Question:
Alex, I found what you write so sensational and very interesting. Have you ever wrote – or tried to get published – any article about this issue in a "main stream" newspaper? – Hide quoted text — Show quoted text – Sunday there was on tv in my country about south-africa. Twenty percent of the population is infected, it was said. Today I read on www.aegis.com that only ten percent of the infected are tested. The rest are estimates. Actually, they are _both_ estimates and extrapolations, but the 11.4% percent is based on better research. However, neither number is accurate, because they never use confirmatory tests in these surveys. The real number is likely to be closer to 2-5%. If that. Here is the lowdown. Everything is dependent on cash. The WHO (19% infection, etc.) has very little of it. As a result, they depended on the collection of blood from women at antenatal clincs, which was very cheap, because these clinics already existed and blood was already taken anyway. However, the result was that they only had data from pregnant women, who are unrepresentative of general population. They are younger, they are sexually active (duh) and they are all female. And pregnant, which brings me to the second point – the tests used. The cheapest test out there is called ELISA (actually a group of tests). The problem with them is, that they’re not very reliable, because they will "spike" (go positive) when you’ve been exposed to any of 70 known factors and pathogens. Malaria, tb, ddt, the common cold, the flu, herpes, will all make these ELISA tests spike. But the main reason that these tests never should have been taken as the final word, is that they "spike" because of… <drumroll… pregnancy!! Then, the South African HSRC came along, with a little more money, and they took a random population sample of 10,000 or so people, who they gave a single, orally administered ELISA. Just for them being representative and unpregnant, the result was that 11.4% of the population was now officially HIV positive. That’s a dive of 40%, just by doing the test a little right. The real problem that has remained and still isn’t solved, is that none of the positive testing individuals were followed up by what are called confirmatory tests. Usually, that would be another ELISA, just to see if the first one was right. If this second ELISA is negative, the positive first test is basically thrown out of the window (so to speak), and the patient is considered HIV negative. If the second is positive, then a Western Blot test is performed. This is a more specific and also more expensive test, which is why it is never used in surveys in Africa. ELISA has an extraordinary false positive rate, especially in Africa. However, this combination of tests has previously resulted in one Italian military transfusion center of only 6.25% of the original positive testing individuals, who remain being considered HIV positive. So you can see. 20% estimated national HIV infection from blood from pregnant women. The same test on the general populace – 11.4% infection. Follow up tests… 0.7% infection rate? Who knows until the tests are actually done, but it seems very reasonable to assume. (11.4% times 0.0625 or 1/16th) The main stream media presents estimates as facts. Yes they do, all the time. Do anyone here know which test was used in the beginning of the epidemic in the western countries? Probably some form of ELISA. Alex " "One in five heterosexuals could be dead from AIDS at the end of the next three years," the nation’s most popular talk show host Oprah Winfrey warned her audience in 1987. " http://www.fumento.com/realaids.html
Response:
In fact, it assumes that there is a fixed, limited number of false positives out there. When in fact the number of people who have been exposed to factors that will make them test false positive will vary hugely, and increase hugely in Africa relative to Europe or North America.
PS, I should also include, that these HIV tests have been standardized for Western Europe and the USA, not Africa. And that even from early on in the epidemic, there has always been the assumption that HIV is endemic in Africa, a priori. Alex
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And this has been discredited by another poster. See that post for the discreditation of your "research". Really? What did he say? That in places with low prevalence, the huge majority of positive ELISAs are false? I already knew that, and it’s even spelled out in the WHO report and in their own words (page 7):
Plus (and I must be sleepwalking through this), it has been proven that it is possible to have the huge majority of single ELISAs be false positive, even in (sub-populations of) alleged high prevalence regions (which of course makes loads of sense). "It seemed something was confounding the tests, and the prime suspect was plasmodium falciparum, one of the parasites that causes malaria: Of the twenty-one subjects who tested positive, sixteen had had recent malaria infections and huge levels of antibody in their veins. The researchers tried an experiment: They formulated a preparation that absorbed the malaria antibodies, treated the blood samples with it, then retested them. Eighty percent of the suspected HIV infections vanished. " http://www.whatisaids.com/rollingstone.htm Alex
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snip Alex, I wonder why you are so convinced that HIV is a 100%-killer-virus, and why you provide AIDS orthodoxy with a simple and convincing excuse for the troubling but obvious fact that death rates southern Africa (where HIV always has been endemic) are relatively low.
HIV is not a 100% killer. Unfortunately, nearly 90% of infected individuals will develop immune dysfunction resulting in AIDS. Most diseases are less likely to be so nasty to such a great percentage of individuals. Like Ebola–I think about 60% of infected individuals develop hemorrhagic disease (from which most die, making it clearly horrible in its own right). The life expectancy has declined sharply in the last decade in many African countries that HAD been steadily rising prior to the onset of the HIV pandemic. George M. Carter *** Another example: X-Mailer: QUALCOMM Windows Eudora Version 6.0.0.22 Mime-Version: 1.0 Content-Type: text/plain; charset="us-ascii"; format=flowed List-Subscribe: List-Unsubscribe: Mailer: AEGiS List Server (please help: <http://www.aegis.org/about/donate.htm) Research article Health and economic impact of HIV/AIDS on South African households: a cohort study Max O Bachmann1 and Frederick LR Booysen2 1Department of Community Health, University of the Free State, PO Box 339(G52), Bloemfontein 9300, South Africa 2Department of Economics and Centre for Health Systems Research and Development, University of the Free State, PO Box 339, Bloemfontein 9300, South Africa BMC Public Health 2003 3:14 (published 1 April 2003) Abstract http://www.biomedcentral.com/1471-2458/3/14/abstract Full-text http://www.biomedcentral.com/1471-2458/3/14 Background South African households are severely affected by human immunodeficiency virus / acquired immunodeficiency syndrome (HIV/AIDS) but health and economic impacts have not been quantified in controlled cohort studies. Methods We compared households with an HIV-infected member, and unaffected neighbouring households, in one rural and one urban area in Free State province, South Africa. Interviews were conducted with one key informant in each household, at baseline and six months later. We studied 1913 members of 404 households, with 94% and 96% follow up, respectively. Household and individual level analyses were done. Results Members of affected households, compared to members of unaffected households, were independently more likely to be continuously ill (adjusted odds ratio (OR) 2.1, 95% CI 1.3-3.4 at follow up), and to die (adjusted OR 3.4, 95% CI 1.0-11), mainly due to infectious diseases. Government clinics and hospitals were the main sources of health care. Affected households were poorer than unaffected households at baseline (relative income per person 0.61, 95% CI 0.49-0.76). Over six months expenditure and income decreased more rapidly in affected than in unaffected households (baseline-adjusted relative expenditure 0.86, 95% CI 0.75-0.99 and income 0.89, 95% CI 0.75-1.05). Baseline morbidity was independently associated with lower income and expenditure at baseline but not with changes over six months. Conclusions HIV/AIDS affects the health and wealth of households as well as infected individuals, aggravating pre-existing poverty. AEGiS is made possible through unrestricted grants from Boehringer Ingelheim, Bridgestone/Firestone, iMetrikus, the John Lloyd Foundation, the National Library of Medicine, and users like you. Make a donation today: https://www.aegis.org/about/donate.htm
Response:
I read in a Fact Sheet from CDC(2000) that in developing countries where there can be difficult to take tests, healthworkers can diagnose AIDS if canser or malnutrition can be ruled out. But what about those "fast-tests" which are used on salvia etc? I know a company in my country that has sold those to CDC – and I am told they are used in "third world"? Do they work? Are they acurate? If yes, why don’t we use them in our western world – in bloodbanks and everywhere..? – Hide quoted text — Show quoted text – Actually, it is the most likely range for HIV infection, and probably a little too high. I have worked in the field of emergency medicine and/or HIV/AIDS as either a volunteer or in full-time paid employment since 1984. Back in the early 90s I was "seeing" about 2% of patients that I *thought* were HIV positive (already had AIDS) based on clinical observations. In 2003 I am seeing about 50% of patients that I *think* are HIV positive based on clinical observations. Wow, that’s amazing. Do you clinically/visually diagnose cancer too? But seriously, is it possible that what you’re seeing, and a relatively new influx of poor people from the countryside? A change in demographics after the lifting of restrictions? Granted this is related to people who are already in trouble so the estimate is not that 50% of people are HIV positive, but that 50% of sick people who are in contact with my particular type of work are HIV positive and already evidencing signs of AIDS. But they’re not tested… I certainly think that more than 5% of the population is HIV positive with the likely range being closer to that of the official statistics. Which keep changing. No, it is not a dive of 40%. Even at antenatal clinics there has not been a 50% or more test result ever, not even in the most highly infected areas and groups. Yes, it is a dive of 40%. You went from an estimated national prevalence of 19% to 11.4% OK, the percentage figure refers to the change, not to the total. That’s somewhat more plausible. No, it’s a dive of 40%. 
