Diagnosing HIV in mothers and infants

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PROVING HIV INFECTION IN MOTHERS AND BABIES The Perth Group Western Australia www.theperthgroup.com www.virusmyth.net/aids/perthgroup [email protected] This file has speaker notes

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Transcript of Diagnosing HIV in mothers and infants

Page 1: Diagnosing HIV in mothers and infants

PROVING HIV INFECTION IN MOTHERS AND BABIES

The Perth GroupWestern Australia

www.theperthgroup.comwww.virusmyth.net/aids/perthgroup

[email protected]

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This file has speaker notes

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PROVING HIV INFECTION IN MOTHERS AND BABIES

A more detailed analysis of this problem is available at

www.virusmyth.net/aids/perthgroup

In the Nevirapine presentation

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DIAGNOSIS OF HIV INFECTION IN MOTHERS

ANTIBODY TESTS

•Blood sample

•HIV proteins

•Technique (ELISA and Western blot)

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HIV PROTEINS

Montagnier 1983 & Gallo 1984

Claimed to have isolated/purified a retrovirus HIV by separating it from everything else including proteins in cell cultures

Barré-Sinoussi, F et al. (1983). “Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS).” Science 220: 868-71.Gallo, RC et al. (1984). “Frequent detection and isolation of cytopathic retroviruses (HTLV-III) from patients with AIDS and at risk for AIDS.” Science 224: 500-503.

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WHY NO PICTURES OF “PURIFIED VIRUS”?

Montagnier videotaped interview at Pasteur Institute 18th July 1997

Copyright to and available from Djamel Tahi <[email protected]>

Text of interview published in Continuum (1998) 5: 30-34. www.virusmyth.com/aids/data/dtinterviewlm.htm

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No particles “typical of retroviruses” in “purified virus”

Montagnier interview at Pasteur Institute July 1997Continuum (1998) 5: 30-34. www.virusmyth.com/aids/data/dtinterviewlm.htm

“Did Gallo purify?

“Gallo?..I don’t know if he really purified.I don’t believe so”

MONTAGNIER ONMONTAGNIER AND GALLO

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“I repeat, we did not purify”

Montagnier interview at Pasteur Institute July 1997Continuum (1998) 5: 30-34. www.virusmyth.com/aids/data/dtinterviewlm.htm

MONTAGNIER DID NOT ISOLATE/PURIFY HIV

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Bess JW, Gorelick RJ, Bosche WJ, Henderson LE, Arthur LO. Microvesicles are a source of contaminating cellular proteins found in purified HIV-1 preparations. Virology 1997;230:134-144.

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HIV PROTEINS IN NORMAL HUMAN PLACENTA p18/p24/p120

“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”

Faulk, WP et al (1991). “HIV proteins in normal human placentae.” American Journal of Reproductive Immunology 25: 99-104.

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THE “HIV” PROTEINS p41/p120/p160

Montagnier considers p41 to be cellular actin

p160, p120 in “HIV” WB are oligomers of p41

Pinter AW et al (1989). “Oligomeric structure of gp41, the transmembrane protein of human immunodeficiency virus type 1 Journal of Virology 63: 2674-9.Zolla‑Pazner S et al (1989). Reinterpretation of Human Immunodeficiency virus Western Blot patterns. NEJM 320:1280‑1281.

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“We agree that you can come to the conclusion from gel electrophoresis patterns that there are only quantitative differences between HIV and [cellular] microvesicles”

Bess et alNational Cancer Institute USA

Bess, J. W., R. J. Gorelick, et al. (1997). Email correspondence August 2000 re Microvesicles are a source of contaminating cellular proteins found in purified HIV-1 preparations. Virology 230: 134-144

“We have been unsuccessful in separating microvesicles from HIV”

