Medical Forum / Diseases and Disorders / AIDS / October 2005
South African Babies Have Crying Need for Improved HIV Test
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Alex - 25 Sep 2005 18:42 GMT Note the contradictions ("The tests we have at our disposal are cheap but they do the job as quickly as the DNA test that we can't afford" - so they don't need better tests, which they can't afford right now?), the fallacies ("[ELISA]'s a cheap, effective procedure that can spot 99 percent of all HIV infections with only two false positives per thousand" - there are huge false positive numbers in surveys, especially in populations with few positive tests) and the downright ignorance ("In an ELISA test, blood is drawn and mixed with chemicals that detect the antibodies" - ELISA does not detect antibodies or viruses, just individual proteins that are assumed to be unique to HIV antibodies, but aren't or are similar enough not to cause false positive test results).
This is from a publication that is supposed to be better informed.
http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2000/12/04/BU1 42009.DTL
"The tests we have at our disposal are cheap but they do the job as quickly as the DNA test that we can't afford," Stevens said.
Today the most common test for AIDS is ELISA, short for Enzyme-Linked Immunosorbent Assay. It's a cheap, effective procedure that can spot 99 percent of all HIV infections with only two false positives per thousand. It is used throughout the world, including South Africa.
In an ELISA test, blood is drawn and mixed with chemicals that detect the antibodies -- the natural defensive cells -- that appear within weeks after a person is infected with HIV.
Although the test works well for adults, Stevens said, it simply doesn't provide enough information when working with HIV-suspected infants. This is because the child is born with antibodies from infected mothers. These antibodies can linger in the child's blood stream for anywhere from several weeks to several months after birth.
Phillip - 26 Sep 2005 07:16 GMT "Alex" <avdeelen.REMOFETHIS1@wanadoo.nl> wrote...
> Note the contradictions ("The tests we have at our disposal are cheap but > they do the job as quickly as the DNA test that we can't afford" - so they > don't need better tests, which they can't afford right now?)... But a decade or two ago, South Africa was the richest nation on the African continent. I wonder what happened to suddenly make it so poor? Also, the industrialized nations surely have dumped billions of dollars on South Africa in addition to other African nations for HIV prevention and treatment, where did those billions go? Of course we know where they went, they are sitting in Swiss bank accounts like every other penny in foreign aid ever given to a third-world country. Who's the dictator of South Africa, Mugabe or Mbeki or Mfume or something, how much foreign aid is sitting in his own personal Swiss bank account?
And to be fair, the same thing is happening in the USA, with local health departments taking federal funds and failing to do anything to stop the spread of the virus. Just like San Francisco, perhaps we should tell South Africa that they're getting ten million dollars and that's ALL, and then they might spend their allotment a little more carefully because they know that's all they get. If the money winds up in Switzerland, tough sh.t, their constituents are gonna die. If their constituents want to live, then they should behead the officials and file a legal claim against Banque du Zurich to recover the stolen money.
greg78 - 29 Sep 2005 10:43 GMT Oh my! I had to respond to this completely inane post. Phillip clearly doesn't have the foggiest idea what he is talking about, so I will have to attempt to educate him (if that is possible). What is my expertise? Well, firstly I was born in and have LIVED in South Africa all my life. Secondly, I know a bit about "HIV" and the "tests" for it.
Firstly, Thabo Mbeki IS the President of South Africa and he is not a dictator. He has been elected to two consecutive terms in free and fair elections. Does Phillip not recall that South Africa used to be ruled under the Apartheid system and that in 1994 Nelson Mandela was elected to the Presidency in the country's first elections in which all its citizens were eligible to vote? What rock has Phillip been living under?
Secondly, South Africa is STILL the richest nation in Africa. But Africa is a VERY poor continent and South Africa's average annual income is still less than $5000 a year I believe.
Thirdly, although our country does struggle with issues of corruption it is a darnside less corrupt than most other African nations. We have received some money for AIDS awareness, but South Africa is developed enough to provide basic health resources for its people. We do not receive BILLIONS of dollars of aid. For Phillip's information, the Johannesburg Stock Exchange is in the top 20 biggest in the world and I think at last count South Africa had the 15th largest economy in the world. We also have an advanced financial and logistical infrastructure and our economy is mostly manufacturing. SO, we are not some tinpot African nation!
Thabo Mbeki does NOT have millions sitting in any Swiss Bank account. That would not wash in South Africa, I can assure you. If Phillip kept himself at all abreast of international news he would know that our president is highly respected worldwide for his ethics.
Now onto this subject of HIV tests for babies. Once again, if Phillip did some very simple research (as I did) this would be no great mystery to him either. The HIV tests are not recommended for use on infants because of the issue of maternal antibodies being transferred from the mother. Thus it would be impossible to determine if the antibodies had been generated by the neonate in response to HIV particles or if there was no HIV present in the baby and the baby had "inherited" the antibodies.
So how to get around this problem? Well, the clevers at the CDC proclaim that with neonates, it is acceptable to use a PCR test to determine HIV infection. This all sounds perfectly logical, because PCR is supposed to pick up HIV genetic material. Funny then, that the same test is NOT to be used to diagnose HIV infection in adults. One would think that this would be the most accurate diagnosis. But clearly the CDC and other regulators don't think so. Surely the PCR "viral load" test should be the gold standard if it only picks up HIV genetic material? How can you have HIV genetic material if you don't have the virus?
So we have this bizarre situation where PCR tests are suitable for diagnosis of HIV infection in babies but not in adults. Go figure. Try and get a sensible answer from a proponent of the HIV/AIDS hypothesis on that one. What will you hear? A lot of hot air, posturing, obfuscating, obscuring and general BS.
With regards the availability of these tests in South Africa, they are available although they are pricy. But I don't see how it matters much because these days they're fond of dosing mothers up on DNA chain terminators (oops AZT doesn't even do that, does it?) before the poor blighters are even born.
And just finally a comment on the general tone of Phillip's most offensive of posts. It is clear from your post that you are a white supremacist of the most insidious ilk. I mean you say things like "perhaps we should tell South Africa that they're getting ten million dollars and that's ALL". Oh well gee thanks, you know us darkies down here, we need all the help that we can get from the white "boss". And another pearler from your warped perception of the world: "If their constituents want to live, then they should behead the officials and file a legal claim against Banque du Zurich to recover the stolen money." Oh yes, because black people are all uncivilised barbarians who regularly decapitate their leaders. Funny how they would behead the leader and then file a legal claim. Don't you know, Phillip, most blacks can't read or write either? So, Phillip why don't you go an pull that KKK mask over your head again and return your head to the anal passage that it must have emerged from momentarily to write your post.
DavidT - 29 Sep 2005 12:12 GMT Phillip, you are confusing President Mbeki with his next-in-command, vice president Jacob Zuma (Dismissed because of fraud/corruption). Mind you, there is a nasty whiff in the air- who says it doesn't go right to the top? In the 1960s and 70s, donor countries pumped millions into the ANC's coffers - helping the downtroden masses fight evil apartheid. Funny, no-one seems to know where all the money went.
A bit of it spent on drugs to prevent mother-child HIV transmission in SA (resisted at each and every turn by Mbeki and his asinine health minister Manto Msimang) would do a lot to restore the country to a health ststus befitting the "richest" in Africa. (or is that Nigeria, I forget.....if you count the billions that Nigerian princesses and wives of ex-leaders seem to be keen to get us all to put in our bank accounts, it probably is Nigeria first, SA second)
Mugabe is of course the leader of that well-governed haven of peace and democracy, Zimbabwe, which has been brought from its status as bread-basket of Africa to a famine-scourged land by his enlightened policies of land reform (oops, I mean only in those areas of the country which are ambivalent to his wonderful rule - funy coincidence that).
Anyhow, back on track- HIV testing with confirmatory ELISA is the test employed for dtection of HIV infection. It is invalid in infants because of placental transfer of antibodies, so the docs use another method instead. Not ideal, just practical common sense. The fact that the test (PCR) is not meant to be employed as a primary diagnostic test is just one of those simple facts of life.
