HIV Dissidents, continued

A while back I wrote about the case of HIV-dissident Christine Maggiore and the death of her three-year-old daughter. To recap: mother is HIV positive, she refuses anti-retrovirals while pregnant and after daughter's birth, she breastfeeds daughter (a known risk for HIV transmission), daughter dies at 3-and-a-half-years-old two days after starting amoxicillin for a proposed ear infection, medical examiner reports "AIDS-related pneumonia", family is livid, LA Times chronicles all in this article. The crew at Dean's World, who deny the HIV-AIDS hypothesis, support the family, who has the report reviewed by a pathologist. You can read his report here.

This is where it gets interesting. The pathologist who reviewed the report is Dr. Mohammed Ali Al-Bayati, PhD, DABT, DABVT, and he finds that the medical examiner in LA is in error. He is being passed off as an expert by Dean and by others. Writes David Crowe:

Dr. Mohammed Al-Bayati is a respected pathologist (PhD) and a dual board certified toxicologist with over twenty-five years experience and over forty articles published in the scientific and medical literature.

All true, but extremely misleading. Dr. Al-Bayati may be perfectly competent at what he does, I don't know. But he has no particular expertise that makes him qualified to refute the medical examiner's (ME's) report. What an autopsy report includes is a summary of the clinical events and medical history, a gross description of the body and internal organs, and a description of microscopic histologic findings. The last two are the job of a pathologist, something Dr. Al-Bayati proclaims to be. However, it is helpful to know that the world of pathology is split into two: clinical pathology and anatomic pathology. When a pathology resident sits for board exams, he actually takes two different tests, one for clinical and one for anatomic. It is possible to become board certified in one and not the other. In fact, it is possible to become board certified in one with zero experience in the other; and it is possible to become board certified in clinical pathology without any training in skills required to create or understand an autopsy report that addresses mainly anatomic findings.

This is important to know - because Dr. Al-Bayati is not a board certified anatomic pathologist! This matters, because an autopsy report is the purview of an anatomic pathologist, someone who is trained and educated in the recognition and interpretation of anatomic data, mainly microscopic histology. Dr. Al-Bayati could have reached his current station without ever once taking a single anatomy, histology, or anatomic pathology course. Indeed, there is no indication from his credentials that he is the least bit qualified to claim expertise in reviewing the medical examiner's findings. So how could he be considered an expert in anatomic pathology? (He isn't a board certified clinical pathologist either; however, he does have education and experience in clinical chemistry and toxicology, so any expertise in these areas will be granted).

This is not an ad hominem attack. He (and others) is passing himself off as someone with special expertise in evaluating these anatomic pathological findings, and he simply does not; the American Board of Pathology would agree with me. It certainly does not mean he can't have an opinion or that his arguments don’t deserve refutation (if I were saying that, then that would be ad hominem). It just means it is very misleading to say his opinion has any special sway over any other average person's. I should disclose that as a pathology resident, I am not board certified in anatomic pathology, either. However, one day soon I will be, and I am currently learning and training in basic skills that allow me to evaluate Dr. Al-Bayati's report. The opinions that I render here are based on my education as a pathology resident and the materials available to me in pathology texts and the medical literature. I reserve the right to change my mind based on more information - I am not an expert, but I am competent and knowledgeable of anatomic pathology.

At this point, if you are interested, you should probably read the report. Then go read this rebuttal by Orac at Respectful Insolence. Much of what I say overlaps with his post (however, his is much more thorough and encompassing than mine could ever be). I hope to add to a few points he has brought up.

To summarize, the ME found the following (via Orac):

  1. Pneumocystis carinii was found in Eliza Jane's lungs by Gomori methenamine silver staining in association with pink foamy casts in the alveoli. The lungs were also edematous (water-logged).
  2. Eliza Jane was mildly neutropenic (low neutrophil--a type of white blood cell--count) and profoundly anemic (low red blood cell count)
  3. Eliza Jane's brain contained throughout its white matter with relative sparing of cortex a number of variable-sized microglial nodules characterized by multinucleate giant cells associated with moderate pallor and myelination, occasional macrophages, and angiocentric pattern. These lesions stained positive by immunohistochemistry (IHC) for the HIV core p24 protein, a finding consistent with HIV encephalitis.
  4. There was atrophy of the spleen and thymus
  5. There was enlargement of the liver with fatty infiltrate of the cells (steatosis) and ascites

(note: immunohistochemistry is staining based on the presence or absence of a specific substance with antibodies. Normal histologic staining is just pink and purple color based on the acidity or basicity of the tissue in question.)

Taking these finding at face value for the time being, Dr. Al-Bayati has two tasks: 1) to discredit the findings from the ME and draw into doubt her conclusions, and 2) to come up with an alternative explanation for the child's death. #1 is the most important; the ME basis her conclusions on the probability that the findings can be explained by an AIDS diagnosis (relative to other possibilities). Dr. Al-Bayati can hypothesize (#2) all he likes, but it's a waste of time if the likelihood of these hypotheses are extremely low and the likelihood of the ME's explanation much higher. So he tries to refute each of these findings as being consistent with an AIDS diagnosis where he can; where he can not, he pushes an alternative:

  1. P. carinii pneumonia was not present and the findings were consistent with pulmonary edema caused by anaphylactic shock
  2. The blood abnormalities are a classic symptom of parvovirus B19, which he will later hypothesize as the culprit in this whole saga
  3. Most of the brain findings were non-specific, and the specific findings are false positives.
  4. The atrophy of the spleen and thymus is caused by the previous three-week illness
  5. The liver changes were due to liver toxicity from the amoxicillin (penicillin) the child was taking for two days for an ear infection.

Lets start with the first one, since this is by far the most important. The fungus P. carinii is a very rare human pathogen that is seen only in hosts with compromised immune systems. (Dean Esamy disputes this fact, but he is grvely mistaken; expanded thoughts on this here.) Historically it was seen in patient on long course steroid treatment and treated cancer patients with destroyed bone marrows. It was exceedingly rare until the advent of AIDS, where it became much more common, afflicting most of these patients at first (note: this was how AIDS was first recognized, by the sudden appearance of many cases of P. carinii pneumonia - called PCP - in the early 80's). A finding of PCP equals an immunocompromised host; and it means an AIDS diagnosis if no congenital or acquired cause of immune system compromise can be found (based on statistical likelihood). While the organism is fairly ubiquitous, it is almost never found in normal histologic examination, never in the alveoli (small air sacs that make up the lung), and never in the quantities or with the same microscopic background seen in AIDS patients and other immunocompromised individuals. The ME found P carinii on special stains (GMS) and "pink foamy alveolar casts" on normal stains (H&E).

As a matter of fact, if the presence of PCP can't be refuted, Dr. Al-Bayati's whole case goes down the drain. So what does he claim? That the organisms were there but there was no pneumonia. No PCP, no AIDS:

Pneumonia is a term that refers to inflammation and consolidation of the pulmonary parenchyma. The microscopic examination of Eliza Jane's lungs revealed no inflammation. The ME did not observe any inflammatory response in the alveoli or in the interstitial tissue to justify a diagnosis of...PCP or any other form of pneumonia.

