
and most basic of these rules, the requirement to obtain and electron
micrograph of the material which is present at a sucrose density
gradient of 1.16 gm/ml. In fact no claim of HIV isolation is
isolation. All such claims are based on a set of phenomena ("HIV"
proteins such as p24, reverse transcriptase enzyme activity, "HIV"
particles, "HIV PCR") detected in cultures of tissues of AIDS
patients none of which is even specific for retroviruses. And
without isolation who can say whether the proteins used in the HIV
antibody tests are unique to HIV? These facts are accepted by
Philip Mortimer and his colleagues from the UK Public Health
Laboratory Service: "Experience has shown that neither HIV
culture nor tests for p24 antigen are of much value in diagnostic
testing. They may be insensitive and/or non-specific"[5].

Yes, I know that we have all been shown pictures of something
called HIV but that should come as no surprise because, in the
extensive retrovirology literature, retrovirus-like particles are
commonplace. For a start try insects, reptiles, fish and tapeworms.
They are also found in the majority of healthy human placentas and
while it is true that electron microscopy reveals retroviral-like
particles in 90% of enlarged lymph nodes from AIDS patients, the
identical particles can also be found in 90% of enlarged lymph
nodes from patients who do not have AIDS and who are not at risk
for developing AIDS [6]. If the particles seen in lymph nodes from
AIDS patients are HIV as the AIDS experts assure us, what are the
particles seen in the lymph nodes of patients who are not at risk
from AIDS and what is their relationship to the plethora of other
particles seen in cultures of tissues from AIDS patients?

Wait on, I hear some ask, what about the polymerase chain reaction
or PCR? For those who don't know, this is a new and very sensitive
technique for finding genetic blueprints. Surely this can put us
straight about the antibody tests? Not so I'm afraid. To perform the
PCR you need to begin with a piece of RNA or DNA which you can
say for certain belongs to the HIV genome. To obtain the HIV
genome first you need to isolate an HIV particle. That's where the
HIV genome comes from and that is the only way to know the RNA
or DNA actually belongs to the virus. Even the most charitable
interpretation of the data available to date does not show that a
unique retrovirus, HIV, has been isolated. Furthermore, even if one
assumes that the process of selecting the RNA and DNA molecules
(molecular probes) used in the PCR are from the HIV genome there
are still many problems with the use of the PCR to prove HIV
infection. For a start, at best, the PCR detects single genes and most
often, only bits of genes. If your PCR finds two or three genetic
fragments out of a possible dozen complete genes is this proof that
you have all the genes? The whole genome? No it is not, and in fact
HIV experts admit that the majority of HIV genomes studied are
defective. This means they are incomplete and could never
orchestrate the synthesis of a viral particle. Even if all genomes
were complete let's not imagine for a moment having the plans
means you've built the house. Basic retrovirology long teaches us
you can



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bentley
Unregistered

Re: Help! new
      #2773 - 04/05/00 12:19 PM


I hope you dont take the advice of someone who doesnt even sign
his/her name..Tell me...Anom..How much is this political and not
first hand experience? I would hate to see how you would react if
you did become deathly ill and the medical profession refused to
treat you because of your so called distrust in the science of HIV. I
dont know what I do and dont believe when it comes to this thing
called aids. What I do know is that people have died because of not
using any intervention. So..remember just because you believe it is
because of the drugs or lifestyle or a thought process..advising to
others who are in this predicament not to trust their doctors or the
scientists or the drug companies..will only put these people at risk.
If they dont do treatment and live you get to be right..if they dont do
treatment and die..your advice was lethal. But I am sure you would
find a way to be right about that...Now that I vented...I too have
questioned all the tests and the philosophies behind this so-called
virus. Even attended "Heal" meetings. When I almost died, then I
realized I might need to take some other kind of action..I am not
saying drug therapy is for everyone nor do I say that relying on a
test to determine whether I am healthy or not is the end all...I am
saying spouting out your political agenda when one is faced with a
possible life threatening situation does not really help them make
their decisions. It just puts more fear and mistrust into their already
confused minds. Like I said, if they follow your advice and they
live a healthy life..more power to you. I have seen the opposite. It
would be sad if someone chooses not to intervene when they might
need to into taking care of their health because now they are afraid
that the drugs will kill them..Instead they die of "pcp" or aids
related lymphoma, but you got to be right about how the drug
companies are having a conspiracy. Is that really having
compassion for others' lives or is it just the need to shout out and be
right? Well I am finished preaching from my pulpit.
Bentley



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gary stein
Unregistered

Re: Help! new
      #2774 - 04/05/00 12:20 PM

Do not liston to this drivel, I am pretty sure I know who the person
is that posted this message in that he/she is a very prolfic poster to
sci.med.aids, and misc.health.aids. They are known as Aids
dissedants and in some cases I beleive they should face crimnal
charges for the lies and half truths they tell people such as yourself.
Who are new to Aids and don't have the breadth of understanding to
see them for the idiots that they are. Do your own research before
you believe what anyone tells you. However there is no
scientifically valid argument that HIV causes Aids or that T-Cell
and Viral Load tests are not useful in monitoring your health status.
As to the test results you have reported there can be many reasons
for the differences. As you have seen in other responses to your
question the tests can very due to different labs being used or
different assay methods at the same lab or just due to the normal
percentage of error that is inhereant in the testing procedure used.
Do not panic about developling a resitance to the Meds recent
studies and common sense say that if you stop all medications then
no resitance can develope, it is only when you do not take the
medications as directed that an extreme risk of developling
resistance occurs.



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marc
Unregistered

Re: Help! new
      #2775 - 04/05/00 12:21 PM



PLEASE talk with you doctor about your decision to stop your
therapy - these drugs are typically good for "one shot" and you need
to make your best one count. Take care, my friend - Peace.



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paul
Unregistered

Re: Help! new
      #2776 - 04/05/00 12:22 PM



I've been HIV+ for 14 years, and in that time, my viral load and
CD4 count has jumped around quite a bit, and often inexplicably.
Most doctors might be cautiously optimistic if the numbers are
heading in the right direction, but very few will draw conclusions
after just one test following a baseline.

Statistically, the difference between 190 and 210 isn't worth
anything, given the normal variation in counts. And even the
difference between 490,000 and 240,00 is much less significant
than it appears. What doctors look for is a "log" reduction, which is
an exponential reduction. That means, for example, a drop from 10
to the 3rd (1000) to 10 to the 2nd (100).

Don't be seduced by the numbers. Not only are they NOT precise,
but the numbers don't mean anything in and of themselves, they only
indicate trends.

I've taken a lot of drugs, and only rarely have been bothered by side
effects. A lot depends on your state of mind. It's not hard to talk
yourself into a rash, or palpitations, or an upset stomach. For a
while I was worried about peripheral neuropathy, and then I bought
a new pair of shoes and realized the old ones were too tight!

You also have to understand that you've just had the biggest shock
of your life, and it is very hard to adjust to. I think I walked around
in a daze for months. You need to take this opportunity to take
control of your life in a way you haven't had to do before. I would
suggest that you have a long talk with your doctor and honestly
explain to him how you are feeling about all this. If he isn't
sympathetic, nad can't help you explore what you need to do, find
another doctor!

Lastly, you don't have AIDS. You have a virus which someday
might kill you if you don't deal with it. It's no different than any
other disease that men have had to deal with. The nice thing about it
is that you might survive it, and have a really good life along the
way.



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michael
Unregistered

Re: Help! new
      #2777 - 04/05/00 12:23 PM

Very interesting response.. I do believe it has to with attitude and taking care of your body like every human being should do...



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