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Medical Forum / Diseases and Disorders / AIDS / March 2005

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HIV and pregnancy

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Greg - 17 Mar 2005 06:38 GMT
Hey everyone:  I was looking to perhaps hear from some couples where the
husband was HIV positive, and the wife wasn't, but where the couple had
children together without transmitting the disease to either wife or child.
I am HIV pos. but my wife isn't...we want to have a child of our own, and
the doctor is reassuring us that the chances of getting my wife infected are
slim to none (I've been undetectable for six years now).  But I need to get
some advice and hear maybe from some couples like us.

My email address isn't listed on here, so I would have to hear your replies
through the newsgroup.  Hope this is okay.....

Thanks!

Greg
PaulKing - 17 Mar 2005 09:03 GMT
STUDY EXPOSES MYTH OF SEXUAL TRANSMISSION

The 10-year Padian study observed sexually active couples in which one
partner was HIV positive.

The result: in 10 years, not one uninfected partner contracted HIV, even
though all participants admitted to having sex without condoms.

The study states, 'We followed up 175 HIV-discordant couples over time,
for a total of approximately 282 couple-years of follow up. The longest
duration of follow-up was 12 visits (6 years).

We observed no seroconversion [infection] after entry into the
study." In the three-year Stewart study (1985) not one male partner of
HIV-positive women contracted HIV. Prostitution is not even listed as an
HIV risk category by the CDC, because of the extremely low incidence of
HIV transmission to clients who have no other risk factors (i.e. drug
abuse).

These findings bolster the hypothesis of some AIDS scientists that chronic
malnutrition and other environmental factors, and not a
sexually-transmitted virus, are the causes of weakened immunity in people
diagnosed with one of the nearly 30 AIDS-defining diseases (which vary
from country to country).
GMCarter - 17 Mar 2005 12:07 GMT
>STUDY EXPOSES MYTH OF SEXUAL TRANSMISSION
>
>The 10-year Padian study observed sexually active couples in which one
>partner was HIV positive.

This is a COMPLETE lie and not what Padian said at all.

You should be sued for libel for this--and having repeated it OVER AND
OVER AND OVER despite being repeatly shown that this is a complete and
utter distortion.

        George M. Carter
Bennett - 17 Mar 2005 20:06 GMT
> STUDY EXPOSES MYTH OF SEXUAL TRANSMISSION
<snip>
> We observed no seroconversion [infection] after entry into the
> study."

Alternatively you can read this report:

378 serodiscordant couples, no other risk factors for HIV outside of
exposure to their HIV+ partner.

130 stopped having sex.  Of those 130, 40 died (average followup 20
months, quite a death rate).

Among condom users: zero transmissions in 124 couples.

Among inconsistent or non-condom users: 12 seroconversions in 121
couples.  Taking into account followup times that was around 4.8% per
year.

Try not to cherry pick your evidence young man.

Cheers

Bennett

******
A longitudinal study of human immunodeficiency virus transmission by
heterosexual partners. European Study Group on Heterosexual
Transmission of HIV.

de Vincenzi I.

European Centre for the Epidemiological Monitoring of AIDS, Hopital
National de Saint-Maurice, France.

BACKGROUND. Worldwide, the predominant mode of human immunodeficiency
virus (HIV) transmission is heterosexual intercourse, but the risk of
heterosexual transmission and the effectiveness of measures to prevent
it are not well defined. METHODS. We conducted a prospective study of
HIV-negative subjects whose only risk of HIV infection was a stable
heterosexual relationship with an HIV-infected partner. Every six
months the subjects were interviewed, tested for HIV, and counseled
about safe sexual practices. RESULTS. A total of 304 HIV-negative
subjects (196 women and 108 men) were followed for an average of 20
months. During the study, 130 couples (42.8 percent) ended their sexual
relationships, most often because of the HIV-infected partner's illness
or death. Of the 256 couples who continued to have sexual relations for
more than three months after enrollment in the study, only 124 (48.4
percent) used condoms consistently for vaginal and anal intercourse.
Among these couples, none of the seronegative partners became infected
with HIV, despite a total of about 15,000 episodes of intercourse.
Among the 121 couples who used condoms inconsistently, the rate of
seroconversion was 4.8 per 100 person-years (95 percent confidence
interval, 2.5 to 8.4). Eleven couples refused to answer questions about
condom use. The risk of transmission increased with advanced stages of
HIV infection in the index partners (P < 0.02) and with genital
infection in the HIV-negative partners (P < 0.04). Withdrawal to avoid
ejaculation in the vagina had a protective effect in uninfected women
(P < 0.02). CONCLUSIONS. Consistent use of condoms for heterosexual
intercourse is highly effective in preventing the transmission of HIV.
Among couples not using condoms regularly, the risk of HIV transmission
varies widely.
PaulKing - 19 Mar 2005 09:58 GMT
AS OF 1999, IT WOULD SEEM THE ROCHE AMIPLICOR HIV-1
MONITOR TEST IS THE MOST POPULAR PCR "VIRAL LOAD" TEST.