Pragmatism rules, but denialists work themselves into a froth of indignation as a result. Of course, they will tell you this means HIV does not exist. Rather like running your car into a brick wall and saying "I usually spot brick walls using my keen eyesight. However, today I failed to see one because I was driving with my eyes closed. I don't usually use a car to find brick walls, and hey, even the car manufacturers don't really suggest that this is how I detect them. Therefore I'll just ignore my car wreck and pretend the brick wall never existed...."
greg78 - 29 Sep 2005 12:42 GMT Unbelievable - "The fact that the test (PCR) is NOT meant to be employed as a primary diagnostic test is just one of those simple facts of life." David, dissidents get into a "frothy" not so much because the test is not a "primary diagnostic" test but because there is a clear conflict between saying the test is diagnostic in infants but not in adults. This IS a valid scientific argument and you just fob it off by saying that it's a "fact of life". "Don't question the docs, you crazy denialists, just accept whatever illogical nonsense we dish up and get on with it."
I would also take issue with the statement that "pragmatism rules" in this case. David, are you saying: "it doesn't make any sense, but it works and so just accept it."? I think that what should rule in this case is a workable theory that has no space for paradoxes such as the one described above. I will make my point again: if the PCR test detects HIV genetic material it should be good as a diagnostic test for neonates AND adults. Can David supply us with any reference for why the PCR test would be a more accurate test for diagnosis of infection in babies? In this case, evidence and theory should rule, not pragmatism.
And for the record, the fact that the PCR is incapable of repeatedly detecting "HIV genetic material" is not the basis for me being sceptical about the existence of HIV. My reasons are far more substantial - PCR is only one of the innumerable inconsistencies thrown up by the HIV/AIDS hypothesis.
DavidT - 29 Sep 2005 13:16 GMT >PCR is only one of the innumerable inconsistencies thrown up by the HIV/AIDS hypothesis.
All hypotheses have inconsistencies. Science accepts the best possible theory until a better one comes along. The concept that AIDS is caused by something nebulous other than HIV, like lifestyle or drugs, has so many inconsistencies as to be completely untenable. If you have another theory, lets hear it.
greg78 - 29 Sep 2005 14:37 GMT Well, I happen to disagree with you that the lifestyle/malnutrition argument has so many inconsistencies so as to be untenable, but that is another argument. I agree, some (not all) hypotheses have inconsistencies - those are the ones that can never be deemed to be fact. (In case you are unaware of this, hypotheses which are found to have NO inconsistencies are then deemed to become laws. For example, Newton's Law of Gravitational Force.) So, if you think that the HIV/AIDS hypothesis has inconsistencies then you have essentially conceded your argument - it is not fact (or law) that HIV causes AIDS. In some other fields it may be acceptable to accept an hypothesis until a better one comes along, but I think that in this case, this approach is simply not good enough. Why? Because peoples' LIVES are at stake. Therefore, it is, in my opinion, better to say "we don't know what is making you sick", than to say well "we have some halfbaked idea which results in us putting you on these meds that will kill you in the long run anyway, but you better take it cos we don't know what else to do".
If you concur that the AIDS hypothesis has inconsistencies (as I interpret you statement: "All hypotheses have inconsistencies.") then you should be quite happy to allow people with other ideas to investigate them and NOT vilify and humiliate them because they have dared to questioned an unproven fact which is essentially an "hypothesis".
Also, in this particular debate, you are proposing the hypothesis, therefore it is up to YOU to defend your argument. I, on the other hand, am opposing your hypothesis and I DON'T have to supply an alternative one to convince you that the current one is WRONG! But, as I'll point out again, you acknowledge that your hypothesis is wrong because you acknowledge that it has inconsistencies!
DavidT - 29 Sep 2005 19:09 GMT >you acknowledge that your hypothesis is wrong because you acknowledge that it has inconsistencies! Logical fallacies. HIV/AIDS is not a single hypothesis, but multiple strands of evidence woven into an explanation of what we observe and more importantly, can predict - basic tenets of science. Yes there may be some things we don't know - but science has progressed by building upon what we do know first, and finding out about other things as we go along. With your attitude, we'd still be in the dark ages - "Well, we can't explain that to our total 100%satisfaction, so let's completely discard the hypothesis".
You shouldn't quote Newton's laws as having no inconsistencies - it was precicely because of inconsistencies in them that Einstein was prompted to develop his theory of relativity.
Life isn't all hard science fact. Its a game of balancing risks and making judgments. There is overwhelming evidence that the drugs prolong life and prevent progression to AIDS/death. Even if the scientists had absolutely no idea what caused "AIDS", or why the drugs worked, people would take them, as I would if I had HIV that was damagingf my immunity. If you wish to argue that the mechanisms of apoptotic CD4 lymphocyte death is incompletely understood, and therefore convince yourself that this is an inconsistency big enough to invalidate the entire theory of HIV pathogenesis, then that is your choice.
If I wished to ignore that I have "HIV", then fine - I'll live or die with the consequences (I don't BTW). But If I make others suffer by my own choices, like Christine did, or Mbeki does, or Pasquerelli did, then that is unacceptable in my book.
Iconoclaster - 30 Sep 2005 00:15 GMT >"HIV/AIDS is not a single hypothesis, but multiple strands of evidence woven into an explanation of what we observe and more importantly, can predict - basic tenets of science."
Ah, yes. That's absolutely true. And the more we observe, th more inconsistencies we find. So... another strand is woven into the fabrik of HIV/AIDS. Not based on any evidence, mind you; just added by decree. Do patients who are HIV+ die of liver disease? Well, don't blame the ARVs; just invent another virus that attacks the liver. Are there Long-Term-NonProgessors? Just tell the Moronic Majority that there are special proteins ("defensins") protecting these people who don't abide by the rules.
>"Yes there may be some things we don't know - but science has progressed by building upon what we do know first, and finding out about other things as we go along."
There have been times when it worked that way. But for heaven's sake, man! You and your ilk have had 21 years, and you have not come up with something that's even halfway believable! We're still no further than we were in 1983, and those who wanted to pursue other avenues of research have been blocked. I might add that a massive amount of money has been relocated from taxpayers' pockets to those of pharma stockholders and corrupt scientists. Is this how science has to move forward?
Gary Stein - 04 Oct 2005 19:27 GMT > >"HIV/AIDS is not a single hypothesis, but multiple strands of evidence > woven into an explanation of what we observe and more importantly, can [quoted text clipped - 20 lines] > relocated from taxpayers' pockets to those of pharma stockholders and > corrupt scientists. Is this how science has to move forward? No it is you and your denialist coworkers who are completely lacking evidence to back up there statements. You especially seem completely unable to do anything other then posting inane personal opinions that are so baseless in fact as to be laughable.
Gary Stein
pauleewhiting - 04 Oct 2005 21:01 GMT "No it is you and your denialist coworkers who are completely lacking evidence to back up there statements. You especially seem completely unable to do anything other then posting inane personal opinions that are so baseless in fact as to be laughable."
My GOD, Gary, you've done it again!
Why, why, why do we torture ourselves so?
Why do we keep submitting ourselves to such intelligent, cutting remarks?
That's it! I am hereby renouncing my membership in Club Denial...
..I just wish I hadn't wasted all that time learning the secret handshake!
-Paul Whiting
Gary Stein - 04 Oct 2005 19:23 GMT > Well, I happen to disagree with you that the lifestyle/malnutrition > argument has so many inconsistencies so as to be untenable, but that is [quoted text clipped - 12 lines] > the long run anyway, but you better take it cos we don't know what else to > do". So your saying that because you don't understand the science behind HIV and AIDS you think all people should ignore the two decades of clinical evidence that shows no inconsistencies as to the deadly nature of AIDS? By clinical evidence I am not talking about drug trials, or HIV isolation, but rather the data collected from 100's of thousands of individual patients medical records. In every retrospective study of AIDS patients medical records there simply are no inconsistencies, falling CD4 counts and rising Viral Load numbers correlate directly with patient health and survival rates in every case.
