AIDS testing

[Arbiter]

I found an interesting entry on wikipedia the other day about ICL or idiopathic CD4+ lymphocytopenia.

http://en.wikipedia.org/wiki/Idiopathic_CD4+_lymphocytopenia

It's a condition characterized by a very low CD4+ white blood cell count. The same blood cell found deficient in AIDS. Some studies have attributed ICL to drug abuse, as certain recreational drugs result in serious CD4+ deficiency.

What I find interesting is that although the definitions for AIDS and ICL are nearly identical, ICL is apparently a very rare disease.

AIDS definition:

http://en.wikipedia.org/wiki/AIDS

In 1993, the CDC expanded their definition of AIDS to include all HIV positive people with a CD4+ T cell count below 200 per µL of blood or 14% of all lymphocytes.[72]

AIDS is a so-called "condition". It's not a virus like HIV where physical evidence (aside from the white blood cell count) proves the condition.

ICL CD4+ definition:

CD4+ cell count less than 300 cells per microliter

Lack of laboratory evidence of HIV infection

Nearly identical, except for AIDS definition requiring HIV+ evidence. The symptoms of the two conditions, opportunistic infections, are identical.

Some questions I have:

1. Is it possible that ICL is "HIV negative AIDS"? I'm not saying (never did) that AIDS is not caused by HIV. But the question is relevant.

2. Since the two definitions are so close, is it possible that the condition known as AIDS is simply ICL without the presence of HIV?

3. If HIV presence is disregarded, then technically any condition that results in low CD4+ cells can "cause" AIDS?

 

[mister]

Finally, somebody with half a brain.... People wake up. WAKE UP.

 

[alloytoo]

WOW!

Things other than HIV result in Immune deficencies.

Better tell those folk undergoing radiation and chemotherapy

All those folk taking anti-rejection drugs.

An interesting quote (don't know about the rest of the website)

Today we know that Acquired Immune Deficiency Syndrome (AIDS) is a disease and not a syndrome. A syndrome is commonly used to refer to collections of symptoms that do not have an easily identifiable cause. This name was more appropriate 13 years ago, when doctors were only aware of the late stages of the disease and did not fully understand its mechanisms. A more current name for the condition, regardless of an AIDS diagnosis, is HIV Disease. This name is more accurate because it refers to the pathogen that causes AIDS and encompasses all the condition’s stages, from infection to the deterioration of the immune system and the onset of opportunistic diseases. However, AIDS is still the name that most people use to refer to the immune deficiency caused by HIV.

 

[PeterCH]

1. Is it possible that ICL is "HIV negative AIDS"? I'm not saying (never did) that AIDS is not caused by HIV. But the question is relevant.

No. To have AIDS you must have the HIV virus.

2. Since the two definitions are so close, is it possible that the condition known as AIDS is simply ICL without the presence of HIV?

No. There are many conditions which are similar but this condition is hardly 'so close' it only appears to a lay person reading a Wiki article. HIV has other effects outside of CD4 destruction both on the immune system and other tissues, and there are other issues.

3. If HIV presence is disregarded, then technically any condition that results in low CD4+ cells can "cause" AIDS?

No.

If you're interested in how HIV causes its effects, and don't mind registering for free, here is a link:
http://www.clinicaloptions.com/HIV/Annual Updates/2009 Annual Update/Modules/Pathogenesis.aspx

 

[Arbiter]

Peter, I only use wiki as a source because it's a good summary of sources of a higher level. Just because I prefer to break things down to basic does not mean I am unable to understand the technicalities behind them.

And you really didn't think a lot before answering. If AIDS is defined by the WHO and the CDC as a certain blood count + HIV, then barring HIV, AIDS can be the broad name for any condition that includes a very low CD4+ count? That's not rocket science.

And there's no debate that the primary cause of AIDS onset is the destruction of CD4+ cells by HIV. And we're dealing with the primary problem here.

The question still stands. If the primary definition and proof of AIDS is a low CD4+ count, why can ICL not be considered to be AIDS without HIV?

 

[tco21]

If you want answers, contact the AIDS study centre @ Tuks. visit www.up.ac.za and follow the links.

 

[cyghost]

Peter, I only use wiki as a source because it's a good summary of sources of a higher level. Just because I prefer to break things down to basic does not mean I am unable to understand the technicalities behind them.

