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Medical Forum / Diseases and Disorders / AIDS / December 2006CD4 Counts Without AIDS
From the Alive And Well mailing list: New Study Questions Reliability of T Cell Counts Finds HIV Negatives with AIDS Defining Numbers Following the news that viral load is not an accurate method of assessing or predicting immune status comes word from the Journal of Infectious Diseases that T cell counts may be less reliable measures of immune competence than previously believed. A study in Africa conducted by the World Health Organization (WHO) revealed that HIV negative populations can have T cell counts below 350, a number that would, according to WHO guidelines, qualify for an AIDS diagnosis in HIV positive populations. Another surprising conclusion from the same WHO study: HIV positives that started AIDS drug treatment with low T cell counts had the same survival outcomes as HIV positives that began treatment with high T cell counts. Check out the conundrums in this November 11 2006 article from New Scientist found online at http://www.newscientist.com/article/dn10511-are-we-prescribing-hiv-drugs-properl y.html Are We Prescribing HIV Drugs Properly? In cash-starved regions of the world, deciding who should get anti-retroviral drugs for HIV is a tough call. Now it seems that one of the main tools for making that decision may be less reliable than it appeared. World Health Organization guidelines recommend starting anti-retroviral drugs when someone's CD4 cell count has fallen below 350 cells per microlitre, an indicator of HIV infection, or for people with symptoms of AIDS whose CD4 count has dropped to below 200. Brian Williams of the WHO and his colleagues studied HIV-positive and HIV-negative populations in eight African countries including Ethiopia, South Africa, Uganda and Zambia. They found that between 3 and 5 per cent of HIV-negative people had CD4 counts below 350. What's more, when people with low pre-infection cell counts did contract HIV, and received anti-retrovirals, they survived for about nine years - the same as people with high counts (Journal of Infectious Diseases, vol 194, p 1450). The new findings call into question just how much we understand about CD4 cells and their interaction with HIV, says Williams. "Generally, if you have high CD4 counts you can be considered to be doing pretty well and if you have very low counts, you're in trouble," says Williams. But CD4 counts can vary a lot naturally so if you follow the WHO guidelines to the letter, then some people started on anti-retrovirals would not even be infected with HIV, he concludes. === Lancet Study Challenges Claims about HAART Treatment Does Not = Life The surprising conclusion from a recent study published in the medical journal, The Lancet: After starting treatment with HARRT, viral response improved but such improvement has not translated into a decrease in mortality. The multi-center study reported in The Lancet article tracked the effects of HAART on some 22,000 previously treatment naove HIV positives between 1995 and 2003 at 12 locations in Europe and the USA. Instead of finding data that provide a ringing endorsement of anti-HIV drug therapy, the studys results refute popular claims that the newer anti-HIV meds extend life or improve health. Commenting on the article, Felix de Fries of Study Group AIDS-Therapy in Zurich, Switzerland had this to say: The Lancet study shows that after a short period of time, HAART treatment led to increases in precisely those opportunistic infections that define AIDSfrom fungal infections of the lungs, skin and intestines to various mycobacterial infections. De Fries also notes that while HAART has led to no sustained increases in CD4 counts, no reduction in AIDS-defining illness and no decrease in mortality rates, its use is associated with a list of serious adverse events including cardiovascular disease, lipodystrophy, lactacidosis, liver and kidney failure, osteoporosis, thyroid dysfunction, neuropathy, and non-AIDS cancers among users. For more information, please refer to The Lancet, issue 368:451-58 and/or The Study Group AIDS-Therapy by telephone or fax at 0041 44 401 34 24 or by email at felix.defries@tele2.ch === Journal Article Advocates Radical Approach to AIDS Prevention Questions Popular Ideas about HIV in Africa Excerpted from http://www.health-e.org.za/news/article.php?uid=20031447 Taking a swipe at those who try to blame sexual behaviour for the rampant HIV epidemic in southern Africa, Professor Eileen Stillwaggon says that they are caught up in "exotic notions" about Africans. Instead, AIDS prevention efforts will be more successful if they focus on "biological and socio-economic factors" that