What I have indicated above is the simple, standard procedure of how tests are supposed to be done. The fact is that the standards of testing in surveys is a lot lower than when HIV infection is diagnosed in an individual. And that shouldn’t be. I am not sure that it *is* lower for the diagnosis. ELISA followed by a Western Blot is pretty conclusive. Yes but, there is a big difference diagnosing individuals and testing these large surveys. In these large surveys **confirmatory tests aren’t done**. " Strategy I All serum/plasma is tested with one ELISA or simple/rapid assay. Serum that is reactive is considered HIV antibody positive. Serum that is non-reactive is considered HIV antibody negative. " Page 7 Table A UNAIDS and WHO recommendations for HIV testing strategies according to test objective and prevalence of infection in the sample population Surveillance 10% I <10% II Diagnosis clinical symptoms/ signs of HIV infection 30% I <30% II What happens with individuals who can afford private medical care is that viral load tests are usually also run immediately so as to determine what treatment, if any, to initiate. As to false negatives, they don’t occur according to the WHO. However, it is false positives that are the issue. Also, these SURVEYS have no confirmatory tests performed. Certainly not Western Blot, whatever may happen at _some_ South African private clinics. It is my understanding that Western Blot tests are run on all positive samples. At *all* private clinics there would be either a Western Blot and/or a viral load test. Remember the clinic gets paid for the onerous task of ordering the test. The WHO doesn’t depend on posh private clinics, but on (leftover) blood collected at antenatal clinics. And they are very specific. Countries where HIV infection is assumed to be greater than 10% (like South Africa), "strategy 1" (page 7) is carried out, which is a single ELISA test, nothing more. If it’s positive, the sample is assumed to be HIV positive. In countries where HIV is assumed to be greater than 30%, this strategy 1 is even used for diagnosis. http://www.who.int/bct/Main_areas_of_work/BTS/HIV_Diagnostics/ Evaluation_reports/Operational%20Characteristics_HIV%20Report9_10.pdf This document is from 1998. As is clear from the data below, Moira, in these Italian data, there are 31 people who tested positive, only *2* remained positive after further testing. That _is_ an extraordinary false positive rate. And this has been discredited by another poster. See that post for the discreditation of your "research". Really? What did he say? That in places with low prevalence, the huge majority of positive ELISAs are false? I already knew that, and it’s even spelled out in the WHO report and in their own words (page 7): " When a single screening assay is used for testing in a population with a very low prevalence of HN infection, the probability that a person is infected when a positive test result is obtained (i.e., the positive predictive value) is very low, since the majority of people with positive results are not infected. " The problem with using this as an excuse of not assuming the same for so-called high infected regions, is: 1) you have to assume a high infection rate before testing starts and 2) it doesn’t take into account a local high prevalence of factors that will cause false positives and that are unique to that local area. (Malaria, tb, ddt [outlawed in most places], leprocy, all kinds of bacteria, and of course the exclusive use of blood samples from pregnant women.) In fact, it assumes that there is a fixed, limited number of false positives out there. When in fact the number of people who have been exposed to factors that will make them test false positive will vary hugely, and increase hugely in Africa relative to Europe or North America. Alex
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Actually, it is the most likely range for HIV infection, and probably a little too high. I have worked in the field of emergency medicine and/or HIV/AIDS as either a volunteer or in full-time paid employment since 1984. Back in the early 90s I was "seeing" about 2% of patients that I *thought* were HIV positive (already had AIDS) based on clinical observations. In 2003 I am seeing about 50% of patients that I *think* are HIV positive based on clinical observations.
Wow, that’s amazing. Do you clinically/visually diagnose cancer too? But seriously, is it possible that what you’re seeing, and a relatively new influx of poor people from the countryside? A change in demographics after the lifting of restrictions? Granted this is related to people who are already in trouble so the estimate is not that 50% of people are HIV positive, but that 50% of sick people who are in contact with my particular type of work are HIV positive and already evidencing signs of AIDS.
But they’re not tested… I certainly think that more than 5% of the population is HIV positive with the likely range being closer to that of the official statistics.
Which keep changing. No, it is not a dive of 40%. Even at antenatal clinics there has not been a 50% or more test result ever, not even in the most highly infected areas and groups. Yes, it is a dive of 40%. You went from an estimated national prevalence of 19% to 11.4% OK, the percentage figure refers to the change, not to the total. That’s somewhat more plausible.
No, it’s a dive of 40%. What I have indicated above is the simple, standard procedure of how tests are supposed to be done. The fact is that the standards of testing in surveys is a lot lower than when HIV infection is diagnosed in an individual. And that shouldn’t be. I am not sure that it *is* lower for the diagnosis. ELISA followed by a Western Blot is pretty conclusive.
Yes but, there is a big difference diagnosing individuals and testing these large surveys. In these large surveys **confirmatory tests aren’t done**. " Strategy I All serum/plasma is tested with one ELISA or simple/rapid assay. Serum that is reactive is considered HIV antibody positive. Serum that is non-reactive is considered HIV antibody negative. " Page 7 Table A UNAIDS and WHO recommendations for HIV testing strategies according to test objective and prevalence of infection in the sample population Surveillance 10% I <10% II Diagnosis clinical symptoms/ signs of HIV infection 30% I <30% II What happens with individuals who can afford private medical care is that viral load tests are usually also run immediately so as to determine what treatment, if any, to initiate. As to false negatives, they don’t occur according to the WHO. However, it is false positives that are the issue. Also, these SURVEYS have no confirmatory tests performed. Certainly not Western Blot, whatever may happen at _some_ South African private clinics. It is my understanding that Western Blot tests are run on all positive samples. At *all* private clinics there would be either a Western Blot and/or a viral load test. Remember the clinic gets paid for the onerous task of ordering the test.
