Is there any evidence from clinical trials that protease
inhibitors alone (monotherapy) is worse than the combination
"cocktails"?
27
Mar
PI monotherapy?
tod…@ix.netcom.com(Todd Miller) wrote:
>Is there any evidence from clinical trials that protease
>inhibitors alone (monotherapy) is worse than the combination
>"cocktails"?
For the benefit of those who can accept statistically significant
findings, I’m reposting the following …
The following is from information presented at the XIth International
Conference on AIDS in Vancouver. From what I’ve heard, I believe
similar results are sustained at well over a year…
(This summary is from http://www.projinf.org/pub/19/update.html)
%below detection@24wks %below detection@48wks
IDV 41% 56%
AZT+3TC 0% 0%
AZT+3TC+IDV 90% 86%
Median VL drop(logs)@24wks Median VL
drop(logs)@48wks
IDV -0.8 -1.6
AZT+3TC -0.6 -0.4
AZT+3TC+IDV -2.2 -2.3
Median increase in CD4@24wks Median increase in
CD4@48wks
IDV 106 158
AZT+3TC 14 14
AZT+3TC+IDV 127 218
(has *your* spaceship left without you? ….beee-bop-da-woo-wop !)
- Hide quoted text — Show quoted text -
dav…@home.com (Dave Thomson) wrote:
>tod…@ix.netcom.com(Todd Miller) wrote:
>>Is there any evidence from clinical trials that protease
>>inhibitors alone (monotherapy) is worse than the combination
>>"cocktails"?
>For the benefit of those who can accept statistically significant
>findings, I’m reposting the following …
>The following is from information presented at the XIth International
>Conference on AIDS in Vancouver. From what I’ve heard, I believe
>similar results are sustained at well over a year…
>(This summary is from http://www.projinf.org/pub/19/update.html)
> %below detection@24wks %below detection@48wks
>IDV 41% 56%
>AZT+3TC 0% 0%
>AZT+3TC+IDV 90% 86%
> Median VL drop(logs)@24wks Median VL
>drop(logs)@48wks
>IDV -0.8 -1.6
>AZT+3TC -0.6 -0.4
>AZT+3TC+IDV -2.2 -2.3
> Median increase in CD4@24wks Median increase in
>CD4@48wks
>IDV 106 158
>AZT+3TC 14 14
>AZT+3TC+IDV 127 218
>(has *your* spaceship left without you? ….beee-bop-da-woo-wop !)
tod…@ix.netcom.com(Todd Miller) replied:
>I didn’t see any statistics in your post or at the web page,
>but thanks for the pointer.
You’re welcome.
>I’ve learned that HIVers say lots
>of things they can’t back up very well.
You *did* miss the spaceship, didn’t you? Looks like Johndog may have
made it though. Haven’t seen his crap lately.
- Hide quoted text — Show quoted text -
>Todd
In <5hgclk$1…@ha2.rdc1.sfba.home.com> dav…@home.com (Dave Thomson)
writes:
- Hide quoted text — Show quoted text -
>dav…@home.com (Dave Thomson) wrote:
>>tod…@ix.netcom.com(Todd Miller) wrote:
>>>Is there any evidence from clinical trials that protease
>>>inhibitors alone (monotherapy) is worse than the combination
>>>"cocktails"?
>>For the benefit of those who can accept statistically significant
>>findings, I’m reposting the following …
>>The following is from information presented at the XIth International
>>Conference on AIDS in Vancouver. From what I’ve heard, I believe
>>similar results are sustained at well over a year…
>>(This summary is from http://www.projinf.org/pub/19/update.html)
There is no mention of statistical significance between PI monotherapy
and triple cocktails at this web page or in the summary data you
presented. Do you have another source that confirms the statistical
significance you claim?
Is 56% being below detection (crixivan only) significantly different
from 86% (triple cocktails)? Is a median viral load drop of 1.6 logs
statistically different from 2.3 logs? Is a median increase in CD4
cells of 158 different from 218? I suspect there was too much
variation in the relatively small study you cite for there to be
any statistical significance. This would explain why the authors
of the web page do NOT say anything about statistics–the numbers
were not statistically different.
Indeed, The Miami Herald ran a story on the front page of the
St Patrick’s day edition about the developing fiasco of a
clinical trial in Brazil (there is a post on sci.med.aids about
this). In this article, Dr Eduoardo Motti, head of Merck’s
clinical research in Brazil, "said there is no clinical data
showing indinavir alone is inferior to combination therapy".
Dr Motti also knows there is no statistical significance
in these numbers.
So, does anyone else know of data that would prove Dr Motti
wrong? Or does Dave have some statistics that he’s holding
back on us?
Todd Miller, PhD
- Hide quoted text — Show quoted text -
tod…@ix.netcom.com(Todd Miller) wrote:
>In <5hgclk$1…@ha2.rdc1.sfba.home.com> dav…@home.com (Dave Thomson)
>writes:
>>dav…@home.com (Dave Thomson) wrote:
>>>tod…@ix.netcom.com(Todd Miller) wrote:
>>>>Is there any evidence from clinical trials that protease
>>>>inhibitors alone (monotherapy) is worse than the combination
>>>>"cocktails"?
>>>For the benefit of those who can accept statistically significant
>>>findings, I’m reposting the following …
>>>The following is from information presented at the XIth International
>>>Conference on AIDS in Vancouver. From what I’ve heard, I believe
>>>similar results are sustained at well over a year…
>>>(This summary is from http://www.projinf.org/pub/19/update.html)
>There is no mention of statistical significance between PI monotherapy
>and triple cocktails at this web page or in the summary data you
>presented. Do you have another source that confirms the statistical
>significance you claim?
>Is 56% being below detection (crixivan only) significantly different
>from 86% (triple cocktails)? Is a median viral load drop of 1.6 logs
>statistically different from 2.3 logs? Is a median increase in CD4
>cells of 158 different from 218? I suspect there was too much
>variation in the relatively small study you cite for there to be
>any statistical significance. This would explain why the authors
>of the web page do NOT say anything about statistics–the numbers
>were not statistically different.
Lets just look at the 24 weeks data:
%below detection@24wks
IDV 41%
AZT+3TC+IDV 90%
(note: n=27 and n=30 for the IDV and AZT+3TC+IDV groups, respectively)
So you’re wondering if 90% is statistically significant from 41% ? I’m
not going to do the calculations ‘cos it’s so ridiculous to even
suggest that two distributions this far apart could ever NOT
be significant ! I don’t know if it’s even POSSIBLE to get spreads
large enough for two distributions centered on .41 and .90 which would
not suggest a difference. Maybe you’d have to adjust your criteria for
significance for this one. If I got more than twice the number of
miles per gallon by using a different gasoline I think I’d switch,
even if next time I only got 190% of the mileage. The data from
protocol 035 is similar to findings in other studies and there’s no
evidence the tails of these distributions ever come close to each
other.
It’s not too late to board the mother ship !
Interestingly, however, I noted how readily you came to your
conclusions of statistical INsignificance ! (you can’t find the data
so therefore it must exist in a form which supports your desires)
I’d also like to point out that you did ask for *evidence*.
