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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