And you really didn't think a lot before answering. If AIDS is defined by the WHO and the CDC as a certain blood count + HIV, then barring HIV, AIDS can be the broad name for any condition that includes a very low CD4+ count? That's not rocket science.

And there's no debate that the primary cause of AIDS onset is the destruction of CD4+ cells by HIV. And we're dealing with the primary problem here.

The question still stands. If the primary definition and proof of AIDS is a low CD4+ count, why can ICL not be considered to be AIDS without HIV?

So you want to know that if the definition of AIDS includes HIV and you take HIV away, if it is still AIDS? And you don't think it is a silly question at all?

 

[Arbiter]

Not at all. Because ICL and AIDS have the same devastating effects yet ICL is considered "rare" only because of the frequency of HIV in ICL-like cases.

If something other than fluid exchange with someone HIV positive, like drug abuse or malnutrition, can cause a condition identical to AIDS, don't you think that deserves some spotlight?

Since AIDS is incurable, but those other things are curable. Maybe the amount of false positive results popping up in poor African countries aren't HIV at all, but the cause of poor nutrition which leads to ICL/AIDS?

I'm not saying poor nutrition IS the cause of AIDS. I'm just saying I think it's irresponsible to not consider the possibility. ARVs are very dangerous, especially to people in poor health aka the majority of Africa.

 

[cyghost]

Here you go then

I think your concern is misplaced at the very least.

 

[alloytoo]

Not at all. Because ICL and AIDS have the same devastating effects yet ICL is considered "rare" only because of the frequency of HIV in ICL-like cases.

If something other than fluid exchange with someone HIV positive, like drug abuse or malnutrition, can cause a condition identical to AIDS, don't you think that deserves some spotlight?

Since AIDS is incurable, but those other things are curable. Maybe the amount of false positive results popping up in poor African countries aren't HIV at all, but the cause of poor nutrition which leads to ICL/AIDS?

I'm not saying poor nutrition IS the cause of AIDS. I'm just saying I think it's irresponsible to not consider the possibility. ARVs are very dangerous, especially to people in poor health aka the majority of Africa.

ICL is defined by an absence of HIV or any other obvious cause.

Myth #5: AIDS in Africa is another name for old diseases caused by poverty
Fact: AIDS in Africa is characterised by recorded increases in the prevalence of a number of illnesses in young adults.

Numerous studies in Africa have shown that HIV infection predicts higher disease and death rates. While poor people have greater exposure to HIV and are more likely to progress to AIDS faster once infected with HIV, there is no evidence that poverty is the cause of AIDS. Here are two examples of the evidence that HIV is the cause of AIDS in Africa: A study in Rakai, Uganda disproves that poverty is the cause of AIDS. The study looked at nearly 20,000 people and found a much higher death rate among HIV+ people. Furthermore, the HIV-related death-rate was higher among better-educated and well-off people. A count of death certificates in South Africa from 1997 to 2002 showed a 57% rise in deaths that cannot be explained by population growth or improved death registration. While in 1997, most adults who died were between the ages of 60 to 79, by 2002 most adults who died were between the ages of 20 to 44 (see Statistics South Africa report on mortality). The report has since been updated for 2003 (and part of 2004). The HIV-related mortality trends have become even clearer. This cannot be explained by poverty, because (1) economic conditions in South Africa have not changed drastically enough to explain this sudden rise in adult mortality (on the contrary, the social wage in South Africa has increased during this time) and (2) if it had, we would expect to see a much higher rise in deaths among the elderly. The only plausible explanation of the increase in adult mortality in South Africa is HIV. (Also see South African Medical Research Council report).

 

[BinaryJack]

I'm not saying poor nutrition IS the cause of AIDS. I'm just saying I think it's irresponsible to not consider the possibility. ARVs are very dangerous, especially to people in poor health aka the majority of Africa.

That is of course making the assumption that it has not been considered a possibility.

http://books.google.co.za/books?id=...&resnum=3#v=onepage&q=ICL is not Aids&f=false

 

[Arbiter]

While in 1997, most adults who died were between the ages of 60 to 79, by 2002 most adults who died were between the ages of 20 to 44 (see Statistics South Africa report on mortality). The report has since been updated for 2003 (and part of 2004).

