NEW DOUBTS
OVER AIDS INFECTION AS HIV
TEST DECLARED INVALID
By Neville Hodgkinson
The Sunday Times (London) 1 Aug. 1993
THE "AIDS
test" is scientifically invalid and incapable of determining
whether people are really infected with HIV, according to a new
report by a team of Australian scientists who have conducted the
first extensive review of research surrounding the test.
Doctors should
think again about its use, say the authors. "A positive HIV
status has such profound implications that nobody should be required
to bear this burden without solid guarantees of the verity of the
test and its interpretation," they conclude.
The findings,
likely to cause intense debate in the medical fraternity and anguish
for many HIV-positive people, are contained in an article published
by the respected science journal, BioTechnology.
Many people
who appear to be infected with HIV, say the researchers, can be
suffering from other conditions such as malaria or malnutrition
that produce a positive result in the test. Even flu jabs can produce
the same effect. As a result, predictions by the World Health Organisation
(WHO) that millions are set to die because of being HIV-positive
may be wildly inaccurate.
The paper also
lends powerful support to the theory, held by growing numbers of
scientists, that HIV is not the true cause of AIDS. One of its authors,
Eleni Eleopulous, a biophysicist at the Royal Perth Hospital, said
this weekend: "There is no proof that people labelled as 'HIV-positive'
are infected with such a retrovirus. We should really question the
role of 'HIV' in the causation of AIDS."
Overall, the
findings "mean the tests have not been scientifically evaluated",
she said.
The authors
say that neither of the two main HIV tests used have been adequately
checked for accuracy. These tests rely on detecting antibodies to
HIV in blood samples. But people whose immune systems have been
activated by several other conditions, including tuberculosis and
multiple sclerosis, can trigger the same reaction, giving a false-positive
result.
Promiscuous
homosexual men, illicit drug users, multiple blood transfusion recipients
such as haemophiliacs and people subject to multiple infections
become increasingly liable to give a positive result the longer
their immune system is weakened, regardless of HIV.
To have confidence
in antibody tests, they must first be validated by having their
results checked against a "gold standard" that is, isolation
of the virus itself. However, this has never been done with the
AIDS test. The report adds that a procedure used to confirm the
validity of diagnostic tests by looking for a virus's genetic material
has also been shown to produce false results and cannot be considered
as synonymous with isolating the virus.
The AIDS tests
look for the detection of a protein called p24, generally considered
the equivalent of isolating the virus. However, it has been detected
in one out of 150 healthy individuals, 13% of people suffering from
warts a condition that signals a weakened immune system and 41%
of patients with multiple sclerosis, another immune system disorder.
Heavy exposure
to sperm can also set up an antibody reaction, especially when entering
the body through anal intercourse. It is another probable source
of false-positives.
The WHO, which
is seeking an extra Pounds 2billion a year for its AIDS prevention
programme, estimates that about 14m people have been infected with
HIV worldwide. It claims the total will reach 30-40m by the year
2,000, and that most will eventually contract AIDS.
Developing
countries are said to face the biggest threat, with Africa alone
already having an estimated 8m HIV-infected people. However, according
to the BioTechnology report, these are the countries where the tests
may be at their most unreliable because of widespread ill-health
caused by other diseases. Severe malnutrition and multiple infections
are especially likely to produce a misleading result in the test.
Claims that current AIDS tests are virtually 100% accurate are based
on studies of healthy subjects.
Eleopulous
said that the paper, which underwent detailed scrutiny by other
experts, concentrates on the shortcomings of one of two main categories
of "AIDS test" known as "western blot", generally
considered the more definitive of the two.
However, she
said doubts were even stronger over the validity of the other test,
called Elisa. This is usually administered first but is widely acknowledged
to carry a high risk of false-positives.
Screening with
Elisa in Russia in 1991 produced 30,000 positive tests, of which
only 66 were confirmed using western blot. In the United States,
a study among military applicants produced 6,000 individuals with
an initially positive but subsequently negative Elisa test.
Dr Philip Mortimer,
of the virus reference division at Britain's Public Health Laboratory
Service, accepted last week that some fair points about the weakness
of the western blot had been made, but he rejected claims that Elisa
was even worse. He maintained that the situation described in the
article was not typical of this country, where there is less reliance
on western blot.
An initial
positive test would be followed by a combination of different Elisa
tests, although sometimes including western blot, and a test of
a follow-up specimen, said Mortimer. "Only if the positive
reactions on both specimens are confirmed, usually in a reference
laboratory, is a positive report issued."
He believed
there was no evidence that people had been falsely told in Britain
that they were HIV-positive.
The findings
have been welcomed by Professor Peter Duesberg, a top American virologist
who maintains that HIV is not the cause of AIDS. He said the evidence
helped to explain how "a false correlation" had been found
between "HIV" antibodies and AIDS.
"The whole
virus hypothesis of AIDS is based on this correlation," he
said. "Its proponents have nothing else: no mechanism whereby
HIV could do the damage attributed to it, no animal tests, no cure,
no vaccine, no virus activity.
"They
have nothing conventional in terms of virus-disease argument, except
this correlation with antibodies. If this study is correct, and
I have no reason to doubt it, it means that even that is now falling
apart."
The findings
have already led to a call by the New York Native, an influential
gay newspaper, for legal action against the American government
by relatives of people who have killed themselves, or suffered toxic
effects from taking the anti-viral drug AZT, as a result of positive
HIV tests.
Charles Ortleb,
the editor, said: "If the test doesn't work, and if people
really don't know that they are infected, the whole thing needs
to be rethought ... This should be given high priority by the research
establishment. We think that as a practical matter, no one should
trust this test." *
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