> If you concur that the AIDS hypothesis has inconsistencies (as I interpret > you statement: "All hypotheses have inconsistencies.") then you should be > quite happy to allow people with other ideas to investigate them and NOT > vilify and humiliate them because they have dared to questioned an > unproven fact which is essentially an "hypothesis". Which of us every said we are not "happy to allow people with other ideas to investigate" what we ask is that that investigation actually produce some data that backs up your statements but for some reason your side of the argument has consistently been unable to accomplish that simple task.
> Also, in this particular debate, you are proposing the hypothesis, > therefore it is up to YOU to defend your argument. I, on the other hand, > am opposing your hypothesis and I DON'T have to supply an alternative one > to convince you that the current one is WRONG! But, as I'll point out > again, you acknowledge that your hypothesis is wrong because you > acknowledge that it has inconsistencies! I propose nothing other then looking at the evidence provided by the clinical data and educating yourself so that you can understand what it is you are reading before you expose personal opinions that could cost someone there life.
Gary Stein
pauleewhiting - 04 Oct 2005 20:50 GMT "I propose nothing other then looking at the evidence provided by the clinical data and educating yourself so that you can understand what it is you are reading before you expose personal opinions that could cost someone there life."
So, Gary, let me just go out on a limb here...
How is possble for the dissidents to have such *magical powers of pursuation* that we can convince intelligent adults to abandon their faculties of reason and jump head-long into some sort of denialist abyss?
Do you honestly think the folks out there who are HIV+ are just too f.cking stupid to figure out whether, or not, the doctors and scientist who disagree with the HIV theory of AIDS are full of it?
How dumb do you think these people are?
Don't you *trust them* to make their own informed decisions about their health based on *all available* information?
What? Do you think they need to have their hand held while they go to the bathroom? Are they just simple-minded, little children to you?
I *trust them* to make their own informend decisions.
I think they are *fully capable* of deciding for themselves whether the dissidents are full of sh.t.
And I *believe* in their ability to be thinking, responsible adults.
Do you, Gary?
-Paul Whiting
Gary Stein - 05 Oct 2005 19:30 GMT > "I propose nothing other then looking at the evidence provided by the > clinical data and educating yourself so that you can understand what it is [quoted text clipped - 6 lines] > pursuation* that we can convince intelligent adults to abandon their > faculties of reason and jump head-long into some sort of denialist abyss? It is human nature to want to hear that everything is all right when just the opposite is true. That said after the impact of an AIDS diagnosis has had time to get beyond the patients initial reaction the vast majority of patients do indeed regain there ability to think rationally about the situation. It is only those who seem to get stuck in the spot of needing to deny the danger that get caught up in your propaganda.
> Do you honestly think the folks out there who are HIV+ are just too > f.cking stupid to figure out whether, or not, the doctors and scientist > who disagree with the HIV theory of AIDS are full of it? No I have maintained just the opposite in fact, that is why the numbers of denialists has remained so stable over the years. The vast majority of people do in fact see that you have no evidence to back up your ideas and come to the understanding that denialists ideas are faith based rather than science based.
> How dumb do you think these people are? A great deal smarter then you protray yourself as being.
> Don't you *trust them* to make their own informed decisions about their > health based on *all available* information? See above.
> What? Do you think they need to have their hand held while they go to the > bathroom? Are they just simple-minded, little children to you? [quoted text clipped - 5 lines] > > And I *believe* in their ability to be thinking, responsible adults. As do I, again that is why after 20 years there is still only about a thousand or two who believe as you do, while the rest of the world understands that HIV = AIDS, and ARV is the currently best available treatment for symptomatic AIDS.
Gary Stein
wilyretrovirus - 05 Oct 2005 21:25 GMT "It is human nature to want to hear that everything is all right when just
the opposite is true. That said after the impact of an AIDS diagnosis has
had time to get beyond the patients initial reaction the vast majority of
patients do indeed regain there ability to think rationally about the situation. It is only those who seem to get stuck in the spot of needing to deny the danger that get caught up in your propaganda."
Sorry, Gary, BS alert.
I haven't met one person that fits the above profile.
The HIV mythology runs quite deep. You should give yourself a nice, big pat on the back for that.
pauleewhiting - 06 Oct 2005 05:44 GMT "I *trust them* to make their own informend decisions.
I think they are *fully capable* of deciding for themselves whether the dissidents are full of sh.t.
And I *believe* in their ability to be thinking, responsible adults..."
"It is human nature to want to hear that everything is all right when just the opposite is true. That said after the impact of an AIDS diagnosis has had time to get beyond the patients initial reaction the vast majority of patients do indeed regain there ability to think rationally about the situation. It is only those who seem to get stuck in the spot of needing to deny the danger that get caught up in your propaganda."
Brian Mailman - 06 Oct 2005 18:23 GMT > And I *believe* Oh, great!! YOU'RE the one that keeps Tinkerbell alive!
B/
Fondoo - 06 Oct 2005 23:34 GMT pauleewhiting wrote:
> And I *believe* Oh, great!! YOU'RE the one that keeps Tinkerbell alive!
B/
Now that was funny
pauleewhiting - 09 Oct 2005 03:20 GMT >pauleewhiting wrote: > [quoted text clipped - 5 lines] > > Now that was funny Thanks! I aim to TEASE!
-Paul Whiting
Iconoclaster - 29 Sep 2005 23:57 GMT >"The concept that AIDS is caused by something nebulous other than HIV, like lifestyle or drugs, has so many inconsistencies as to be completely untenable."
But what could be more nebulous than HIV, Master David? The poppers and other street drugs I've seen many people use, were very real. Nothing nebulous about it (except maybe to the users themselves). The pharmacology of most of these drugs is rather clear. So are the effects of sleep deprivation and malnutrition. All these things are far less nebulous than a virus that nobody can see, nobody can isolate, and is believed to have properties that no other virus of this same (supposed) class has.
DavidT - 30 Sep 2005 17:35 GMT >The poppers and other street drugs I've seen many people use, were very real. Nothing nebulous about it (except maybe to the users themselves). The pharmacology of most of these drugs is rather clear. So are the effects of sleep deprivation and malnutrition. Careful now- I hope you are not accusing Christine of feeding her baby girl poppers or starving her.
> All these things are far less nebulous than a virus that nobody can see, nobody can isolate, and is believed to have properties that no other virus of this same (supposed) class has. Let's all conveniently forget about SIVs and SHIVs then shall we - no, no similarity there obviously!
Iconoclaster - 01 Oct 2005 00:42 GMT (Hmmm! I'm gonna enjoy this one)
>"Careful now- I hope you are not accusing Christine of feeding her baby girl poppers or starving her."
Of course I'm not suggesting any such thing. Children do get sick, you know. There are many pediatric diseases (and I've had them all, some 100 years ago). Personally, I would not have treated a child's ear infection with antibiotics (too dangerous, and usually ineffective). But I'm not an M.D., and I don't treat patients. But the point is that children get sick from many causes, and unfortunately, some die. The U.S. has never been in a favorable position on the scale of child mortality (compared to other developed nations). But you, and other apologists, have a one-track mind. You simply won't accept that Eliza Jane Scovill could have died from any other cause than HIV. It just has to be. Otherwise your virtual world will fall apart.
>"Let's all conveniently forget about SIVs and SHIVs then shall we - no, no similarity there obviously!"
You know very well I read that article on SHIVs, and commented on it. Yes, there IS a similarity with HIV: Sloppy science! Like not performing control experiments. Do you know what's in the supernatant of a cell culture?
Gary Stein - 04 Oct 2005 19:51 GMT > (Hmmm! I'm gonna enjoy this one) > [quoted text clipped - 12 lines] > accept that Eliza Jane Scovill could have died from any other cause than > HIV. It just has to be. Otherwise your virtual world will fall apart. Pot Kettle Black, it is your side that has much more to lose should the autopsy show that the poor child was in deed HIV infected and PCP was found in her lungs. Because if that is the finding then your entire thesis is shown to be false while if the opposite is found it has no impact on the HIV=AIDS argument at all until Christine's HIV status is made clear.
Gary Stein
Iconoclaster - 01 Oct 2005 23:55 GMT >"Let's all conveniently forget about SIVs and SHIVs then shall we - no, no similarity there obviously!"