The WHO doesn’t depend on posh private clinics, but on (leftover) blood collected at antenatal clinics. And they are very specific. Countries where HIV infection is assumed to be greater than 10% (like South Africa), "strategy 1" (page 7) is carried out, which is a single ELISA test, nothing more. If it’s positive, the sample is assumed to be HIV positive. In countries where HIV is assumed to be greater than 30%, this strategy 1 is even used for diagnosis. http://www.who.int/bct/Main_areas_of_work/BTS/HIV_Diagnostics/ Evaluation_reports/Operational%20Characteristics_HIV%20Report9_10.pdf This document is from 1998. As is clear from the data below, Moira, in these Italian data, there are 31 people who tested positive, only *2* remained positive after further testing. That _is_ an extraordinary false positive rate. And this has been discredited by another poster. See that post for the discreditation of your "research".
Really? What did he say? That in places with low prevalence, the huge majority of positive ELISAs are false? I already knew that, and it’s even spelled out in the WHO report and in their own words (page 7): " When a single screening assay is used for testing in a population with a very low prevalence of HN infection, the probability that a person is infected when a positive test result is obtained (i.e., the positive predictive value) is very low, since the majority of people with positive results are not infected. " The problem with using this as an excuse of not assuming the same for so-called high infected regions, is: 1) you have to assume a high infection rate before testing starts and 2) it doesn’t take into account a local high prevalence of factors that will cause false positives and that are unique to that local area. (Malaria, tb, ddt [outlawed in most places], leprocy, all kinds of bacteria, and of course the exclusive use of blood samples from pregnant women.) In fact, it assumes that there is a fixed, limited number of false positives out there. When in fact the number of people who have been exposed to factors that will make them test false positive will vary hugely, and increase hugely in Africa relative to Europe or North America. Alex
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Actually, they are _both_ estimates and extrapolations, but the 11.4% percent is based on better research. However, neither number is accurate, because they never use confirmatory tests in these surveys. The real number is likely to be closer to 2-5%. If that. Not true according to what we are seeing in the field. Actually, it is the most likely range for HIV infection, and probably a little too high.
I have worked in the field of emergency medicine and/or HIV/AIDS as either a volunteer or in full-time paid employment since 1984. Back in the early 90s I was "seeing" about 2% of patients that I *thought* were HIV positive (already had AIDS) based on clinical observations. In 2003 I am seeing about 50% of patients that I *think* are HIV positive based on clinical observations. Granted this is related to people who are already in trouble so the estimate is not that 50% of people are HIV positive, but that 50% of sick people who are in contact with my particular type of work are HIV positive and already evidencing signs of AIDS. I certainly think that more than 5% of the population is HIV positive with the likely range being closer to that of the official statistics. – Hide quoted text — Show quoted text – Then, the South African HSRC came along, with a little more money, and they took a random population sample of 10,000 or so people, who they gave a single, orally administered ELISA. Just for them being representative and unpregnant, the result was that 11.4% of the population was now officially HIV positive. That’s a dive of 40%, just by doing the test a little right. No, it is not a dive of 40%. Even at antenatal clinics there has not been a 50% or more test result ever, not even in the most highly infected areas and groups. Yes, it is a dive of 40%. You went from an estimated national prevalence of 19% to 11.4%
OK, the percentage figure refers to the change, not to the total. That’s somewhat more plausible. – Hide quoted text — Show quoted text – The real problem that has remained and still isn’t solved, is that none of the positive testing individuals were followed up by what are called confirmatory tests. Usually, that would be another ELISA, just to see if the first one was right. If this second ELISA is negative, the positive first test is basically thrown out of the window (so to speak), and the patient is considered HIV negative. ELISA tests don’t give false negatives. Now what you have indicated here is simply not true. The same sample that tests positive on an ELISA is run on a Western Blot test. These are highly accurate. What I have indicated above is the simple, standard procedure of how tests are supposed to be done. The fact is that the standards of testing in surveys is a lot lower than when HIV infection is diagnosed in an individual. And that shouldn’t
be. I am not sure that it *is* lower for the diagnosis. ELISA followed by a Western Blot is pretty conclusive. What happens with individuals who can afford private medical care is that viral load tests are usually also run immediately so as to determine what treatment, if any, to initiate. As to false negatives, they don’t occur according to the WHO. However, it is false positives that are the issue. Also, these SURVEYS have no confirmatory tests performed. Certainly not Western Blot, whatever may happen at _some_ South African private clinics.
It is my understanding that Western Blot tests are run on all positive samples. At *all* private clinics there would be either a Western Blot and/or a viral load test. Remember the clinic gets paid for the onerous task of ordering the test. – Hide quoted text — Show quoted text – For the WHO data I know this for a fact, because I e-mailed them personally. If the second is positive, then a Western Blot test is performed. This is a more specific and also more expensive test, which is why it is never used in surveys in Africa. Not true. They are used as a standard in South Africa. Again, not in these large surveys. And not in the HSRC study, which is the most accurate of the lot. ELISA has an extraordinary false positive rate, especially in Africa. From what I hae been advised is that the ELISA test has a slightly higher rate of positive results than are confirmed by the Western Blot. I forget what the differential is, but it is hardly an "extraordinary false positive rate". As is clear from the data below, Moira, in these Italian data, there are 31 people who tested positive, only *2* remained positive after further testing. That _is_ an extraordinary false positive rate.
And this has been discredited by another poster. See that post for the discreditation of your "research". Moira, the Faerie Godmother
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– Hide quoted text — Show quoted text – Actually, they are _both_ estimates and extrapolations, but the 11.4% percent is based on better research. However, neither number is accurate, because they never use confirmatory tests in these surveys. The real number is likely to be closer to 2-5%. If that. Not true according to what we are seeing in the field. Actually, it is the most likely range for HIV infection, and probably a little too high. If HIV is only a 10%-killer virus, then a 20-50% infection rate leads to the same (death-)outcome as a 2-5% infection rate in the case of a 100% killer virus. Alex, I wonder why you are so convinced that HIV is a 100%-killer-virus, and why you provide AIDS orthodoxy with a simple and convincing excuse for the troubling but obvious fact that death rates southern Africa (where HIV always has been endemic) are relatively low.
Hi Wolfgang, Why do you assume that the "tests" are accurate? There are lots of reasons why an inaccurate test like ELISA would go off, known reasons, like pregnancy, malaria, ddt, etc. So as far as I’m concerned, there is no basis for assuming that HIV is endemic in Southern Africa. No rational, sociological or demographic reason either. HIV doesn’t spread more easily between men and women in Africa than in Europe, America, etc. as serodiscordant couple studies have shown again and again. No greater sexual activity, as sociological studies have shown again and again. In the beginning of 2000 (when holding the presidency of the UN Security Council) the US declared AIDS in Africa a national security thread. Look for instance at the effect of this absurd proclamation on the exchange rate of the South African currency. AIDS remains a thread to the nation reponsible for the AIDS hysteria, but the Rand has already recovered.
Well it are signs like that, which show that the disbelief of the apocalyptic paradigm of the AIDS industry isn’t limited to the government. Alex
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Nevirapine can be very dangerous for the liver. During oneandhalf a year there were reported to WHO 62 cases of death – related to nevriapine. And in the same eighteen months how many babies who would otherwise have been HIV positive are now HIV negative? All meds have side effects, some of which can be fatal. The pay off often makes the risk worthwhile.
Indeed, it is unlikely that these deaths are attributable to the single dosages taken by pregnant mothers but rather from cumulative toxicities of standard use in an ARV combination. Pre-existing conditions like HCV or chronic HBV or alcohol consumption may exacerbate this toxicity. George M. Carter
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Actually, they are _both_ estimates and extrapolations, but the 11.4% percent is based on better research. However, neither number is accurate, because they never use confirmatory tests in these surveys. The real number is likely to be closer to 2-5%. If that. Not true according to what we are seeing in the field. Actually, it is the most likely range for HIV infection, and probably a little too high.