The lesions of PCP usually comprise an interstitial infiltrate of plasma cells and lymphocytes; an interstitial fibrosis; an interstitial diffuse alveolar damage; and hyperplasia of type II pneumocytes; the alveoli are filled with characteristic foamy exudates...

So, got that? PC, but no P, because it doesn't fit the (strict) textbook definition of pneumonia. Well let's just see what the textbooks have to say. From Pediatric Pathology (Stocker & Dehner):

The organism has an elliptical shape with sharply demarcated borders and a pale center containing a distinctive black dot. A foamy transudate often totally lacking in inflammatory cells fills the alveoli.

From Spencer's Pathology of the Lung (Hastleton - 1996):

In typical cases of PCP, many alveoli and alveolar ducts are filled with characteristic amorphous, foamy eosinophilic material... There is an associated interstitial pneumonia with an infiltrate that consists mainly of lymphocytes and plasma cells... Alveolar walls may appear thickened due to the cellular infiltrate and edema, but fibrosis is not a feature in the early stages of the disease. The interstitial infiltrate is very variable and may even be minimal.

From Surgical Pathology of Diffuse Infiltrating Lung Diseases (Flint & Colby - 1987):

The histologic changes associated with PCP vary enormously from nearly normal histology to the classic foamy intra-alveolar exudate... Histologic patterns that may be appreciated include: nearly normal histology with few inflammatory cells scattered around aggregates of organisms plastered against the alveolar walls; an intense interstitial pneumonia with interstitial infiltrates...; diffuse alveolar damage...; the classic pattern with eosinophilic foamy intra-alveolar exudates and edematous alveolar walls with a mild chronic inflammatory infiltrate and prominent type II cells.

From Pulmonary Pathology (Dunnill - 1987):

Histologically alveolar septa are increased in thickness and infiltrated with plasma cells and lymphocytes... In immunosuppressed patients plasma cells and lymphocytes may be scanty. The characteristic feature is the intra-alveolar exudate... The intra-alveolar cellular reaction to the exudate is notable for its absence...

Finally, fromPractical Pulmonary Pathology (Leslie & Wick - 2005):

(PCP) can mimic any lung injury pattern... The histology of pneumocystis infection is that of frothy intra-alveolar exudates (so-called "alveolar casts") with many organisms.

So an exhaustive search of my pathology texts shows that Dr Al-Bayati's assertion, that inflammation must be present, is not at all supported by the whole of the pathology profession. In fact, it seems logical that diseases which depress the body’s abilities to mount inflammatory responses would not have very much inflammation around these organisms. The ME's findings, organisms and foamy alveolar casts with little inflammation, is entirely consistent with the diagnosis if PCP. Not to put too fine a point on it: show 100 pathologists lung tissue that matches the description in the ME's report, and you'll get 100 diagnoses of PCP.

This, of course, does not equal AIDS; it just makes it very likely. Dr. Al-Bayati then goes on to site many studies of PCP in HIV-negative and non-AIDS patients (but there's no PCP, right? Well, just in case, I guess). However, every one of the patients in the studies he cites is severely immunocompromised from various medical treatments or malignancies, neither of which describes this child. His lame attempt to account for an immunodeficiency brought upon by thymic and bone marrow atrophy from a chronic (3 weeks maximum) illness. This doesn't pass the clinical smell test, and no such patients are represented in the studies he cited. People don't develop PCP after short duration of an upper respiratory tract infection and an ear infection. I challenge Dr. Al-Bayati to find a single documented case.

At this point, short some plausible explanation for immunosuppression, in a child of an HIV+ mother who breastfed, AIDS is high on the list of probable diagnoses; in fact, it’s the only probable diagnosis.


Moving on to #2, that the child was anemic (low number of red cells) and neutropenic (low number of specific white cells, called granulocytes). From Pediatric Pathology:

Red and white cell elements may be increased, normal, or suppressed.

The presence of these abnormalities in this case neither proves, nor disproves, the presence of AIDS. As we say, it neither sensitive, nor specific. The more interesting fact is how these relate to the alternative hypothesis. For this, you should read Orac. The upshot is that B19 usually causes pure red cell abnormalities (but not always), and it only causes that in patients with a predisposing problem in red cell production or immunosuppression – and AIDS is one of these predispositions. If B19 was involved, (and there is no specific evidence that it was) it doesn't preclude a diagnosis of AIDS - it may actually support it.


Now for #3, that the HIV p24 positive staining seen in sections of the brain are not specific and could be false positives. This is the only point made by Mr. Al-Bayati that has any real plausibility. He cites a study done in 1992 that calls into question the specificity of the p24 immunostain. Many previous studies, especially studies involving CNS tissue, had expressed confidence that the p24 stain would stain positively only in cases where HIV was present. This study found that some kidney tissues with similar-looking pathology stained positive with p24 antibodies.

A few points: In terms of immunostains, 1992 is ancient history. I have contacted an author from that study to determine if any further studies were done, and if improvements have been made to the stain. I will update if he and I are able to communicate.

Moreover, positive-staining with a non-specific stain just means that the information yielded from this particular study is not-conclusive. The other non-specific pathological findings (giant cells, etc.) are consistent with a diagnosis of HIV-encephalitis; nothing Al-Bayati quoted from the ME does the slightest to rule this out – we must rely on the other information elsewhere in the study that more or less points specifically to an AIDS diagnosis.

In other words, this simply means that a positive p24 stain is no the be-all-end-all test for HIV/AIDS; there was evidence given (when a lot was needed) that this was a false positive.


#4: the thymic and splenic atrophy. From Pediatric Pathology:

Marked thymic atrophy... is seen in children with AIDS. It may be impossible to visualize the thymus at the autopsy table... Most children with AIDS have massive splenomegaly. There is obliteration of the white pulp with hyperplasia of the splenic cords.

This is consistent with what the ME saw. Dr. Al-Bayati would argue that he saw a small spleen, not a large one. However, he claims the 40 g spleen was "85% of the expected normal average weight for age." However, a large or small spleen is not determined on its relation to the average, but it's the relationship to the normal range (2 standard deviation around the mean). Furthermore, the normal range for a three-year-old is 36 to 45 g according to pediatric pathology texts; so there was no underweight spleen in any meaningful sense of the word. And histologically, she saw atrophy of certain elements consistent with an AIDS spleen.

Again, neither of these findings is sensitive nor specific; yet they are consistent with an AIDS diagnosis in a child.


Lastly, #5, that the changes seen in the liver are consistent with his alternative hypothesis.

What the ME saw was called steatosis, or accumulation of fats inside the liver cells. Also of note: the liver weighed 500g and there was no mention of liver inflammation or necrosis (cell death) in Al-Bayati's relayed report. He claims that this weight represents a rapid accumulation of water due to shock and that the histologic changes are consistent with those seen in amoxicillin toxicity (the drug she received for two days before death). He even provides several citations of the literature that support this; however, a careful reader will notice that these cases all describe hepatic drug toxicity, which is accompanied by destruction of the liver cells themselves.