Oh, stop waving these SHIVs in my face! I already told you that paper sucks, and I told you why. No control experiment without "virus" Do you have any idea what kind of crap is present in the supernatant of a cell culture?
Fondoo - 03 Oct 2005 08:15 GMT I got Defensins!! ba ha ha ha ha ha ha ha!!!
Gary Stein - 04 Oct 2005 19:46 GMT > >"The concept that AIDS is caused by something nebulous other than HIV, > like lifestyle or drugs, has so many inconsistencies as to be completely [quoted text clipped - 3 lines] > other street drugs I've seen many people use, were very real. Nothing > nebulous about it (except maybe to the users themselves). Why is it that the hundreds of studies on poppers and street drugs have never shown them to have any correlation direct or indirect to AIDS? How do you explain the fact that the vast majority of street drug users never have any symptoms of AIDS and all the ones that do are HIV positive?
> The pharmacology of most of these drugs is rather clear. So are the > effects of sleep deprivation and malnutrition. Yes they are and they have nothing in common with AIDS.
> All these things are far less nebulous than a virus that nobody can see, > nobody can isolate, and is believed to have properties that no other > virus of this same (supposed) class has. Yes again correct but sadly for you all of your "far less nebulous" items are in fact so clear that it can be said with great specificity that they have absolutely no relation to AIDS.
Gary Stein
pauleewhiting - 04 Oct 2005 21:13 GMT "The pharmacology of most of these drugs is rather clear. So are the effects of sleep deprivation and malnutrition.
Yes they are and they have nothing in common with AIDS."
"You won't get any argument from any one hear on MHA as to the importance of diet/nutrition, clean water, and palative health care for people everywhere around the world. That said while all the above can and does slow the progression of AIDS it is by no means sufficient to treat someone who has a less then 200 CD4 Tcell count."
"The only way to ultimately treat AIDS in concert with good nutrition, clean water and palative health care is with ARV would you agree with that statement?"
"It seems odd that that should be the case in that the importance of diet and nutrition in treating AIDS patients has been recognized in the west since the beginning of the epidemic."
David Canzi -- non-mailable - 30 Sep 2005 05:55 GMT >Unbelievable - "The fact that the test (PCR) is NOT >meant to be employed as a primary diagnostic test is just one of those >simple facts of life." David, dissidents get into a "frothy" not so much >because the test is not a "primary diagnostic" test but because there is a >clear conflict between saying the test is diagnostic in infants but not in >adults. In adults, the PCR test is less reliable than the antibody tests. In infants, the antibody tests are less reliable than the PCR test. Infants carry antibodies to things they haven't been exposed to, because they got those antibodies from their mother. You are straining at gnats and making theatrical gagging sounds.
 Signature David Canzi "I am not denying anything." -- Celia Farber
pauleewhiting - 30 Sep 2005 06:38 GMT "In adults, the PCR test is less reliable than the antibody tests."
David, if that's the case, then why is the PCR used to detect someone's "viral load"?
Isn't detecting how much actual virus someone has in his or her blood a pretty good indication of whether or not they have the HIV virus in the first place?
Thus, if the PCR is so darned accurate in counting actual virus particles, why isn't it used to diagnose HIV infection, instead of simply looking for antibodies to HIV?
After all, there are a lot of antibodies to other diseases and conditions (including pregnancy) that can a cross-reaction on the HIV tests, right?
And the PCR has no cross-reactivity, since it's literally counting the amount of actual HIV virus in a person's blood, yes?
greg78 - 30 Sep 2005 11:32 GMT Paulee
I think we will ask this question until we are blue in the face, and we will ask it in hundred different ways, and in the end we will have to accept what you and I already know. They don't have an answer for our questions. Their beloved theory can't explain it. What we will hear is a lot of stuff basically telling us to stop being like "gnats" and screaming "theatrically". Oh wow, that's definitely going to stop me from wanting to know the answer.
Oh and by the way, I don't deny anything, either.
pauleewhiting - 01 Oct 2005 00:36 GMT "I think we will ask this question until we are blue in the face, and we will ask it in hundred different ways, and in the end we will have to accept what you and I already know. They don't have an answer for our questions. Their beloved theory can't explain it. What we will hear is a lot of stuff basically telling us to stop being like 'gnats' and screaming 'theatrically'. Oh wow, that's definitely going to stop me from wanting to know the answer."
Yes, Greg, along with the question as to how, precisely, the entire heterosexual pandemic of AIDS is occurring only on the continent of Africa when "HIV" has spread worldwide.
David Canzi -- non-mailable - 01 Oct 2005 03:47 GMT >"In adults, the PCR test is less reliable than the antibody tests." > >David, if that's the case, then why is the PCR used to detect someone's >"viral load"? Detection and measurement are different problems.
>Isn't detecting how much actual virus someone has in his or her blood a >pretty good indication of whether or not they have the HIV virus in the >first place? Viral load tests can't measure HIV at very low levels.
>Thus, if the PCR is so darned accurate in counting actual virus particles, How accurate is "so darned accurate" and who says PCR is that accurate?
 Signature David Canzi "I am not denying anything." -- Celia Farber
pauleewhiting - 01 Oct 2005 16:50 GMT "How accurate is "so darned accurate" and who says PCR is that accurate?"
You said it, not me...
FALSE POSITIVE VIRAL LOADS - What Are We Measuring? - By Matt Irwin - 2001
Abstract
"Polymerase chain reaction (PCR) and other RNA assays are being used with increasing frequency in a variety of fields of science and medicine, especially in the study of the human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome (AIDS). In spite of the widespread use of these tests, however, there are several inconsistencies that raise serious doubts about their accuracy. RNA assays are perhaps most heavily relied upon in the medical management of people diagnosed with AIDS and in people who test positive on the HIV antibody tests, where they are used to measure a person's "viral load". Because many important clinical decisions are made based on these tests, the highest standards of sensitivity and specificity should be required."
"The most significant inconsistency in RNA assays for people diagnosed HIV-positive is the presence of false positive viral loads, which occur commonly in 3% to 10% of people who have no risk factors for HIV and who test negative on the HIV antibody tests (people considered HIV-negative). In the United States, where the prevalence of HIV infection is about 0.4%, this false positive rate means that random screening using the viral load test would produce 30 to 100 false positives for every 4 true positives."
"Other inconsistencies include the finding that between 99.99% and 99.9999% of the HIV virions estimated by this method are not infectious, which raises questions about their ability to cause disease. This paper will review a number of studies that focus on false positive results on HIV RNA assays, and will also briefly review some of the other inconsistencies that raise questions about their accuracy. This review is not meant to be a comprehensive review, but rather to highlight the most serious problems and discuss their implications for management of HIV infection as well as their implications for furthur research. The most likely explanation for the findings to be reviewed in this paper is that much of the RNA measured by viral load assays does not come from HIV, but rather comes from other microbes and from normal human cells."
Conclusions
"While this paper does not explain the cause of false positive viral loads, it does demonstrate that there is a surprisingly high rate of false positives. This finding raises enough questions to advise caution regarding the current heavy reliance placed on them when making treatment decisions for people diagnosed HIV-positive."
"False positive viral loads occur commonly in 3 to 10% of people who are HIV negative, with the highest reported rate being 60%. The highest false positive viral load reported was in the range of 10,000 to 100,000 copies per milliliter, and it is possible that some values over 1.5 million also indicated false positives although no follow up data is available for these cases. This fact must be contrasted with the current practice of changing antiretroviral regimens if a person's viral load does not fall below 50, as described in Mylonakis et al.'s (2001) description of current practice guidelines."
"One hypothesis that could explain these findings is that HIV viral load assays commonly misidentify RNA from normal human cells and from other microbes as being from HIV. This hypothesis could be tested by measuring viral loads in acutely ill people with high RNA levels in their blood. Because anti-HIV medications reduce RNA synthesis in a wide variety of cells, the reductions in viral load that accompany the use of these medications may indicate a non-specific reduction in total RNA burden, as opposed to a specific reduction in HIV RNA. This argument is supported by the finding of Piatak et al (1993) and others that most people with high viral loads do not have culturable/infectious virus, and that even in people who do have culturable virus, between 99.99% and 99.9999% of the viruses are non-culturable and non-infectious. These "non-infectious" viruses may represent falsely elevated viral loads due to misidentification of RNA from human cells and other microbes."