Statistical significance is rarely necessary to reason "evidence"
sufficient for further investigation. However I gave you this starting
point for the studies where you CAN find statistical significance data
(both on surrogate and clinical markers, I may add). For example,
couldn’t you just look at the full results from this study which were
presented in Vancouver? Couldn’t you look at the findings of ACTG320
which was stopped early due to the STATISTICALLY significant reduction
in mortality and STATISTICALLY significant reductions in disease
progression as a result of AZT+3TC+Crixivan over AZT+3TC? Is it
too difficult for you to see ‘evidence’ from the combination of the
surrogate data I presented with the findings of this trial ?
Although some of the surrogate data is NOT statistically significant
to the confidence intervals used in some of these studies, other
studies have found that the CLINICAL data HAS been significantly
different for a similar treatment arm ! No-one ever suggested the
surrogate markers were perfect.
In <5hiftd$l…@ha2.rdc1.sfba.home.com> dav…@home.com (Dave Thomson)
writes:
>Todd:
>Is 56% being below detection (crixivan only) significantly
different from 86% (triple cocktails)? Is a median viral load
drop of 1.6 logs statistically different from 2.3 logs? Is a
median increase in CD4 cells of 158 different from 218? I
suspect there was too much variation in the relatively small
study you cite for there to be any statistical significance.
This would explain why the authors of the web page do NOT say
anything about statistics–the numbers were not statistically
different.<
Dave:
>>Lets just look at the 24 weeks data:
%below detection@24wks
IDV 41%
AZT+3TC+IDV 90%
(note: n=27 and n=30 for the IDV and AZT+3TC+IDV groups,
respectively)
So you’re wondering if 90% is statistically significant from 41%
? I’m not going to do the calculations ‘cos it’s so ridiculous to
even suggest that two distributions this far apart could ever NOT
be significant ! I don’t know if it’s even POSSIBLE to get
spreads large enough for two distributions centered on .41 and
90 which would not suggest a difference.<<
—————————————————————-
Comment: Ahem. For the statistics-impaired here, let me point
out that these are not distributions, but simply a binary
tabulation of response vs. non response, 41% = 11/27 in one
group, and 90% = 27/30 in the other. The simplest way to tell if
these response fractions are significantly different (i.e.: Is
the difference between groups likely to have come about by luck
of the draw, rather than treatment effect?) is to construct the
relevant 2 x 2 contingency tables, and calculate the chi square
statistic (with Yates correction for df=1).
This can even be done here without a stats program: Here we
have a total of 57 patients and a total of 38 responders, for an
average response probability of 38/57 = 2/3. If the differential
treatment between groups had had no effect, we would thus have
expected 27 * 2/3 = 18 responders in the IDV group (rather than
the observed 11), and 27-18 = 9 non-responders rather than the
observed 27-11 = 16. Similarly, there should have been 30 * 2/3
= 20 responders in the IDV+AZT+3TC group, rather than the
observed 27, and 30-20 = 10 nonresponders, rather than the
observed 3. The chi square statistic is thus the sum of the four
(observed-expected)^2/expected values, with the Yates correction
of .5:
(18-11-.5)^2 / 18 = 2.347
(16-9-.5)^2 / 9 = 4.694
(27-20-.5)^2 / 20 = 2.112
(10-3-.5)^2 / 10 = 4.225
——————————
Total Chi Square = 13.38
You can read off the corresponding p value for 1 degree of
freedom in any book of statistics tables: it is p << .001 (p =
001 corresponds to chi square 10.8, and my tables don’t go
higher). That means there is far less than 1 chance in 1000,
probably less than 1 chance in 5000, that such a lopsided
response difference between groups was due to chance alone, given
the total response rate observed in these groups, and the sample
sizes given. One of these table cells has fewer than 5 elements,
so the result should probably be compared with the Fisher exact
test (for which a computer program would be necessary), but the
larger sizes of the other cells suggest that this would not
change the result much. It’s going to be highly significant by
any test. I’ll leave results of other trials to calculation by
the student, now that I’ve illustrated how.
Also, of course, we’re talking here of statistical
significance, not clinical significance. Still, it was the idea
of statistical significance which Todd questioned, and that
question, at least, can be laid to rest.
Steve Harris, M.D.
Steven B. Harris wrote:
[edit]
> Also, of course, we’re talking here of statistical
> significance, not clinical significance. Still, it was the idea
> of statistical significance which Todd questioned, and that
> question, at least, can be laid to rest.
> Steve Harris, M.D.
Actually Toddy’s ignorance is both statistically and clinically
significant.
Conceptual illiteracy, and the blindness of bigotry and envy
are a contagion of communication.
I guess that’s why we all feel better when he shuts up.
Charles McCarthy, P.M.D. (Hon)
Clinical Specialist
Californ writeth:
>>But getting back to Dr. Harris and his apparent statement
that "a healthy adult might have a CD4+ lymphocyte count of 800
to 1000…" I should add that a healthy adult might have a count
of 1,000… or he might have a count of 1200 or 800 or 600 or
430. It is even possible that a count below 430, while statist-
ically unusual according to the above study, may nevertheless be
"normal" and healthy for a given person – certainly a lot
less abnormal than is made out to be based on now-outdated
assumptions about what constitutes normal CD4 counts.<<
Gosh, yes, Californ. But there is a big difference between a
CD4 count of 450 which has been stable for years, and one that
was 500 last year, 550 the year before, and 600 the year before,
and so on. You will remember in that case my analogy of the guy
falling off the 100 story building, who says as he passes the
50th floor: "Well, I’m okay so far." Wise people project trends.
And as far as a single count, the problem is that you cannot
keep going to lower and lower numbers by insisting that each
could represent a (more and more rare) varient of normal health.
Saying that a count of 430 might be unusual, but still on the
tail-end of normal and healthy, does not imply that this is STILL
true of 300. Or of 200. This way lies the madness of JohnBull,
who will tell you that there’s nothing wrong with wasting away to
a T-cell count of zero, so long as you maintain your optimism,
and stay off AIDS drugs.
Unfortunately for JohnBull, at some point in T-cell count
drop, reality bites. When following groups of HIV-infected
individuals, it is noted that they become markedly more at risk
for opportunistic infections (with pneumocystis being the most
sensitive one) below CD4 counts of 200. The median CD4 count at
which the first AIDS-defining opportunistic infection appears, is
50 to 60, depending on group and age. This same number is also
seen in studies done on cohorts who did not receive AZT prior to
onset of AIDS, so AZT has nothing to do with this association
(remember Kimberly Bergalis and Arthur Ashe). The association of
CD4 count and opportunistic infection risk in untreated people is
seen in studies of women and men alike, and in hemophiliacs,
transfusion victims, and gay people. More than 95% of AIDS
victims drop below a CD4 count of 50 before they die, so such
profound drops are routine for AIDS, and have happened to
hundreds of thousands of HIV-infected persons. However, I am not
aware of a single report of a sustained CD4 count this low (60)
in someone who did not otherwise have a good explanation for it
(such as chemotherapy or leukemia), who was NOT infected with
HIV. A count this low MEANS that a person is almost certainly
infected with HIV, in much the same way that particular lesions
on the skin means that a person is almost certainly infected with
Herpes zoster/varicella (the chickenpox virus).
So you continue to tell people who have CD4 counts of 430 that
they are not in trouble, while all the time dishonestly staying
away from telling people at what CD4 counts they ARE in trouble.
