Reprinted from Impression Magazine, Issue June 07 1999, www.ironminds.com
By Celia Farber
“The difference between thinking you will live and
thinking you will die often depends on an HIV antibody test that
is shockingly unreliable. The case of a 3-year-old boy in North
Carolina proves that even hospitals have to admit this now…”
Whether you are an HIV believer or an HIV skeptic, you can't possibly
argue that the HIV antibody test is not wracked with problems. It
is the gateway to the Kafkaesque nightmare known as AIDS, which
manifests itself physically, emotionally, sexually and socially.
For the entire global superstructure of AIDS -- in all its multifarious
forms of abuse -- to be teetering atop a diagnostic test so unreliable
is a terrifying specter.
What are the problems with the testing? (There are two tests, by
the way, the "ELISA" test and the "Western Blot"
test. The latter is said to be more accurate, and is used in this
country as a confirmatory measure against two prior ELISA tests.)
For starters, it does not test for HIV per se, but for patterns
of proteins thought to be specific to HIV. These are specified as
''p'' for protein, followed by a number that represents a molecular
weight. HIV is recognized by proteins p24, p17, gp41, gp120, etc.
It wasn't until the early '90s that researchers thought to check
how ubiquitous these ''HIV proteins'' might actually be.
In 1993, the first major critique of the HIV tests was written by
a team of researchers from Perth, Australia, and published in the
journal Bio/Technology. Researchers Eleni Papadopulos-Eleopulos,
Valendar F. Turner, and John M. Papadimitriou reported that p24
antibodies have been found in a number of people who do not have
HIV, including 41 percent of patients with multiple sclerosis and
one out of every 150 healthy people with no afflictions. Conversely,
they found that p24 is not found in all HIV patients or even all
If things were right in the world of science, this paper would have
been the metaphorical iceberg that sank the Titanic. I recall feeling
a palpable sense of shock when I first read it. It's now six years
later, and nothing has changed. But listen to what these researchers
unveiled about the HIV test.
They made four major points: 1) The tests are not standardized,
meaning different labs have different criteria for determining what
is negative and what is positive, and 2) not reproducible, meaning
the test fails when tested against itself, and repeated tests can
alternate between positive and negative; 3) proteins that are thought
to be exclusive to HIV might instead be cellular contaminants or
debris; and 4) there is no ''gold standard'' for the HIV test, meaning
there is no purified isolation of HIV to test against.
They reported on Amazonian Indians who have no contact with anybody
outside their tribes and have no AIDS. Somehow, 13 percent of the
Indians were HIV-positive, according to the Western Blot test. "The
above data,'' the Perth team wrote, ''means either that HIV is not
causing AIDS… or the HIV antibody tests are not specific.''
There are at least 70 underlying conditions -- including pregnancy,
auto-immune disorders, fever, flu, flu shots and malaria -- that
can trigger a false-positive test result. That could account for
many of the so-called AIDS cases in Africa, where only the ELISA
test -- the more problematic of the two tests -- is used. What if
all these Africans are really testing positive for malaria?
The HIV test is a scale, not a "yes" or a "no."
Many people fall in the gray zone and are told they are either positive
or negative, depending on which country they are in and which lab
their blood has been sent to. The Perth team cites data from a mass
screening performed by the U.S. military, in which there were 4,000
people who had two positive ELISAs followed by a negative Western
Blot. All 4,000 would have been told they were HIV-positive anywhere
in Africa and even in England, but negative in the United States
and Scotland. The researchers also found 80 people who had two positive
ELISAs and a positive Western Blot, followed by a negative Western
Blot. Those 80 people, had they not been part of this particular
study in which blood was tested over and over, would have been sent
home with a death sentence -- told they had the AIDS virus. In the
United States, the criteria for telling a person they are positive
stops with two ELISAs and one positive Western Blot. How many other
people, if they had the luxury of an additional Western Blot, might
turn up negative?
I have met, over the years, dozens of people who have stories of
tests coming back positive, then negative, then indeterminate. In
some cities, results have varied from lab to lab, with the difference
between thinking you will live and thinking you will die hinging
on a minute gradation of color, and perhaps the mood and or belief
system of the lab technician. If the blood is known to come from
a gay man, for instance, it will be more likely to come back positive.