"Another implication of the findings is that the diagnosis of HIV-infection continues to rely heavily on the ELISA and Western Blot antibody tests. The accuracy of these antibody tests and the experimental methodology used to determine their sensitivity and specificity should thus be carefully examined, especially since some authors consider false positives to be a problem with these tests as well (Proffitt et al. 1993, Challakeree et al. 1997, de Harven 1998a&b, Giraldo 1998, MacKenzie 1992, Papadopulos-Eleopulos et al. 1993, Sayre et al. 1996). A strong correlation between positive viral loads and positive HIV antibody tests is expected because the viral load tests are designed to look for RNA sequences that come from the proteins used in the antibody tests. If a person tests positive for the antibodies, they are likely to have RNA with the same code sequences in their blood because this RNA is used by the cells to code for these proteins. This means that a false positive HIV-antibody test is very likely to increase the risk of a false positive viral load."
"Furthur examination of what factors increase the risk of false positive or falsely elevated viral loads would be extremely valuable since many treatment decisions are currently based in viral load measurements. Until such research is undertaken, however, it is advisable to make treatment decisions based on a person's symptoms and on the presence of clinical illness, and not to rely heavily on viral load test results. If a person appears to be clinically worse even though their viral load has gone down, it may be advisable to reduce or stop the medications being administered. Much of the reduced viral load observed in this situation may be due to toxic effects on human cells. Likewise, if a person is clinically healthy even though their viral load is high and they are not on any anti-HIV medications, it may be advisable to withhold medication and instead encourage conservative health promoting measures that focus on nutritional, social, psychological, and spiritual health, rather than focusing on treatments whose primary goal is to reduce the person's 'viral load'."
Matt Irwin MD is a family practice resident who wrote several literature reviews on HIV and AIDS while attending medical school at George Washington University. He also holds a Master's degree in social work from the Catholic University of America. In addition to his interest in alternative views of HIV and AIDS, he specializes in health promotion with nutritional, psychological, social, and spiritual interventions, as well as classical homeopathy. He has a practice near Washington, D.C.
For the entire article, please see go to http://www.virusmyth.net/aids/data/miloads.htm
David Canzi -- non-mailable - 03 Oct 2005 06:57 GMT >"How accurate is "so darned accurate" and who says PCR is that accurate?" That question was written in response to this line by you: "Thus, if the PCR is so darned accurate in counting actual virus particles,"
When you argue against something the mainstream isn't saying, you deceive people into thinking the mainstream is saying that. It's a dishonest tactic. I wanted you to tell me how accurate the mainstream was claiming viral load tests are, in order to demonstrate that you're misrepresenting the mainstream. I guess that was like the angry father in a Bill Cosby skit saying to his son: "Go get me something to hit you with."
Now for the Matt Irwin article you quoted:
>FALSE POSITIVE VIRAL LOADS - What Are We Measuring? - By Matt Irwin - >2001
>"Polymerase chain reaction (PCR) and other RNA assays are being used with >increasing frequency in a variety of fields of science and medicine, [quoted text clipped - 7 lines] >are made based on these tests, the highest standards of sensitivity and >specificity should be required." Sensitivity and specificity are measures of a test's usefulness for deciding whether or not a person is infected. They don't apply to the use of a test to measure how much virus is present. In the very first paragraph, Matt irwin has already entered the twilight zone of irrelevancy.
 Signature David Canzi "I am not denying anything." -- Celia Farber
Fondoo - 03 Oct 2005 07:41 GMT Hey Bro they use the PCR test to test babies as per the IHO's 2005 guidlines,why does that sound so insane? Because they do admit it to picking up RNA other than HIV. But guess what? Two PCR's = Baby Chemo This is the crazy I just lived thru, I defy you to tell me this is ok and in my babies best interest
>"Polymerase chain reaction (PCR) and other RNA assays are being used with >increasing frequency in a variety of fields of science and medicine, [quoted text clipped - 7 lines] >are made based on these tests, the highest standards of sensitivity and >specificity should be required." Sensitivity and specificity are measures of a test's usefulness for deciding whether or not a person is infected. They don't apply to the use of a test to measure how much virus is present. In the very first paragraph, Matt irwin has already entered the twilight zone of irrelevancy.
 Signature David Canzi "I am not denying anything." -- Celia Farber Hey Bro they use the PCR test to test babies as per the IHO's 2005 guidlines,why does that sound so insane? Because they do admit it to picking up RNA other than HIV. But guess what? Two PCR's = Baby Chemo This is the crazy I just lived thru, I defy you to tell me this is ok and in my babies best interest
pauleewhiting - 03 Oct 2005 18:49 GMT "Sensitivity and specificity are measures of a test's usefulness for deciding whether or not a person is infected. They don't apply to the use of a test to measure how much virus is present. In the very first paragraph, Matt irwin has already entered the twilight zone of irrelevancy."
No, David, I am afraid the Twighlight Zone is strictly the territory of the apologists. Let's just take a quick gander at the disclaimer from the PCR, shall we?
PCR "Viral Load" 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." (Roche, Amplicor HIV-1 Monitor Test Kit, section "Intended Use")
So, David, if the PCR is "not intended to be used as a screening test for HIV or as a diagnostic test to confirm the presence of HIV infection" then why is it used to determine someone's "viral load?"
The things that make ya go "Hmmmmm..."
pauleewhiting - 01 Oct 2005 19:22 GMT "How accurate is "so darned accurate" and who says PCR is that accurate?"
You said it, not me...
FALSE POSITIVE VIRAL LOADS - What Are We Measuring? - By Matt Irwin - 2001
Abstract
"Polymerase chain reaction (PCR) and other RNA assays are being used with increasing frequency in a variety of fields of science and medicine, especially in the study of the human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome (AIDS). In spite of the widespread use of these tests, however, there are several inconsistencies that raise serious doubts about their accuracy. RNA assays are perhaps most heavily relied upon in the medical management of people diagnosed with AIDS and in people who test positive on the HIV antibody tests, where they are used to measure a person's "viral load". Because many important clinical decisions are made based on these tests, the highest standards of sensitivity and specificity should be required."
"The most significant inconsistency in RNA assays for people diagnosed HIV-positive is the presence of false positive viral loads, which occur commonly in 3% to 10% of people who have no risk factors for HIV and who test negative on the HIV antibody tests (people considered HIV-negative). In the United States, where the prevalence of HIV infection is about 0.4%, this false positive rate means that random screening using the viral load test would produce 30 to 100 false positives for every 4 true positives."
"Other inconsistencies include the finding that between 99.99% and 99.9999% of the HIV virions estimated by this method are not infectious, which raises questions about their ability to cause disease. This paper will review a number of studies that focus on false positive results on HIV RNA assays, and will also briefly review some of the other inconsistencies that raise questions about their accuracy. This review is not meant to be a comprehensive review, but rather to highlight the most serious problems and discuss their implications for management of HIV infection as well as their implications for furthur research. The most likely explanation for the findings to be reviewed in this paper is that much of the RNA measured by viral load assays does not come from HIV, but rather comes from other microbes and from normal human cells."
Conclusions
"While this paper does not explain the cause of false positive viral loads, it does demonstrate that there is a surprisingly high rate of false positives. This finding raises enough questions to advise caution regarding the current heavy reliance placed on them when making treatment decisions for people diagnosed HIV-positive."
"False positive viral loads occur commonly in 3 to 10% of people who are HIV negative, with the highest reported rate being 60%. The highest false positive viral load reported was in the range of 10,000 to 100,000 copies per milliliter, and it is possible that some values over 1.5 million also indicated false positives although no follow up data is available for these cases. This fact must be contrasted with the current practice of changing antiretroviral regimens if a person's viral load does not fall below 50, as described in Mylonakis et al.'s (2001) description of current practice guidelines."