I’m sure your squirrely mind squirrels away from THAT question
like mad. Let me help. Statistics on prospectively followed
untreated people show that a sustained CD4 count of 60, without a
major bone marrow destroying disease to explain it, means you are
in big immunologic trouble, and that almost without doubt (99.99+
% chance) that you are infected with HIV (this is as pure an
association as exists in medicine between an infectious disease
and a lab test which doesn’t test directly for the organism). It
also means that quite soon (a year or two), without treatment,
you are going to develop AIDS. Which, without treatment, is very
rapidly fatal (days to months). So if you have a CD4 count this
low and have decided NOT to visit your doctor to do something
about it, you should be prepared for the consequences of denying
the carefully statistically examined painful experiences of
others. In that case, settle your affairs, make peace with your
loved ones, and don’t buy any green bananas.
Steve Harris, M.D.
Steven B. Harris wrote:
> :
:
> sizes given. One of these table cells has fewer than 5 elements,
> so the result should probably be compared with the Fisher exact
> test (for which a computer program would be necessary), but the:
——————————————————————
Fisher’s exact test for testing independence in a 2×2 contingency
table is available on-line at http://nlh10.nlh.no/~matfola/fisher.htm
Oyvind Langsrud
Steven B. Harris (sbhar…@ix.netcom.com) wrote:
: Californ writeth:
: >>But getting back to Dr. Harris and his apparent statement
: that "a healthy adult might have a CD4+ lymphocyte count of 800
: to 1000…" I should add that a healthy adult might have a count
: of 1,000… or he might have a count of 1200 or 800 or 600 or
: 430. It is even possible that a count below 430, while statist-
: ically unusual according to the above study, may nevertheless be
: "normal" and healthy for a given person – certainly a lot
: less abnormal than is made out to be based on now-outdated
: assumptions about what constitutes normal CD4 counts.<<
: Gosh, yes, Californ. But there is a big difference between a
: CD4 count of 450 which has been stable for years, and one that
: was 500 last year, 550 the year before, and 600 the year before,
: and so on. You will remember in that case my analogy of the guy
: falling off the 100 story building, who says as he passes the
: 50th floor: "Well, I’m okay so far." Wise people project trends.
Well, you’re right as far as the the analogy goes. The problem is that it
often is taken far beyond that. For one thing, CD4 counts decline with
age, as has been pointed out to you before. As you may know, people only
get older, never younger, so this is likely to be associated with
long-term decline in this measure. Second, the man walking around happily
and healthily on the 20th floor is often treated as if that is a priori
evidence of a health problem – as if he had just crashed through 80
floors. While wise people project trends, there are no real safeguards to
keep AIDS doctors from extrapolating from even just one Tcell count/test.
After all, to ensure that the "low" 450 CD4 count is not transient, one
ought to wait let’s say 3 or 6 months. That is to say, 3 to 6 months to
pressure and terrorize the hell out of the "HIV antibody positive
diagnosed" patient into "hit-it-hard-hit-it-early" long-term medical
treatment as well as let him experience many of various non-HIV effects of
the diagnosis. Those effects include financial and emotional devastation,
social ostracization, and a possible vicious cycle of compromised health
that is caused by and contributes to those experiences and is liable to
affect the next Tcell test result. (Even those diagnosed not HIV positive
could well experience drops in their CD4 counts due to the knowledge of
what "low" CD4s allegedly mean in those who are positive. But they won’t
be pressured into anti-HIV drugs.) No safeguards are in place, no
reasonable guarantee is there that the psychophysiological effects
following from the "HIV positive" diagnosis itself and/or the low CD4
counts and/or the ongoing medical combination therapy immediately
thereafter won’t singularly or together effect the next CD4 counts, which
are then reinterpreted as the effects of HIV. Indeed, it is hard to
imagine anyone *not* being subject to the various "non-HIV effects of an
HIV-positive diagnosis", once so stigmatized. Whatever may be the alleged
effects of HIV, there is no way to separate the non-HIV effects of the
diagnosis on CD4 counts from the alleged HIV-associated effects. It is
inevitable that the former will be mistaken for the latter, and help
create the very "trend" you are looking for.
: And as far as a single count, the problem is that you cannot
: keep going to lower and lower numbers by insisting that each
: could represent a (more and more rare) varient of normal health.
To the contrary, there is plenty of possible non-HIV effects of the
diagnosis to compromise health, cause stress, and even ruin ones life, all
of which can reflect itself in reduced CD4 counts and distance even a
previously healthy person from his previously normal health. The burden of
proof is on the medical profession to separate out those effects from
alleged HIV-associated immune decline (to the extent that is in fact
measured by a CD4 count). The CD4 test itself cannot make such
distinctions. There are many more people with higher counts subject to
this dynamic than there are people with very low counts such as below 100,
precisely because any standard distribution of people will have a larger
percentage closer to the center.
: Saying that a count of 430 might be unusual, but still on the
: tail-end of normal and healthy, does not imply that this is STILL
: true of 300. Or of 200. This way lies the madness of JohnBull,
: who will tell you that there’s nothing wrong with wasting away to
: a T-cell count of zero, so long as you maintain your optimism,
: and stay off AIDS drugs.
I am sure that John@blackdog knows full well that very few of those who
have negligible counts have avoided long-term AIDS drugs and also avoided
the terrible pessimism and vicious downward spiral that they are subject
to (since they are told by people like you they have an invariably fatal
condition), so it’s a moot point.
: So you continue to tell people who have CD4 counts of 430 that
: they are not in trouble, while all the time dishonestly staying
: away from telling people at what CD4 counts they ARE in trouble.
I don’t have any idea of what you think is dishonest, as if you would be
the authority on that? I will allow that a count of, say 50, *may* well
mean someone is in trouble. That cannot distinguish *why* said person is
in trouble – whether AZT combo therapy (and other drugs)-associated health
destruction, the long-term, ongoing, non-HIV effects of an HIV positive
diagnosis, one or more of many known causes of compromised immunity, or
the supposed effects of HIV itself. I think it is unlikely to find many
people for whom all those items other than "HIV" are ruled out. Nor can
we expect the effort to be made to rule out all other known causes of
immune suppression, because 1) that’s difficult/impossible to do, and 2)
we cannot expect doctors who have an "it is HIV" mindset to suddenly
start looking at their patients disease from a "multifactorial" mindset.
I prefer to focus on those in the much larger category of CD4 counts in
let’s say the 200-600 range who have, as Dr. Abrams would say, seen all
their friends jump on the antiviral drug bandwagon and die so they have
chosen to remain naive to said drug use. Said persons have also had less
time to succumb to the non-HIV effects of an HIV positive diagnosis and
therefore have more chance to break out of the vicious cycle it entails.
Californ
PS: For those interested in my list of some of the non-HIV effects of an
HIV antibody positive diagnosis, I will post that separately.
SOME OF THE NON-HIV EFFECTS OF AN HIV POSITIVE DIAGNOSIS
1) HIV positive patients have their problems analyzed and treated less
directly in the context of those problems. Instead, symptoms are looked at
in the context of HIV infection. Consequently, their doctor’s HIV-colored
glasses may lead to different diagnoses and different treatments than
patients with the same exact conditions who are HIV antibody negative.
HIV positive people are subject to a more negative treatment experience
for the same conditions which HIV negative people have. Many doctors will
not treat HIV positive people. And those doctors who do treat them may
fail to treat conditions not "associated" with HIV and focus primarily or
totally on alleged HIV associated issues. Unfortunately the real problems
damaging the health of the patient may become ignored as HIV and a host of
surrogate markers gets all the attention. In this way people with positive
HIV diagnoses are potentially subject to inferior medical care.