can be addressed relatively easily and cheaply, she argues persuasively in the latest edition of Africa Policy Journal. "Differences in sexual behaviour cannot explain 50-fold differences in HIV prevalence around the world," writes the economics professor from Gettysburg College. "Yet global AIDS policy relies almost entirely on behavioural interventions - abstinence or condoms - for HIV prevention. Southern Africa's very high AIDS rate has been a source of much speculation. President Thabo Mbeki has been the most vocal proponent for poverty to be put on the global AIDS agenda, and has also condemned Western notions of African sexuality in the context of AIDS. Stillwaggon is no AIDS denialist, but she doesn't mince words when she condemns those who propose that changing sexual behaviour is the main solution to Africa's AIDS epidemic. "Policymakers seem to be convinced (without evidence) that Africans are having more sex than Americans. They do not ask why US college campuses, where rates of chlamydia and genital herpes are as high as 30 to 40 percent, do not have high rates of HIV." She argues compelling for a return to "the fundamental causes" of the raid spread of AIDS in poor countries - biological and socio-economic factors. As far as biology is concerned, says Stillwaggon, the immune systems of people in southern Africa are weakened by malnutrition and parasitic illnesses. Malnutrition - a deficiency of energy, protein and minerals such as iron, zinc and vitamins - makes a person far more susceptible to infectious and parasitic diseases. These deficiencies make it hard for new cells to be built, including CD4 cells that protect the body from infections. "A malnourished, parasite-laden population gives rise to a very different epidemic dynamics from that of a healthier population, but models used by the major AIDS organisations do not take this into consideration," says Stillwater. Instead, she says, they use a "one-size-fits-all" approach based on behaviour change that ignores factors that make poor people especially vulnerable. The easier, cheaper approach would be to address nutritional deficiencies and parasite infections. Stillwaggon's approach is a radical departure from the norm, and offers fresh solutions to AIDS prevention where the decades-old mantra of "abstain, be faithful and condomise" has been unable to stop the spread. === AIDS and the Ecology of Poverty More on Stillwaggons ideas from the Oxford University Press web site: http://www.us.oup.com/us/catalog/general/subject/Economics/Developmental/?view=u sa&ci=9780195169270 Why does AIDS policy ignore much of what is known about epidemics and why they spread? HIV/AIDS flourishes where people are dying of myriad other diseases that are almost unknown among affluent populations. In her book "AIDS and the Ecology of Poverty," Eileen Stillwaggon draws on conventional epidemiology, which recognizes that people who are malnourished, burdened with parasites and infectious diseases, and who lack access to medical care are vulnerable to other diseases, regardless of whether they are transmitted by air, water, food, or sexual contact. HIV/AIDS is no exception. This book delivers a telling critique of the behavioral explanation of epidemic AIDS and the stereotypes that lie beneath it. It also shows how the methodologies applied in recent epidemiology and health economics are based on a one-risk-fits-all model that ignores the greater vulnerability of poor people and gives rise to policies that are narrow, shortsighted, and dead-end. Stillwaggon combines the insights of economics and biology to explain the epidemic spread of HIV/AIDS in poor populations in developing and transition countries. Drawing on a wealth of scientific evidence, the author demonstrates that the HIV/AIDS epidemic cannot be stopped in isolation. She offers pragmatic solutions to economic, social, and health problems that beset poor populations and contribute to the spread of HIV/AIDS. === One Day at a Time: Facing Fear, Overcoming Disease and Letting Go of the Numbers From a letter to Alive & Well founder Christine Maggiore: I only wish I had your knowledge and convictions when I chose to start HIV medications. Tests can scare you to death, quite literally. My story begins one Friday afternoon when my doctor called and told me Id tested HIV positive. Making this bad news worse, he added that he would not continue seeing me as a patient. Abandoned and in a fog of fear and self-loathing, I found another doctor who put me on medications immediately even though I had no symptoms. I took the meds for over three years during which time I developed a host of terrible symptoms: a distended abdomen, sunken cheeks, high cholesterol, a partially