But you will recall that the ME found no evidence of such destruction - just fat accumulation (which also takes more than two days to occur). So if the picture seen by the ME is inconsistent with Dr. Al-Bayati's hypothesis, what is it consistent with?

Well, isolated steatosis is usually seen in alcoholics, pregnancy, and obesity. None of these describe this child. However, Albisetti et al. described hepatic steatosis present frequently in a study of HIV+ children using ultrasound, biopsy, and autopsy. Where previously this change had been associates with HIV drugs (AZT, etc. - this has been described quite a bit in the literature), this study found isolated steatosis in many children before they had been treated. In fact, every autopsy or biopsy occurrence of steatosis had been untreated except for one. And this makes sense, if you realize that most children are treated in this country, studies would tend to make it seem as if it were due to the drugs themselves (it would be hard to differentiate). Since this study found many children yet untreated, it was able to show this change in isolation – associated only with AIDS.

And, again, the weight is above the weight he cited, but not outside the normal range; also, it was actually right at the mean according to a different citation in a pediatric pathology text.

This is in no way sensitive or specific for an AIDS diagnosis. But it is consistent with it, and inconsistent with the alternative hypothesis.


So, in summary, all five main pathologic findings, as presented by Dr. Al-Bayati himself, are consistent with an AIDS/HIV diagnosis. The PCP pneumonia in patient lacking the other risk factors (and three weeks of a mild upper respiratory illness is not a risk factor) is fairly specific for AIDS. All the other findings do not constitute strong evidence, but such is already represented by the PCP. As far as the alternative hypothesis goes, the PCP and steatosis are inconsistent with Dr. Al-Bayati’s characterization. Their presence does not rule out his hypothesis, but it does require an explanation. And the literature supports AIDS as by far the most likely suspect.

(You’ll note I confined myself to the pathologic aspects of this case, and not the clinical features. I feel I am only qualified to adequately analyze the former and not the latter. For this, see Orac.)


As a postscript to this analysis, let me comment on the case as it stands now. Rumor has it that the child’s parents are being investigated with the intention of possibly charging them with a crime for exposing their child to HIV and failing to treat. Most people who have written about this case who also agree with my conclusions support this course of action.

But I think I can, at the very least, make a good argument why this should not happen. In all I have read regarding this case, and from all I have read of Christine Maggiore and her activism, I have seen no evidence that she has an agenda that exceeds advocating for what she finds to be the truth. Also, I choose to believe, until presented with evidence otherwise, that she was a loving mother who is very saddened by the loss of her daughter. Though her beliefs, and the actions that extended from them, may have directly led to the infection of her daughter with HIV, its progression to AIDS, and her death from its complications, I believe the pain that Ms. Maggiore now suffers from the consequences of those beliefs is more than any punishment that she should have to endure.

She shares responsibility in this child’s death. But she was acting in good faith in what she thought was the best interests of her child. I don’t see any crime in that. (I have significantly expanded and qualified these thoughts here.)


Update: Follow-up here.


Link Round-Up:
HIV Dissidents
HIV Dissidents, Continued
HIV Dissidents: The Continuing Saga
Parents Vs. The State
Maggiore on PrimeTime Live

Respectful Insolence 1
Respectful Insolence 2
Respectful Insolence 3
Nick Bennett's Rebuttal to Al-Bayati's Report

The Medical Examiner's Report
Mohammed Al-Bayati's Comment on ME's Report

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She shares responsibility in

She shares responsibility in this child's death. But she was acting in good faith in what she thought was the best interests of her child. I don't see any crime in that.

I don't see any justice in punishing the mother either, but what you've said so far here is surely not enough of a reason for the conclusion. Supposing that you, acting in good faith on what you think is the best information possible, take my treasured Ming vase (because you mistakenly believe that it was stolen from you). Does the fact that you were acting in good faith mean you don't have to give it back?

Supposing that in the process of trying to forcibly "recover" the vase from me, you drop it and it shatters into a million pieces. Does the fact that you were acting in good faith mean that you don't have to pay me compensation for the destruction of what was, in fact, my vase?

Supposing that I try to stop you from taking the vase and you break my leg in the process of trying to forcibly stop me from forcibly stopping you. Does the fact that you were acting in good faith mean that you don't have to make restitution to me for breaking my leg in the process of taking and destroying what was, in fact, my vase, from my own property?

Broadly speaking, what does the fact that someone is acting in good faith have to do with anything? If it's somebody else's property you're damaging or taking, why should good faith or acting on what you think is the best information have any mitigating effect on your guilt or what you owe for the damage?

I should disclose that as a

I should disclose that as a pathology resident, I am not board certified in anatomic pathology, either. However, one day soon I will be, and I am currently learning and training in basic skills that allow me to evaluate Dr. Al-Bayati’s report. The opinions that I render here are based on my education as a pathology resident and the materials available to me in pathology texts and the medical literature.

On a slightly humorous note, I guess that means JTK can't be a pathologist since reading those textbooks involves believing what other people say based on reputation.

Trent is of course being

Trent is of course being respectful and logical. But let us be clear on what an ad hominem argument is. It's a logical fallacy that works like this:

1 Person A makes claim X.
2 Person B makes an attack on person A.
3 Therefore A's claim is false.

Those advancing the ad hominem fallacy may in fact be correct. I for example can make an ad hominem arugment here that Trent's not qualified here by his own admission. That wouldn't be a personal attack or an insult, but it would be an ad hominem argument. It would also be correct. It would still not establish the truth or falsehood of Trent's arguments.

I can make the mirror of ad hominem arguments here--I'm not sure what that's called--by simply noting that Dr. Al-Bayati's curriculum vitae is here. I would also note that he has served as an expert witness in numerous court cases questioning the findings of medical examiners. I would also think it fair to note the endorsement of Dr. Al-Bayati and his findings by those who have worked with him in court cases involving challenging other medical examiners' reports, AND, the endorsement of his report and its findings by a professor of pathology at the University of Illinois at Chicago, available right here.

None of that makes Al-Bayati correct, of course.

I am short on timem at the moment so I have not read your entire refutation, Trent, but, I challenge you on this one statement:

The fungus P. carinii is a very rare human pathogen that is seen only in hosts with compromised immune systems.

This is false. P. carnii is found in 100% of all human beings' lungs, including yours. It is latent, and only becomes pathological in severely immune-compromised people. This is important, because it means that we have to ask whether she had any symptoms consistent with p. carnii pneumonia. If she did, then an AIDS diagnosis would be easier to justify; if all we have is that the examiners heard that the mother had HIV and then went looking for p. carnii, the jig is up: of course they found it, you'll find it in any corpse if you look hard enough.

I note also the fact that the parents have asked repeatedly for the medical examiner to provide the results of an HIV test and that there has been no response. We need to see the original report.