Hmmm, maybe an increase in crime? Gangs? Drug trafficking that shot up exponentially? People between the ages of 60 and 79 were born in 1918 to 1937. The population was somewhat lower then with malnutrition being much less of a problem. But those between 20 and 44 were born between 1950's and 1970's. Let's guess what happened there that could cause a lot of early deaths.

Don't throw an abuse of statistics at me. I can spot rubbish a mile away. That site is designed to cater for the masses of people who google "stop AIDS" who don't ask questions and take everything for granted.

And how about we talk about the amount of diseases that cause false positives on Western Blot tests, like TB?

http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102199871.html

CONCLUSION: Our results support the idea that confirmatory tests are necessary in a screening program for HIV 1 infection in tuberculous patients. This finding is particularly important in developing countries that utilize the WHO AIDS case definition, since tuberculosis has been shown to be the most common cause of diagnostic error.

And that after both ELISA and Western Blot tests were used. They found the same with leprosy, another not-quite-rare problem in Africa.

And here is another study they did that found that non-HIV antibodies reacted to HIV exposure, invalidating antibody response tests.

http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102192527.html

RESULTS: All rabbit anti CMV sera reacted with HIV-1 p24 and/or with p17. Most of human sera with very high titres of antibodies to CMV-p150 reacted with HIV-1 p24/17.

The problem lies with the fact that there is no incentive to study whether the tests might be faulty or giving false positive results. No one would gain except the nameless, faceless person in Africa whom no one could care about.

http://www.aliveandwell.org/html/viral_load_tcell/low_cd4.html

has an article reprinted from the British Medical Journal Online of September 2003 that agrees with the ideas that 1) Very low CD4+ counts are found in a variety of conditions where HIV is negative and 2) Many diseases other than HIV will produce a positive HIV test result.

And for those who don't understand the value of older research, before AIDS became a political and economic giant player, here's a study from 2007.

http://www.ncbi.nlm.nih.gov/pubmed/17824484

Leprosy antibodies in HIV negative populations gave a strong response to HIV antigens. This then produces a false positive result even on Western Blot tests.

The occurrence of these high false-positive rates in M. leprae-infected individuals suggests a possible complication of serodiagnosis of HIV in regions where mycobacterial infections are endemic

Need I remind you that TB, the biggest "AIDS killer" is also mycobacterial infection?

 

[alloytoo]

Hmmm, maybe an increase in crime? Gangs? Drug trafficking that shot up exponentially? People between the ages of 60 and 79 were born in 1918 to 1937. The population was somewhat lower then with malnutrition being much less of a problem. But those between 20 and 44 were born between 1950's and 1970's. Let's guess what happened there that could cause a lot of early deaths.

Don't throw an abuse of statistics at me. I can spot rubbish a mile away. That site is designed to cater for the masses of people who google "stop AIDS" who don't ask questions and take everything for granted.

Theres a certain irony here.

1997 - 2003 = 6 years

the 60-79 age group, would reasonably be expected to be the age group experiencing the highest death rate, aside from extraordinary circumstances such as war, disease or famine.

In six years that shifted to 20-44 year olds.

War?

No.

Famine?

nope.

Disease?

Hey hey. maybe we have a winner.

Now in typical illusionist fashion you're trying to distract with the non-important.

Birthdates? Irrelevant, but of interest that healthcare had dramatically improved by the 50s, 60s 70s, including anti-biotics, improved immunisations, increased rural access to health care etc etc, in fact the improvements in heath care should have raised the mortality age.

In six years majority mortality SKIPPED entire generations, and you want to blame crime?

sniff sniff....my BS detector seems to be functioning alright.

 

[Arbiter]

The study doesn't give numbers on how many people aged 20-44 died in 1997 compared to 2002. Maybe 30% of all deaths in 1997 were aged 20-44 and 32% were aged 60-79. And maybe that changed to 32% of all deaths aged 20-44 in 2002. Hell, they don't even say what percentage of people aged 20-44 had HIV or not. It doesn't give other causes of death. It simply gives you the information it wants you to see. The study is pathetic and poorly presented and shines of mainstream mediocrity.

