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To Mr Bennnett:
Thank-you for your response. I would like to draw us back to some of the data that I presented from the paper I referenced in my previous post, because it did not seem to be considered enough in your reply and I am genuinely interested in your feedback. It may not convince me that HIV = AIDS, but I am always willing to reconsider my position.
In an earlier post, I alluded to HIV positive rates in SA of at least 7% in those over 55 years of age, equally distributed among males and females. This was determined with 1 ELISA test -- so I think we would both agree that it is reasonable to assume the false positive rate would be equally distributed amongst both sexes. There are at least 2 things in these data that I find very interesting:
a) They are equally distributed among both sexes - and I think you have acknowledged that is much different than developed countries, and
b) The people who had these tests had no idea they were HIV positive. Now, one can not assume that this means they were asymptomatic, but I think it is reasonable that this was the case, otherwise, as I mentioned in my previous post, it is very unlikely they would allow themselves to be tested due to the stigma associated with an HIV postive test in Africa.
Let's examine these a little closer.
First, when one look at the rate of HIV prevalence in the younger people in S/A (presented in my last post) it is reasonable to assume that many of these HIV + people over 55, have likely been HIV positive for decades. The most obvious question is -- why do they not have AIDS by now? I guess one has a few options as conclusions: a) they are all long- term non-progressors, or b) they are false positives. Even if we assume that only half became HIV+ at about 20 years of age, you'd expect a lot of people over 55 to have full-blown AIDS, by this point in time.
Second, how does one explain the difference in the distribution of HIV positive cases between SA and the developed world? On the one hand they appear to be equally distributed (SA) among the sexes, on the other they are still very much associated with certain risk groups. If it were genetic, and associated with being black, then would you not expect to see cases equally distributed among blacks in other parts of the world? I do not believe that is the case. Ironically, in the report quoted, the HIV + rate was higher in white children than in black children.
Another possible reason is that the virus is more bi-directionally transmissible in that population. But again, that seems highly unlikely. So one has to wonder, is there something else that is causing these people to test HIV+.
You said (re HIV rates in S/A) "The figures are not absurd: infection rates with CMV easily top 50% in adults, RSV seropositivity is nigh on 95% by age two. Pneumocystis is a commensal in over 90% of the adult population. Staph Aureus is found in at least 33% of the community. "
I agree - for those infections quoted above, those rates are completely believable and I am not sure what your point was here. Most populations in the world are exposed to those microorganisms at a very young age and become seropositive. The point that I was trying to make was if those HIV rates are correct, we should be seeing far more cases of AIDS than we are seeing and if we are NOT seeing these people develop into AIDS cases, than it begs the question – are the rates accurate?
In the case of HIV, we are talking about an infection, that by best guesses was "spawned in the middle of the last century" and "with an average clinical latency of 10 years, combined with ignorance, denial and insufficent assistance ..." OK, let's look at that statement for a moment in the context of HIV positivity rates.
If one uses the developed world as an example, we have a virus that has been circulating for 50-70 years (some reports I have read suggest the 1930s as the starting point) and in this period very few people have actually experienced full-blown AIDS. Indeed it took until the early 1980s for the syndrome to even appear and be recognized as something different and something potentially new.
The syndrome was first noticed in highly sexually active gay males who, in addition to having multiple sex partners, use a lot of drugs, both legal and otherwise. While I would agree that the infection had to initially show up somewhere, I would expect that if the syndrome has been around for 30-50 years in the timeline, we would have seen it appear in the heterosexual female population first. Why? Because there were far more unprotected acts of sex, particularly among female prostitutes during that 50 year period and therefore more opportunity to spread the virus. If there were any population group where one would have expected to see AIDS first, that would have been it. In addition, even as we move further along the timelines to the present, cases of AIDS (or HIV positive people) among female prostitutes and straight, drug-free porn stars, are rare.
The prevalence rate of HIV in white, sexually inactive SA children was found to be 11.3%. This would represent 96,000 infections in this group, of which, only 570 could have been from MTCT (based on prevalence estimates for white females aged 15-49). Why are these children testing HIV positive? Where did they get it? Either we have a huge number of white children who are lying and are sexually active or drug users, using dirty needles (not likely on both cases) or there is something wrong with the estimate, derived from the ELISA test.
Finally, you have said you would be relatively unconcerned about a white, straight, healthy, single female from a developed country, with a single positive ELISA. What would your position be with a white, 12-year old, sexually inactive healthy girl in SA with a single positive ELISA, or a black, 12 year-old girl in the same circumstances? If AIDS is indeed a disease by clinical diagnoses above all else, how much attention should we be putting on some of the data we are being fed?
I would love to know the prevalence of HIV for those in SA (or in many other areas for that matter) who are healthy and over 75 years of age. A cohort of 75 plus HIV + individuals would really throw that 10- year timeline to AIDS out the window. Even the 55+ data calls it into serious question
Competing interests: None declared