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Medical Forum / Diseases and Disorders / AIDS / September 2006New CDC HIV testing proposal and "Elite Controllers"
New CDC HIV testing proposal is BAD medical practice. The new CDC proposal for mandatory HIV testing of low-risk people who come into contact with the medical system at emergency rooms and ambulatory care centers is BAD medical practice. I stand in opposition to it. In addition, I urge all physicians to stand up and join with me in opposition to these new HIV testing policies proposed by the CDC. The new CDC recommendation to routinely perform HIV antibody testing on the entire low-risk population is a BAD IDEA. This is why: "Elite Controllers" are HIV positives who are alive and well without disease for many years without ever taking anti-HIV drugs. Although current opinion suggests these are rare individuals, my opinion is that they are not so rare and many more will be stepping forward to identify themselves to participate in the Mass General Hospital study. My point is that this is a population of HIV positive people who never get sick and don't have a disease. The risks of toxic anti-HIV drugs (bone marrow suppression, liver failure and Stevens Johnson Syndrome) is far greater to them than the theoretical risk of Kaposi's Sarcoma or Pneumocystis Carinii pneumonia which are the hallmark of classic AIDS as first described in the San Francisco Gay population in the early 1980's. We know that the Elite Controllers are not rare because the CDC estimates that there are a quarter million HIV positives in the low-risk general population who are unaware of their HIV status. These people are generally healthy and find no reason to seek out medical testing and are probably Elite Controllers. The new CDC recommendations to test all these low-risk people in the general population will merely identify Elite Controllers in the population and then recommend to them the standard toxic anti-HIV drug treatment which is far more dangerous to their health than their HIV positive status which will not cause a disease in this population. I urge all physicians to stand up and join with me in opposition to these new HIV testing policies proposed by the CDC which are BAD medical practice. Signed: www.drdach.com It's a bad idea to take highly toxic "medicines" in the absence of any symptoms, but if almost everyone had an "HIV" it would be interesting to see what the results would be, whether one is an "establishment" person or a "dissident" one. If someone wanted my advice on health matters, and they could get an "HIV test" for free, I would want to know the results, because it means that something is probably wrong on the molecular level, though the notion that a "retrovirus" is doing any harm is beyond ludicrous, of course. The test is an indicator, nothing more, but the more indicators the better, unless there is a risk involved. Here, the major risk is that the person will think that he or she has a terminal disease and then may take "medicines" that will destroy his or her liver, among other things. > It's a bad idea to take highly toxic "medicines" in the absence of any > symptoms, but if almost everyone had an "HIV" it would be interesting [quoted text clipped - 8 lines] > or she has a terminal disease and then may take "medicines" that will > destroy his or her liver, among other things. www.drdach.com wrote: Problem is that by routine testing the low risk population (non-iv drug user heterosexuals) we are uncovering HIV positive people who never get sick and don't have a disease, called Elite Controllers. We know from experience that when you notify people in low risk groups that they have HIV, they are fired from their jobs, cant get health insurance, ostracized from the community and some commit suicide. Considering this kind of downside to uncovering this information, it is not valuable. It is harmful . By the way, after 20 years of HIV research, there has never been a documented case (in the medical literature) of HIV or AIDS disease transmitted from Elite Controller to another person (spouse or partner) through heterosexual contact, so the idea that by testing these people we will reduce transmission rate is false. There is no transmission risk from Elite Controllers. In addition, heterosexual transmission between couples is actually quite rare and may never happen after many years of contact in some couples as reported by Dr. MacGregor, Horsburgh and Levy: (see references below) MacGregor RR et al. Failure of culture and polymerase chain reaction to detect human immunodeficiency virus (HIV) in seronegative steady sexual partners of HIV-infected individuals. Clin Infect Dis. 1995 Jul;21(1):122-7. Horsburgh CR et al. Concordance of polymerase chain reaction with HIV antibody detection. J Infect Dis. 1990 Aug;162:542-5. Levy JA. The transmission of AIDS: the case of the infected cell. JAMA. 1988;259(20):3037-8. Regards from www.drdach.com >The new CDC proposal for mandatory HIV testing of low-risk people who >come into contact with the medical system at emergency rooms and >ambulatory care centers is >BAD medical practice. You have said 4 times that the CDC is proposing mandatory testing. That's once more than the Bellman. The NPR article Don Saklad posted a link to said this: "The change means that when patients see a doctor or go to a hospital, they will be asked if they've been tested for HIV and, if they haven't, asked to be screened or tested." http://www.npr.org/templates/story/story.php?storyId=6119310 I don't see anything there about "mandatory testing". Do you have a link to a reliable source for your claim?  SignatureDavid Canzi "Do not let superstition inhibit your actions." -- Jeane Dixon, horoscope for Virgo, May 17, 1990. > >The new CDC proposal for mandatory HIV testing of low-risk people who > >come into contact with the medical system at emergency rooms and > >ambulatory care centers is > >BAD medical practice. > You have said 4 times that the CDC is proposing mandatory > testing. That's once more than the Bellman. [quoted text clipped - 12 lines] > -- > David Canzi Yes you are correct in that the exact word mandatory is not used. However, in the hospital emergency room setting, any test that the doctor recommends is routinely included in the panel. Patients are there because they trust the doctor to order the correct tests. This setting creates an environment where the test becomes essentially mandatory. This is based on my experience as an ER physician. www.drdach.com
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