If HIV is only a 10%-killer virus, then a 20-50% infection rate leads to the same (death-)outcome as a 2-5% infection rate in the case of a 100% killer virus. Alex, I wonder why you are so convinced that HIV is a 100%-killer-virus, and why you provide AIDS orthodoxy with a simple and convincing excuse for the troubling but obvious fact that death rates southern Africa (where HIV always has been endemic) are relatively low. In the beginning of 2000 (when holding the presidency of the UN Security Council) the US declared AIDS in Africa a national security thread. Look for instance at the effect of this absurd proclamation on the exchange rate of the South African currency. AIDS remains a thread to the nation reponsible for the AIDS hysteria, but the Rand has already recovered. Cheers, Wolfgang
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| I don’t believe a LOT OF STUFF you write considering it (HIV | stuff) comes from sites such as virusmyth etc. | | Well that’s simply not true, because I’ve only been quoting from WHO.int, | certi.org, etc. websites. | | Besides, "it’s from Virusmyth.net so it isn’t true" simply isn’t an argument. | | I said a "LOT OF STUFF" not ALL THE STUFF. Learned something new regarding the surveillance. But quite honestly just because you’re right about one thing, doesn’t make you right about everything. Skeptical would have been a better word to have used. I didn’t say "it’s from Virusmyth.net so it isn’t true" either although that is my opinion quite honestly. I found that site almost 2 years ago and was shocked. However at the time, I had friends who were doing masters in microbiology, and I’m taking their word over these sites. I’ve found a lot of misinformation over the internet, so if I think it looks wrong, then I’m skeptical. Again, I don’t really care about the issue. I’m not going to pretend to know more than I do. Some ‘dissidents’ deny the link between HIV and AIDS, some demand ALL research be banned immediately. Personally, I believe HIV causes AIDS. More importantly I also believe there is no cure, so I’m going to try avoid getting it in the first place. I don’t believe deodorants, amyl/alkyl nitrates, poverty etc cause AIDS. Vitamin C supplements won’t cure AIDS. Neither will raping anybody. You often quote Rian Malan’s Rolling Stone article and link to virusmyth. The substance of this thread is the same as the others you’ve written that do, only the "WHAT IS AIDS" is not linked in this one. Rob
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Nevirapine can be very dangerous for the liver. During oneandhalf a year there were reported to WHO 62 cases of death – related to
nevriapine. And in the same eighteen months how many babies who would otherwise have been HIV positive are now HIV negative? All meds have side effects, some of which can be fatal. The pay off often makes the risk worthwhile. Knowing that the frequence of reporting on side-effects is very low all over – and that the virus can be blamed for every side-effect, I find it strange to go for nevirapine to newborn babies. Besides, the baby kick on to its own immunesystem when it is about eighteen months.
And the baby may sero-convert or may not. Babies who have been given a single dose of Nevirapine after birth when the mother was given a single dose of Nevirapine just before the birth have a much higher rate of sero-conversion than babies untreated by Nevirapine. Another thing; are the positiv tested mothers told not to breastfeed their children? What do they give them then? Do anyone know if the virus is found to exist in breastmilk?
HIV positive mothers are told not to breastfeed their children if possible. Clinics now provide formula free of charge where this is a prophylactic treatment. This assumes that the mother can provide proper artificial feeding. Otherwise exclusive breast feeding is recommended. The mother is then counselled *not* to supplement the breast feeding with anything else. Combination of breast and bottle is the most dangerous because the formula increases the risk of the virus which *is* found in breast milk being introduced through the stomach lining. I am not 100% how this works, but for HIV positive mothers no breast is best (assuming sterility, proper mixing etc.) and exclusive breast feeding is nearly as good. Mixed breast and formula is the most risky. Some of us remember the seventies – when companies sold breastmilk-substitute in Africa – telling mothers that if they used this, their children would be healthy. Many babies died because first of all, the mothers were not told to boil the water.
That is true. But before AIDS there was no reason for substituting formula for breast except for the financial gain of the companies concerned. For HIV negative women there is no reason to use formula and many reasons not to. A friend of mine visited her homecountry in Africa. She brought her meds with her. But there was no fridge where she stayed, so the meds could not be used.
Surely she knew, if it was her home (country), that there would be no fridge? An HIV positive friend of mine travels to Uganda, Kenya, Zimbabwe, Zambia, Senekal, Nigeria, Mocambique, Swaziland and Lesotho (amongst other African countries) doesn’t have any problems with his meds whatsoever. He leaves home with this meds in a cooler bag with ice. When he arrives at his destination the meds are simply put into the fridge. Where there is no fridge for a short space of time (like an overnight visit to a remote village) he simply buys ice and keeps his meds in the cooler bag. He would not go to a place where there was no fridge or electricity, although such remoteness doesn’t tend to get many Western visitors (I realize your friend was visiting her own home) simply because his life depends on the correct taking of his meds, and part of that is the correct storage of his meds. I have travelled with him, and have watched him monitor the storage of his meds. Moira, the Faerie Godmother
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I don’t believe a lot of stuff you write considering it (HIV stuff) comes from sites such as virusmyth etc.
Well that’s simply not true, because I’ve only been quoting from WHO.int, certi.org, etc. websites. Besides, "it’s from Virusmyth.net so it isn’t true" simply isn’t an argument. Alex
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Again – when I read the newspaper in South Africa – to which Alex gave the URL; they take about estimates as facts. The rate of HIV is 11,5 pst, they write – and they continue with saying that this means that 4,5 mill africans are hivpos. But this is not true, it’s estimates. If less than ten percent of the estimated infected population are tested, we know then that 450 000 persons are tested hivpos. I think we all should be more sceptic than we seem to be to statistics and its estimates. Remember what was estimated in Uganda som years ago – and what was said in the beginning of the epidemic in US and Europa(when they used ELISA) A person I know thought for two weeks that he was hivpos. He was told so when he should donate blood. Then the WB was taken and came out negative.He was told that a flue alone could make a ELISA pos.
That’s very common. (See the Italian data below.) So – what about Africa?
No such luck. Just the single ELISA, as according to the WHO. And – is this WB to trust so much?