"One hypothesis that could explain these findings is that HIV viral load assays commonly misidentify RNA from normal human cells and from other microbes as being from HIV. This hypothesis could be tested by measuring viral loads in acutely ill people with high RNA levels in their blood. Because anti-HIV medications reduce RNA synthesis in a wide variety of cells, the reductions in viral load that accompany the use of these medications may indicate a non-specific reduction in total RNA burden, as opposed to a specific reduction in HIV RNA. This argument is supported by the finding of Piatak et al (1993) and others that most people with high viral loads do not have culturable/infectious virus, and that even in people who do have culturable virus, between 99.99% and 99.9999% of the viruses are non-culturable and non-infectious. These "non-infectious" viruses may represent falsely elevated viral loads due to misidentification of RNA from human cells and other microbes."
"Another implication of the findings is that the diagnosis of HIV-infection continues to rely heavily on the ELISA and Western Blot antibody tests. The accuracy of these antibody tests and the experimental methodology used to determine their sensitivity and specificity should thus be carefully examined, especially since some authors consider false positives to be a problem with these tests as well (Proffitt et al. 1993, Challakeree et al. 1997, de Harven 1998a&b, Giraldo 1998, MacKenzie 1992, Papadopulos-Eleopulos et al. 1993, Sayre et al. 1996). A strong correlation between positive viral loads and positive HIV antibody tests is expected because the viral load tests are designed to look for RNA sequences that come from the proteins used in the antibody tests. If a person tests positive for the antibodies, they are likely to have RNA with the same code sequences in their blood because this RNA is used by the cells to code for these proteins. This means that a false positive HIV-antibody test is very likely to increase the risk of a false positive viral load."
"Furthur examination of what factors increase the risk of false positive or falsely elevated viral loads would be extremely valuable since many treatment decisions are currently based in viral load measurements. Until such research is undertaken, however, it is advisable to make treatment decisions based on a person's symptoms and on the presence of clinical illness, and not to rely heavily on viral load test results. If a person appears to be clinically worse even though their viral load has gone down, it may be advisable to reduce or stop the medications being administered. Much of the reduced viral load observed in this situation may be due to toxic effects on human cells. Likewise, if a person is clinically healthy even though their viral load is high and they are not on any anti-HIV medications, it may be advisable to withhold medication and instead encourage conservative health promoting measures that focus on nutritional, social, psychological, and spiritual health, rather than focusing on treatments whose primary goal is to reduce the person's 'viral load'."
Matt Irwin MD is a family practice resident who wrote several literature reviews on HIV and AIDS while attending medical school at George Washington University. He also holds a Master's degree in social work from the Catholic University of America. In addition to his interest in alternative views of HIV and AIDS, he specializes in health promotion with nutritional, psychological, social, and spiritual interventions, as well as classical homeopathy. He has a practice near Washington, D.C.
For the entire article, please see go to http://www.virusmyth.net/aids/data/miloads.htm
greg78 - 30 Sep 2005 08:08 GMT More gobbledygook from the AIDS orthodoxy! More dodging from the AIDS orthodoxy!
"In adults, the PCR test is less reliable than the antibody tests. In infants, the antibody tests are less reliable than the PCR test." And how, pray tell, do you KNOW that? Or do you just decide, "I, doctor, say it so, and so it shall be"?
But why? WHY WHY WHY? WHY would PCR be less reliable in adults than in infants???? That is what I want you to explain to me. How many more ways must I ask this question??? PCR detects HIV genetic material! What characteristic about babies makes this test acceptable for them, and what characteristic in adults makes it UNacceptable for grownups? Can you please answer my questions! I want to know WHY!!!
David Canzi -- non-mailable - 30 Sep 2005 22:47 GMT >But why? WHY WHY WHY? WHY would PCR be less reliable in adults than in >infants???? I didn't say that PCR is less reliable in adults than in infants.
This is what I said: "In adults, the PCR test is less reliable than the antibody tests. In infants, the antibody tests are less reliable than the PCR test. Infants carry antibodies to things they haven't been exposed to, because they got those antibodies from their mother."
If you had thought about what you were reading, you would have understood that I wasn't saying PCR is less reliable in adults than in infants.
You didn't think.
Thinking takes time. Thinking slows you down. People who post many articles per day are not thinking about what they're saying.
 Signature David Canzi "I am not denying anything." -- Celia Farber
Iconoclaster - 01 Oct 2005 00:25 GMT >"This is what I said: "In adults, the PCR test is less reliable than the antibody tests. In infants, the antibody tests are less reliable than the PCR test."
Well, I understood what you meant all along, Mr. Canzi. In adults, the antibody tests suck (even apologists know that), but PCR is even less reliable. In spite of PCR being less reliable in adults, it's still the best we have for children, because for children the antibody tests are yet even less reliable. (And that is getting very damn f.cking unreliable, I might add).
GMCarter - 01 Oct 2005 12:38 GMT >>"This is what I said: "In adults, the PCR test is less reliable than the >antibody tests. In infants, the antibody tests are less reliable than the [quoted text clipped - 3 lines] >In adults, the antibody tests suck (even apologists know that), but PCR is >even less reliable. Right. More of your incredibly well-thought-out scientific response to the issue.
Iconoclaster - 01 Oct 2005 23:49 GMT >"Right. More of your incredibly well-thought-out scientific response to the issue."
Aw, I do my best trying to explain things in terms common folk can understand. Apologists are different: They use as much pseudo- scientific jargon as possible, hoping the opponents will give up.
GMCarter - 02 Oct 2005 01:32 GMT >>"Right. More of your incredibly well-thought-out scientific response to >the issue." > >Aw, I do my best trying to explain things in terms common folk can >understand. Aw, except you don't f.cking understand what you're talking about so it kinda makes it hard for you to explain anything.
Iconoclaster - 02 Oct 2005 02:08 GMT >"Aw, except you don't f.cking understand what you're talking about so it kinda makes it hard for you to explain anything."
No Mr. Carter, I'm good at what I do. And I've been fairly successful thus far, explaining things in a straightforward way. That's why you get so cross with me sometimes.
GMCarter - 02 Oct 2005 12:34 GMT >>"Aw, except you don't f.cking understand what you're talking about so it >kinda makes it hard for you to explain anything." > >No Mr. Carter, I'm good at what I do. No, Mr. Asswipe. you're not. You have made so many elementary flubs and errors that your completely untrustworthy as a source of anything but enough gas to power a small village.
greg78 - 03 Oct 2005 15:05 GMT Mr Canzi
You can try and derail my question by tying it up in semantics, but it won't work. I'm sure YOU would say that the antibody test is accurate in adults and you are saying that the PCR is less accurate than the antibody tests in adults. That's fine, I read that and I understood it. You then said that in babies the PCR test is less accurate than the antibody tests. I understand that. But the point is that if PCR is suitable to diagnose infection in babies (even if it less reliable than antibody tests) then it should be suitable to diagnose adults (even if PCR is less accurate than antibody tests!). The fact that it is not used to diagnose in adults is an indication that it is NOT considered to be suitable.
I asked you two questions. Firstly, HOW do you KNOW that a) the antibody tests are better than PCR in adults and vice versa for infants? In other words, what gold standard was used in order to validate the comparison?
Secondly, I asked you if you could explain if there were any differences between detecting RNA in babies as opposed to adults which could account for the lack of diagnostic power in adults. Please don't tell me again about maternal antibodies. I understand that they confound the antibody tests in babies. And I understand that that's why there is a reliance on the PCR in infants. What I'm trying to determine is if there is a theoretical underpinning for the policy of relying on PCR in babies but it is not indicated for use in adults.
David Canzi -- non-mailable - 04 Oct 2005 05:48 GMT >Mr Canzi > >You can try and derail my question by tying it up in semantics, Responding to my article, you asked "But why? WHY WHY WHY? WHY would PCR be less reliable in adults than in infants????" I had not said that PCR was less reliable in adults than in infants, and it doesn't follow from what I did say.
By asking that question you misrepresented my position. By asking it with such urgency you drew attention to the misrepresentation. To prevent others from thinking I had said something I had not in fact said, I corrected you. And I pointed out that if you *thought* about what you were reading well enough to actually understand it you would not have misrepresented me.
I am being charitable and assuming your mispresentation of me was accidental rather than intentional.
