"
And going to the university and the University of Florence in particular, it came out that Professor Ruggiero – that’s myself – was in absolute terms the Best Professor in the Entire University... and not only in biology and medicine but overall, concerning all the professors of the entire university" - Dr Marco Ruggiero, Professor of Molecular Biology at the University of Florence.

"Derrida's method consisted in demonstrating the forms and varieties of this originary complexity, and their multiple consequences in many fields. He achieved this by conducting thorough, careful, sensitive, and yet transformational readings of philosophical and literary texts, to determine what aspects of those texts run counter to their apparent systematicity (structural unity) or intended sense (authorial genesis)."
- Wikipedia: Jaques Derrida (and also copy-pasted to 2,520 other websites)

"I have long ago given up looking at anything from Snout... He has no credentials at all to discuss the things he talks about, yet feels free to denigrate a long-established, peer-reviewed Italian journal, and highly competent, even distinguished scientists and scholars. If anyone prefers to take his opinion rather than mine, I think that shows rather poor judgement in view of the curriculum vitae posted on my website and the anonymity and missing C.V. of Snout…"

- Henry H. Bauer. Professor Emeritus of Chemistry, Science Studies and Dean Emeritus of Arts and Sciences, Virginia Polytechnic Institute and State University.

Monday, July 13, 2009

HIV, HCV, organ transplants and surgery - Henry Bauer is utterly clueless

IN EARLY 2007 IN CHICAGO a 38 year old man was brought into hospital suffering unspecified traumatic injuries. Sadly, attempts at resuscitation failed and he died. The one apparent positive from his death was that he was an organ donor, and that the organs which were now useless to him could be used for transplantation to provide a new lease of life for a number of otherwise seriously ill people with organ failure such as in severe kidney, liver or heart disease.

There was a problem though. The donor screening questionnaire revealed he was in a “high risk group” for HIV – he was sexually active with other men. Although donor organs are routinely screened for blood borne viruses such as HIV and hepatitis C through antibody testing, such tests are not absolutely failsafe: antibodies may not be detectable for up to three months after initial infection, (although with modern HIV antibody tests they are generally reliable some weeks sooner than that). Donations from “high risk” individuals can therefore be in the early stages of infection with HIV or hep C without this showing on the usual screening tests, during the “window period”. The chances of that happening are very small, but still there. Even among people with no identified “risk” for HIV this can potentially happen: in the US there are now almost as many people infected heterosexually with HIV each year as males infected homosexually: an increasing proportion of new HIV infections occur in people outside the traditional “risk groups”.

The routine antibody tests for HIV and hep C were done on our Chicago man, and they came up negative. The four transplants went ahead.

Since 2004 there has been a second type of screening test (nucleic acid testing) which looks for the viral RNA or proviral DNA rather than antibodies, and which reduces the false negative period still further, but which is again not quite failsafe, as there is still a short period of several days between infection and the test becoming reliable – the “eclipse period”. Another issue is that the test takes time to perform – several hours – which can be critical in the time frame required for organ transplantation. Nucleic acid testing wasn’t done for the four organs donated by our Chicago man.

Organ transplantation carries risks – it’s major surgery – as well as often lifesaving benefits. As well, the supply of suitable organs is very limited and many people die on the waiting list for transplants. It’s not altogether unreasonable to use organs from a “high risk” individual: after all the chances that a donor would die within 22 days or so of becoming infected with HIV are pretty slim. So slim, in fact, that not a single case of HIV transmission through organ transplantation was known to have occurred since 1986 in the US, among hundreds of thousands of transplants, including from an unspecified number of donors fitting the “high risk groups” for HIV.

Of course, ethically and medico-legally there is a principle that consent for a medical procedure is accompanied by information of any salient risks. The transplant coordination team say they told the three hospitals involved of the donor’s risk status. What is not clear is whether the hospitals informed the four organ recipients. Which could become problematic on the very slim chance anything went wrong.