Western Blot has problems of it’s own, but at least it is more specific than the ELISA. One problem is that it isn’t standardized, but at least it is accepted that in Africa, two of the three ENV proteins being positive equals a positive test (two of p41, p120, p160). GAG (p18, p24, p39 and p55) and POL (p32, p53 and p68) positive bands are discarded and ignored. This is different in different parts of the world, however. In fact the standards for a positive test in Africa are lower, as only 2 (ENV) positive bands are required – at least 3 in the rest of the world. Alex – Hide quoted text — Show quoted text – Actually, they are _both_ estimates and extrapolations, but the 11.4% percent is based on better research. However, neither number is accurate, because they never use confirmatory tests in these surveys. The real number is likely to be closer to 2-5%. If that. Not true according to what we are seeing in the field. Actually, it is the most likely range for HIV infection, and probably a little too high. Then, the South African HSRC came along, with a little more money, and they took a random population sample of 10,000 or so people, who they gave a single, orally administered ELISA. Just for them being representative and unpregnant, the result was that 11.4% of the population was now officially HIV positive. That’s a dive of 40%, just by doing the test a little right. No, it is not a dive of 40%. Even at antenatal clinics there has not been a 50% or more test result ever, not even in the most highly infected areas and groups. Yes, it is a dive of 40%. You went from an estimated national prevalence of 19% to 11.4% 11.4 / 19 = 0.6 which is 0.4 or 40% lower. http://www.independent.co.za/index.php?set_id=1&click_id=13&art_id=vn… 6063345189C308684 The real problem that has remained and still isn’t solved, is that none of the positive testing individuals were followed up by what are called confirmatory tests. Usually, that would be another ELISA, just to see if the first one was right. If this second ELISA is negative, the positive first test is basically thrown out of the window (so to speak), and the patient is considered HIV negative. ELISA tests don’t give false negatives. Now what you have indicated here is simply not true. The same sample that tests positive on an ELISA is run on a Western Blot test. These are highly accurate. What I have indicated above is the simple, standard procedure of how tests are supposed to be done. The fact is that the standards of testing in surveys is a lot lower than when HIV infection is diagnosed in an individual. And that shouldn’t be. As to false negatives, they don’t occur according to the WHO. However, it is false positives that are the issue. Also, these SURVEYS have no confirmatory tests performed. Certainly not Western Blot, whatever may happen at _some_ South African private clinics. For the WHO data I know this for a fact, because I e-mailed them personally. If the second is positive, then a Western Blot test is performed. This is a more specific and also more expensive test, which is why it is never used in surveys in Africa. Not true. They are used as a standard in South Africa. Again, not in these large surveys. And not in the HSRC study, which is the most accurate of the lot. ELISA has an extraordinary false positive rate, especially in Africa. From what I hae been advised is that the ELISA test has a slightly higher rate of positive results than are confirmed by the Western Blot. I forget what the differential is, but it is hardly an "extraordinary false positive rate". As is clear from the data below, Moira, in these Italian data, there are 31 people who tested positive, only *2* remained positive after further testing. That _is_ an extraordinary false positive rate. Table II HIV Screening in Military Blood Transfusion Centers Number of Blood Donations: 25,562 Number of blood donations ELISA positive: 31 Number of blood donations after confirmation test: 2 http://www.certi.org/CMA/newsletter/v03n01.pdf Alex
Response:
Actually, they are _both_ estimates and extrapolations, but the 11.4% percent is based on better research. However, neither number is accurate, because they never use confirmatory tests in these surveys. The real number is likely to be closer to 2-5%. If that.
Not true according to what we are seeing in the field. – Hide quoted text — Show quoted text – Here is the lowdown. Everything is dependent on cash. The WHO (19% infection, etc.) has very little of it. As a result, they depended on the collection of blood from women at antenatal clincs, which was very cheap, because these clinics already existed and blood was already taken anyway. However, the result was that they only had data from pregnant women, who are unrepresentative of general population. They are younger, they are sexually active (duh) and they are all female. And pregnant, which brings me to the second point – the tests used. The cheapest test out there is called ELISA (actually a group of tests). The problem with them is, that they’re not very reliable, because they will "spike" (go positive) when you’ve been exposed to any of 70 known factors and pathogens. Malaria, tb, ddt, the common cold, the flu, herpes, will all make these ELISA tests spike. But the main reason that these tests never should have been taken as the final word, is that they "spike" because of… <drumroll… pregnancy!!
The reasons for using antenatal clinics are varied, but one is that it is one way of getting blood supplies from people who are otherwise usually healthy people. The cheapness thereof relates to the fact that blood samples have to be drawn for sexually transmitted diseases and blood typing anyway, so there are no extra *clinical* costs involved in drawing blood. At most well run clinics pregnant women are counselled to include formal HIV tests (where they get the result, not random ones) so that, if they are HIV positive, nevirapine can be administered at the appropriate time (just before delivery and then, for the baby, after the birth). Now, the ELISA test does sometimes give a false positive in the presence of other pathogens. What you have done is take a fact and then manipulate it to try and prove what you want to believe. Now ELISA never tests false negative, so any blood samples testing negative (and remember that this is the majority of blood samples) can be discarded. Every blood sample in South Africa that tests positive to an ELISA test is retested on the more expensive Western Blot test. This includes bloods taken for antenatal sampling, and bloods taken for random sampling (I have participated in the latter and it is amazing to see one’s blood sample just being dropped, unmarked, into a container which will later be tested purely for statistical purposes). Then, the South African HSRC came along, with a little more money, and they took a random population sample of 10,000 or so people, who they gave a single, orally administered ELISA. Just for them being representative and unpregnant, the result was that 11.4% of the population was now officially HIV positive. That’s a dive of 40%, just by doing the test a little right.
No, it is not a dive of 40%. Even at antenatal clinics there has not been a 50% or more test result ever, not even in the most highly infected areas and groups. Now when test results are released they indicate that they are drawn from antenatal clinics (our official rate) or from other sources, for example, "In a test of mineworkers conducted by …", or "In a test of 36 matric pupils from the same class at one school in Soweto …" The real problem that has remained and still isn’t solved, is that none of the positive testing individuals were followed up by what are called confirmatory tests. Usually, that would be another ELISA, just to see if the first one was right. If this second ELISA is negative, the positive first test is basically thrown out of the window (so to speak), and the patient is considered HIV negative.
ELISA tests don’t give false negatives. Now what you have indicated here is simply not true. The same sample that tests positive on an ELISA is run on a Western Blot test. These are highly accurate. If the second is positive, then a Western Blot test is performed. This is a more specific and also more expensive test, which is why it is never used in surveys in Africa.
Not true. They are used as a standard in South Africa. ELISA has an extraordinary false positive rate, especially in Africa.