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EN

V

PO

LG

AG

p160p120

p32

p41

p68

p53

p55

p39

p24

p18

Western blot strip13

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Immune complexes, rheumatoid factor, anti‑cardiolipin, anti‑nuclear factor, anti‑cellular, anti‑platelet, anti‑red cell, anti‑actin, anti‑DNA, anti‑tubulin, anti‑thyroglobulin, anti‑albumin, anti‑myosin, anti‑trinitrophenyl anti‑thymosin, anti-lactoferrin, anti-TNF-α, anti-beta-2 glycoprotein I, anti-prothrombin, anti-neutrophil cytoplasmic, anti-ssDNA, anti-RNA, anti-histones, anti-nuclear antigen SS-A, anti-mitochondrial,anti-reticulin, anti-smooth muscle, anti-gut epithelial cell, anti-lymphocytic ganglioside, anti-Fab, anti-protein S, anti-brain proteins, anti-synthetic peptides of ubiquitinated histone H2A, anit-Sm-D antigen, anti-U1-A RNP antigen, anti-60 kD SSA/Ro antigen, anti-histone H1 and anti-histone H2B antibodies.

Anti‑lymphocyte auto‑antibodies in 87% of seropositives.

AUTO-ANTIBODIES IN HIV/AIDS PATIENTS14

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• Hypergammaglobulinaemia predicts seropositivity*

• Antibodies directed against fungi and mycobacteria cross-react with HIV proteins

• Fungal and mycobacterial diseases are the indicator diseases present in 90% of AIDS patients

• Kashala et al 1995 advised caution using Western blot in high prevalence mycobacterial areas

ANTIBODY CROSS-REACTIVITY

*Brenner, B., S. Schwartz, et al. (1991). “The prevalence and interaction of human immunodeficiency virus and hepatitis B infections in Israeli hemophiliacs.” Israel journal of medical sciences 27: 557-561.

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EN

V

PO

LG

AG

p160p120

p32

p41p68p53

p55p39p24p18

AFR AUS FDA RCX CDC 1

CDC 2

CON MACUK FRAGER

ANY 2

HIV WESTERN BLOT STRIP

p32 p32 p32

p24 p24

ANY 1

ANY 1

p160/p120ANDp41

p160/p120ORp41

p160/p120ORp41

OR

ALL 3

OR

AN

Y 1

GAG

OR

POL

ANY 1

ANY 1

AN

Y S

TR

ON

G B

AN

D3

WE

AK

BA

ND

S

AN

Y 3

GAG

OR

POL

p24

AND AND ANDAND

ANY 1

ANY 1

OR

ANY 1

ANY 1

ANY 1

p24

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NO

NE

ES

SE

INT

IAL

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GOLD STANDARD

HIV ITSELF

HIV ISOLATION/PURIFICATION

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ANTIBODY DIAGNOSIS IN CHILDREN

Additional problem

Persistence of maternal antibodies in infant

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Mother-to-child transmission of HIV infection. The European Collaborative Study. (1988). Lancet ii: 1039-43.

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“In adults, adolescents, and children infected by other than perinatal exposure, plasma viral RNA nucleic acid tests should NOT be used in lieu of licensed HIV screening tests (e.g., repeatedly reactive enzyme immunoassay)” (emphasis in original).

“HIV nucleic acid (DNA or RNA) detection tests are the virologic methods of choice to exclude infection in children aged <18 months” (“Positive results on two separate specimens) (emphasis added).

CDC 2000 Revised AIDS Surveillance Definition 

Centers for Disease Control and Prevention. Mortality and Morbidity Weekly Reports 1999;48 (RR-13):1-27, 29-31.

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“The Amplicor HIV-1 [RNA] Monitor test is not intended to be used as a screening test for HIV-1 or as a diagnostic test to confirm the presence of HIV-1 infection”

Roche Diagnostic Systems, 06/96, 13-08088-001. Packet Insert

Roche Laboratories

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Recommendations:

1. The public should be informed there is a scientific problem.

2. A small, international conference or a congressional review of the scientific evidence for and against the HIV theory of AIDS. In the presence of highly regarded, international, disinterested adjudicators, not all scientists, and of Nobel Laureate standard. Acceptable to both sides of the debate and the conveners.

3. Funding dissident scientists to undertake experiments to prove or disprove the HIV theory. A relatively inexpensive undertaking.

4. To be conducted and concluded this year.

5. A moratorium on HIV testing until results are known.

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