We also have to ask how anyone justifies a diagnosis of AIDS in a child that to all reports was perfectly healthy until she got the sniffles and died 15 days later of symptoms perfectly consistent with anaphylactic shock. You do not go from 0 to AIDS in 15 days, not by any description of this disease I've ever read from any source anywhere. All of this is why a lot of us were shocked when the M.E. tried to pass this off as an AIDS death.

I'm busy today, but I'll try to get back to you with more later.

I tried reading Orac's

I tried reading Orac's response, by the way, but it was so full of false accusations that I couldn't get through it. The man argues first and foremost through attacks on others' credibility. I do not, for example, "wave credentials" at anybody, not for my friends or detractors. I note only that credentials do matter, and that in any area of science, a qualified scientist should be respected as having the right to a dissent, even if it's a minority position, AND, that one shouldn't treat qualified scientists as kooks or people who can be dismissed with an airy wave of the hand. That is all I have ever said on the subject of credentials; Orac's dishonesty in this leads me to the (admittedly ad hominem) conclusion that he can't be trusted to be honest on anything else.

...not to mention the

...not to mention the hazards of rendering a diagnosis on a patient you have never examined and whose medical records you have never seen, making his arguments hold no more weight than anyone else's.

Ad Hominem, HIV,

Ad Hominem, HIV, etc.
Interesting discussion of the nature of arguments ad hominem, HIV skepticism, and EJ Scovill here at Cattalarchy.

I can't let my life...

Ad Hominem, HIV, EJ,

Ad Hominem, HIV, EJ, etc.
Interesting discussion of the nature of arguments ad hominem, HIV skepticism, and EJ Scovill here at Cattalarchy. Trent refutes Al-Bayati's d...

So we shouldn't hold our

So we shouldn't hold our breath for any actual real response then Dean? Instead all you do is wave your hands blabbling about dishonesty this and that without actually bothering to answer the main points or even supporting the claim? Aren't you just being an incredibly big hypocrite as you whinge about 'ad hominems' against Al Bayeti by others without addressing their arguments, yet turn around and do exactly that? Just throw out fallacy after fallacy and unsupported ad hominems by claiming Orac is dishonest without explaining why, that will get you through!

Well done Dean!

I have posted a reply to

I have posted a reply to Dean, and another paper simialr to mine here:

http://catallarchy.net/blog/archives/2005/11/29/hiv-dissident-the-continuing-saga/

Dean Esmay mentions that

Dean Esmay mentions that Al-Bayati has served as an expert witness in numerous court cases questioning the findings of medical examiners.

By all means look at his previous "expert" opinions.

Al-Bayati:Expert for hire

Al-Bayati's past history speaks for itself but not in the way that Dean thinks.

Here is an example of Al-Bayati's "logic" from an interview he made with a fellow Denialist. The amusing (or depressing) point is where the interviewer brings up the subject of amyl nitrites or "poppers". The interviewer is apparently a Duesberg supporter and is expecting Al-Bayati to agree with Duesberg too. Well- not quite. Al-Bayati apparently agrees with Peter Duesberg that "popper" use is correlated with Kaposi's Sarcoma but comes up with a wierd and wonderful alternative explanation for the link.

Abuse of "poppers" causes headaches.
Take aspirin for headaches.
Aspirin causes thrombocytopenia.
Presribed corticosteroids for thrombocytopenia.
Corticosteroids causes AIDS and KS.

Yeah, Chris, I'd seen you

Yeah, Chris, I'd seen you comment that before. It's pretty rich. It would be ridiculous enough even if all those things were true, but that's not even so.

Well, I repeat myself

Well, I repeat myself because I still have trouble understanding how anyone can take Al-Bayati seriously.

Have you managed to read any of his other "reports" from other cases?

The same pattern is present.

1) Cast as much doubt as possible on the official report. Cerebral and retinal haemorrhaging doesn't necessarily indicate violent trauma. Broken ribs were from recuscitation attempts at hospital or if healed from birth.

2) Come up with an alternative explanation no matter how implausible or unsubstantiated. It was the vaccine. It was corticosteroids etc.

Al-Bayati's use of the term "differential diagnosis" appears to mean: form an opinion and then selectively interpret the data to fit it.

And before anyone accuses me of ad hominem fallacies, I am not arguing that it logically follows that Al-Bayati's "expert" opinion on the the death of EJ Scovill is false because his previous judgements are highly dubious. It should however stimulate a much larger portion of skepticism than Dean Esmay can muster. It should stimulate a careful examination of Al-Bayati's arguments. You, Orac and Nick Bennett have done so and pointed out the flaws in his "expert" report.

I read Al-Bayati’s

I read Al-Bayati’s report
First his credentials. He is no MD or trained human pathologist. Even vet pathologists need years of training in post doctorial program to analyze tissue. Vet pathologists are not good at human pathology and vise versa. I think he is really just a clinical researcher at best. These people may think they can read slides but they can’t.
I don’t see that he looked at slides of autopsy anyway.
He pulls this HPV- B19 out of thin air. Sure it causes red cell aphasia, but this is confined to red cell precursors. The bone marrow atrophy is not explained. You can get it in any chronic disease. There are specific inclusions seen in HPV-B19 They are not mentioned.

Look at her MCV. The anemia looks like iron deficiency or chronic disease.
Encephalitis and brain involvement are rare. There is no evidence of HPV-B19.

The neuropathologist saw evidence of HIV. This is a very arcane field. Al-Bayati has real balls getting into an area like this where he knows nothing. I don’t know why the original pathologist didn’t run a serologic test for HIV. It would have entirely nailed the case down.
As for the lungs, the presence of the foamy edema fluid and pneumocystes is an obvious indicator of active pneumocystes pneumonia. Al-Bayati is wrong to say you have to have a lot of inflammatory cells. And of course almost all of these patients have AIDS unless other immunological deficits are present.
There is absolutely no evidence of any allergic reaction or any thing specific to amphicillin. This is just another thing pulled out of thin air. All of the other findings are that of an acutely and chronically ill child.

More rebuttals of HIV/AIDS

More rebuttals of HIV/AIDS "skeptics"
Now, two others have weighed in, and they both agree with me. First up is Trent McBride, a pathology resident who blogs at Catallarchy.

Oh, what fun to be an expert

Oh, what fun to be an expert witness. A gun for hire. I am a lawyer. I know of very few cases where a hired-gun expert exhibits any judicial temperment at all. In the Darwinian world of litigation the unreliable expert finds himself being selected against from the git-go.

Trent: Great scientific

Trent:

Great scientific commentary on the Al-Bayati "report" of the Six-Highly-Improbable-Things-Eliza-Jane-Could-Have-Died-Of-Despite-Having-PCP-And-HIV-encephalitis.

However, I do believe punishment for Ms. Maggiore is appropriate and indicated.