SEVERAL MONTHS LATER, one of the recipients was undergoing assessment for re-transplantation – the organ was apparently failing. As part of the assessment s/he was routinely screened for HIV and hepatitis C – and came up positive for both viruses. As part of the epidemiological investigation, stored samples from the donor were tested – this time with the more sensitive nucleic acid tests that can identify HIV and HCV during much of the window period where the antibody tests will miss a recent infection. He was positive for both. The three other organ recipients were then tested, and they too tested positive for both viruses. The dreaded but very unlikely event – almost a freak occurrence - had happened, and left four people with dual blood borne virus co-infections to add to their other health problems.

This case raises numerous technical and ethical issues, not the least of which is whether consent for the transplants was truly informed if, as at least one recipient claimed, she was not told of the donor’s risk status, and would have refused the kidney had she known. And how, exactly, should the transplant teams have quantified such a risk, which was at the time only theoretical? How much do recipients have the right to know about the donor? Should organs from “high risk” donors even be used? Who, exactly, is “high risk” these days? Should nucleic acid testing be part of the routine donor screen, given the low probability that any given donor will have infections not picked up by standard screening, and the potential for the extra delay to compromise the viability of the transplant?

However, raising those important issues was not the point of this post. This is a blog about Henry Bauer’s bizarre theories about HIV and AIDS, and his take on this case , “HIV”, organ transplants, surgery is a fine illustration of his hopelessly confused, contradictory and downright ignorant pontification about the significance of HIV test results.

FOR OBVIOUS ETHICAL REASONS, deliberately conducted experiments to demonstrate the transmissibility of HIV in humans can never be done. While some of us might take a certain secret pleasure in seeing some of the more prominent denialists publicly demonstrating the courage of their convictions by injecting themselves with a reliably infectious dose of blood from an HIV positive person, it’s not going to happen. Well, actually it kind of did once. A barking mad Florida doctor called Robert Willner stuck himself with a needle coated in allegedly HIV positive blood in several media stunts during the 1990s.  This was some time after he had been struck off for repeated infractions amounting to gross professional misconduct, including claiming to cure people with HIV/AIDS by injecting them with… ummm… ozone.

Unfortunately, we will never know the results of Willner’s publicity stunts, because he died a few months later, apparently from causes unrelated to HIV. [Incidentally, also of interest would be an explanation from denialists about how pumping ozone (a highly oxidative chemical) into people’s veins is supposed to treat a condition that according to the most currently popular denialist account is supposedly the result of “oxidative stress”. But I digress.]

The Chicago cases provide a kind of “natural experiment” that demonstrates the transmissibility not only of HIV but also HCV. It was a tragic and unfortunate series of events that modern medicine does its damnedest to try to prevent, usually successfully, which is why this case was so singular. If you were an evil scientist trying to test the transmissibility of HIV, it would be hard to come up with a better “experimental design”.

So what does Henry say about it?

This sad story illustrates the sorts of tragedies that follow from regarding a positive HIV-test as proof of infection by a pathogenic virus. What those tests (ELISA, Western Blot) actually detect is a variety of antibodies to a whole range of proteins, or (PCR test) bits of RNA and DNA, none of which have ever been shown to constitute part of an authentic virion of HIV. On the other hand, there is copious evidence that a great range of conditions can deliver a “positive” on an HIV test. In the present context, most pertinent are the reports that TRAUMA is associated with positive tests — see for example reports from emergency rooms and autopsies, p. 85 in The Origin, Persistence and Failings of HIV/AIDS Theory. When a person who has had surgery subsequently tests HIV-positive, it’s immediately assumed that infection resulted from blood transfusion or infected instruments; but perhaps the positive test merely reflects the trauma of the surgery or whatever manifest illness later ensues, as with a 65-year-old Indian patient .
The 65-year-old Indian patient, by the way, was a guy who believed that he was infected with HIV through blood transfusions during cardiac bypass surgery. The news article provides few clues as to whether this was or wasn’t the case, but there’s nothing implausible about it. One thing you can be fairly sure of is that in large countries such as India or China it is inevitable that there will be occasional cases of HIV transmitted by transfusions. The probability that any single unit of blood will carry HIV missed by standard antibody screening is extremely small, but in countries with populations of the order of a billion where there are many hundreds of thousands of such donations every year, you can be certain just on statistical probability that someone is going to be unlucky. And you can bet that sometimes this will make the news.