So why don't you consider the material I have linked, regarding the fact that many extremely common illnesses in Africa can give a false positive to an HIV test? ARVs don't cure TB. TB kills you, not AIDS. AIDS may provide conditions favourable for TB infection, but so does a South Africa sub-breadline diet. So do a lot of other things.

 

[PeterCH]

Peter, I only use wiki as a source because it's a good summary of sources of a higher level. Just because I prefer to break things down to basic does not mean I am unable to understand the technicalities behind them.

You don't understand the technicalities behind them. I don't mean that in a nasty way but it's true. Unless you're in the field of course, you won't.

And you really didn't think a lot before answering. If AIDS is defined by the WHO and the CDC as a certain blood count + HIV, then barring HIV, AIDS can be the broad name for any condition that includes a very low CD4+ count? That's not rocket science.

No. AIDS is defined only in the presence of HIV infection. AIDS is an advanced stage of HIV infection.

Now here is the crux, and I explained it to you before but you did not register, I even gave you a link to read, the crux is this:
HIV does not only kill CD4 cells.

HIV infection is responsible for many different effects. Among those is immune system activation (B cell activation and antibody production to numerous epitopes, increased T cell production and death, increased amounts of active (primed) T cells and greater amounts of cytokines and chemokines - substances which are deleterious to the body).
HIV is also directly responsible for apoptosis (programmed cell death triggering) of gastro-intestinal mucosal cells and loss of Th17 cells in the gut, and this leads to not only malabsorption but also increased entry of bacteria and (endo)toxins into the body from the gut which in turns also activates the immune system. The weakened mucosal barrier also makes it possible for opportunistic infections to gain easier entry to the body independent of CD4 count. In fact proinflammatory markers are now being seen as more important than HIV-1 viral RNA counts in terms of prognostication and disease progression by some researchers. The fact is that the more the immune system is activated the worse the outcome is.

In one study they found,
http://www.ncbi.nlm.nih.gov/pubmed/9358102?dopt=Abstract&holding=f1000,f1000m,isrctn
that Elevated CD38 antigen expression on CD8+ T cells is a stronger predictor of HIV progression to AIDS and death than CD4 count - the CD4 cells being the cells the HIV destroys. It's another example of how the hyperstimulation of the immune system caused by the HIV affects health negatively and leads to AIDS.

In Contrast ICL does not have these characteristics.

And there's no debate that the primary cause of AIDS onset is the destruction of CD4+ cells by HIV. And we're dealing with the primary problem here.

CD4 cell loss is only one aspect of HIV infection. The hyperstimulated immune system and other lesser studied effects appear to be key. Science is dicovering new things about HIV each year.

The question still stands. If the primary definition and proof of AIDS is a low CD4+ count, why can ICL not be considered to be AIDS without HIV?

HIV disease is not only about pure CD4 deficiency - and science is discovering this more and more.

 

[PeterCH]

If something other than fluid exchange with someone HIV positive, like drug abuse or malnutrition, can cause a condition identical to AIDS, don't you think that deserves some spotlight?

HIV is one form of immunodeficiency. However you want to group all forms of immunodeficiency in one. This is not the case. There are a variety of immunodeficiency states. One can have a B cell deficiency, T cell deficiency,
neutrophil deficiency, total bone marrow failure, abnormal activation of B cells and many more examples. Those have been show to either be due to genetic mutations (lymphomas, leukemias, etc), external substances (steroids, immuno suppressive agents) and yes even to a lesser degree chronic alcohol abuse, diabetes mellitus (in which elements of the immune system are dysfunctional) and malnutrition. However, HIV is pretty specific for CD4 T cells and results in various other effects - not just CD4 cell deficiency - effects which are not seen in purely malnourished or impoverished people because they require elements of the immune system to be intact and HIV/AIDS involves a selective immune system dysfunction - extreme malnutrition would effect all branches of the immune system (specific and non-specific) more or less equally.

Since AIDS is incurable, but those other things are curable. Maybe the amount of false positive results popping up in poor African countries aren't HIV at all, but the cause of poor nutrition which leads to ICL/AIDS?

Hence the utility of PCR.

Let me rephrase that. You linked an ancient article from 1996. No-no-no.