"The Roche Amplicor HIV-1 Monitor(TM) test kit,  approved by the FDA, was
used by more than 70% of  the laboratories reporting results."

http://www.phppo.cdc.gov/MPEP/pdf/rna/9902rnaa.pdf

The test kit list: http://www.fda.gov/cber/products/testkits.htm 

AMPLICOR HIV-1 MONITOR(TM) TEST

"The AMPLICOR HIV-1 MONITOR Test is not intended to be used  as a
screening test for HIV or as a diagnostic test to confirm
the presence of HIV infection."

http://www.fda.gov/cber/pma/p9500054.htm
http://www.fda.gov/cber/PMAlabel/P9500054LB.pdf 

NucliSens(R) HIV-1 QT -- HIV QT Nov. 13, 2001

"The NucliSens(R) HIV-1 QT assay is not intended to  be used as a
screening test for HIV-1 nor is it to  be used as a diagnostic test to
confirm the presence  of HIV-1 infection."
http://www.fda.gov/cber/pma/p0100010.htm
http://www.fda.gov/cber/pmalabel/P0100010LB.pdf 

COBAS AmpliScreen HIV-1 Test, version 1.5
Approval Date: 12/19/2003

"This test is not intended for use as an aid in diagnosis."

http://www.fda.gov/cber/products/hiv1roc121903.htm
http://www.fda.gov/cber/label/hiv1roc121903LB.pdf 

Procleix(R) HIV-1/HCV Assay -- IN0076-01, Rev. A
Approval Date: 6/4/2004

"The Procleix HIV-1 Discriminatory Assay may be used as an  aid in the
diagnosis of HIV-1 infection." 

http://www.fda.gov/cber/products/hivhcvgen060404.htm
http://www.fda.gov/cber/label/hivhcvgen060404LB.pdf

GENETIC SYSTEMS (TM) rLAV EIA

"The rLAV EIA is intended to be used as a screening test for  donated
blood or plasma and as an aid in the diagnosis of  infection with HIV-1."

http://www.fda.gov/cber/products/hiv1gen062998.htm
http://www.fda.gov/cber/sba/hiv1gen062998S.pdf

VIRONOSTIKAT(R) HIV-1 PLUS O MICROELISA SYSTEM

"System is intended for use as an aid in diagnosis of  infection with
HIV-1. It is not intended for use in  screening blood donors."

http://www.fda.gov/cber/pma/P020066.htm
http://www.fda.gov/cber/pmalabel/P020066LB.pdf

THE CAMBRIDGE BIOTECH HIV-1 WESTERN BLOT KIT

"Accurate diagnosis of HIV-1 infection is important  in determining an
individual's risk for  developing AIDS. Accuracy is complicated by
false-positive and false-negative (EIA) results. It  would appear that in
some limited infections, a  compartmentalized response occurs in which
expression of HIV-1 or its respective Immune  response is limited to a
restricted number of organs  and tissues.(17)"

"Slight ambiguities exist in the designation of the  molecular weights of
the HIV-I antigens. The designations  listed in Figure 1 have been
established by both internal  testing with known markers and consensus of
published
literature.(5-10)"

"Although a blot POSITIVE for antibodies to HIV-1  indicates infection
with the virus..."
"POSITIVE blot results using any specimen type  (serum, plasma, or urine)
should be followed with  additional testing. Such testing may rely on
alternative test methods or specimen types. The  clinical implications of
antibodies to HIV-1 in an  asymptomatic person are not known."

"The sensitivity ... using urine was evaluated by  comparing the urine
results to the results obtained  from testing paired serum specimens
collected from  individuals who were HIV-1 seropositive and from
individuals clinically diagnosed as AIDS patients."

http://www.fda.gov/cber/products/hiv1cam052898.htm
http://www.fda.gov/cber/label/hiv1cam052898Lb.pdf 

OraSure(R) HIV-1 Western Blot Kit

"The OraSure HIV-l Western Blot Kit is an in vitro  qualitative assay for
the detection of antibodies to  individual proteins of the Human
Immunodeficiency  Virus Type 1 (HIV-l) in human oral fluid specimens
obtained with the OraSure HIV-l Oral Specimen  Collection Device.

The OraSure HIV-l Western Blot Kit is not intended  for use with blood,
serum/plasma or urine specimens,  or for screening or reinstating
potential blood donors."
http://www.fda.gov/cber/pma/P950004.htm
http://www.fda.gov/cber/pmalabel/P950004Lb.pdf 

Reveal(TM) Rapid HIV -1 Antibody Test
"The Reveal" Rapid HIV -1 Antibody Test is intended for  use as a
point-of-care test to aid in the diagnosis of  infection with HIV -1. This
test is suitable for use in  multi-test algorithms designed for
statistical validation of rapid HIV test results."

http://www.fda.gov/cber/pma/p000023.htm
http://www.fda.gov/cber/pmalabel/P000023LB.pdf
Bennett - 19 Mar 2005 16:56 GMT
So you quote a bunch of sreening tests that can't be used for
diagnosis, and a bunch of diagnostic tests that can't be used for
screening....your point being?

HIV tests are no different from any other diagnostic test (or "aid to
diagnosis" if you prefer).  Go learn about molecular diagnostics.  Go
learn about FDA approval and restrictions.  They are ultra-paranoid and
have no common sense, but this errs heavily on the side of protecting
the public.

Once again you're quoting selectively, but at least with some semblance
of accuracy.  The trouble is you seem to be making entirely irrelevant
points.

E.g. "The OraSure HIV-l Western Blot Kit is not intended  for use with
blood,
serum/plasma or urine specimens"

Err...but it's intended for testing on saliva.  Sheesh.

At least you managed to track down the product literature on the FDA
site.  Maybe there is hope for you yet, if you can be bothered to
understand it.

Bennett
GMCarter - 17 Mar 2005 12:09 GMT
Sperm washing can reduce the risk of transmission. I don't know a lot
about it, but there are ways to conceive a child without putting your
wife at risk.

You might also consider adopting a child. There are SO many kids who
need a loving home.

Best of luck on your journey together.

        George M. Carter

>Hey everyone:  I was looking to perhaps hear from some couples where the
>husband was HIV positive, and the wife wasn't, but where the couple had
[quoted text clipped - 10 lines]
>
>Greg
 
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