>I'm sure YOU would say that the antibody test is accurate in >adults and you are saying that the PCR is less accurate than the antibody >tests in adults. That's fine, I read that and I understood it. You then >said that in babies the PCR test is less accurate than the antibody tests. Actually I said that, in babies, antibody testing is less accurate tnan PCR.
>I understand that. But the point is that if PCR is suitable to diagnose >infection in babies (even if it less reliable than antibody tests) Actually I said that, in babies, PCR is more reliable than antibody testing.
I am beginning to think that your previous misrepresentation of my position was not accidental.
>Secondly, I asked you if you could explain if there were any differences >between detecting RNA in babies as opposed to adults which could account >for the lack of diagnostic power in adults. You are now trying to sneak in the implication that PCR works better in infants than adults. That is not my position, and it doesn't follow logically from my position, and I have told you so.
Ask honest questions or go to hell.
 Signature David Canzi "I am not denying anything." -- Celia Farber
greg78 - 04 Oct 2005 12:49 GMT My apologies. I didn't proof read my post properly. Getting things the wrong way around was accidental.
What I meant to say was: "I'm sure YOU would say that the antibody test is accurate in adults and you are saying that the PCR is less accurate than the antibody tests in adults. That's fine, I read that and I understood it. You then said that in babies the PCR test is MORE accurate than the antibody tests."
and
"I understand that. But the point is that if PCR is suitable to diagnose infection in babies (even if it is MORE reliable than antibody tests)".
My question remains, HOW is it known that PCR tests are adequate for determining infection in infants in the absence of a workable antibody tests for infants? Surely there has to be some gold standard test to make sure that you are not getting false results on the PCR test, especially if PCR is NOT used to diagnose in adults?
I am not trying to "lead" you into changing your position. What I'm trying to find out is why the PCR test is suitable for infants when it is not suitable for adults. To my mind, one possibility for this could be that something in adults reduces the applicability of the test in adults. Is this so? If not, and you maintain that PCR works with the same accuracy in infants as in adults, then I would like to know why adults are not diagnosed with PCR tests.
Mr Canzi, I think you are fully aware of what I'm trying to get to with this line of questioning. If you don't know the answer, than rather admit that you don't know. You wouldn't be the first.
David Canzi -- non-mailable - 04 Oct 2005 23:33 GMT >My apologies. I didn't proof read my post properly. Getting things the >wrong way around was accidental. > >What I meant to say was: [snip]
>"I understand that. But the point is that if PCR is suitable to diagnose >infection in babies (even if it is MORE reliable than antibody tests)". Why "even if"?
>My question remains, HOW is it known that PCR tests are adequate for >determining infection in infants in the absence of a workable antibody >tests for infants? Surely there has to be some gold standard test to make >sure that you are not getting false results on the PCR test, especially if >PCR is NOT used to diagnose in adults? If they need a gold standard test to determine a test's reliability, how do they determine the reliability of the gold standard test?
I don't know whether they used a gold standard in this case, but they can get a pessimistic estimate of a test's reliability without a gold standard.
If they try a test on a large group and 99% of the results are negative, they know the test is at least 99% specific, without a gold standard.
>I am not trying to "lead" you into changing your position. What I'm trying >to find out is why the PCR test is suitable for infants when it is not [quoted text clipped - 3 lines] >infants as in adults, then I would like to know why adults are not >diagnosed with PCR tests. Given the need to test a patient and a choice between two tests, the doctor uses the test that is more reliable. Antibody testing is more reliable than PCR for adults, so the doctor uses antibody testing on adult patients. PCR is more reliable than antibody testing for infants, so the doctor uses PCR for an infant patient.
That isn't the whole story, but it's enough to explain why a different test would be used for infants than for adults.
 Signature David Canzi "I am not denying anything." -- Celia Farber
pauleewhiting - 05 Oct 2005 01:39 GMT If they need a gold standard test to determine a test's reliability, how do they determine the reliability of the gold standard test?
Is A Positive Western Blot Proof Of Hiv Infection? - by Val Turner
Originally published In Biotechnology June 1993. Volume 11 Pages 696-70
SUMMARY
It is currently accepted that a positive Western blot (WB) HIV antibody test is synonymous with HIV infection and the attendant risk of developing and dying from AIDS.
In this communication we present a critical evaluation of the presently available data on HIV isolation and antibody testing. The available evidence indicates that:
(a) the antibody tests are not standardised;
(b) the antibody tests are not reproducible;
(c) the WB proteins (bands) which are considered to be coded by the HIV genome and to be specific to HIV may not be coded by the HIV genome and may in fact represent normal cellular proteins;
(d) even if the proteins are specific to HIV, because ***no gold standard*** has been used and may not even exist to determine specificity, a positive WB may represent nothing more than cross-reactivity with the many non-HIV antibodies present in AIDS patients and those at risk, and thus be unrelated to the presence of HIV.
We conclude that the use of the HIV antibody tests as a diagnostic and epidemiological tool for HIV infection needs to be reappraised.
INTRODUCTION
To date, the only routinely used methods for demonstrating the presence of HIV in vivo are the ELISA and WB antibody tests.
In the ELISA, the "HIV proteins" are present as a mixture. For the WB, the HIV proteins are dissociated and placed on a polyacrylamide gel slab. After electrophoresis, which separates the proteins by molecular weight and charge, the proteins are transferred to a nitrocellulose membrane by electroblotting. In performing the antibody test, in both ELISA and WB,the patient's serum is added to the antigen preparation. It is assumed that if HIV antibodies are present, they will react with the HIV proteins which, after washing, are visualised by an enzyme anti-human-immunoglobulin chromogen reaction.
In the ELISA the reaction is read optically. For the WB, individual proteins are recognised and interpreted visually as coloured bands, each of which is designated with a small "p" (for protein), followed by a number, (which is the molecular weight in kilodaltons),for example p41 (Fig. 1).
The WB is believed to be highly sensitive and specific, and a positive result is regarded as synonymous with HIV infection. A positive HIV status has such profound and far reaching implications that no one should be required to bear this burden without solid guarantees of the verity of the test and its interpretation. In this paper, the evolution of the antibody tests, the basis of their specificity, and the validity of their interpretation are evaluated.
Acceptance of an antibody test for HIV as being scientifically valid and reliable requires the following:
(i) A source of HIV specific antigens;
(ii) Standardisation;
(iii) Determination of the test's reproducibility.
Once these criteria have been met, and before the introduction of the antibody tests into clinical medicine, the test's sensitivity, specificity and predictive values must be determined by the use of ***a gold standard,*** HIV itself. [Emphasis mine.]
PART ONE - http://www.sumeria.net/aids/blot1.html
PART TWO - http://www.sumeria.net/aids/blot2.html
GMCarter - 05 Oct 2005 12:07 GMT >If they need a gold standard test to determine a test's reliability, how do >they determine the reliability of the gold standard test? [quoted text clipped - 3 lines] >Originally published In Biotechnology >June 1993. This crap has been refuted quite a lot in the 12 years since Val scribbled it out.
pauleewhiting - 05 Oct 2005 01:49 GMT "If they try a test on a large group and 99% of the results are negative, they know the test is at least 99% specific, without a gold standard."
Okay, David, but how do the doctors and clinicians make the final diagnosis of "HIV-positivity" when both the Elisa and Western Blots come back positive from the lab?
The HIV tests are known to have "false-positive" results, so in order to prevent somone who's *not really* HIV-positive from being told they are, how is the final determination made by the doctor or clinician?
David Canzi -- non-mailable - 07 Oct 2005 03:32 GMT >"If they try a test on a large group and 99% of the results are negative, >they know the test is at least 99% specific, without a gold standard." > >Okay, David, but how do the doctors and clinicians make the final >diagnosis of "HIV-positivity" when both the Elisa and Western Blots come >back positive from the lab? ELISA negative = negative. ELISA positive + WB positive = positive. ELISA positive + WB indeterminate = indeterminate. ELISA positive + WB negative = ?
I don't know the answer to the last one. I tested positive (both ELISA and WB) on my first ever HIV test in 1989, and have had no particular reason to keep informed about testing methods since then.