From what I hae been advised is that the ELISA test has a slightly higher rate of positive results than are confirmed by the Western Blot. I forget what the differential is, but it is hardly an "extraordinary false positive rate". However, this combination of tests has previously resulted in one Italian military transfusion center of only 6.25% of the original positive testing individuals, who remain being considered HIV positive. So you can see. 20% estimated national HIV infection from blood from pregnant women. The same test on the general populace – 11.4% infection. Follow up tests… 0.7% infection rate? Who knows until the tests are actually done, but it seems very reasonable to assume. (11.4% times 0.0625 or 1/16th)
No, it doesn’t seem very reasonable to assume anything of the sort. Those of us who live and work in South Africa are starting to have friends, family and colleagues who have died of HIV related illnesses. This evidence is a clear indication that the problem is bigger than the 1 -2% you are claiming. We would like to have a low rate of HIV infection, but self-delusion is not the answer to that desire. Moira, the Faerie Godmother
Response:
| However, this combination of tests has previously | resulted in one Italian military transfusion center of | only 6.25% of the original positive testing individuals, | who remain being considered HIV positive. | | So you can see. 20% estimated national HIV infection | from blood from pregnant women. | The same test on the general populace – 11.4% infection. | Follow up tests… 0.7% infection rate? | | Who knows until the tests are actually done, but it seems | very reasonable to assume. (11.4% times 0.0625 or 1/16th) Stated another way. IF there was ONE person in a million that had AIDS. Say Moira then somehow came up with a list of TEN possible people out of this million, you’d say that’s it’s B/S as she only had a 10% success rate. It’s a little cheaper, and smarter testing 10 people, than testing all the million people, however. Now if the population was a billion, Moria still came up with a list of ten people and only the same one guy had aids. Then the success rate of the MOIRA test according to Alex would be 10% still. The way I see it it that ELISA can be used to do the rough work, then fine tuning done by WB? How do you think the Italian military you refer to came up with the 6.25% figure? ELISA and then a WB of course. ELISA says who almost surely doesn’t have AIDS, not who surely does. Another point – those tests were done in 1985. Aids wasn’t so big then. Also the ELISA tests have improved drastically since then. So have cellphones, computers etc. You’re still running an 8088 or a 286 today? If there really was an infection rate of 30% that 6,25% ppv would change to 80%. even for those old ELISA tests. HIV+ HIV- total ELISA SAYS + 2850 70 2920 ELISA SAYS – 150 6930 7080 3000 7000 10000 10000 is a sample population. 10000 * 0.30 = 3000 ( assuming 30% really have AIDS) 7000 * 0.94 = 6930 ( assuming the OLD elisa assays got 94% accuracy in their negatives) 3000 * 0.99 = 2850 ( assuming this ELISA 99% specific ) 2850/2920 = 88% ([really HIV+ overlaps with ELISA+ result] / [total ELISA+ result]) AND NO I HAVE VERY LITTLE MEDICAL KNOWLEDGE. I don’t even have Level 1 1st aid. I got this method off a stats site, which was probably demonstrating P(A given B) not the same as P(B given A) | | The main stream media presents estimates as facts. | | Yes they do, all the time. | As opposed to taking a census. Random samples are used in stats for this very reason. | Do anyone here know which test was used in the beginning | of the epidemic in the western countries? | | Probably some form of ELISA. | "Probably some form of ELISA" Which means you’re taking a guess, and this isn’t your field after all… Rob
Response:
Nevirapine can be very dangerous for the liver. During oneandhalf a year there were reported to WHO 62 cases of death – related to nevriapine. Knowing that the frequence of reporting on side-effects is very low all over – and that the virus can be blamed for every side-effect, I find it strange to go for nevirapine to newborn babies. Besides, the baby kick on to its own immunesystem when it is about eighteen months. Another thing; are the positiv tested mothers told not to breastfeed their children? What do they give them then? Do anyone know if the virus is found to exist in breastmilk? Some of us remember the seventies – when companies sold breastmilk-substitute in Africa – telling mothers that if they used this, their children would be healthy. Many babies died because first of all, the mothers were not told to boil the water. A friend of mine visited her homecountry in Africa. She brought her meds with her. But there was no fridge where she stayed, so the meds could not be used. – Hide quoted text — Show quoted text – Actually, they are _both_ estimates and extrapolations, but the 11.4% percent is based on better research. However, neither number is accurate, because they never use confirmatory tests in these surveys. The real number is likely to be closer to 2-5%. If that. Not true according to what we are seeing in the field. Here is the lowdown. Everything is dependent on cash. The WHO (19% infection, etc.) has very little of it. As a result, they depended on the collection of blood from women at antenatal clincs, which was very cheap, because these clinics already existed and blood was already taken anyway. However, the result was that they only had data from pregnant women, who are unrepresentative of general population. They are younger, they are sexually active (duh) and they are all female. And pregnant, which brings me to the second point – the tests used. The cheapest test out there is called ELISA (actually a group of tests). The problem with them is, that they’re not very reliable, because they will "spike" (go positive) when you’ve been exposed to any of 70 known factors and pathogens. Malaria, tb, ddt, the common cold, the flu, herpes, will all make these ELISA tests spike. But the main reason that these tests never should have been taken as the final word, is that they "spike" because of… <drumroll… pregnancy!! The reasons for using antenatal clinics are varied, but one is that it is one way of getting blood supplies from people who are otherwise usually healthy people. The cheapness thereof relates to the fact that blood samples have to be drawn for sexually transmitted diseases and blood typing anyway, so there are no extra *clinical* costs involved in drawing blood. At most well run clinics pregnant women are counselled to include formal HIV tests (where they get the result, not random ones) so that, if they are HIV positive, nevirapine can be administered at the appropriate time (just before delivery and then, for the baby, after the birth). Now, the ELISA test does sometimes give a false positive in the presence of other pathogens. What you have done is take a fact and then manipulate it to try and prove what you want to believe. Now ELISA never tests false negative, so any blood samples testing negative (and remember that this is the majority of blood samples) can be discarded. Every blood sample in South Africa that tests positive to an ELISA test is retested on the more expensive Western Blot test. This includes bloods taken for antenatal sampling, and bloods taken for random sampling (I have participated in the latter and it is amazing to see one’s blood sample just being dropped, unmarked, into a container which will later be tested purely for statistical purposes). Then, the South African HSRC came along, with a little more money, and they took a random population sample of 10,000 or so people, who they gave a single, orally administered ELISA. Just for them being representative and unpregnant, the result was that 11.4% of the population was now officially HIV positive. That’s a dive of 40%, just by doing the test a little right. No, it is not a dive of 40%. Even at antenatal clinics there has not been a 50% or more test result ever, not even in the most highly infected areas and groups. Now when test results are released they indicate that they are drawn from antenatal clinics (our official rate) or from other sources, for example, "In a test of mineworkers conducted by …", or "In a test of 36 matric pupils from the same class at one school in Soweto …" The real problem that has remained and still isn’t solved, is that none of the positive testing individuals were followed up by what are called confirmatory tests. Usually, that would be another ELISA, just to see if the first one was right. If this second ELISA is negative, the positive first test is basically thrown out of the window (so to speak), and the patient is considered HIV negative. ELISA tests don’t give false negatives. Now what you have indicated here is simply not true. The same sample that tests positive on an ELISA is run on a Western Blot test. These are highly accurate. If the second is positive, then a Western Blot test is performed. This is a more specific and also more expensive test, which is why it is never used in surveys in Africa. Not true. They are used as a standard in South Africa. ELISA has an extraordinary false positive rate, especially in Africa. From what I hae been advised is that the ELISA test has a slightly higher rate of positive results than are confirmed by the Western Blot. I forget what the differential is, but it is hardly an "extraordinary false positive rate". However, this combination of tests has previously resulted in one Italian military transfusion center of only 6.25% of the original positive testing individuals, who remain being considered HIV positive. So you can see. 20% estimated national HIV infection from blood from pregnant women. The same test on the general populace – 11.4% infection. Follow up tests… 0.7% infection rate? Who knows until the tests are actually done, but it seems very reasonable to assume. (11.4% times 0.0625 or 1/16th) No, it doesn’t seem very reasonable to assume anything of the sort. Those of us who live and work in South Africa are starting to have friends, family and colleagues who have died of HIV related illnesses. This evidence is a clear indication that the problem is bigger than the 1 -2% you are claiming. We would like to have a low rate of HIV infection, but self-delusion is not the answer to that desire. Moira, the Faerie Godmother
Response:
Actually, they are _both_ estimates and extrapolations, but the 11.4% percent is based on better research. However, neither number is accurate, because they never use confirmatory tests in these surveys. The real number is likely to be closer to 2-5%. If that. Not true according to what we are seeing in the field.
Actually, it is the most likely range for HIV infection, and probably a little too high. Then, the South African HSRC came along, with a little more money, and they took a random population sample of 10,000 or so people, who they gave a single, orally administered ELISA. Just for them being representative and unpregnant, the result was that 11.4% of the population was now officially HIV positive. That’s a dive of 40%, just by doing the test a little right. No, it is not a dive of 40%. Even at antenatal clinics there has not been a 50% or more test result ever, not even in the most highly infected areas and groups.
Yes, it is a dive of 40%. You went from an estimated national prevalence of 19% to 11.4% 11.4 / 19 = 0.6 which is 0.4 or 40% lower. http://www.independent.co.za/index.php?set_id=1&click_id=13&art_id=vn… The real problem that has remained and still isn’t solved, is that none of the positive testing individuals were followed up by what are called confirmatory tests. Usually, that would be another ELISA, just to see if the first one was right. If this second ELISA is negative, the positive first test is basically thrown out of the window (so to speak), and the patient is considered HIV negative. ELISA tests don’t give false negatives. Now what you have indicated here is simply not true. The same sample that tests positive on an ELISA is run on a Western Blot test. These are highly accurate.
