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
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 £ 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
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." *