2) Cases have been seen of people with HIV positive diagnoses getting
inferior treatments specifically "because they are going to die anyway".
This is especially pronounced in third world cases but seen elsewhere also.
3) Unlike HIV negatives, HIV positive people are subject to the immune
depressing effects and toxicities of taking AZT and other various AIDS
drugs. As compared to Negatives, HIV Positives are more likely to have
their CD4s checked (which can terrorize them if they have *normally* low
(under 500) counts. If the CD4 count is tested immediately after first
getting the HIV positive diagnosis, the CD4 counts may fluctuate downwards
even more and lead to the conclusion the PWHIV is seriously immune
depressed (rather than transiently so as a result of the trauma of
learning the diagnosis.) This causes further likelihood of pressure to
take immunosuppressive AZT combination therapy and PCP prophylaxis.
4) Unlike HIV negatives, those with HIV antibody diagnoses potentially
suffer years of fear, stress, and declining health caused by the HIV
diagnosis itself (the very real "voodoo effect"). They may adopt a
sickness or death mentality, if only because their HIV status is so often
a topic of discussion. They will likely associate with and identify with
others who have a similar diagnosis and mentality, both aquaintances and
doctors. They will suffer heartbreak as some of those acquaintances die
from some combination of 1) *real* causes of collapsed health such as the
effects of long-term use of recreational or medical drugs, plus 2) the
non-HIV effects of an HIV diagnosis – both factors of which they attribute
to HIV.
5) HIV positives may experience never-ending fear, disillusionment, and/or
depression, possibly acting it out with increasingly self-destructive
behavior because of the belief they have that HIV will lead to AIDS and
"AIDS is invariably fatal". They are subject to ongoing ostracism, loss
of jobs, loss of insurance, disturbed relationships, etc. Their medical
expenses may rise precisely when their income has dropped or stopped,
forcing them into poverty. They may then cut back on paying for healthier
food, nutritional supplements, and "alternative" immunity building
non-toxic therapies and services precisely when their stress load is
increasing to dangerous levels.
6) HIV positives may only be able to afford government-subsidized or
sanctioned medical care, thereby further pressuring them to take only
prepaid "acceptable" but toxic treatments such as AZT combination
chemotherapy and avoiding or not getting reimbursed for non-toxic
immunity-building therapies and services. Once lured into government
programs or too destitute to afford otherwise, it will be hard to get
treatments or information outside of the pharmaceuticals-oriented
paradigm. Meanwhile, some positive attention, special services, food
subsidies, etc. may make HIV positives less likely to *want* to challenge
their growing dependency upon the system.
In any or all of these ways, and others ways not listed here, the HIV
positive diagnosis itself is a self-fulfilling prophecy. This leads to a
higher correlation between a positive diagnosis and declining health or
even "AIDS" than will be seen with a negative diagnosis, even absent any
effect of HIV itself. Obviously, some or all of these non-HIV effects of
an HIV positive diagnosis can and will be blamed on (or confused with)
HIV. But, even those who still believe that HIV plays a role in disease
and/or that HIV usually leads to AIDS should check to see that they are
not aggravating and reinforcing the aforementioned non-HIV issues of those
they know who have had an HIV-positive diagnosis. The first step is to
help show them the "vicious cycle" nature of the diagnosis itself.
Awareness of the cycle is an important first step (though not the only
step) in breaking the cycle.
Calif…@netcom.com
- Hide quoted text — Show quoted text -
In article <californE805wz….@netcom.com>, calif…@netcom.com writes:
> Steven B. Harris (sbhar…@ix.netcom.com) wrote:
> : Californ writeth:
> : >>But getting back to Dr. Harris and his apparent statement
> : that "a healthy adult might have a CD4+ lymphocyte count of 800
> : to 1000…" I should add that a healthy adult might have a count
> : of 1,000… or he might have a count of 1200 or 800 or 600 or
> : 430. It is even possible that a count below 430, while statist-
> : ically unusual according to the above study, may nevertheless be
> : "normal" and healthy for a given person – certainly a lot
> : less abnormal than is made out to be based on now-outdated
> : assumptions about what constitutes normal CD4 counts.<<
> : Gosh, yes, Californ. But there is a big difference between a
> : CD4 count of 450 which has been stable for years, and one that
> : was 500 last year, 550 the year before, and 600 the year before,
> : and so on. You will remember in that case my analogy of the guy
> : falling off the 100 story building, who says as he passes the
> : 50th floor: "Well, I’m okay so far." Wise people project trends.
> Well, you’re right as far as the the analogy goes. The problem is that it
> often is taken far beyond that. For one thing, CD4 counts decline with
> age, as has been pointed out to you before.
But nothing like the decline seen in prospective and concurrent studies of HIV
infected people. You continue to construct theories you find congenial while
ignoring the simple, straightforward, interpretations of the available
information.
And you are right in one area, there is little or no prospective protection
against incompetent, fraudulent or malevolent use of diagnostic tests or
therapies. Caveat emptor. At least in medicine there are licensure exams and
professional disciplinary bodies. Who is there to discipline those who purvey
nostrums such as are often posted here and ensure the accuracy of the claimed
benefits. Who checks the claims of Ed Lieb for rebound exercise? What
science confrims the benefits of tahitian noni? For that matter, what
controlled observations confirm your opinions on the adverse effects of an HIV
diagnosis on the immune system? Not the MACS studies which documented loss of
cd4 cells only in the hiv infected who were diagnosed retroactively by looking
at stored sera.
>In article <californE805wz….@netcom.com>, calif…@netcom.com
writes:
Harris writes:
: Gosh, yes, Californ. But there is a big difference between
a CD4 count of 450 which has been stable for years, and one that
was 500 last year, 550 the year before, and 600 the year before,
and so on. You will remember in that case my analogy of the guy
falling off the 100 story building, who says as he passes the
50th floor: "Well, I’m okay so far." Wise people project
trends.:
To which Californ replies:
>>Well, you’re right as far as the analogy goes. The problem is
that it often is taken far beyond that. For one thing, CD4 counts
decline with age, as has been pointed out to you before. As you
may know, people only get older, never younger, so this is likely
to be associated with long-term decline in this measure.
Comment:
This is completely irrelevant. CD4 counts decline with age
from birth to puberty, but not in the adult ranges in which the
average AIDS patient falls. So long as you’re not talking about
children (and perhaps senior citizens) with AIDS, it’s a non-
issue. Try again.
Californ:
>> Second, the man walking around happily and healthily on the
20th floor is often treated as if that is a priori evidence of a
health problem – as if he had just crashed through 80 floors.
While wise people project trends, there are no real safeguards to
keep AIDS doctors from extrapolating from even just one Tcell
count/test. After all, to ensure that the "low" 450 CD4 count is
not transient, one ought to wait let’s say 3 or 6 months. That is
to say, 3 to 6 months to pressure and terrorize the hell out of
the "HIV antibody positive diagnosed" patient into "hit-it-hard-
-hit-it-early" long-term medical treatment as well as let him
experience many of various non-HIV effects of the diagnosis.
