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TESTING AND SURVEILLANCE

HIV PROTEINS

“...analysis of the proteins demands mass production

and purification”

Luc Montagnier 1997

Montagnier 1983Material at 1.16 gm/ml

“Purified virus”

3 proteins react with patient serump24/25 =“HIV”

No EM

“I REPEAT, WE DID NOT PURIFY”

NO PARTICLES “TYPICAL OF

RETROVIRUSES” IN THE “PURIFIED” VIRUS

Luc Montagnier Pasteur Institute Interview July 1997

THE “HIV” PROTEINS p41/120/160

MONTAGNIER 1983, 1997p41 PROTEIN IS CELLULAR ACTIN

Arthur 1992; Orentas, 1993; Pearce-Pratt 1994; Sasaki 1995; Choudhury 1996

ACTIN PRESENT IN PURE HIV

THE “HIV” PROTEINS p41/p120/p160

Pinter 1989 J. Virology 63: 2674-79

p160, p120 IN “HIV” WB OLIGOMERS OF p41

“Confusion over the identification of these bands has resulted in incorrect conclusions…some clinical specimens may been identified erroneously as seropositive…”

THE “HIV” PROTEINS p24

MORTIMER 1992 p24 NON-SPECIFIC

SCHUPBACH 1992 p24 IN 49/60 (82%) of "presumably uninfected but serologically indeterminate” and “5/5 seronegative blood donors”Agbalika 1992; Vincent 1993 HIGHEST LEVELS OF p24 IN NON-INFECTED ORGAN TRANSPLANT RECIPIENTS

THE “HIV” PROTEINS p32

Henderson1987 studied the p30-32 and p34-36 of "HIV purified by double banding" in sucrose density gradients. Comparison with the amino-acid sequences of these proteins with Class II histocompatability DR proteins proved that "the DR alpha and beta chains appeared to be identical to the p34-36 and p30-32 proteins respectively”

Cellular origin also acknowledged by other HIV experts such as Arthur 1995.

THE “HIV” PROTEINS- p17/18

Stricker 1987 Sera from AIDS patients bind to a p18 protein bind to mitogenically stimulated but uninfected in uninfected lymphocytesChassagne 1986 MCA to "HIV" p18 reacts with dendritic cells in the lymphatic tissues of a variety of patients with a number of non-AIDS related diseasesParravcini 1988 the "same pattern reactivity was present in normal tissue taken from uninfected individuals as in those taken from HIV positive subjects”Faulk 1991 MCA to “HIV” proves p17 present in normal, uninfected human placenta

HIV PROTEINS IN NORMAL HUMAN PLACENTA p18/p24/p120

Faulk and Labarrere 1991Immunocytochemical reactivity using poly- and monoclonal antibodies

“Placentae from 25 normal term pregnancies were collected by vaginal delivery...Antigens gp120 and p17 were identified in normal chorionic villi…Antigen p24…in villous mesenchymal cells...localized to HLA-DR positive cells”

WHY THE ANTIBODY REACTIONS?

Infectious agents (inc. mycobact, fungi)Autoantibodies (many inc. actin & myosin)Non-specific and cross reacting antibodies

?HIV

GOLD STANDARD

HIV ITSELFHIV ISOLATION

HIV ISOLATION PROBLEMATIC

RT (inc. mitochondria)PARTICLES

ANTIGEN/ANTIBODY REACTIONSp24

ALL NON-SPECIFIC

NIAID Web site“Currently available HIV antibody tests are extraordinarily accurate, both in terms of sensitivity (the ability of the test to give a positive finding when a subject is truly HIV-infected) and specificity (the ability of the test to give a negative finding when a subject is truly HIV-free)”.

PIE IN OVEN NO PIE

LIGHT ON 80 10

LIGHT OFF 2 640

82 650

DAYS 732Pies 82One every 9 daysSensitivity 97.6%Specificity 98.5%

DISEASE NO DISEASE

POSITIVE

NEGATIVE

HIV NO HIV

POSITIVE

NEGATIVE

Assay Name (Manufacturer) Global Panel

Sensitivity SpecificityDetect HIV 1 + II 100% 97.4%Cambridge 99.6% 99.7%Abbott 3rd generation 100% 100%HIV

The panel included 332 HIV negative specimens

and 203 sera positive for HIV-1 and 60 positive for HIV-2

specimens

AIDS Blood

Donors

HIV POS 86 19

HIV NEG 2 795

88 814

Sensitivity 97.73%Specificity 97.67%

GALLO JAMA 1985

NO RISK HOSPITAL PATIENTS St. Louis 1988

HOS NUM ALL MEN 25-44 WOM 25-441 2897 7.8 21.7 7.42 4406 5.6 18.4 7.83 1968 3.2 13.3 3.54 1720 1.9 7.1 0.75 5380 0.9 3.2 0.86 3299 2.6 7.7 3.37 3823 1.9 1.8 2.48 4275 1.8 5.7 0.8

BURKE NEJM 1988

1.2 MILLION/135,1871.4 and 0.148 per 1000

HEALTHY MILITARYRECRUITS

HIV NO HIV

POSITIVE 14 1

NEGATIVE 0 135172

14 135173

Total 135187Sensitivity 100.0%Specificity 99.9993%

BURKEHIV POSITIVE = 2E + 2WBHIV NEGATIVE = NOT ABOVE

TRULY INFECTED = 2E +2WB+4XWBNOT TRULY INFECTED= NOT ABOVE

THE DE FACTO HIV GOLD STANDARDS

THE CLINICAL SYNDROMELOW RISK/GOOD HEALTH

REPEATING THE TEST

AIDS NO AIDS

AB POS

AB NEG

HIV NO HIV

AB POS

AB NEG

NIAID Web site“Currently available HIV antibody tests are extraordinarily accurate, both in terms of sensitivity (the ability of the test to give a positive finding when a subject is truly HIV-infected) and specificity (the ability of the test to give a negative finding when a subject is truly HIV-free)”.

“At present there is no recognized standard for

establishing the presence or absence of HIV-1 antibody in

human blood”

Abbott Laboratories1988, 1998

The real purpose of scientific method is to make sure Nature hasn't misled

you into thinking something you don't actually know... One logical slip and an entire scientific edifice comes tumbling down. One false

deduction about the machine and you can get hung up indefinitely.

Robert Pirsig, Zen and the Art of Motorcycle Maintenance