Society would punish a parent whose child died of starvation even if the parent earnestly believed food was toxic. Society would punish a parent whose child died of blood loss even if the parent believed that hospitals were replacing children with clones. And society should punish Ms. Maggiore for depriving her child of life-saving treatment. Just because she's convinced herself that 99.9% of the entire HIV/AIDS infrastructure is 100% wrong, doesn't give her the right to bet her child's life on it.

If parents aren't punished for such gross neglect of their children that ends in death, how many more will die over stupidity, ignorance, indifference and maniacal hubris? In the realm of HIV/AIDS denialists, let's make sure Eliza Jane's death is not in vain - may she be the last child to die of neglect so needlessly from this treatable disease.

But, Katy, is there a

But, Katy, is there a punishment that scoiety can render that comes close to the death of a child? Isn't that punishment enough? She supposedly never had the child tested. Are the doctors responsible? Shouldn't society try to remedy this stuff on the front end than on the back end?

It's not that I don't believe she deserves punishment; it's that I think she's already received it.

As an infection clinician, I

As an infection clinician, I can tell you that EJ's clinical symptoms do not fit the diagnosis of either drug allergy or acute parvovirus infection.

As for Maggiore's culpability, I agree with what you say Trent about her own situation. But Maggiore has done more than just live her life by her own misguided principles. She has eliberately put others at risk through her inaction (EJ, who paid the ultimate price) and in my medical field this counts as criminal negligence. She has also actively encouraged others to think as she does, promoting her book, her husband's film and numerous media appearances. The fact that she is still held up as a shining example of the truth by women (see responses to her justiceforej site http://www.justiceforej.com/ ) should tell us all about the pernicious influence of this type of thinking.

I'd personally hate for her and her family to go through any more pain, but the denial must stop, and the endangerment of more people must also.

Maggiore has met with Thabo Mbeki, who by all accounts was impressed by her story and denialist stance. It can be no coincidence that Mbeki's regime has held sway over the genocide of infant South African children from a preventible disease. 40 000 kids infected each year, because of denial, fomented and encouraged by HIV dissidents like Maggiore.

Logical analysis of ad

Logical analysis of ad hominem
What really caught my eye, though, was how he describes ad hominem arguments:...

When I saw Dean using strict logical form, I got excited because it meant a chance to do something useful with careful philosopical reasoning.

Thanks Deetee! Well stated.

Thanks Deetee! Well stated. I also feel that we need to take into account that Christine Maggiore is not just an private individual mother in this case, but also a public figure and educator (or misedicator). The laws for slander and libel are written to take this into account also; public figures are expected to be commented on differently than are private individuals. You can say things about "the mayor" or "the president" that you could not say about the same person were they not a public figure.

The situtation in South Africa is not technically "genocide", but whatever type of "-cide" it is, it must be stopped. The blame does not rest entirely with Thabo Mbeki, he had a lot of help from Manto and from the "Presidential AIDS Advisory Panel" which was criminal. If only people would be punished for telling lies to Mbeki about HIV and AIDS. It is astounding to me, that it is legal to tell deadly lies to government officials.

As for "ad hominem", pretty much the whole denialist house of cards is built on an ad hominen foundation: If scientists pre-Gallileo were wrong about the sun circling the earth, or if doctors were once wrong about scurvy or SMON, then maybe all doctors and scientists today who study HIV and AIDS might be wrong.

Christine Maggiore, Peter Duesberg, Mohammed Al Bayati, and the other denialists are often very clever in not telling direct lies, but instead using half-truths that equate to lies. For one example, Christine claims that "Pregnancy causes a false positive HIV test" or "pregnancy can cause a false positive HIV test", but fails to mention that less than 2 percent of pregnant women would have a false positive ELISA, that it would be a weak false positive not a strong one, and that a false positive ELISA would be detected by the indeterminate or negative western blot.

What is the flip side of an

What is the flip side of an ad hominem attack: where people claim to be right of claim that their friend is right because of their credentials, rather than because of their logic? Denialists are also fond of this. "Trust Mohammed Al Bayati! He's a respected pathologist!". Or "Trust Peter Duesberg! He's a respected retrovirologist!".

Mohammed Al Bayati has published that a high percentage of AIDS patients in the early clinical trials for AZT were HIV-negative. Upon questioning what he meant by HIV-negative, he insisted that he meant that they were HIV-seronegative. In fact 100% of the participants in those trials were HIV-seropositive and tested many times with both ELISAs and western blots. When this lie was pointed out to him, he said "I am the EXPERT! I am willing to defend this in court!". Apparently he is not familiar with perjury laws.

Actually, yes, its called an

Actually, yes, its called an "appeal to authority", which isn't necessarily a logical fallacy, but often is.

I think it is worth

I think it is worth repeating that Christine Maggiore is not a scientist nor does she have any medical training. By all accounts she was a very loving mother who wanted the best for her children.

The people who I find morally responsible are people like Peter Duesberg who should know better but spread misinformation and deception. Duesberg has no excuses for his actions. In contrast to his victims he is not infected with HIV. He will probably outlive many more of his supporters.

That being said, Maggiore has left herself open to criticism by her grandstanding and the use of her childrens alleged perfect health to argue that HIV does not cause AIDS.

Trent: I'm troubled by your

Trent:

I'm troubled by your interpretation of punishment in this case. By denying her helpless child life-saving treatment over self-imposed delusions, Ms. Maggiore killed that child. To say that is punishment enough negates the value of the life of the child and the crime against the state.

Punishing negligent homicide is not contingent upon the perceived agony of the offender. My mother does not have a right to kill me and be absolved of punishment because she later agonizes over my death. After all, I died - what about me? What about my right to live? I don't think I would rest easily knowing the state decided my killer was suffering enough by his/her own misery. That's sort of beside the point.

And not that this should be relevant but you'd have a very tough time convincing anyone that Ms. Maggiore acted in the best interest of her child at any point in time. While the child lay in a hospital room dying, Ms. Maggiore never once mentioned "oh, by the way, although HIV does not cause AIDS, I have tested positive." She coolly stood by and withheld vital information as doctors scrambled to find what was wrong with Eliza Jane. Doesn't sound like a desperate parent, much less an agonized one.

Trent: I'm sorry, I didn't

Trent:

I'm sorry, I didn't address your questions. Yes, I do think you're right that society should deal with these things on the front end, like all other social ills. However, given an imperfect world some things wind up on the back end and they need to be dealt with there too.

There are 5 people the state should prosecute. Five individuals that turned a blind eye to a child in need - mom, dad and EJ's 3 doctors.

I do believe the 3 doctors of Eliza Jane are just as culpable as Ms. Maggiore. The very first time that child had so much as a sniffle, each one of them should have insisted the child be tested for HIV, given Ms. Maggiore's known status (and involved Child Protective Services if faced with resistance). With untreated HIV, the slightest illness could have caused a rapid fall - as evidenced by how an "ear infection" became PCP, HIV Encephalitis and death in 3 weeks.

Actually, yes, its called an

Actually, yes, its called an “appeal to authority", which isn’t necessarily a logical fallacy, but often is.