Those effects include financial and emotional devastation,
social ostracization, and a possible vicious cycle of compromised
health that is caused by and contributes to those experiences and
is liable to affect the next Tcell test result. (Even those
diagnosed not HIV positive could well experience drops in their
CD4 counts due to the knowledge of what "low" CD4s allegedly mean
in those who are positive. But they won’t be pressured into
anti-HIV drugs.) No safeguards are in place, no reasonable
guarantee is there that the psychophysiological effects following
from the "HIV positive" diagnosis itself and/or the low CD4
counts and/or the ongoing medical combination therapy immediately
thereafter won’t singularly or together effect the next CD4
counts, which are then reinterpreted as the effects of HIV.
Indeed, it is hard to imagine anyone *not* being subject to the
various "non-HIV effects of an HIV-positive diagnosis", once so
stigmatized.<<
Comment:
It’s not hard for me to imagine. But then I have a different
feeling about what kinds of worry the body can take, and not come
down with fungal infection of the lungs, or some weird thing. I
see worry and pathological stress all the time in my patients, as
they face the age related decay of their bodies (average age of
my practice is probably 84). What I don’t see is AIDS.
The idea that people under psychological stress suffer gross
failure of the immune system and then diseases like toxoplasmosis
of the brain and pneumocystis carinii pneumonia, suffers from the
small problem that there are a lot of people out there in the
world under ungodly amounts of emotional stress, and they don’t
get these AIDS diseases. When was the last epidemic of CMV
retinitis/blindness in Florida’s death rows, where men wait 10
years locked for 23 hours a day in cells the size of your
bathroom, for their date to be strapped into the electric chair
and fried like bacon? Can’t think of one? How strange. A small
epidemic of pneumocystis perhaps? No?
It’s also more than a little strange that in many medical
problems where the prognosis is as grim as death row, or AIDS–
or worse!– from ALS to glioblastoma multiformae to cystic
fibrosis in kids, nobody gets AIDS or anything remotely
resembling AIDS. Are these people under stress? Yes. Told they
are dying? Yes. Medically hexed? Yes, if anybody is. But no
AIDS.
No, for your theory to work, people somehow have to magically
suffer only the disease they are told they will– ie, it’s not
enough to say that people’s cellular immune systems to crap out
and start admitting fungi because they are told they have a fatal
disease (because clearly that doesn’t happen)– YOUR theory has
to hold that their immune systems crap out only when people are
told they have HIV (or, to be fair, some other immune problem).
This borders on mysticism, and in honor of this monumentally
stupid suggestion, I think I’ll write a little essay to go along
with yours, suggesting that smokers get lung cancer only because
society expects them to– not because of cigarettes at all.
Prove me wrong.
Californ
>> Whatever may be the alleged effects of HIV, there is no way
to separate the non-HIV effects of the diagnosis on CD4 counts
from the alleged HIV-associated effects. It is inevitable that
the former will be mistaken for the latter, and help create the
very "trend" you are looking for. <<
Comment:
Certainly there are ways to separate out these effects. For
one thing, you can look at the incidence of CD4 absence in people
who show up with AIDS as a presenting illness, and hadn’t been
medically followed before. This was the way it always was prior
to early 1984, remember? Guess what– it’s perfectly possible to
lose all your CD4s and get an AIDS-type infection without ever
having had an HIV test. But when you DO test all those people,
after the fact, they are HIV positive (like Bergalis and Ashe and
thousands of others).
So now your bizarre theory has to 1) posit that low CD4s and
opportunistic infections create HIV positivity, in order to
explain that almost perfect association where HIV is looked for
and found 99.99% of the time, AFTER the unexplained immune
failure is found. THEN, you theory has to posit 2) that an HIV
diagnosis itself (rather than the HIV) *creates* immune failure
in those cases where HIV is diagnosed BEFORE immune decline.
Rather a coincidence, hey? Here you’ve got a test result that
follows and is the result of a certain kind of odd immune failure
(JohnBull has blamed cheating labs for this), and yet this
strange and odd kind of immune failure is also physiologically
caused when people are TOLD about this odd test result (but NOT
when they have many other life-threatening or terminal problems).
Gosh, you live in an ironic and cruel universe, Californ. One
that positively conspires to make it look like a simple and
obvious explanation is the correct one, when it really isn’t.
Californ
>>To the contrary, there is plenty of possible non-HIV
effects of the diagnosis to compromise health, cause stress, and
even ruin ones life, all of which can reflect itself in reduced
CD4 counts and distance even a previously healthy person from his
previously normal health.<<
Comment:
Name one that is specific to an HIV diagnosis, as opposed to
any other grave threat of medical or judicial death. And don’t
say AZT, because it’s been well-shown that decline of CD4s
occurred at the same rate in HIV positive people before AZT was
ever given, and that further it occurs at the same rate in people
who decided not to take AZT. And at roughly the same rate in all
AIDS groups, if you adjust for age. AZT has not affected the
rate of CD4 decline in HIV-positive people. If anything, the
opposite.
Californ:
>> The burden of proof is on the medical profession to
separate out those effects from alleged HIV-associated immune
decline (to the extent that is in fact measured by a CD4 count).
The CD4 test itself cannot make such distinctions.<<
Comment:
Well, you can’t rule out such mystical effects of lab test
knowledge as you postulate, unless you blind people from the
results of their lab tests. Which is not only unethical, but
pretty silly, for reasons detailed below.
Again, that CD4′s don’t bomb out to AIDS levels with any
other kind of high mental stress (as a generic response) is
pretty good evidence that the HIV-associated immune decline has
nothing whatsoever to do with the fact that the person knows he
has a positive HIV test. Unless again, however, if you’re into
some mystical belief that says that the body has unconscious
control over lab test values, and makes its CD4s disappear only
when you tell it that CD4′s are going to go away (and not CD34′s
or CD8′s, or whatever).
However, as with the smoking example, such medical theories as
these are really religious theories, because they ascribe such
sophisticated power to suggestion, that people must actually be
Gods or Advanced Beings from Another Plane, in disguise. Tell
the truck-driver from Peoria that his CD4 lymphocytes (say what?)
are going to disappear completely, and– lo– they do, leaving
his NK cells behind like the smile on the Cheshire cat. But not
if you tell him he has any other fatal disease– that doesn’t
work (they only go down a little, then– the generic CD4 response
to steroids and stress, which isn’t anything like the magnitude
of AIDS). Tell him that his alpha2 microglobulin urine excretion
and p24 antigenemia is going to increase, and I suppose that
happens also. Medical hexing is pretty sophisticated, eh
Californ? I guess you new age people call this the mind-body
interaction? I would say, more the "mind-textbook-lab-test-
body" reaction. You just have to be careful to issue the proper
physiologic hex, in the proper technical terms, of course, and —
hot damn–the guy who doesn’t know where his liver is, will
suddenly micro-manipulate his own immune system to give himself
the total cell-mediated deficiency state you tell him he’s going
to develop. Gosh. And we know it has to be this, because in
HIV-positives
…
read more »
calif…@netcom.com wrote:
>Well, you’re right as far as the the analogy goes. The problem is that it
>often is taken far beyond that. For one thing, CD4 counts decline with
>age, as has been pointed out to you before.
But not below 50 or 100 cells per cubic mm. With the consequences of
AIDS. See below.
George M. Carter
SI - MED/94338608; Montaner JS; Le T; Hogg R; Ricketts M; Sutherland
D; Strathdee SA; O’Shaughnessy M; Schechter MT
TI - The changing spectrum of AIDS index diseases in Canada.