What I have indicated above is the simple, standard procedure of how tests are supposed to be done. The fact is that the standards of testing in surveys is a lot lower than when HIV infection is diagnosed in an individual. And that shouldn’t be. As to false negatives, they don’t occur according to the WHO. However, it is false positives that are the issue. Also, these SURVEYS have no confirmatory tests performed. Certainly not Western Blot, whatever may happen at _some_ South African private clinics. For the WHO data I know this for a fact, because I e-mailed them personally. If the second is positive, then a Western Blot test is performed. This is a more specific and also more expensive test, which is why it is never used in surveys in Africa. Not true. They are used as a standard in South Africa.
Again, not in these large surveys. And not in the HSRC study, which is the most accurate of the lot. ELISA has an extraordinary false positive rate, especially in Africa. From what I hae been advised is that the ELISA test has a slightly higher rate of positive results than are confirmed by the Western Blot. I forget what the differential is, but it is hardly an "extraordinary false positive rate".
As is clear from the data below, Moira, in these Italian data, there are 31 people who tested positive, only *2* remained positive after further testing. That _is_ an extraordinary false positive rate. Table II HIV Screening in Military Blood Transfusion Centers Number of Blood Donations: 25,562 Number of blood donations ELISA positive: 31 Number of blood donations after confirmation test: 2 http://www.certi.org/CMA/newsletter/v03n01.pdf Alex
Response:
Again – when I read the newspaper in South Africa – to which Alex gave the URL; they take about estimates as facts. The rate of HIV is 11,5 pst, they write – and they continue with saying that this means that 4,5 mill africans are hivpos. But this is not true, it’s estimates. If less than ten percent of the estimated infected population are tested, we know then that 450 000 persons are tested hivpos. I think we all should be more sceptic than we seem to be to statistics and its estimates. Remember what was estimated in Uganda som years ago – and what was said in the beginning of the epidemic in US and Europa(when they used ELISA) A person I know thought for two weeks that he was hivpos. He was told so when he should donate blood. Then the WB was taken and came out negative.He was told that a flue alone could make a ELISA pos. So – what about Africa? And – is this WB to trust so much? – Hide quoted text — Show quoted text – Actually, they are _both_ estimates and extrapolations, but the 11.4% percent is based on better research. However, neither number is accurate, because they never use confirmatory tests in these surveys. The real number is likely to be closer to 2-5%. If that. Not true according to what we are seeing in the field. Actually, it is the most likely range for HIV infection, and probably a little too high. Then, the South African HSRC came along, with a little more money, and they took a random population sample of 10,000 or so people, who they gave a single, orally administered ELISA. Just for them being representative and unpregnant, the result was that 11.4% of the population was now officially HIV positive. That’s a dive of 40%, just by doing the test a little right. No, it is not a dive of 40%. Even at antenatal clinics there has not been a 50% or more test result ever, not even in the most highly infected areas and groups. Yes, it is a dive of 40%. You went from an estimated national prevalence of 19% to 11.4% 11.4 / 19 = 0.6 which is 0.4 or 40% lower.
http://www.independent.co.za/index.php?set_id=1&click_id=13&art_id=vn… 6063345189C308684 – Hide quoted text — Show quoted text – The real problem that has remained and still isn’t solved, is that none of the positive testing individuals were followed up by what are called confirmatory tests. Usually, that would be another ELISA, just to see if the first one was right. If this second ELISA is negative, the positive first test is basically thrown out of the window (so to speak), and the patient is considered HIV negative. ELISA tests don’t give false negatives. Now what you have indicated here is simply not true. The same sample that tests positive on an ELISA is run on a Western Blot test. These are highly accurate. What I have indicated above is the simple, standard procedure of how tests are supposed to be done. The fact is that the standards of testing in surveys is a lot lower than when HIV infection is diagnosed in an individual. And that shouldn’t be. As to false negatives, they don’t occur according to the WHO. However, it is false positives that are the issue. Also, these SURVEYS have no confirmatory tests performed. Certainly not Western Blot, whatever may happen at _some_ South African private clinics. For the WHO data I know this for a fact, because I e-mailed them personally. If the second is positive, then a Western Blot test is performed. This is a more specific and also more expensive test, which is why it is never used in surveys in Africa. Not true. They are used as a standard in South Africa. Again, not in these large surveys. And not in the HSRC study, which is the most accurate of the lot. ELISA has an extraordinary false positive rate, especially in Africa. From what I hae been advised is that the ELISA test has a slightly higher rate of positive results than are confirmed by the Western Blot. I forget what the differential is, but it is hardly an "extraordinary false positive rate". As is clear from the data below, Moira, in these Italian data, there are 31 people who tested positive, only *2* remained positive after further testing. That _is_ an extraordinary false positive rate. Table II HIV Screening in Military Blood Transfusion Centers Number of Blood Donations: 25,562 Number of blood donations ELISA positive: 31 Number of blood donations after confirmation test: 2 http://www.certi.org/CMA/newsletter/v03n01.pdf Alex
Response:
PS, About the WHO – they even stipulate on their site, that in populations where HIV infection is _assumed_ to be greater than 10%, they use "strategy 1", or a single ELISA with no confirmatory testing, in their surveys. (See Table A at page 7) "Strategy I All serum/plasma is tested with one ELISA or simple/rapid assay. Serum that is reactive is considered HIV antibody positive. Serum that is non-reactive is considered HIV antibody negative. " http://www.who.int/bct/Main_areas_of_work/BTS/HIV_Diagnostics/ Evaluation_reports/Operational%20Characteristics_HIV%20Report9_10.pdf The HSRC is doing the same. So Moira, whether Western Blot is available in clinics in South Africa, it is _not recommended or required_ by the WHO when they create their antenatal data based estimates. The WHO makes a very clear distinction between testing for surveillance purposes, and the diagnostic testing of individual patients. And it’s all money related. To quote: "UNAIDS and WHO recommend three testing strategies, which have been recently updated, to maximize accuracy while minimizing cost. " And what’s more, in countries where they _assume_ infection rates of greater than 30%, only one single ELISA will do in diagnosis. Alex
Response:
– Hide quoted text — Show quoted text – | However, this combination of tests has previously | resulted in one Italian military transfusion center of | only 6.25% of the original positive testing individuals, | who remain being considered HIV positive. | | So you can see. 20% estimated national HIV infection | from blood from pregnant women. | The same test on the general populace – 11.4% infection. | Follow up tests… 0.7% infection rate? | | Who knows until the tests are actually done, but it seems | very reasonable to assume. (11.4% times 0.0625 or 1/16th) Stated another way. IF there was ONE person in a million that had AIDS. Say Moira then somehow came up with a list of TEN possible people out of this million, you’d say that’s it’s B/S as she only had a 10% success rate.
She did? Just kidding. It’s a little cheaper, and smarter testing 10 people, than testing all the million people, however.