Actually it is always a logical fallacy. If what person X says about subject Y is true it is because it happens to be true, not because she happens to be an authority in subject Y.

Dean Esmay usually trots out

Dean Esmay usually trots out his "ad hominem" whine within the first 20 keystrokes in any discussion of AIDS. It's ironic, since his argument against the AIDS theory is that it was cooked-up by the drug companies to inflate their profits. It's "War for Oil" with a couple of terms changed.

It's of course fair to comment on Al Bayatri's credentials since he's been offered as an authority. One denialist commenting on my blog called his paper the "second coroner's report." But having established that Al Bayatri is simply a hired gun with no special expertise doesn't end the discussion, and if it did the ad hominem whine would be legitimate. What we have here, and at Orac's, is a thorough factual rebuttal of Al Bayatri's claims, and that's as far from ad hominem as one can possibly get.

Esmay makes the mistake of offering up an assertion that can be evaluated for truth or falsity, to wit he claims that P. carinii is ubiquitous in humans. All that I've seen suggests that it's not, certainly not at the levels found in the poor dead child's lungs. So it would be good if somebody was to beat Esmay over the head on his one factual claim.

As to Maggiore's punishment, I don't buy the argument that she deserves a pass from the justice system because she's lost a child. This is like the old legal saw about the guy who murders his parents and seeks clemency on the ground that he's an orphan. Maggiore is not simply misguided, she's offering herself up as an authority and advising others to do as she's done, and we know that death follows. The law has to make an example of her. Follow your heart if you must, but if your heart is so full of hubris that you kill a child, there's a price to pay, and so far we see no signs of remorse on her part.

If Maggiore is willing to do a national tour admitting she was wrong and advising people to seek medical help in cases like EJ's I'd be for cutting her some slack. But as long as she engages in blame-shifting, lying, and smokescreening, she needs to be slapped around by the law.

A child died because of her arrogance and stupidity. If that's not murder, it's certainly negligence and it needs to be recognized as such.

But what the hell was the

But what the hell was the HIV serology's result? Was she positive or negative - that would clear all this up!

Richard, follow the link at

Richard, follow the link at the bottom the the post to see my reply re: Dean's argument about P. carinii.

pipo22, It is unlikely that the MEs did HIV tests (it is not routine post-mortem) because by the time they found all the evidence for AIDS, it was too late (HIV is very labile).

On second thought, that

On second thought, that argument applies to HIV PCR (a direct test for the virus), but not so much for serologies. If they got a good refrigerated blood sample, they could have possibly done it, I think. However, if they used all their blood doing all the routine txicology, etc., they might not have been able to run it.

“If Maggiore is willing to

“If Maggiore is willing to do a national tour admitting she was wrong and advising people to seek medical help in cases like EJ’s I’d be for cutting her some slack. But as long as she engages in blame-shifting, lying, and smokescreening, she needs to be slapped around by the law” Richard Bennett.

I share your feelings ,but alas, as so often is the case with those who exploit their heart rending concern for “the children” if the child is destroyed in the process they seldom admit that they might been wrong. This does, at the cost of their child’s life, unmask their real agenda, self promotion. Hopefully this will cause some people to wake up but you can’t go around locking up every publicity seeking crackpot.

As much as I think Christine

As much as I think Christine Maggiore should be charged with negligent homicide in the death of Eliza Jane, her daughter, I don't hold her criminally responsible for duping others (particularly some heads of state that shouldn't be so gullible). I mean, hell, some of the folks who declined antivirals after being mislead by Maggiore's half-truths and convoluted distortions of science should, perhaps, sue her for their subsequent illnesses on the basis of....umm....I don't know, say fraud. But at the end of the day, they're adults; able to make their own decisions.

A child is an entirely different story. Eliza Jane had two parents with the key to her health and they both failed her miserably. The conflicts of interest are staggering. Maggiore's husband, Robin Scovill, is on the heels of his one-sided ad for Maggiore that masquerades as a "documentary" called "The Other Side of AIDS." It's essentially a dirty, relentless attack on Gallo with no substance whatsoever. If Scovill now claims his child had AIDS, his career as a film maker is over in the first act. In death, his daughter has written the most compelling review of his work - lethal trash. And Maggiore has built an empire of self-promotion and book sale revenues.

Even in their child's death, they sought the "second opinion" of a denialist veterinarian over thousands of independent pathologists. Maggiore's consistent rhetoric is about science and truth yet she is open ONLY to one outcome - that HIV is not related to AIDS. Any other scientific outcome is dismissed at the onset - someone should point out to her that science accepts whatever the outcome.

Goodness, I'm still seething

Goodness, I'm still seething over the notion that Maggiore's "agony" over the death of her daughter EJ - which she caused - should exempt her from criminal prosecution.

WTF?! And what's next? Maggiore should be given the green light to have unprotected sex with anyone she likes, pass on a potentially fatal virus all because she doesn't believe HIV causes AIDS?! And then find absolution from criminal prosecution because she "agonizes" over the death of her paramour's? Huh?! Have our senses gone completely mad?!

Gee, maybe I don't buy the whole "heroin is a bad drug that kills" paradigm so I can inject it in my kids. Naturally I'll be heartbroken if they die and - voila! - that's "punishment enough."

Honestly, that logic is even more ludicrous than Maggiore.

Well, Katy, what's ludicrous

Well, Katy, what's ludicrous is your silly heroin analogy. I'm not sure your escalating hostility is worthy of response, but here it goes. I didn't develop my original argument at all (on purpose), and looking back, I've given the impression that it consists of merely "because she's already been punished." (I take responsibility for that) That would be a bad argument if it was all I had, but it's not, and here is the argument.

So a body of scientific evidence exists that comments on the hypothesis that a) HIV causes AIDS and b) drugs that control the virus are beneficial to exposed children. Now, I, and almost everyone else, read that evidence to say that the hypotheses are accepted. Christine Maggiore does not. It follows from her belief then, that treating her child would be harmful.

If Maggiore is deemed otherwise competent to hold custody of her child, and if she truly beleives that a given treatment would harm her, and not help her, then, assuming the mother is acting in good faith in what she perceives as the best interests of her child, I'm not so sure the state should have the authority to intercede.

There is a legitimate argument which states that the scientific evidence for the hypothises above is so strong, that maybe the state should intercede in the best interests of the child. OK. But one has to acknowledge that there are situations where the evidence is not so strong and the decision that would be "in the best interest of the child" is not so clear. There was a case last year where a local authority tried to press charges of child abuse against a father who refused to put his hyperactive son on Ritalin. Now, that clearly escapes the bound of state authority. But the question becomes: where do you draw the line?

I am, at least, making the case for the argument that maybe it should not be drawn at all. All things considered, I trust parents more to look after the best interests of their children, compared to the state. Now certainly parents can do some extremely evil things, and, clearly, this case turned out for the worst; but I like my rule in general, and would be careful before I went around making exceptions for different diseases.