AD - British Columbia Centre for Excellence in HIV/AIDS, St Paul’s
Hospital, Vancouver, Canada.
AB - OBJECTIVE: To describe the changing spectrum of AIDS index
diseases in Canada over a 10-year period from 1981 to 1991. DESIGN: A
descriptive, population-based study. SETTING: Canada. PATIENTS: All
cases of AIDS in Canada reported by the Division of HIV/AIDS
Epidemiology of the Department of National Health and Welfare. MAIN
OUTCOME MEASURES: Age-standardized rates of initial AIDS
manifestations (1987 Centers for Disease Control and Prevention case
definition), by year of diagnosis among adults in Canada. RESULTS: A
total of 6641 adult AIDS cases were examined. The rate of Pneumocystis
carinii pneumonia (PCP) peaked in 1989 with a rate of 3.18 per
100,000, declining to 2.74 per 100,000 in 1991 (P = 0.894). Similarly,
the rate of Kaposi’s sarcoma (KS) stabilized during this interval from
1.06 per 100,000 in 1987 to 1.14 per 100,000 in 1991 (P = 0.189). In
contrast, the rates of all other AIDS-defining illnesses increased
from 1.48 per 100,000 in 1987 to 3.43 per 100,000 in 1991 (P = 0.001).
For these other AIDS index diseases, significant rate increases were
observed for esophageal candidiasis, cytomegalovirus (CMV) diseases,
wasting syndrome, toxoplasmosis, and Mycobacterium avium complex (MAC)
disease. CONCLUSIONS: Our study shows a leveling and decline in
incidence of KS and PCP, respectively, and a concomitant increase of
other diagnoses, especially esophageal candidiasis, CMV, wasting
syndrome, toxoplasmosis, and MAC disease in Canada. These findings
highlight the importance of developing specific strategies to prevent
emerging AIDS index diseases and serve as a cautionary note to
practicing clinicians, indicating the relative widening of the
spectrum of HIV index diseases.
SO – AIDS. 1994 May;8(5):693-6.
SI - ICA10/94369613; Bernal A; Frazier R; Del Junco G; Gathe J Jr;
Piot D
TI - Endoscopy studies of AIDS: the 90′s versus the 80′s.
AD - Special Diseases Unit, Park Plaza Hospital, Houston, Texas.
AB - OBJECTIVE: A comparative study of the endoscopic findings of
AIDS in the 90′s vs. the early 80′s. Those years precluded
antiretroviral therapy as well as most of the primary and secondary
prophylaxis of opportunistic infections. To analyze the impact, if
any, of those measures on the epidemiology and clinical spectrum in GI
diseases. METHOD: Retrospective review of 263 gastroscopies and 226
colonoscopies in 321 HIV+ individuals from 1990 to 1993. Review of
data from an earlier study, demographically comparable with regard to
age, sex, and risk factor of 174 patients from 1982 to 1985, is
presented as the last percentage in brackets. Gastric emptying studies
were also performed with a mixture of 2 mCl 99mTc sulfur colloid with
scrambled eggs. RESULTS: All of the 321 cases reviewed met the CDC
criteria of AIDS. There were 318 males and 3 females; mean age was
36.7 years. Risk factors included homosexuality in 303 cases,
bisexuals 10 cases, intravenous drug use (IVDU) in 3, blood
transfusions in 2 cases. Candida esophagitis was the most frequent
findings (46 = 14.3% (80′s = 23%) Giant ulcer of the esophagus, 6 of
which were CMV proven (26 = 8%) (4%). CMV gastritis and colitis (54 =
16.9%) (6.8%). Intestinal mycobacteria were found in (23 = 7.1%)
(1.3%). Cryptosporidia in (17 = 5.29%) (1.3%); Gastrointestinal KS
could be diagnosed in (27 = 8.4%) (28%); Non-Hodgkins lymphoma
endoscopically in (1 = .3%) (5.7%). Significant delay of gastric
emptying manifested by gastric bezoar, > 200 ml or isotopic studies
were seen in (33 = 10.3%) (0%). CONCLUSIONS: Endoscopic evaluation of
AIDS patients continues to be helpful for diagnosis and proper
management. A distinct trend in presentation seems to be evolving as
compared to early years. Candidiasis of esophagus is decreasing
probably due to prophylaxis with antifungal agents. CMV of the
gastrointestinal tract is on the increase despite specific antiviral
agents (gancyclovir and foscarnet). This may be due in part to viral
resistance or different viral strains. KS continues to decline but
this started in mid 80′s for unclear reasons. The increased presence
of delay in gastric emptying defies any clear explanation. Progress in
opportunistic infection therapy with longer life expectancy and more
concomitant MAIC infections could be the base, however, further
studies seem warranted. Is the HIV virus itself the culprit?
SO – Int Conf AIDS. 1994 Aug 7-12;10(1):185 (abstract no. PB0170).
In article <5hvutp$…@dfw-ixnews11.ix.netcom.com>,
sbhar…@ix.netcom.com(Steven B. Harris) wrote:
> : There is a big difference between
> a CD4 count of 450 which has been stable for years, and one that
> was 500 last year, 550 the year before, and 600 the year before,
> and so on. You will remember in that case my analogy of the guy
> falling off the 100 story building, who says as he passes the
> 50th floor: "Well, I’m okay so far." Wise people project
> trends.:
Harris, obviously you don’t get it. What the AIDS establishment has
done, is that it’s created such a long HIV-latency period (now pushing 13
years) that T- cells (and some other so called "AIDS symptom) is bound to
effect the person at one point in his or her life. Once a T-cell count
drops a little (which is normal in 13 years of life for one reason or
another), or the person gets a cold or something, Doctors start
prescribing the AIDS antivirals. And as for after that, you know the
story. They haven’t saved one life yet. Plus, T-cell counts may be
unreliable since some AIDS patients have less than 100, or even zero T-
cells, and are still healthy. And even if they have 0 t-cells in the 100
ml of blood the doctor measured, they could have T-cells in the lymph
nodes…which most of them are in.
> Again, if poppers were the cause of AIDS in gay men before HIV
> tests and AZT, how did gay men manage to do it, looking at
> results like these?
If sex leads to HIV, and then AIDS, than how do you explain the low AIDS
numbers among teenagers, the most sexually active group. Only 200 AIDS
cases among them a year…if that. I’m still having a hard time
understanding your beliefs, Dr. Harris. Science has finally found a way
to stop HIV (protease inhibitors), but AIDS still develops and people
still die. Obviously this is another reason why HIV can not be the
causative agent of AIDS.
Sam
——————-==== Posted via Deja News ====———————–
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- Hide quoted text — Show quoted text -
In article <860082409.23…@dejanews.com>, heresiesofl…@hotmail.com wrote:
> In article <5hvutp$…@dfw-ixnews11.ix.netcom.com>,
> sbhar…@ix.netcom.com(Steven B. Harris) wrote:
> > : There is a big difference between
> > a CD4 count of 450 which has been stable for years, and one that
> > was 500 last year, 550 the year before, and 600 the year before,
> > and so on. You will remember in that case my analogy of the guy
> > falling off the 100 story building, who says as he passes the
> > 50th floor: "Well, I’m okay so far." Wise people project
> > trends.:
> Harris, obviously you don’t get it. What the AIDS establishment has
> done, is that it’s created such a long HIV-latency period (now pushing 13
> years) that T- cells (and some other so called "AIDS symptom) is bound to
> effect the person at one point in his or her life. Once a T-cell count
> drops a little (which is normal in 13 years of life for one reason or
> another), or the person gets a cold or something, Doctors start
> prescribing the AIDS antivirals.