Not for finding out the overall infection rate. For that, you need a large sample size, that is representative (age, gender, geography, income, etc.) of the entire population. Pregnant women are not representative of the entire population. Which is why when using one single (orally adminstered) ELISA, the HSRC ended up with a much lower estimate than had previously been arrived at. Robbo, no one is disputing the use of sampling or using estimates. However, to be relevant instead of misleading, they have to be done correctly. Now if the population was a billion, Moria still came up with a list of ten people and only the same one guy had aids. Then the success rate of the MOIRA test according to Alex would be 10% still. The way I see it it that ELISA can be used to do the rough work, then fine tuning done by WB? How do you think the Italian military you refer to came up with the 6.25% figure? ELISA and then a WB of course. ELISA says who almost surely doesn’t have AIDS, not who surely does.
Of course. The point being that a single, positive ELISA should never be the last word. It _was_ the last word in the WHO data, AND in the HSRC study. Another point – those tests were done in 1985. Aids wasn’t so big then.
That’s not what they said in 1985… Also the ELISA tests have improved drastically since then. So have cellphones, computers etc. You’re still running an 8088 or a 286 today? If there really was an infection rate of 30% that 6,25% ppv would change to 80%. even for those old ELISA tests.
And at 11.4%? (Single ELISA?) But the operative word being *if*. And how do we know? Because of the tests. Here something to mull over. If these tests were so great, wouldn’t they be accurate *no matter what* the level of infection in the general population is? Also, the assumption is that there is either a fixed number of fixed percentage of false positives to the overall number of tests. I think false positives are much more variable, and reliant on the presence of factors that _cause_ false positives. It makes all the sense in the world to assume that false positives have something to do with the factors that cause them – African strains of malaria, ddt use, etc. Things that aren’t occuring in Italy, for instance. HIV+ HIV- total ELISA SAYS + 2850 70 2920 ELISA SAYS – 150 6930 7080 3000 7000 10000 10000 is a sample population. 10000 * 0.30 = 3000 ( assuming 30% really have AIDS)
(You mean HIV.) Which is where things go wrong. The _assumption_ of HIV infection in the general populace. It was 19%. Now it’s 11.4%. Based on…? (1.5% less, and the WHO would have to do follow-up tests in it’s antenatal data.) 7000 * 0.94 = 6930 ( assuming the OLD elisa assays got 94% accuracy in their negatives) 3000 * 0.99 = 2850 ( assuming this ELISA 99% specific ) 2850/2920 = 88% ([really HIV+ overlaps with ELISA+ result] / [total ELISA+ result]) AND NO I HAVE VERY LITTLE MEDICAL KNOWLEDGE. I don’t even have Level 1 1st aid. I got this method off a stats site, which was probably demonstrating P(A given B) not the same as P(B given A)
Where they go wrong is the a priori presumption of a high infection rate. Rationally speaking, there is no reason to _ever_ assume a high HIV infection rate. Not before the tests say so. | | The main stream media presents estimates as facts. | | Yes they do, all the time. | As opposed to taking a census. Random samples are used in stats for this very reason.
That’s not what the previous poster was alluding to. When it’s estimated that one woman is raped every thirty seconds, it is stated in the media that one woman *is* raped (not "estimated to be raped") every thirty seconds. That’s what he meant, he wasn’t criticizing the use of estimations. And by the way, my field of specialty is political science, so statistics is within my area of expertise. Alex
Response:
I don’t believe a lot of stuff you write considering it (HIV stuff) comes from sites such as virusmyth etc. Maybe to argue in your favour, websites directly disputing what virusmyth, perth group etc write just don’t seem to exist… If there was an advisory on the WHO site explaining where ‘dissident’ sites are going wrong, less misinformation would be passed around. Personally I don’t really care that much about the whole thing, as I’ve got a lot of other things to worry about. And I’d be arguing about something I have little clue about anyway. If you were arguing against GM foods, yes, I’d agree. Regarding AIDS – Treating people with AIDS is big money, but that hits the medical aids and private companies AFAIK. Prevention, where possible, would be a better solution and means the problem could be controlled. You’ve got some points about the surveillance, and I’m neutral on that. BUT I’m assuming they’ve already taken what you’ve written into account when they make the estimates. I agree that things should be done properly – IMO those with HIV should get proper medication and councelling, not just a single ELISA and sent away. THAT would be big money, but life should be more important than paper. But then poor countries usually resulted from governments who couldn’t care less in the first place. Rob
Response:
Sunday there was on tv in my country about south-africa. Twenty percent of the population is infected, it was said. Today I read on www.aegis.com that only ten percent of the infected are tested. The rest are estimates. The main stream media presents estimates as facts. Do anyone here know which test was used in the beginning of the epidemic in the western countries?
Read these links and weep or laugh satanically, or do both at the same time. http://www.virusmyth.net/aids/index/africa.htm Hayek.
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Sunday there was on tv in my country about south-africa. Twenty percent of the population is infected, it was said. Today I read on www.aegis.com that only ten percent of the infected are tested. The rest are estimates.
Actually, they are _both_ estimates and extrapolations, but the 11.4% percent is based on better research. However, neither number is accurate, because they never use confirmatory tests in these surveys. The real number is likely to be closer to 2-5%. If that. Here is the lowdown. Everything is dependent on cash. The WHO (19% infection, etc.) has very little of it. As a result, they depended on the collection of blood from women at antenatal clincs, which was very cheap, because these clinics already existed and blood was already taken anyway. However, the result was that they only had data from pregnant women, who are unrepresentative of general population. They are younger, they are sexually active (duh) and they are all female. And pregnant, which brings me to the second point – the tests used. The cheapest test out there is called ELISA (actually a group of tests). The problem with them is, that they’re not very reliable, because they will "spike" (go positive) when you’ve been exposed to any of 70 known factors and pathogens. Malaria, tb, ddt, the common cold, the flu, herpes, will all make these ELISA tests spike. But the main reason that these tests never should have been taken as the final word, is that they "spike" because of… <drumroll… pregnancy!! Then, the South African HSRC came along, with a little more money, and they took a random population sample of 10,000 or so people, who they gave a single, orally administered ELISA. Just for them being representative and unpregnant, the result was that 11.4% of the population was now officially HIV positive. That’s a dive of 40%, just by doing the test a little right. The real problem that has remained and still isn’t solved, is that none of the positive testing individuals were followed up by what are called confirmatory tests. Usually, that would be another ELISA, just to see if the first one was right. If this second ELISA is negative, the positive first test is basically thrown out of the window (so to speak), and the patient is considered HIV negative. If the second is positive, then a Western Blot test is performed. This is a more specific and also more expensive test, which is why it is never used in surveys in Africa. ELISA has an extraordinary false positive rate, especially in Africa. However, this combination of tests has previously resulted in one Italian military transfusion center of only 6.25% of the original positive testing individuals, who remain being considered HIV positive. So you can see. 20% estimated national HIV infection from blood from pregnant women. The same test on the general populace – 11.4% infection. Follow up tests… 0.7% infection rate? Who knows until the tests are actually done, but it seems very reasonable to assume. (11.4% times 0.0625 or 1/16th) The main stream media presents estimates as facts.
Yes they do, all the time. Do anyone here know which test was used in the beginning of the epidemic in the western countries?
Probably some form of ELISA. Alex " "One in five heterosexuals could be dead from AIDS at the end of the next three years," the nation’s most popular talk show host Oprah Winfrey warned her audience in 1987. " http://www.fumento.com/realaids.html
Response:
Sunday there was on tv in my country about south-africa. Twenty percent of the population is infected, it was said. Today I read on www.aegis.com that only ten percent of the infected are tested. The rest are estimates. The main stream media presents estimates as facts. Do anyone here know which test was used in the beginning of the epidemic in the western countries?
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-Michelle re-started Atkins 1/4/05 (quit due to pregnancy 3/01) 292/280/175 