The cases of failure to treat due to religious concerns are not analogous to this. Stories of Jehovah's Witnesses and blood transfusions and Christian Scientists and cancer treatment do not speek to this srgument at all. Not that it would necessarily come to a different conclusion (but I think it does), it just had to b answered separately. One issue accepts the truth of the impact of a treatmetn on a disease, it just ignores it for religious concerns. The other rejects the beneficence of the treatment altogether.

And that's the issue at hand. Who is the final arbiter of the conclusions of science as it pertains to a child? The state or the parents? Assuming that the parents are acting in good faith toward what they think are the child's best interests, I, for now, choose parents.

As an aside: If you disagree, then take it further. Should the state simply dictate guidelines for how pediatricians should treat each child (deferring, of course to the doctors' best judgement, when necessary)? Why do the docs even ask the parents for permission at all? If the state is the final arbiter of scientific medical evidence, then the treatments should just be mandated, right? I guess permission is asked just because it sounds nice? The language of these question may sound ridiculous, and I am being a littel fecetious here, but I think the fundamental questions are legitimate. Not unanswerable for my opponents, but legitimate.

Again, I am not necessarily saying that this case wouldn't fall behind a line where we have to step in and hold the oarents accountable; but for those who are, the burden is on you to state where and how to draw the line, and why it should be drawn there.

[...] e best interests of

[...] e best interests of her child. I don’t see any crime in that. Charles Johnson correctly pointed out in the comments that this analysis was incomplet [...]

My last lengthy comment is a

My last lengthy comment is a new post. Please address any comments on the subject of legal/moral liability of the parents in this case in that thread:

http://catallarchy.net/blog/archives/2005/12/03/parents-vs-the-state/

Any comments regarding the scientific aspects of the above post, carry on :)

A longtime AIDS Denialist

A longtime AIDS Denialist Fintan Dunne has interviewed Al-Bayati and Andrew Maniotis.

Interview with Al-Bayati and Maniotis

They have clearly read the comments made by yourself, Orac and Nick Bennet. They have also left some traces of their internet searches.

The only new point that has been added is that the alleged allergic reaction was apparently caused by the dye in the amoxicillin preparation.

According to Dunne Red Dye 40 is chemically related to Nevirapine. ????

The whole affair to air on

The whole affair to air on ABC Primetime tonight, Dec 8.

http://www.justiceforej.com/ABC-Primetime.html

http://abcnews.go.com/Primetime/
Thursday, Dec. 8 at 10 p.m. ET
...
Christine Maggiore is HIV positive, but doesn't believe the virus causes AIDS. Have her controversial views endangered her daughter's life?

I have seen some evil people

I have seen some evil people in my day but Christine Maggiore takes the prize. Killing her own child in such a egotist fashion just boggles the mind. She is one of the most cold blooded murderers I have seen. Her lies,denials and utter self centeredness killed her daughter straight up.
One hopes that charges will be brought to bear on her and the husband extremely soon so that at least her son will have a fighting chance at life. If not,it won't be long before he joins his sister.
Just totally disgraceful. And that quack she has should lose his license to pratice medicine,he is a danger to anyone he comes in contact with.

Michael
editor
www.thehereandthere.net

Clearly, Christine Maggiore

Clearly, Christine Maggiore should not be allowed to raise her children according to her beliefs, but rather, according to the collective wisdom of the State. Also, no parent has a right to treat their child according to their own beliefs, they should always consult with a licensed allopathic medical doctor, who after all knows better. To do any less is to endanger the child, and thus damage society (the State), to whom the child belongs. Most parents recognize this, which is why they send their children to be educated by the State, and to be treated by doctors that are licensed by the State. Everyone knows that the State and it's licencees are infallible and trustworthy and good. People that don't believe what everyone else believes need to be re-educated, so they are not a danger to the rest of society, and themselves.

Were we watching different

Were we watching different shows? Michael claims the son will soon join his sister....did he not hear that both the son and the husband tested negative? And she is one of the most cold blooded murderers Michael has ever seen.Rightly or wrongly this woman acted in what she believed to be the best interests of her child.hardly the act of a cold blooded murderer.Her views on hiv/aids,however misguided, are and have been no secret for years.Are the state authorities/hospitals/doctors etc all "cold blooded murderers" for not having acted earlier by stepping in and performing tests on her daugther and forcing medications? She has been on the cover of Mothering magazine and interviewed by them and still no action is taken by any authority .It seems ridiculous that if you infect someone with Hiv sexually it is a criminal offence but that if you have a child,with no anti retroviral medication and you breast feed that child then no-one even forces an HIV test!
as a side note,according to the autopsy, an HIV test was done but the result not was not recorded.Anyone know where the result can be found?

Were we watching different

Were we watching different shows? Michael claims the son will soon join his sister....did he not hear that both the son and the husband tested negative? And she is one of the most cold blooded murderers Michael has ever seen.Rightly or wrongly this woman acted in what she believed to be the best interests of her child.hardly the act of a cold blooded murderer.Her views on hiv/aids,however misguided, are and have been no secret for years.Are the state authorities/hospitals/doctors etc all "cold blooded murderers" for not having acted earlier by stepping in and performing tests on her daugther and forcing medications? She has been on the cover of Mothering magazine and interviewed by them and still no action is taken by any authority .It seems ridiculous that if you infect someone with Hiv sexually it is a criminal offence but that if you have a child,with no anti retroviral medication and you breast feed that child then no-one even forces an HIV test!
as a side note,according to the autopsy, an HIV test was done but the result not was not recorded.Anyone know where the result can be found?

Side-stepping the moral

Side-stepping the moral thunder here, may I just ask those of you who are certain that Maggiore is criminally negligent what evidence you are basing the following assumptions on:

1. That breastfeeding has been shown to result in "increased risk of" transmission of HIV. Are you not familiar with the studies that have shown the opposite to be true? It's hard to follow your logic on this thread because you all seem woefully ignorant of the actual data, to date.
2. Are you under the impression that children whose mothers chose to take the mainstream road and medicate their children in untero and in early childhood with cocktail therapy, and/or AZT, have fared well? Does this mean that you are not familiar with the extensive body of research that reveals deaths both in utero and in early childhood as a result of this medical model? It is so extensive that it almost boggles the mind that this dialogue can be taking place, in these reactionary, primitive tones of condemnation. I'd be quite happy to start laying out crosses for you if you folks really aren't familiar with the literature. So, whaddaya say? Shall we?

Well, Rich, I can't speak

Well, Rich, I can't speak for the others here, but I am certainly familiar with the research regarding the things you mention. So all those studies that show clear increased risk of transmision with breastfeeding, and the fact that pediatric HIV/AIDS is almost nonexistent now after HAART therapy - these can just be wished away?

Of course, you leave no citations; so I'll just go on believing every medical source I've ever read.