Are you trying to imply that antivirals would then further lower CD4 counts?
> And as for after that, you know the
> story. They haven’t saved one life yet.
According to the literature they have ….. What are your sources?
> Plus, T-cell counts may be
> unreliable since some AIDS patients have less than 100, or even zero T-
> cells, and are still healthy. And even if they have 0 t-cells in the 100
> ml of blood the doctor measured, they could have T-cells in the lymph
> nodes…which most of them are in.
Where on earth did you get the idea that doctors would prescribe
antivirals based on a single T cell count, or for that matter based on T
cell counts alone? Sure they could have T cells elsewhere. That however
does not detract from the strong correlation between low CD4 counts in the
periphery and susceptibility to AIDS indicator diseases, like OIs and KS.
Sure there are healthy HIV-1 infected individuals with low CD4 counts.
Nobody gets sick from low CD4 counts. Low counts however are a pretty good
predictor for susceptibility for opportunistic infections, which will get
you eventually if counts remain low.
> > Again, if poppers were the cause of AIDS in gay men before HIV
> > tests and AZT, how did gay men manage to do it, looking at
> > results like these?
> If sex leads to HIV, and then AIDS, than how do you explain the low AIDS
> numbers among teenagers, the most sexually active group. Only 200 AIDS
> cases among them a year…if that.
How about clinical latency ?
> I’m still having a hard time
> understanding your beliefs, Dr. Harris. Science has finally found a way
> to stop HIV (protease inhibitors), but AIDS still develops and people
> still die.
Much less in people on PIs. See recent posts to this newsgroup. Btw, PIs
don’t stop HIV, they just slow it down (considerably).
> Obviously this is another reason why HIV can not be the
> causative agent of AIDS.
Obviously you haven’t thought about this much.
Marnix Bosch
- Hide quoted text — Show quoted text -
> Sam
> ——————-==== Posted via Deja News ====———————–
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In article <marnix-0304971344090…@fae2xx.biostat.washington.edu>
mar…@u.washington.edu (Marnix L. Bosch) writes:
>In article <860082409.23…@dejanews.com>, heresiesofl…@hotmail.com wrote:
>>[...]
>> Plus, T-cell counts may be unreliable since some AIDS patients have
>> less than 100, or even zero T- cells, and are still healthy. And even
>> if they have 0 t-cells in the 100 ml of blood the doctor measured, they
>> could have T-cells in the lymph nodes…which most of them are in.
>Where on earth did you get the idea that doctors would prescribe
>antivirals based on a single T cell count, or for that matter based on T
>cell counts alone?
>[...]
Here in New York City many people were and still are being
prescribed antivirals based on T cell counts alone. At a recent ACT UP/NY
meeting at the Lesbian and Gay Community Center, I overheard members
who were bemoaning the fact that patients were not receiving baseline VL
tests before they were given combination chemotherapy. In my own case, I
was always prescribed nucleoside analogs based solely on my T cell count.
I refused taking those drugs and that was a good decision for me. I’ve
met hundreds of people who have had the same experience. Their doctors
would say something like, "Yep, you have less then 500 T cells. I think
you should go on AZT. It’s a perfectly pedestrian pharmaceutical." Marnix
is probably too young, or hasn’t been very involved, to know this. He
probably didn’t have to go through the pain of watching someone suffer on
these drugs. I have. It’s not pretty.
-Giacomo
Giacomo’s Cabaret, http://www.panix.com/~jscutero
- Hide quoted text — Show quoted text -
In article <5i1cfo$…@panix.com>, jscut…@panix.com (James Scutero) wrote:
> In article <marnix-0304971344090…@fae2xx.biostat.washington.edu>
> mar…@u.washington.edu (Marnix L. Bosch) writes:
> >In article <860082409.23…@dejanews.com>, heresiesofl…@hotmail.com wrote:
> >>[...]
> >> Plus, T-cell counts may be unreliable since some AIDS patients have
> >> less than 100, or even zero T- cells, and are still healthy. And even
> >> if they have 0 t-cells in the 100 ml of blood the doctor measured, they
> >> could have T-cells in the lymph nodes…which most of them are in.
> >Where on earth did you get the idea that doctors would prescribe
> >antivirals based on a single T cell count, or for that matter based on T
> >cell counts alone?
> >[...]
> Here in New York City many people were and still are being
> prescribed antivirals based on T cell counts alone. At a recent ACT UP/NY
> meeting at the Lesbian and Gay Community Center, I overheard members
> who were bemoaning the fact that patients were not receiving baseline VL
> tests before they were given combination chemotherapy. In my own case, I
> was always prescribed nucleoside analogs based solely on my T cell count.
> I refused taking those drugs and that was a good decision for me. I’ve
> met hundreds of people who have had the same experience. Their doctors
> would say something like, "Yep, you have less then 500 T cells. I think
> you should go on AZT. It’s a perfectly pedestrian pharmaceutical." Marnix
> is probably too young, or hasn’t been very involved, to know this. He
> probably didn’t have to go through the pain of watching someone suffer on
> these drugs. I have. It’s not pretty.
> -Giacomo
> Giacomo’s Cabaret, http://www.panix.com/~jscutero
I am happy that I still present an aura of youth around me, but regardless
of my age and personal experience, I have a hard time believing that
antivirals would be prescribed WITHOUT an HIV test, i.e. based on CD4
counts alone. Is this really your experience James ?
Marnix Bosch
- Hide quoted text — Show quoted text -
In article <5i1cfo$…@panix.com>, jscut…@panix.com (James Scutero) writes:
> In article <marnix-0304971344090…@fae2xx.biostat.washington.edu>
> mar…@u.washington.edu (Marnix L. Bosch) writes:
>>In article <860082409.23…@dejanews.com>, heresiesofl…@hotmail.com wrote:
>>>[...]
>>> Plus, T-cell counts may be unreliable since some AIDS patients have
>>> less than 100, or even zero T- cells, and are still healthy. And even
>>> if they have 0 t-cells in the 100 ml of blood the doctor measured, they
>>> could have T-cells in the lymph nodes…which most of them are in.
>>Where on earth did you get the idea that doctors would prescribe
>>antivirals based on a single T cell count, or for that matter based on T
>>cell counts alone?
>>[...]
> Here in New York City many people were and still are being
> prescribed antivirals based on T cell counts alone.
I think the orignal statement referred to treatement based on a diagnosis of
HIV which was made solely on the basis of cd4 cell counts.
calif…@netcom.com wrote:
>In any or all of these ways, and others ways not listed here, the HIV
>positive diagnosis itself is a self-fulfilling prophecy. This leads to a
>higher correlation between a positive diagnosis and declining health or
>even "AIDS" than will be seen with a negative diagnosis, even absent any
>effect of HIV itself.
>Calif…@netcom.com
What a great hypothesis except it’s too unrealistic. One assumption
that this whole thing is based on is the fact that people KNOW about
their HIV status. Bare in mind that many people go to their doctors
because of some forms of infections and it is that time that they find
out they are HIV+, with very low CD4 counts. Please give me the
reference about CD4 count drop to 0 without HIV but solely as a result
of stress.