blocked artery, an enlarged heart, digestive disorders, depression, a swollen liver, memory loss, peripheral neuropathy and asthma. After reading at the Alive & Well web site, I wondered what was making me so sick, HIV or the HIV treatments. I decided to stop taking the medications. My health began to improve right away. On my next visit to the doctor, I explained that I had stopped taking the drugs because it felt like the medicine was killing me. The doctor's response was, How do you know it was your medicine and not the disease that was causing your illnesses?" When I told him all of my symptoms disappeared after I quit taking the pills, his only comment was, "Oh." Then he pulled out a list of medications to see what he could give me for "salvage therapy". I haven't been back to the doctor since. I believe that had I continued on the medication, I would have died within a few months. I feel so much better now. Have I made the right decision? I'm still a little nervous about it and I'm just taking it one day at a time. I think back now about those first few days when I had been dealt a shocking blow. I remember thinking that this was not what I expected at this stage of my life--everything was going so well for me. I think back on how I let a doctor take all of that away from me with just a few words over the phone. This diagnosis has taught me so much about myself, about my resilience and the importance of thinking for myself. Today I am happy and healthy, and just glad to be alive! Every day is a good day, and I catch myself not even thinking about HIV anymore. The medicine reminded me of it three times a day. Now I just think, Thank God that's over! Thank you so much for being there for me, Mickey == New Cost Free Way to Help Alive & Well Stay Alive and Well Great news: Alive & Well can earn money every time you search the Internet using GoodSearch.com, a search engine that donates half its revenue to the charities its users designate. GoodSearch works just like any regular search engine, and its powered by Yahoo! so you get great results. To help raise funds for Alive & Well, go to http://www.goodsearch.com and enter Alive & Well as the charity you want to support. If just 500 people on this list used GoodSearch four times a day, it would raise more than $7,000 in a year without anyone spending a dime! Please log on to GoodSearch.com today to help Alive & Well continue sharing important news and information and providing support for HIV positives worldwide. And be sure to spread the word to friends, family and colleagues so they can fund our efforts when they search the Internet. Here are three other easy ways to help Alive & Well through GoodSearch: 1. Put a logo and link to GoodSearch on your own website (see http://www.goodsearch.com/Logo.aspx for details). 2. Encourage everyone you know to download the GoodSearch toolbar (go to http://www.goodsearch.com/toolbars.aspx to learn more). 3. Make GoodSearch the homepage on all of the computers in your company or school (instructions at http://www.goodsearch.com/MakeHomepage.aspx). Thanks from Alive & Well and the good people at GoodSearch! === New Web Sites Former State Senator Stephen Davis just launched two new web sites, both designed specifically as starting points for people whove tested HIV positive to help them begin to explore the other side of AIDS. http://www.HelpForHIV.com offers a gentle introduction to the concept that test results may be wrong and provides supporting scientific literature. The site includes links to 50 podcasts featuring recorded interviews with various dissident experts, along with links to videos, scientific papers and newspaper and magazine articles dealing specifically with HIV tests and AIDS drugs. The site also lists books, links to all AIDS rethinking websites and blogs, and has a questionnaire people can fill out to help build a database for future legal action. The second new site http://www.livingwithouthivdrugs.com/ archives a growing collection of true-life stories of HIV positives living healthy and happy lives without HIV medications. Davis plans to promote HelpForHIV.com in the coming weeks and months through blogs and chat rooms, radio interviews, Google and Yahoo ads, and if all goes well, some TV spots. Davis says, My hope is that these new websites can attract a large number of HIV positives and help them learn the truth about the HIV tests and HIV drugs, creating a powerful community of support at the grassroots level. === Not So New Web Sites Worth A Second Look - Theres a whole new links page at the Alive & Well web site enabling visitors to find new science and medical information, lots of health resources and more. Check it out at http://www.aliveandwell.org - Visit http://aras.ab.ca to find new links to recent articles on topics ranging from the AIDS drug tenofovir to routine HIV testing and several new pieces inspired by Celia Farber's March 2006 article in Harpers magazine, AIDS and the Corruption of Science. - Dont miss the new Challenges page at the Rethinking AIDS web site, which features a collection of informative and entertaining exchanges with AIDS and other medical experts on a variety of related subjects. See http://www.rethinkingaids.com/Challenges/index.html "Alex" <avdeelen.REMOFETHIS1@wanadoo.nl> wrote in message > A study in Africa conducted by the World Health Organization (WHO) revealed that > HIV negative populations can have T cell counts below 350, a number that would, > according to WHO guidelines, qualify for an AIDS diagnosis ..... Now this is the time for you to discuss malnutrition. I only objected to you saying malnutrition causes aids. > "Alex" <avdeelen.REMOFETHIS1@wanadoo.nl> wrote in message > > [quoted text clipped - 4 lines] > Now this is the time for you to discuss malnutrition. > I only objected to you saying malnutrition causes aids. I don't think I ever said that. I'll leave 'AIDS' to the experts. What I did say is that it would be interesting to know what the role of malnutrition is in false positive ELISA test results. In fact I'm interested in details on anything that causes false positive results in the ELISA HIV antibody test. Alex "Alex" <avdeelen.REMOFETHIS1@wanadoo.nl> wrote in message > What I did say is that it would be interesting to know what > the role of malnutrition is in false positive ELISA test results. > > In fact I'm interested in details on anything that causes false > positive results in the ELISA HIV antibody test. Here is something I posted in another group with reguard to the ELISA HIV antibody test. " Death" <Death@yourdoor.net> wrote in message > I find it strange to say the least that Gallo who worked > to create a weapons-grade virus for the grub-ment, quits [quoted text clipped - 26 lines] > > http://www.veterinaryireland.ie/ivj/feb02/Vet-PeerRev-Feb022.pdf "Alex" <avdeelen.REMOFETHIS1@wanadoo.nl> wrote in message > " Death" <Death@yourdoor.net> schreef in bericht > > [quoted text clipped - 9 lines] > What I did say is that it would be interesting to know what > the role of malnutrition is in false positive ELISA test results. Perhaps I spoke toooooo soon By CLARE NULLIS Associated Press Writer CAPE TOWN, South Africa Africa, a continent usually synonymous with hunger, is falling prey to obesity. It's a trend driven by new lifestyles and old beliefs that big is beautiful. Ask Nodo Njobo, a plump hairdressing assistant. She is coy about her weight, but like many African women, proud of her "big bum." She says she'd like to be slimmer, but worries how her friends would react. "Here, if you lose a lot of weight, people automatically think you have TB or AIDS. It's not like in America and Europe where you go on a diet to lose weight," Njobo said. More than one-third of African women and a quarter of African men are estimated to be overweight, and the World Health Organization predicts that will rise to 41 percent and 30 percent respectively in the next 10 years. "We have gone from undernutrition to overnutrition without ever having passed healthy nutrition," said Krisela Steyn, the retired director of the South African Medical Research Council's Chronic Disease and Lifestyle unit. Although the figures are lower than in affluent countries, many experts fear that health systems already stretched by the AIDS virus, malaria and poverty-related diseases may snap under the additional burden of heart disease, strokes, cancer and diabetes, conditions linked to obesity. Worldwide, an estimated 1 billion people are overweight, compared to 800 million who are undernourished. Ironically, the poorest are often most vulnerable. Children born with low birth weights to malnourished mothers tend to be more at risk of becoming overweight as adults. They are also more prone to obesity as family members give them too much food to help them catch up, according to experts at a recent conference on chronic disease in Cape Town. The problem is most pronounced in South Africa, where death rates from obesity and diabetes are on the rise. Some 56 percent of South African women are now either obese or overweight, compared to fewer than 10 percent who are underweight. More than 17 percent of adolescents here are overweight _ for teenage girls, it's 25 percent, according to the Medical Research Council. The traditional diet is heavy in starch, with foods like maize meal and white bread being staples. Three spoons of sugar in coffee and tea are the norm. And, as elsewhere in the