First let me depict what I

First let me depict what I believe to be the pyramid of logic of those who hold Maggiore in contempt, and please correct me if I am wrong because if I am wrong in my groundlaying assumptions then nothing that follows will be right:

1. Christine Maggiore should have taken ARV drugs during pregnancy.
2. Christine should have had EJ tested for HIV, and NOT breastfed her.
3. Christine should have, if EJ was confirmed positive, put EJ on some kind of HAART regimen.
4. Said regimen would have lowered EJ's viral load and improved her health.
5. EJ died of "AIDS" as evidenced by Ribe's pathological findings. the fact that she followed no known AIDS trajectory is insignificant. She had high CD4 cell counts, no opportunistic infections, none of the supposedly characteristic slow and gradual manifestations of an ERODING immune system that we have come to know as "AIDS."
6. You can die of AIDS in less than three weeks.
7. You can die of AIDS with a high lymphocyte and CD4 count.
8. You can die of AIDS with no evidence of HIV infection. (I have seen no data on this point.)
9. You can die of AIDS with no Opportunistic infections, no warnings, none of the classic telltale signs of immune suppression that were once called ARC...remember?
10. You can die of AIDS related pneumonia despite 3 pediatricians declaring your lungs to be "clear."
11. If not, then what is the assumption? They were incorrect, all three?
12. The only VALID point to make here, is that IF EJ did have PCP, then she might have been saved by IV Bactrim. That is THE only effective remedy for PCP, especially late stage--IV Bactrim. Hence, a competent pediatrician should have, if EJ had PCP, diagnosed it in LIFE and given Christine and Robin a chance to choose between Bactrim or NO Bactrim. Instead they were told their daughter had an ear infection, given a choice between antibiotic and no antibiotic, and they chose the antibiotic. Knowing EJ's HIV status would have made zero difference if in fact she died of PCP. ALMOST ALL AIDS DEATHS FROM PCP in the early years WERE FOUND TO HAVE BEEN PREVANTABLE IF TREATED WITH BACTRIM. Instead they were treated with X Y or Z toxic useless HIV drug and they died, en masse. PCP is a known disease with a known cure, and the 'cure' can take place ONLY outside of the HIV treatment paradigm, which assaults HIV (viral load) INSTEAD of treating the usually very treatable illness that is manifesting.

Anybody who knows anything about AIDS or has ever known anybody who has AIDS or has lived through this thing can tell you that PCP is a very slow, very clearly manifesting, very serious illness that nobody HAS WITHOUT KNOWING IT. It is diagnosed via lung biopsy, usually after weeks of a MOST devastating cough and very acute wheezing. Also very low CD4 cells.

Are you people very young? Ignorant of AIDS history? What?

Next we will talk about the TRUE history of HAART in pediatric patients. If dead children upsets you more than anything, and it should, you will really not like this data very much. You seem to think EJ is the one dead child among a sunflower field of happy, thriving, ARV treated children. You are in very deep denial. You chose a word that describes yourselves.

"Gentlemen I beseech you. In the bowels of Christ, think it possible that you might be wrong."

Oliver Cromwell

Mr. McBride, I shall provide

Mr. McBride,

I shall provide citations for everything I have said here. It is, however, almost 1 am, so it will have to wait until the morning.

Do I have your gentleman's promise that you will accept the data, absorb it, if I take the time to provide it?

ABC News has posted the LA

ABC News has posted the LA County Coroner's report (and seemed to fix whatever was causing it not to load earlier):
http://abcnews.go.com/images/Primetime/la%20county%20coroner%20report.pdf

I am reading the autopsy

I am reading the autopsy report.In the toxicology report on the heart blood there is a line which states." Outside test HIV Done Quest Diagnostics." dated 7/29/05 Would I be naive to think that the results of this test would change the minds of some of the participants in this debate? What are the results of this test?

Also Dr. Villard, PCP is an opportunistic infection,though some of the questions you raise deserves answers. If CD4 count isn't low you shouldn't die of HIV associated PCP. Do you know what the CD4 count was? The blood counting machine may have counted some nucleated red cells as lymphocytes. These may have been released from the bone marrow
during resucitation- cardiac massage.

I'm assuming a hiv antibody

I'm assuming a hiv antibody test was performed on EJ at the time of the autopsy as I have not read the report. So, what was the result? Was she HIV+ or HIV-? Surely someone here on this forum must know the answer to my Question......Ben

Nothing like unanswered

Nothing like unanswered questions to take the fun out of a good hangin' eh?

Katy, you will resent the discussion I hope to open up, as it will interupt your moral rapture against the Murderous Mother.

To answer a previous post, I am not a doctor. I just have many friends who have died in the course of following mainstream HIV advice and it turned me into an avid reader of this incredibly diverse body of literature (HIV/AIDS.) I think if we are going to get to the true, scrape rock bottom of any of these questions we should agree on one unresolved question at time, and then proceed. Which is most important to those of you still partaking?

1. HIV and breastfeeding? (What does the up to DATE literature say?)
2. HAART in utero and in pediatrics?
3. Whether Ribe's "AIDS related pneumonia," is actually PCP and if so, whether it can manifest like this in a child (in life and upon autopsy.)
4. Whether, as Dean Esmay has been slammed here for asserting, 100% of us harbor the P cariini fungus, or whether as Ribe says it occurs only in the severely immune suppressed. THIS ought to at least be know-able and solveable.
5. Whether EJ had high Cd4 counts and/or whether such counts can be done post mortem.
6. Ditto the test for HIV infection.
7. Whether there exists in the literature a precedent for a 17 year HIV positive healthy mother who gives birth to one negative child and one positive child. (Yet we do not know whether EJ was HIV infected, correct?)But in terms of MTCT--what CAN we say about this?
8. I would like to know, further, whether Katy et al believe that doctors, state officials, etc, who have forced toxic regimens onto HIV positive children resulting in their deaths from the drugs should be charged with homicide. Let us say for the sake of argument I knew of such cases and could lay them out in unassailable terms: What would Katy, Bennett etc say? What about scientists who have pushed said regimens and journalists who have promoted them?
9. Is the "bias" of Al Bayati, that HIV does not cause AIDS, shared by thousands of scientists, more distortive than the "bias" that HIV does cause AIDS, shared also by thousands? I think they are biases of equal weight. Those who sneer at Al Bayati might also sneer at the other camp if they truly feel offended by "bias."
10. Is it a teneable position to say: It is not yet clear what killed EJ? This is, judging from the program, Maggiore's position. When asked: "What do you think killed your daughter?" she said, through tears: "It's so hard to say." This is called "denialism" here. It would be if the coroner in question had an un-blighted record and stellar reputation.

This leads to my next and final question: Do those of you who take Ribe's coroner's report on EJ as reliable think that his prior record and scientific reputation matters here?

Are any of you familiar with it?

I think we have to put alot of yet to be disclosed facts on the table before we can even begin to have a REAL discussion about this.

Lastly: Why must this word "denialist" be used? Are you that insecure about your beliefs that you must infuse your every terminology with your disdain?

Looking forward to feedback about which road or roads of inquiry might lead us to the place we all claim to...already have arrived at, namely The Truth.