JR
In article <1997Apr3.221103@mcrcr6>,
holzm…@mcrcr6.med.nyu.edu (ROBERT S. HOLZMAN) wrote:
> >>In article <860082409.23…@dejanews.com>, heresiesofl…@hotmail.com wrote:
> >>>[...]
> >>> Plus, T-cell counts may be unreliable since some AIDS patients have
> >>> less than 100, or even zero T- cells, and are still healthy. And even
> >>> if they have 0 t-cells in the 100 ml of blood the doctor measured, they
> >>> could have T-cells in the lymph nodes…which most of them are in.
> I think the orignal statement referred to treatement based on a diagnosis of
> HIV which was made solely on the basis of cd4 cell counts.
The CDC admits that about 62,000 AIDS cases were not tested for HIV. But
heresies is right in saying that someone who has a low T-cell count, and
is HIV positive, giving antivirals worsens the patient, since one of the
side effects of them is leukocytopenia (sp?)….which is the
immunodeficiency of white blood cells. I don’t believe heresies is
saying that HIV diagnoses are made solely on T-cell counts, but rather
antivirals are prescribed to healthy low T-cell count HIV-postives.
——————-==== Posted via Deja News ====———————–
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In article <marnix-0304971559580…@fae2xx.biostat.washington.edu>
mar…@u.washington.edu (Marnix L. Bosch) writes:
>[...]
>I am happy that I still present an aura of youth around me, but regardless
>of my age and personal experience, I have a hard time believing that
>antivirals would be prescribed WITHOUT an HIV test, i.e. based on CD4
>counts alone. Is this really your experience James ?
I have spoken with people who were not given valid HIV tests and
were prescribed nucleoside analogs, yes. When you consider the fact that
from the inception of diagnostic HIV antibody testing, to at least 1987,
the HIV test, and the criteria for interpreting a positive result then
was wildly inaccurate and has been subsequently discredited as a
diagnostic tool. Many disease conditions caused "false-positive" reactions
on those HIV tests. There were people who tested false-positive on those
invalid tests who were never tested again, and who were routinely prescribed
AZT at extreme doses. There was a time when AZT was even prescribed
to people who tested HIV positive on those bogus tests when their CD4
counts were over 500, so even CD4 counts were sometimes not even a barrier
to prescribing the toxic drug. Antivirals were prescribed without valid
HIV tests.
-Giacomo
Giacomo’s Cabaret, http://www.panix.com/~jscutero
In article <marnix-0304971559580…@fae2xx.biostat.washington.edu>
mar…@u.washington.edu (Marnix L. Bosch) writes:
>[...]
>I am happy that I still present an aura of youth around me, but regardless
>of my age and personal experience, I have a hard time believing that
>antivirals would be prescribed WITHOUT an HIV test, i.e. based on CD4
>counts alone. Is this really your experience James ?
I have spoken with people who were not given valid HIV tests and
were prescribed nucleoside analogs, yes. When you consider the fact that
from the inception of diagnostic HIV antibody testing, to at least 1987,
the HIV test, and the criteria for interpreting a positive result then
was wildly inaccurate and has been subsequently discredited as a conclusive
diagnostic tool. Many disease conditions caused "false-positive" reactions on
those HIV antibody tests. There were people who tested false-positive on
those invalid tests who were never tested again, and who were routinely
prescribed AZT at extreme doses. There was a time when AZT was prescribed
to people who tested HIV positive on those bogus tests when their CD4
counts were over 500, so CD4 counts were sometimes not even a barrier to
prescribing the toxic drug. In conclusion, antivirals were prescribed
without HIV tests based only on CD4 counts.
-Giacomo
Giacomo’s Cabaret, http://www.panix.com/~jscutero
- Hide quoted text — Show quoted text -
In article <5i3cb6$…@panix.com>, jscut…@panix.com (James Scutero) wrote:
> In article <marnix-0304971559580…@fae2xx.biostat.washington.edu>
> mar…@u.washington.edu (Marnix L. Bosch) writes:
> >[...]
> >I am happy that I still present an aura of youth around me, but regardless
> >of my age and personal experience, I have a hard time believing that
> >antivirals would be prescribed WITHOUT an HIV test, i.e. based on CD4
> >counts alone. Is this really your experience James ?
> I have spoken with people who were not given valid HIV tests and
> were prescribed nucleoside analogs, yes. When you consider the fact that
> from the inception of diagnostic HIV antibody testing, to at least 1987,
> the HIV test, and the criteria for interpreting a positive result then
> was wildly inaccurate and has been subsequently discredited as a conclusive
> diagnostic tool. Many disease conditions caused "false-positive" reactions on
> those HIV antibody tests. There were people who tested false-positive on
> those invalid tests who were never tested again, and who were routinely
> prescribed AZT at extreme doses. There was a time when AZT was prescribed
> to people who tested HIV positive on those bogus tests when their CD4
> counts were over 500, so CD4 counts were sometimes not even a barrier to
> prescribing the toxic drug. In conclusion, antivirals were prescribed
> without HIV tests based only on CD4 counts.
> -Giacomo
> Giacomo’s Cabaret, http://www.panix.com/~jscutero
This notion of false positives has been pushed around this newsgroup quite
a bit, and I remember people claiming malaria and TB and some other
infectious diseases as basis for false positivity in ELISA. From very
early on western blot was included in the testing procedure to weed out
most false positives (i.e. positives in ELISA based on p24 reactivity
alone). My (perhaps false) impression was that although not perfect (no
test ever is) the HIV antibody test combining ELISA and WB was actually
pretty good. Of course later generation tests have further improved on
both sensitivity and specificity.
What is the evidence for your statement that there were people that were
false positive and that never got tested again ? How without a retest can
you determine false positives ? Is your criteria for validity the one Val
Turner paper ? And do you consider everybody tested positive with a test
that is not perfect a ‘false positive’ ?
Your anecdotes do not convince me. The tests were never bogus, but newer
tests are better. What you have indicated is that there was (or maybe even
is) a chance that people that test positive for a reason other than HIV-1
infection were prescribed antivirals. That may or may not be true, but I’d
like to see some evidence to back it up. But what I originally reacted to
was the claim that antivirals are described without HIV-1 testing. No
evidence to support this notion has been put forward by you or anybody
else.
Marnix Bosch
sbhar…@ix.netcom.com(Steven "Steven B. Harris" writes:
> Unfortunately for JohnBull, at some point in T-cell count
> drop, reality bites.
The consistent "t-cell drop" you reply upon is not observed except
in association with "anti-viral" poisoning, or other profound and
obvious drug poisoning. Claims otherwise are simply dishonest.
Your whole argument about this is defunct. I don’t know why you
keep dragging it out. We have demolished it every time. The fact
is that, as Scutero showed you, people with an "HIV" diagnosis
simply do not experience a "t-cell drop" unless they take the
toxic substances you promote. The same would apply to people
without such a diagnosis, who took the same poison for the same
time.
And, as we have proved here, the fewer people prepared to do this
idiotic thing, the fewer "Aids deaths" we have. Your attempts to
explain this away have been ludicrous, too.
John
—
Dr. Luc Montagnier, "discoverer of HIV", Institute Pasteur Paris:
"There are too many shortcomings in the theory that HIV causes all
signs of AIDS"