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TESTING AND
SURVEILLANCE
HIV PROTEINS
“...analysis of the proteins
demands mass production
and purification”
Luc Montagnier 1997
Montagnier 1983
Material at 1.16 gm/ml
“Purified virus”
3 proteins react with patient serum
p24/25 =“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, 1997
p41 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 lymphocytes
Chassagne 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
diseases
Parravcini 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 1991
Immunocytochemical reactivity using polyand 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 ITSELF
HIV ISOLATION
HIV ISOLATION
PROBLEMATIC
RT (inc. mitochondria)
PARTICLES
ANTIGEN/ANTIBODY REACTIONS
p24
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
LIGHT ON
LIGHT OFF
DAYS
Pies
One every
Sensitivity
Specificity
80
2
82
732
82
9
97.6%
98.5%
NO PIE
10
640
650
days
DISEASE NO DISEASE
POSITIVE
NEGATIVE
HIV
POSITIVE
NEGATIVE
NO HIV
Assay Name (Manufacturer) Global Panel
Sensitivity
Detect HIV 1 + II
100%
Cambridge
99.6%
Abbott 3rd generation 100%
HIV
Specificity
97.4%
99.7%
100%
The panel included 332
HIV negative specimens
and 203 sera positive
for HIV-1 and 60
positive for HIV-2
specimens
GALLO JAMA 1985
AIDS
Blood
Donors
HIV POS
HIV NEG
Sensitivity
Specificity
86
2
88
97.73%
97.67%
19
795
814
NO RISK HOSPITAL PATIENTS
St. Louis 1988
HOS
1
2
3
4
5
6
7
8
NUM ALL MEN 25-44 WOM 25-44
2897 7.8
21.7
7.4
4406 5.6
18.4
7.8
1968 3.2
13.3
3.5
1720 1.9
7.1
0.7
5380 0.9
3.2
0.8
3299 2.6
7.7
3.3
3823 1.9
1.8
2.4
4275 1.8
5.7
0.8
BURKE NEJM 1988
1.2 MILLION/135,187
1.4 and 0.148 per 1000
HEALTHY MILITARY
RECRUITS
POSITIVE
NEGATIVE
Total
Sensitivity
Specificity
HIV
NO HIV
14
0
14
135187
100.0%
99.9993%
1
135172
135173
BURKE
HIV POSITIVE
HIV NEGATIVE
= 2E + 2WB
= NOT ABOVE
TRULY INFECTED
= 2E +2WB+4XWB
NOT TRULY INFECTED= NOT ABOVE
THE DE FACTO
HIV GOLD STANDARDS
THE CLINICAL SYNDROME
LOW RISK/GOOD HEALTH
REPEATING THE TEST
AIDS
AB POS
AB NEG
NO AIDS
HIV
AB POS
AB NEG
NO HIV
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 Laboratories
1988, 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