In fact, blood has been tested for this bias, as journalist John
Lauritsen has reported. The same sample tested positive when the
lab thought it came from a gay man, and negative when the lab thought
it was from a low-risk heterosexual. Anonymous testing, including
the do-it-yourself blood and oral tests you can find in drugstores,
doesn't suffer from similar biases, but it is still flawed in the
four ways described above.
Medical researcher Dr. Roberto Giraldo, who for the past six years
has been working at a lab of clinical immunology at a large New
York hospital, published his findings in Continuum's most recent
When an HIV test is performed, the blood is first diluted. With
ELISA, it is diluted 400 times. The dilution is somewhat less with
the Western Blot. Most blood tests that look for antibodies against
germs use undiluted blood. But to prevent false positive results,
some blood tests -- including tests for measles, mumps and cytomegalovirus
-- do use diluted blood. However, these are only diluted at a ratio
of 1:16 or 1:20.
''What makes HIV so unique that the test serum needs to be diluted
400 times?'' asks Giraldo. ''And what would happen if the individual's
serum is not diluted?''
Well, he decided to find out. Giraldo ran about 100 specimens, including
his own blood, undiluted. Every single sample tested negative for
HIV when diluted to 1:400 and came back positive when tested without
dilution. ''… the results presented here,'' he writes, ''suggest
that every single human being has HIV antibodies. And this suggests
that everybody has been exposed to HIV antigens.''
In other words, HIV, (if, for now, we agree such an endogenous entity
exists, which is another whole kettle of fish) is not a thing or
a bug or a whole round viral entity that you either have or don't
have. It is all a question of degree. If you have been exposed to
HIV antigens many, many times, your levels of HIV will eventually
rise to the point where you will test positive.
But as the poet Tomas Transtromer once put it, perhaps we are seeing
these events from the wrong perspective -- a heap of stones instead
of the face of the sphinx.
What the Perth team is actually trying to tell us is that HIV is
part of all of us. When they say it doesn't ''exist,'' as they notoriously
have, they seem to be saying that it does not exist as a foreign
invader. It exists as part of our genome, composed of maybe millions,
maybe billions, of retroviral particles.
* * *
Why does this all matter? Because a flaw in a diagnostic test can
wreak havoc and tragedy in a human life.
Last month in Winstom Salem, North Carolina, 3-year-old Joey Daniels
was struck by a car. He suffered a fractured skull and was rushed
to a nearby hospital. A week later, as Joey was recovering, some
of his blood splashed on hospital workers when an I.V. was being
changed. (This story was reported by WXII Channel 12 newscaster
Joey was given an HIV test. He tested positive, and a doctor told
Joey's already traumatized mother, LaTonia, the news. Both of Joey's
parents are negative, and LaTonia asked how this could have happened
to her son. The doctor told LaTonia she needed to launch an investigation
into her entire family and circle of friends because the child had
been sexually abused. There was no other explanation, the doctor
said, for the child being positive.
More testing was ordered, and LaTonia spent two days waiting, trying
not to go insane. She thought about finding out who had infected
her son or hurt him and "killing them." But then the second
round of test results came in, and Joey was found to be HIV-negative.
LaTonia was relieved, but understandably livid. (Imagine how lives
would have been shattered in one moment had she begun accusing family
members of sexual abuse!) She asked the doctor to apologize, but
in keeping with HIV-related arrogance, he refused. The case was
referred to the Culpepper, Virginia-based watchdog group International
Coalition for Medical Justice (ICMJ).
''This is very Southern,'' remarked ICMJ's director Deane Collie,
herself a Southerner. ''This mother told me she would have been
satisfied with an apology. In the South, a man in that situation
would be expected to act like a gentleman, to admit he had made
a mistake and to apologize. But he refused.''
Even some of the hospital's staff have encouraged LaTonia to contact
an attorney. The hospital, meanwhile, held a press conference, where
a remarkable admission was made. In her effort to clear the hospital
of any wrongdoing, a hospital spokesperson announced that ''…
these HIV tests are not reliable; a lot of factors can skew the
tests, like fever or pregnancy. Everybody knows that.''