An alternative confirmatory HIV testing strategy based on initial testing on either SD Bioline or Determine assays followed by testing of reactive samples on the Determine or SD Bioline gave 100% sensitivity (95% CI; 99.1–100) and 100% specificity (95% CI; 96–99.1) with Uni-Gold™ as tiebreaker for discordant results.

http://www.biomedcentral.com/1471-2334/9/19

False positives with modern rapid antibody tests are very rare.

But to further negate your concerns I will also say that to initiate a person on ART a VIRAL LOAD is necessary - it's done at a time when CD4 drops to 200-250 the current common African cut off for ART commencement.

Viral Loads count HIV 1-RNA through PCR and false positives do not occur - not at high VL counts anyway. Qualitative tests are also available for confirmation but these are expensive and unnecessary.

I'm not saying poor nutrition IS the cause of AIDS. I'm just saying I think it's irresponsible to not consider the possibility. ARVs are very dangerous, especially to people in poor health aka the majority of Africa.

Do note that in advanced HIV and in early HIV the antibody based HIV tests are all NEGATIVE. Yes, in stage 4 HIV disease many of these once positive tests become negative. However these people have extremely low CD4 counts and extremely high HIV-1 Viral RNA counts.

You've also mentioned TB. TB is very difficult to diagnose in people who are HIV positive. Their sputums are often negative, their skin prick tests are often of low utility because of the high level of exposure in the general population in Africa, TB induced sputum cultures are great but take forever and aren't always positive and biopsies of lymph nodes are not always positive. However, it is possible to ascertain the presence of TB with some degree of accuracy if one keep a high index of suspicion and combinations of xrays, sputum direct and culture tests and symptomatology as well as epidemiological info about TB in a given area can guide one to a suspected TB diagnoses. In that case, TB is usually treated first for a period of time before ART is introduced.

 

[Arbiter]

Peter, do me a favour. Stop thinking like a doctor for a second. Open your little vault to the possibility that the general consensus might be actually be wrong or missing something. That's called being responsible and there's nothing wrong with that.

You say yourself that science is discovering new things all the time about HIV. And yet you would probably not have believed the information you have today, a few years ago.

I've read the studies you posted and I agree with what they show. But increased CD38 expression is also associated with leukemia. And I'll probably find another, ignored condition characterized by that. Perhaps Malaria?

http://www.ncbi.nlm.nih.gov/pubmed/19019204?dopt=AbstractPlus

And how about considering the fact that possible malaria vaccines might induce CD8+ response as well?

http://www.jimmunol.org/cgi/content/abstract/153/10/4636

So you've got little Sipho, who has an immune system and constitution that is the genetic result of maybe a century or two of malnutrition and immense psychological and physical distress of his ancestors. Add that to the fact that, for the past how many years, he hasn't been eating very well and he's been running away from some dictator's army.

While experiencing acute malaria, he's producing this massive immune response of CD38 expression, amongst other things. And of course, the kindly folks from the UN come and administer some trials in Africa where NO ONE is going to complain if all the test subjects drop dead. They give him some attempts at vaccines that cause another blooming CD8+ response. Add that to his malnourished AIDS-level (NOT AIDS) count of CD4+ cells and you've got a candidate scheduled for death in not too long.

How's that for a summary? Sure, it's not complete and it's basic and to the point. If found wanting, I'll provide some more detail.

So now we've got low CD4+ covered and we've got high CD8+ and CD38 covered. Th 17 problems? I promise you I will find some disease very prevalent in Africa that causes that. I will find more about CD38 expression and more about low CD4+. They will all be prevalent problems in Africa. And I know you will too...if you even bothered to look for them.

HIV tests that provide false positives in mass numbers, some older studies show 70% false positive, in people with TB, leprosy and other mycobacterial infections.

Low CD4+ counts caused by poor genes and what can only be described as "Africa living".

Elevated CD38 expression caused by a variety of other problems, of which I have linked two.

We are heading into territory, drawn out by some of the most official sources and research institutions you get, where, amongst many other things, HIV is misdiagnosed due to massive prevalence of conditions causing false positives in even the most advance Western Blot tests.

Where AZT and experimental ARVs are given to the invisible, population of Africa that attempt to cure only a symptom of a much bigger underlying problem. Not to mention the fact that ARVs are brutal on even the healthiest of people who are well nourished.

Where one of the biggest health aid plans ever is doing a lot of damage when it could be greatly increasing the living standards of the people who suffer so much. And decreasing their dependence on medications that might not be there tomorrow.

