Re: Re: Re: Re: Re: Request for Peter Flegg and Outstanding 'Perth Group' Questions 26 November 2004
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Nicholas Bennett,
Infectious Disease Postdoc/Clinician
Department of Pediatrics, University Hospital, Syracuse NY

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Re: Re: Re: Re: Re: Re: Request for Peter Flegg and Outstanding 'Perth Group' Questions

Mr Benvenuti has obviously spent considerable time ploughing through the debate. There are a few points though that he seems to have missed.

HIV has been isolated, just not by the criteria laid out by the Perth Group. Regardless, while it may appear to be a sensible proposal to isolate a pathogen prior to characterising it, this in many cases isn't possible. Other techniques are equally valid, and indeed are considered superior in some respects (e.g. genome sequencing versus EM appearance). I have no idea where he gets the idea that HIV cannot withstand the centrifugation process, since the current standard procedure is a double- centrifugation with sucrose and Optiprep density gradients.

The accusations of misrepresentation are obvious: it is not that the Perth Group simply come to opposite conclusions, but that they selectively ignore key aspects of the literature they quote from to do so. E.g. saying that Montagnier made no efforts to characterise reverse transcriptase when it is clearly stated in black and white that he did. I once had a discussion with someone who presented a paper showing 100% detection of HIV in people with AIDS by PCR, and then claimed that since he "didn't believe" in PCR the paper actually showed that HIV was undetectable in vast numbers of people with AIDS. Amazing logic.

The story of his friend being put on retrovirals in the absence of a confirmatory test is saddening. If true, it would be grounds for negligence in the West. ELISA is only a screening test and requires back- up which doesn't sound as though it was performed (the newer Rapid tests are surprisingly specific, and so he is likely HIV-negative in my opinion). Undetectable viral load is also not grounds for treatment initiation in the West.

Speaking from my perspective, if Mr Benvenuti came to me with no history of exposure but a positive HIV test, I would write him up as a journal article - after performing various biopsies and PCRs. I have seen literally a handful of such cases in the literature - to all intents and purposes, it doesn't happen.

There really isn't a "side" to join - or at least not from my biased perspective - it's simply a case of looking at the literature and seeing what is true. The arguments presented by the dissidents appear sound enough, but in almost all instances are based on flawed logic or misrepresented facts. It is the refusal to accept this that frustrates those like myself, trying to point out the errors. It is indeed dangerous, since there is perhaps a reasonable argument that had President Mbeki not listened to people like the Perth Group the HIV epidemic in South Africa might be significantly less well established.

I agree that factory blindness is an issue, but science doesn't quite work like that. Unlike a production line, we have the amalgamation of epidemiologists, pharmacists, internists, immunologists, radiologists, virologists all seeing data that fits the same theory. Inconsistencies would appear very quickly if that wasn't the case (e.g. for the "MMR causes Autism" debacle, where population studies are completely at odds with the presented lab data). Far more of an issue is the new manager wandering onto the floor and turning off a stop-valve because it doesn't appear to be doing anything, only to have the boiler in the basement explode. Sometimes it's more important to have old eyes...

Nick Bennett njb35@cantab.net

Competing interests: None declared