Snout posted a comment for Henry on this post, and – you guessed it – Henry deleted it. Never mind, here it is:
Snout
said
Your comment is awaiting moderation.
Friday,
10 July 2009 at 9:09 am


Henry, don’t you think it’s odd that out of 400,000 transplants since 1986 in the US that only four recipients (0.001%) are known to have acquired HIV through the procedure? Surely if it were the trauma of surgery itself causing HIV antibodies to appear as a “non specific reaction” you would expect more, wouldn’t you?

And don’t you find it odd that those exact same four recipients also seroconverted for hepatitis C – the only known cases ever of post transplant HIV/HCV coinfection in the US?
And that those four recipients all received organs from the one donor in February 2007. No transplants from any other donor have resulted in post transfusion HIV seroconversion since 1986*, or HIV/HCV coinfection ever.

And strangely, when the donor’s stored serum was tested for HIV and HCV by nucleic acid testing he was positive for both viruses?

Far from supporting your theory of HIV antibodies indicating a “non-specific response to stress”, this tragic freak occurrence is virtually iron-clad evidence that what is detected by both HIV and HCV testing are transmissible agents.

“Standard testing” for organ donation at the time (early 2007) was antibody testing. The limitation of this is that antibody tests are not reliable until the window period following infection has passed: up to about 3 months for both viruses. The very small risk of a donation during the seroconversion period is well known, which is why blood banks refuse “high risk” donors despite the fact the samples are tested for HIV. Unfortunately, the demand for transplantable organs far exceeds supply, and transplant teams sometimes take a calculated risk. The medico-legal issue in this case was that the recipient says she was not informed of the risk status of the donor, and would not have agreed to the transplant had she known.

In the last few years many blood banks have added nucleic acid testing to the screening regimen. This reduces, but does not entirely eliminate, the risk of infected donation being missed by the screening process. Nucleic acid testing for HIV and HCV has also recently been introduced for cadaveric transplants in many parts of the world, partly in response to the 2007 events in Chicago.

I’m staggered that you can read this story as confirming rather than utterly refuting your “non-specific response to stress” theory.

Notes: an article about this case was published in November 2008 in Liver Transplantation:
Transmission of human immunodeficiency virus and hepatitis C virus through liver transplantation. 

Other media reports include a series of articles from November 2007: 
4 transplant patients infected with HIV Experts: Case signals patients’ need for more information on donors
Nov. 13, 2007Transplant patient a ‘mess’ after HIV diagnosis Woman was not told her kidney was high risk, attorney says 
Nov. 16, 2007 Federal officials investigate tainted transplants
At issue is what hospitals knew and told four patients about high-risk donor
---------------------------------------------------------------------------------
*Since this was written in July 2009, there has been another case reported, this time from a living donor in New York.

8 comments:

jtdeshong said...

So glad you're back...and in excellent form!
I find it amazing that Bauer has any followers after such a ridiculous post. It seems he is taking cues from Baker in that he is now writing posts which completely disprove everything he has ever stated or implied in the past.
Can his readers not even see that this post especially proves the transmissibility of HIV? As ORAC would say, "the stupid, it burns!"
JTD

apostleshadamishe said...

THE CURE for HIV/AIDS.......AMBUSH

THE IDEA that AMBUSH cures AIDS
is being proven by the more than 400 individuals who have taken a dose of 60 ml three times daily for 21 days. The result is that AMBUSH 'KILLS' the virus by causing the protein envelope to rupture and the viral particles are discarded by the white blood cells. AMBUSH is able to 'KILL' the virus that are 'hiding' in the lymph system by its 'natural radioactive' properties. This process allows the body to 'return to normal health' with a corresponding immunity to that or those strains of the virus.