world, high-fat, high-sugar fast foods, snacks and fizzy drinks are in. And, like elsewhere, growing urbanization has led to less walking and other exercise and the spread of television has led to a generation of couch potatoes rather than athletes. In South Africa and throughout the continent, it is considered rude to refuse food. "We face a very difficult situation in trying to manage obesity. We are up against social and traditional norms that being fat is a sign that you are wealthy, you are successful, you are happy, that your husband can feed you," Steyn said in an interview. "Plus the trend toward less physical activity and the viewpoint that if you are wealthy you don't sweat," she added. Njobo is typical. She comes from a remote rural village where walking was the main means of getting around. She now works in downtown Cape Town and says she doesn't have time to buy and cook vegetables and lentils so she often grabs convenience foods. She is too tired to exercise after being on her feet all day and after the long bus ride to and from the hair salon. In any case, she wouldn't dream of jogging in the poor suburb where she lives as it is plagued by high crime. South Africa is not alone. In Cameroon, where the diet is rich in palm oil, cornflower products and red meat, 35 percent of the population is overweight or obese. Similar rates are found in Gambia and Nigeria, particularly among women, according to figures presented at a recent conference organized by the Oxford Health Alliance of health professionals and academics. These numbers are still far below the industrialized world _ only about 2 percent of Africans suffer from diabetes, compared with nearly 8 percent in Europe and North America. But the International Diabetes Federation says Africa's overburdened health systems are ill-equipped to diagnose the disease, and treatment is too expensive most of its victims. The federation cites the example of a diabetes patient in Bamako, the capital of the desert country of Mali, needing to spend more than $21 on diabetes care a month _ more than half the average family's income. Poor communities with no electricity or refrigerators face the added problem of how to store insulin. Even in relatively sophisticated cities like Cape Town, the number of diabetes sufferers with amputated feet due to late diagnosis and poor treatment is distressingly high. "It's not true that only the rich have problems with obesity and overweight," says Jean-Claude Mbanya, director of Cameroon's National Obesity Center. "The poor suffer even more." But the South Africans must be suffering from malnutrition - Alex says so. "DavidT" <david199@volcanomail.com> wrote in message > But the South Africans must be suffering from malnutrition - Alex says > so. This was my favorite part > "It's not true that only the rich have problems > with obesity and overweight," says Jean-Claude Mbanya, >director of Cameroon's National Obesity Center. > > "The poor suffer even more." > Africa, a continent usually synonymous with hunger, is falling prey to > obesity. It's a trend [quoted text clipped - 4 lines] > "big bum." She says she'd like to be slimmer, but worries how her friends > would react. Great - now Africa gets to enjoy the sight of a bunch of fat obnoxious niggers who demand this or that while stuffing their ugly black faces with fried chicken and greasy chitlins... World AIDS Day ... bring it on!!! >> "Alex" <avdeelen.REMOFETHIS1@wanadoo.nl> wrote in message >> > [quoted text clipped - 8 lines] > > I don't think I ever said that. I'll leave 'AIDS' to the experts. Not me - I think the experts have no basis to think. > In fact I'm interested in details on anything that causes false > positive results in the ELISA HIV antibody test. The fact that CD4s are often below 350 only illustrates the desperation to find a test that "proves" AIDS. Funny thing though - if you run up 7-8 flights of stairs just before your CD4 test, your test will revel an increase of up to 100% in your CD4 count. Funny how that small detail gets overlooked in the milieu of the orgy of greed and corporate welfare... > From the Alive And Well mailing list: > [quoted text clipped - 9 lines] > previously > believed. The only thing less reliable than CD4 counts would be the viral load test - which was the first time in medical history that a blood test was created for a drug treatment. Alex, it might facilitate discussion if you didn't spam the board with dozens of different articles in one go trying to make all your points concurrently. Choose a specific subject for debate, then stick to it. > From the Alive And Well mailing list: > New Study Questions Reliability of T Cell Counts Finds HIV Negatives with AIDS > Defining Numbers > > Following the news that viral load is not an accurate method of assessing or > predicting immune status.... (Totally incorrect misinterpretation - This one study showed that the presenting viral load is of little help in predicting a single individual's future CD4 decline, and not what you have said it does.) >....comes word from the Journal of Infectious Diseases that > T cell counts may be less reliable measures of immune competence than previously [quoted text clipped - 4 lines] > according to WHO guidelines, qualify for an AIDS diagnosis in HIV positive > populations. Wrong again. A count below 350 is not AIDS-defining. If you think it is, can you post the WHO citation please. > Alex, it might facilitate discussion if you didn't spam the board with > dozens of different articles in one go trying to make all your points > concurrently. Choose a specific subject for debate, then stick to it. Geez, what a f.cking control freak... Bad enough we have to put up with World AIDS Day, but now we have someone telling us how many squares of toilet tissue we need to be counting. > Wrong again. A count below 350 is not AIDS-defining. That depends on who does the interpreting. Fact is, a count around or below 200 CD4 cells is no more indicative of an AIDS diagnosis than it is of how many squares of toilet paper it takes you to do your paperwork, DavidT. Quit trying to hide behind your not-so-clever game of semantics or junk science drug ads - DavidT, it only makes you look like an a.shole. > Quit trying to hide behind your not-so-clever game of semantics > or junk science drug ads - DavidT, it only makes you look like > an a.shole. Who's hiding? And who looks like the a.shole? >> Alex, it might facilitate discussion if you didn't spam the board with >> dozens of different articles in one go trying to make all your points >> concurrently. Choose a specific subject for debate, then stick to it. > >Geez, what a f.cking control freak... LOL...speak for yourself, Frod. >>> Alex, it might facilitate discussion if you didn't spam the board with >>> dozens of different articles in one go trying to make all your points [quoted text clipped - 3 lines] > > LOL...speak for yourself, Frod. Sorry, George Mary, but no matter how desperately you need your nemesis ... I ain't him... But you keep wearing your paranoia on your heroin-stained sleeve... >> Wrong again. A count below 350 is not AIDS-defining. > >That depends on who does the interpreting. What national or international organization of *real* doctors (not doctroids like homeopaths and acupuncturists) interprets a CD4 count of 349 as AIDS-defining? Unlike Dr. D., most of us here do not accept the words of pseudonyms as authoritative, so cite a source we can verify independently. >Quit trying to hide behind your not-so-clever game of semantics >or junk science drug ads - DavidT, it only makes you look like >an a.shole. Your vision is distorted, because you view the world through a.shole-coloured glasses.  SignatureDavid Canzi | Eternal truths come and go. | >>> Wrong again. A count below 350 is not AIDS-defining. >> [quoted text clipped - 6 lines] > Your vision is distorted, because you view the world through > a.shole-coloured glasses. Canzi the Panzi speaketh of that which he does not knoweth... yet. Panzi, go crack your own neck - it's stuck in your crack again. >>>> Wrong again. A count below 350 is not AIDS-defining. >>> >>>That depends on who does the interpreting. In your response to me, you kept your assertion and deleted my request for evidence. Hmmm. SignatureDavid Canzi | Eternal truths come and go. | >>>>> Wrong again. A count below 350 is not AIDS-defining. >>>> >>>>That depends on who does the interpreting. > > In your response to me, you kept your assertion and deleted my > request for evidence. Hmmm. And you deleted all the evidence which satisfies your request for evidence, you hypocritical a.shole... >>>>>> Wrong again. A count below 350 is not AIDS-defining. >>>>> [quoted text clipped - 5 lines] >And you deleted all the evidence which satisfies your request >for evidence, you hypocritical a.shole... This is the "evidence" I deleted: Canzi the Panzi speaketh of that which he does not knoweth... yet. Panzi, go crack your own neck - it's stuck in your crack again. SignatureDavid Canzi | Eternal truths come and go. | So, Life, you haven't responded yet...... Where does it say in any WHO guidelines that a CD4 count below 350 equals AIDS, as you claim it does? Still no response I see. Confirmation that he is brain dead. > So, Life, you haven't responded yet...... > > Where does it say in any WHO guidelines that a CD4 count below 350 > equals AIDS, as you claim it does?
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