Re: Reply to Nicholas Bennett: Haemophiliacs prove 'HIV' to be endogenous 6 January 2005
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Nicholas Bennett,
Infectious Disease Postdoc/Clinician
Department of Pediatrics, University Hospital, Syracuse, NY

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Re: Re: Reply to Nicholas Bennett: Haemophiliacs prove 'HIV' to be endogenous

If Mr Russell were correct, then the screening of donor blood for HIV antibodies should have had no effect on the rate of transmission of HIV (seroconversion on blood product recipients, if he prefers). That isn't true.

Lyophilisation, quite different from allowing a blood spot to dry out at room temperature (which is what the CDC document was referring to), is specifically intended to preserve molecular structure (e.g. virions and human proteins). It is an ideal method to preserve virus, and indeed flash-freezing of virus is a standard process prior to long-term storage of biological specimens.

Homosexuals may well have been in the habit of selling their blood products, the same as anyone else. It is also a slightly unnerving fact that the monetary recompense for donations in the US actually encourages those in most need of quick cash (e.g. IV drug abusers perhaps...) to also participate. Without knowing that a new virus even existed, there was no reason to exclude them or screen the blood donated.

Clotting factor, like many blood products, is generated from pooled donations. As in the Sydney Blood Bank cohort, where 7 people were infected from a single donation (containing a nef-deleted virus), and that was from blood transfusions, not concentrated factor VIII (and by implication, concentrated virus).

I am always amused at the idea that factor VIII, a massively conserved human protein, is somehow considered "foreign" in the context of HIV. If it were, one would think that there would be rather more than the handful of case reports in the literature of post-infusion anaphylaxis (and in fact they appear to not be related to the Factor VIII itself).

HIV has indeed been recovered from lyophilised preps of factor VIII, at least in the laboratory. This indicates that there is no theoretical reason why HIV should NOT have been transmitted via lyophilised factor VIII [1]. Heat treatment and filtration appear to be some of the best ways to completely eliminate virus from preps. Heat treated factor VIII does appear to offer protection compared to untreated products, in matched hemophiliacs [2].

And besides, the original link was NOT with HIV and hemophilia, it was with AIDS and hemophilia [3] because HIV had not yet been discovered.

Reverse-transcription may well be "a common cellular phenomenon", but it is in truth exceedingly low level in the vast majority of cell types in the human body (gamete production notwithstanding). The RT enzyme was in fact _required_ to explain why the virus appeared to replicate via a DNA intermediate, and Howard Temin spent far too long convincing a skeptical field otherwise (does this make all retrovirologists actually dissidents?!).

Again, we're back to Friend virus, which Mr Russell claims has the best purification method for retroviruses. It also uses reverse- transcription - is he now saying that it too is tarred with the same brush? I'm still waiting for the acknowledgement that there are animal precedents for preferential male to female transmission of exogenous retroviruses, as previously rejected.

Nick Bennett njb35@cantab.net

1. McDougal et al. J Clin Invest. 1985 Aug;76(2):875-7. "Thermal inactivation of the acquired immunodeficiency syndrome virus, human T lymphotropic virus-III/lymphadenopathy-associated virus, with special reference to antihemophilic factor.

2. 8. Rouzioux, C., S. Chamaret, L. Montagnier, V. Carnelli, G. Rolland, and P. M. Mannucci. 1985. Absence of antibodies to AIDS virus in haemophiliacs treated with heat-treated Factor VIII concentrate. Lancet. 1:271-272.

3. Jaffe et al J Infect Dis. 1983 Aug;148(2):339-45. "Acquired immune deficiency syndrome in the United States: the first 1,000 cases."

Competing interests: None declared