And we will get to that territory.

You only need to connect the dots.

 

[alloytoo]

The study doesn't give numbers on how many people aged 20-44 died in 1997 compared to 2002. Maybe 30% of all deaths in 1997 were aged 20-44 and 32% were aged 60-79. And maybe that changed to 32% of all deaths aged 20-44 in 2002. Hell, they don't even say what percentage of people aged 20-44 had HIV or not. It doesn't give other causes of death. It simply gives you the information it wants you to see. The study is pathetic and poorly presented and shines of mainstream mediocrity

.

Lots of "If's", "Maybes" & "perhaps"....Don't like the stats, find more detailed ones.

So why don't you consider the material I have linked, regarding the fact that many extremely common illnesses in Africa can give a false positive to an HIV test? ARVs don't cure TB. TB kills you, not AIDS. AIDS may provide conditions favourable for TB infection, but so does a South Africa sub-breadline diet. So do a lot of other things.

So maybe, if all the "ifs", "maybes" and "perhaps" above have an inkling of validity (and your comments about their periods of birth were meaningless.) some of folks diagnosed with AIDS have might, maybe, perhaps have false HIV+ results and giving them ARV's would kill them?

Only giving them ARV's generally extends their lives, which shouldn't according to you happen. Those that don't get ARV's tend to die, and not from cancer related illnesses which suggests that it's not ICL.

 

[PeterCH]

Peter, do me a favour. Stop thinking like a doctor for a second. Open your little vault to the possibility that the general consensus might be actually be wrong or missing something. That's called being responsible and there's nothing wrong with that.

The general consensus is based on millions of pieces of research and not on linking memes.

You say yourself that science is discovering new things all the time about HIV. And yet you would probably not have believed the information you have today, a few years ago.

HIV is thought to cause a lot more nowadays then mere immunodefficiency. People with HIV suffer more cardiovascular disease (stroke, heart attacks), chronic obstructive airways disease (despite not smoking) and many more
non-traditional HIV/non-opportunistic disease end points.

I've read the studies you posted and I agree with what they show. But increased CD38 expression is also associated with leukemia. And I'll probably find another, ignored condition characterized by that. Perhaps Malaria?

That's just the thing - there's tons of overlap my friend. Positive RPR tests are associated with not only syphillis but also with rheumatoid arthritis and SLE. Thinking along your line I would jump to the conclusion that Methotrexate and Azathioprine should be scrapped and SLE treated with Penicillin instead.

http://www.ncbi.nlm.nih.gov/pubmed/19019204?dopt=AbstractPlus

And how about considering the fact that possible malaria vaccines might induce CD8+ response as well?

You are free to research this if you want. If you have a valid proposal, write to the NHI and they may consider it.

http://www.jimmunol.org/cgi/content/abstract/153/10/4636

So you've got little Sipho, who has an immune system and constitution that is the genetic result of maybe a century or two of malnutrition and immense psychological and physical distress of his ancestors. Add that to the fact that, for the past how many years, he hasn't been eating very well and he's been running away from some dictator's army.

I'm not so sure. Populations in Europe have been malnourished themselves - look at the slums of Industrial Revolution Britain or France - that occurred from the late 1700s to the beginning of the 20th century - human suffering, malnutrition, poverty etc - in fact Sipho has it better than Victorian children had it all over Europe and America with WHO and USAID sponsored vaccination programs, free meds and 20th century medical knowledge. I don't buy this. You seem to ignore a lot of history.

While experiencing acute malaria, he's producing this massive immune response of CD38 expression, amongst other things. And of course, the kindly folks from the UN come and administer some trials in Africa where NO ONE is going to complain if all the test subjects drop dead.

These days trials are heavily reviewed by Research Ethics Boards and Institutional Review Boards both in the host country and country which is providing the researchers. In fact NIH for example can't operate in a country if it does not have an REC. They actually create RECs for these people.

They give him some attempts at vaccines that cause another blooming CD8+ response. Add that to his malnourished AIDS-level (NOT AIDS) count of CD4+ cells and you've got a candidate scheduled for death in not too long.

If he was so badly nourished he'd have died already from childhood gastroenteritis. You don't know the reality of Africa.