What is AMBUSH ?
AMBUSH is a radioactive isotope of uranium that is found in the 'palm' plant of which there are more than 3000 species. When ingested, AMBUSH causes the body temperature in the trunk area to rise to about 102 degrees when the individual is sleeping. The preparation takes four hours per batch, which is then given to the individuals for consumption 60 ml three times daily for 21 days. AMBUSH is a herbal preparation in this form but it contains an active ingredient which is a 'NEW' crystalline substance, a drug from the 'palm plant' similarly to ASPIRIN originating from the willow tree bark

RESULTS:
apostleshadamishe@gmail.com

Here is a video taped presentation that I gave at t he Martin Luther King library in Washington

http://www.youtube.com/watch?v=8V53D1w__Po
http://www.youtube.com/watch?v=vPwuwlVBOV0

Snout's Elk said...

Thank you for that extremely helpful information, Apostle Shadamishe. Yes, I personally use radioactive isotopes of uranium to keep my antlers glowing all summer long.

Anonymous said...

Haha, it is I, Fulano de Tal! Did Dr. Bauer think I would disappear just because he refused to publish my posts? I would like to say that Bauer never asked me to prove that HIV causes AIDS. I never claimed to prove that, but I did claim to prove that everything on his site and in his articles was wrong.
Now I see you are joining me in this noble task. Welcome!
I have many many things to say, but here is just one funny one:

In a few posts on his "blog," Dr. Bauer "reports" that sex workers in some countries have lower rates of HIV than married women. He says this weakens the sexually-transmitted HIV theory and strengthens his "theory" because married women are older, on average than sex workers. But he made a muy estupido mistake: the reports really say that a larger percentage of new HIV infections are in married women. This is of course unsurprising since 1) there are many many more married women (that's why I'm so tired!) than sex workers, so even a relatively low riskin the former will produce many more cases than a much larger risk in the latter, and 2) rates of HIV in sex workers are already high, so the increase can be much larger in married women, with a much lower baseline. There is no country in the world where married women have a higher rate (prevalence) of HIV infection than sex workers. In India, there are 8 times as many new AIDS cases in housewives compared to sex workers. But because there are more than 100 housewives for every sex worker the the risk for sex workers is 15 times what it is for housewives. Como ridiculoso! The risk is higher for a younger group that has many sex partners at the same time?
Fulano has many more funny things to say about Dr. Bauer.

¡La ignorancia es atrevida!

Poodle Stomper said...

Snout,
I think I know why your post was moderated out. You started by saying "Henry, don’t you think...". Obviously the answer to anything that follows would be no, no he does not think. Bauer is incapable of thinking so of course he found this question offensive. Glad you are getting better!

-Poodle Stomper

Apostle is just a spammer, btw. I saw his exact same post on another AIDS related board. He is just trying to make a buck by selling quack medicine.

Poodle Stomper said...

It makes me wonder whether Bauer realizes that he is wrong. He must, in my opinion, to moderate out all comments counter to his views. Most denialists spew misunderstood studies and whatnot, many of them probably truly believing themselves correct but Bauer, rather than address critiques of his BS just ignores and moderates them out. Could he be aware that he is full of sh*t and just going on for pride's sake or does he think he is right?

Seth Kalichman said...

Henry Bauer has no sense of right and wrong. Like Duesberg, he is far removed from rational thought. It is truly frightening.

I would like to think that Bauer is in a padded room at an environmentally controlled institution where they give him unrestricted Internet access. Sadly, there are no padded rooms at Virginia Tech.

Do not think for one minute that he sees that he is dead wrong. Bauer’s lack of ability to differentiate reality from fantasy is apparent throughout his adult life. He is used to playing the victim and sees your comments as unjust attacks from a corrupted orthodoxy. That is why he won’t post what you write. He wants to insulate himself with believers.

I doubt that Virginia Tech can do anything about this deranged tenured professor. But for God’s sake can they at least restrict his Internet access?

Chris Noble said...

He is used to playing the victim and sees your comments as unjust attacks from a corrupted orthodoxy. That is why he won’t post what you write. He wants to insulate himself with believers.

That's why it is so amusing when he accuses everybody who disagrees with him of suffering from cognitive dissonance.