Re: "HIV", Factor VIII and CD4s 19 October 2004
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Peter J Flegg,
Blackpool, UK, FY3 8NR

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Re: Re: "HIV", Factor VIII and CD4s

There still seems to be confusion in the minds of the Perth group concerning medical conditions that can affect the immune system in general and cellular immunodeficiency/lymphocyte subsets in particular. Their view is that conditions associated with a degree of immune dysregulation that occurs with antigenic stimulation (like factor VII replacement in haemophilia, or drug use) are sufficient to cause the severe changes that are more typical of HIV-induced cellular immunodeficiency, and therefore lead to the occurrence of AIDS-defining conditions in these groups.

My own MD thesis studied this well-recognised phenomenon in drug users in Edinburgh, and I am well aware of the usually modest changes that can occur in HIV-seronegative drug users. If the Perth Group are true to form, they will now probably look up some of my work and use it against me as “proof” HIV does not exist. (At least it would be interesting to see how badly they can misinterpret my work). Strangely, though, none of these drug users ever developed an “AIDS-defining” condition, while their HIV- infected peers dropped like the proverbial flies all around them.

The facts are that the immunodeficiency provoked by HIV infection is prolonged and profound. HIV seronegative haemophiliacs or drug users only extremely rarely develop AIDS-defining conditions like Pneumocystis. Since the Perth Group insist that they do, then they should be able to provide us with numerous references showing not just small case series or sporadic cases of this phenomenon, but many thousands of cases (to match the tens of thousands of cases of PCP reported in HIV-infected patients).

Can they please do so?

Can they also explain why PCP occurs in HIV positive recipients of blood products, but not in HIV-negatives?

Can they explain why PCP occurs in HIV positive drug users, but not in HIV-negatives?

Can they explain why PCP occurs in HIV positive heterosexuals, but not in HIV-negatives?

Can they explain why PCP occurs in HIV positive homosexuals, but not in HIV-negatives?

The Perth Group previously claimed that many things could cause CD4 lymphocyte counts to decline, and actually cited ten individual references they said showed examples of human CD4 lymphocytes declining to less than 50/mm3 in the absence of HIV infection. When pressed for an explanation as to why not a single one of these ten references supported their very specific claim, they failed to provide one.

Can they do so now?

Competing interests: None declared