But yes- write to the NIH and maybe they'll take your proposal for an alternative form of research to benefit these very people. After all researching on needle sharing drug addicts and prostitutes in Europe and USA will not generate data worthwhile for the African populance.

How's that for a summary? Sure, it's not complete and it's basic and to the point. If found wanting, I'll provide some more detail.

I'm not sure why you're going on about malaria but if it pleases you.....

So now we've got low CD4+ covered and we've got high CD8+ and CD38 covered. Th 17 problems? I promise you I will find some disease very prevalent in Africa that causes that. I will find more about CD38 expression and more about low CD4+. They will all be prevalent problems in Africa. And I know you will too...if you even bothered to look for them.

No I won't. Please do yourself a favour - go do medicine for 6 years then enlist in a post-grad research programme - CDC, NIH, Fogarty and many others offer grants for study.

HIV tests that provide false positives in mass numbers, some older studies show 70% false positive, in people with TB, leprosy and other mycobacterial infections.

HIV false positives are very rare. Before one treats one does a second test. Then one does a CD4 and a viral load. The viral load is PCR based and counts viral RNA - there are no false positives in that.

Low CD4+ counts caused by poor genes and what can only be described as "Africa living".

HIV is not just about low CD4.

Elevated CD38 expression caused by a variety of other problems, of which I have linked two.

Which is all to common in medicine and biology - I gave you an example of false positive RPR. You can't do a meme search on Google and expect to find cross-correlations this way. What you're suggesting is inappropriate.

We are heading into territory, drawn out by some of the most official sources and research institutions you get, where, amongst many other things, HIV is misdiagnosed due to massive prevalence of conditions causing false positives in even the most advance Western Blot tests.

Rubbish. Come on HIV is not misdiagnosed. The tests are almost 100% specific.

Where AZT and experimental ARVs are given to the invisible, population of Africa that attempt to cure only a symptom of a much bigger underlying problem. Not to mention the fact that ARVs are brutal on even the healthiest of people who are well nourished.

Currently trials are being conducted to conclusively prove that starting ART earlier is even more beneficial. HIV linkage with a variety of traditional NON-HIV/AIDS endpoints is very strong - things such as stroke, liver failure and asthma are more common in people with HIV - and we're picking up more and more of this because HIV positive patients are surviving longer.

Here's one for you:
http://www.pulmonaryreviews.com/dec04/pr_dec04_HIVpositivity.html

and another for you:
http://www.i-base.info/htb/v8/htb8-8-9/HIV.html

CONFERENCE REPORTS
HIV viraemia may explain increased risk of cardiovascular disease, death and other serious events in patients interrupting treatment in the SMART trial: new study to randomise patients with CD4 counts >500 to start immediate treatment or defer to <350 cells/mm3

Simon Collins, HIV i-Base

Where one of the biggest health aid plans ever is doing a lot of damage when it could be greatly increasing the living standards of the people who suffer so much. And decreasing their dependence on medications that might not be there tomorrow.

HIV is the killer. The new ARTs are much safer and in fact there is a strong thought among many researchers nowadays that many of the side-effects seen with ART may be due primarily to HIV itself.

I recommend you do one of the following. Instead of posting about things you don't really understand, go do a BSc or better do a medical degree and do a post-grad Masters - there are many opportunities for sponsorhip of a fellowship. Then you can propose ideas to bodies such as the National Institutes of Health and they will sponsor your research.

Drop the AIDS denialism. Please. Ne?

 

[PeterCH]

.

Lots of "If's", "Maybes" & "perhaps"....Don't like the stats, find more detailed ones.



So maybe, if all the "ifs", "maybes" and "perhaps" above have an inkling of validity (and your comments about their periods of birth were meaningless.) some of folks diagnosed with AIDS have might, maybe, perhaps have false HIV+ results and giving them ARV's would kill them?

Only giving them ARV's generally extends their lives, which shouldn't according to you happen. Those that don't get ARV's tend to die, and not from cancer related illnesses which suggests that it's not ICL.

Stopping HIV ART actually kills people:
http://www.nlm.nih.gov/databases/alerts/aids_smart.html

I believe our friend is an AIDS denialist - I would suggest you ignore him because he's just posting nonsense. No personal offense to him but he doesn't know what he's talking about.