>The HIV tests are known to have "false-positive" results, so in order to >prevent somone who's *not really* HIV-positive from being told they are, >how is the final determination made by the doctor or clinician? There is no way to avoid telling a false-positive patient that he's positive. (Most patients who test positive really are positive -- not telling them is not an acceptable solution.) False positives can be revealed by retesting, or suspected when CD4 counts stay high for a long time.
 Signature David Canzi "I am not denying anything." -- Celia Farber
pauleewhiting - 09 Oct 2005 00:55 GMT >>Okay, David, but how do the doctors and clinicians make the final >>diagnosis of "HIV-positivity" when both the Elisa and Western Blots come [quoted text clipped - 14 lines] >be revealed by retesting, or suspected when CD4 counts stay high for >a long time. Okay, David, how is the final determination made once that person has retested? What if, for example, the results come back postitive *again* for "HIV," but it's decided that this person has ZERO risk for having been exposed to "HIV"?
In other words, this person has never even been exposed to "HIV" - as was determined by assessing their risk factor for "HIV infection" which is, in turn, determined by whether, or not, they belong to a "risk group" that is known to have a "high prevalence for 'HIV' infection" - yet they are *still* coming up HIV-positive on the tests...
And, yet, you say that "Most patients who test positive really are positive -- not telling them is not an acceptable solution"... But what if their test results are a "false-positive?" Is telling someone, who's *not really* HIV infected, that they're going to DIE of AIDS, acceptable?
So then, how does the doctor, or clincian, make the *final diagnosis* as to whether, or not, this person is truly HIV positive (whom we've already established has *repeatedly* coming up positive on the Elisa and Western Blot tests, yet has been determined to never have been exposed to "HIV," based on their "risk group" assessment), or if their results were simply a "false positive"?
-Paul Whiting
Fondoo - 05 Oct 2005 08:01 GMT I would like to know as well since they like to test my little baby over and over and tell me that the negative does not count for 18 months. After doing my homework it seems this hospital is working on a different model of care than the IHO's 2005 that seems to conclude two negatives can be accepted at the 4-6 month mark. Oh ya and lets shove all kinds of vaccines into my little girl at the same time we test her no probleeem trust your Doctors they know what’s best. Why do I have to learn this stuff when I'm paying MD's bahhhh!
pauleewhiting - 04 Oct 2005 20:12 GMT "Actually I said that, in babies, antibody testing is less accurate tnan PCR."
"Actually I said that, in babies, PCR is more reliable than antibody testing."
"You are now trying to sneak in the implication that PCR works better in infants than adults. That is not my position, and it doesn't follow logically from my position, and I have told you so."
So, David, let me just go out on a limb here...
If PCR is more reliable than anti-body testing in babies, and anti-body testing is more reliable than PCR in adults, then, precisely, how does Greg's implication that PCR works better in infants than adults *NOT* follow logically from those two assertions?
Let's look at these statements another way:
IF: "PCR is more reliable than anti-body testing in babies."
AND: "anti-body testing is more reliable than PCR in adults."
THEN: "PCR works better in infants than adults."
Wow. I can see why you told Greg to "Ask honest questions or go to hell," since he is *clearly* putting words in your mouth...
-Paul Whiting
David Canzi -- non-mailable - 04 Oct 2005 22:28 GMT >Let's look at these statements another way: > >IF: "PCR is more reliable than anti-body testing in babies." >AND: "anti-body testing is more reliable than PCR in adults." >THEN: "PCR works better in infants than adults." Let's be precise about what is being compared to what:
PCR tests on babies are more reliable than antibody tests on babies. Antibody tests on adults are more reliable than PCR tests on adults.
Your argument goes wrong by assuming, without justification, that adult antibody testing and infant antibody testing are identical.
Your argument reduces to: A > B and C > D, therefore A > D.
 Signature David Canzi "I am not denying anything." -- Celia Farber
Gary Stein - 05 Oct 2005 19:22 GMT > In article > <3315da550fca1aff3a23f66d9555a1c1@localhost.talkabouthealthnetwork.com>, [quoted text clipped - 13 lines] > > Your argument reduces to: A > B and C > D, therefore A > D. Ten bucks the above will be completely beyond Paul's comprehension?
Gary Stein
pauleewhiting - 06 Oct 2005 05:37 GMT PCR tests on babies are more reliable than antibody tests on babies. Antibody tests on adults are more reliable than PCR tests on adults.
Your argument goes wrong by assuming, without justification, that adult antibody testing and infant antibody testing are identical.
Your argument reduces to: A > B and C > D, therefore A > D.
Ten bucks the above will be completely beyond Paul's comprehension?"
Sorry, I forgot to reply to this post. It's been really busy around here lately...
Anyhoo, David, you are *absolutely correct* that my argument *does* reduce to: A > B and C > D, therefore A > D."
So, shed some light on this situation, won't you?
How can the PCR reliably detect a viral load in babies for HIV diagnosis, when it can't do that in adults?
What makes the test able to do something in a developing human, that it can't do in a fully-developed one?
David Canzi -- non-mailable - 06 Oct 2005 07:21 GMT >So, shed some light on this situation, won't you? > >How can the PCR reliably detect a viral load in babies for HIV diagnosis, >when it can't do that in adults? We were not talking about viral load testing, and PCR is not a synonym for viral load.
>What makes the test able to do something in a developing human, that it >can't do in a fully-developed one? This isn't rocket science, Paul.
I'm going to ask you a hypothetical question. Suppose that there are two tests for the hypothetical swine pox disease: the ear wax test and the dandruff test. We know that the ear wax test is more reliable than the dandruff test for men. We know that the dandruff test is more reliable for men than for women. Which test do we use on men?
 Signature David Canzi "I am not denying anything." -- Celia Farber
GMCarter - 06 Oct 2005 12:06 GMT snip
>>What makes the test able to do something in a developing human, that it >>can't do in a fully-developed one? [quoted text clipped - 6 lines] >than the dandruff test for men. We know that the dandruff test is >more reliable for men than for women. Which test do we use on men? I think Paul has a fair question here. Why can't we use a PCR in adults? What's wrong with it that it may have more likelihood of a false positive without confirmatory antibodies?
In infants, the answer is clear. Maternally transmitted antibodies may result in a false positive test for the infant. Testing for virus via PCR indicates that HIV is indeed present. Other clinical issues can provide more certainty as to an actual, productive infection. Infant immune systems are not developed.
By contrast, adults will seroconvert, usually within a month from infection.
The question must be: why would PCR amplify and register a viral load in an otherwise NON-infected individual?
To what degree does this render PCR suspect?
I think these are fair questions for which I don't have ready answers.
However, I do NOT think they provide some bullshit "smoking gun" evidence that HIV doesn't exist or cause AIDS. THAT's also what Paul is fishing for. And it simply will not fly, because PCR is not the only diagnostic for HIV infection. Other diagnostic surrogate markers and clinical presentation all make it pretty clear, not to mention the high specificity and sensitivity of ELISAs and follow-up Western Blot.
See, e.g., http://www.hivguidelines.org/public_html/a-tests/a-tests.htm
George M. Carter
pauleewhiting - 09 Oct 2005 03:34 GMT >I think Paul has a fair question here. Why can't we use a PCR in >adults? What's wrong with it that it may have more likelihood of a [quoted text clipped - 22 lines] >and clinical presentation all make it pretty clear, not to mention the >high specificity and sensitivity of ELISAs and follow-up Western Blot. George, you are absolutely correct - that *is* what I am fishing for...
However, there isn't just one "smoking gun" for providing evidence that HIV doesn't exist or cause AIDS. There are many pieces of evidence to consider.
It's sorta like the AIDS paradigm is a house of cards - it is an impression structure, but it's based on a lot of relationships that are barely held together. And each card - or piece of "evidence" - supporting "The House that AIDS Built" relies on the others to keep the structure cohesive.
So, once you start to *truly question* any of the individual cards, you have to start questioning *all* of the cards. And, suddenly, the house of cards collapses!
It's just like your question about the use of PCR to diagnose HIV in adults, George!
That is a perfectly legitimate question because, logically, if the PCR is so freakin' accurate at counting actual HIV particl
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