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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Learn to use www.pubmed.gov

Learn to use www.pubmed.gov ... here is the answer for one of your questions:
http://www.icmr.nic.in/ijmr/2005/April/0421.pdf

I can assume that once you figure it out, you can find the other liturature yourself (I have, and I'm only an engineer with very little biology training).

This article was pointed out to me today:
http://www.guardian.co.uk/christmasappeal2005/story/0,16796,1664125,00.html

Richard, I'm not going to

Richard, I'm not going to get in a discussion here about many of the issues you bring up - they are well-tread upon in endlessly many other venues, and neither of us are expert enough genuinely persuade each other. What I write about initially, what I do have specific expertise on, and what none of the people of your persuasion have credibly refuted, is this specific case and the specific histopathologic findings. These pertain to your questions #'s 3 & 4 above. Go back and read the post, I see no need to waste time repeating my thoughts here.

AS far as Dean's claims regarding P. carinii, he was hardly slammed. But you're right, he did make an assertion - an assertion that is totally unsupportable, as I have made clear:

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

As you have... "made

As you have... "made clear"... Mr. McBride?

Is that the power that you have, to make things "clear?"

To tell the rest of us when and how we ought to be ashamed of our unresolved questions, our nagging doubts?

Searces in the literature dating back many decades reveals that the embattled fungus we are arguing about IS found in most people, as well as many animals.

There were four people in the Maggiore/Scovill family:

The mother: HIV positive/negative/indeterminate/positive again--healthy 17 years.

The father: HIV negative despite upward of 10 years of normal sexual relations (meaning no latex precautions.)

The son: HIV negative, 8, healthy.

The daughter: HIV status unknown, died from an illness that a coroner (I will leave aside the particulars of Ribe for NOW) calls AIDS.

Let us say for the sake of argument that your hated "denialists" are proven incorrect about EJ, that her cause of death was indeed PCP pneumonia. That remains a matter of debate, at least to some.

But putting that aside for a moment: How do you explain the utter failure of the HIV causation and infection model for the rest of the family?

If HIV CAUSES AIDS and spreads via sex:

Why doesn't Christine herself have AIDS?

Is she miraculously one of the "long term non progressors?"

I would tell you that I ask from the vantage point of having been a gay man immersed in this for 25 years, but I fear you might then become even MORE politically correct.

"The greatest fanatic is the greatest doubter."

Oh, give me a break; quit

Oh, give me a break; quit being so dramatic. Look, as I explained in the link I provided for you, having serologic evidence of exposure to PC and having histopathologic evidence of PC are two totally different things. You need to address this distinction.

I've seen literally hundreds of different patients' lung tissue under a microscope. A significant percentage of those have required GMS staining for various reasons. A very small percentage of those reveal PC. And in every single one of those, the patient had a documented severe immunodeficiency, from either AIDS, immunosupressive drugs, or a hematological malignancy.

Quite frankly, the assertion that PC is found in 100%, most, or even a significant minority of histopatholgic examinations w/ or w/o GMS staining is absurd. It flies in the face of medical and pathologic knowledge and my personal experience in toto. I'll renew my challenge. Find a single citation that claims that PC is seen commonly in histopathologic (not serologic) examination in otherwise normal patients. (Because, histopathology is what we're dealing with here).

As far as your other quesions:

Regarding Maggiore's status: You state her failure to progress to AIDS is "miraculous"; however, the stated rate of non-progression after 10 years is something like 10%. Hardly miraculous. Of course, if you think non-progression is just made up to explain away a problem with the theory, this won't sway you - but you make it sound like it is some sort of internal inconsistency, which it is not.

Regarding her husband's status: The female-to-male transmission during intercourse is something like 1/1000 (unprotected sex). I'll just leave it at that. Thinking further would require some sort of speculation on their frequency of intercourse, protection methods, sexual practices, etc. Such speculation is very inappropriate.

Regarding the lack of transmission to the other child: The stated risk of transmission to a child (delivered vaginally) who is breastfed is ~ 50%. So, statistically, you'd expect one out of two children to be infected - just like this case. You act like the fact is damning evidence, when it is actually what one would predict.

The bottom line: you seem to think that the facts surrounding this family are somehow internally inconsistent. They are not; IF you accept the conventional wisdom on the subject, you can accept these facts easily as not out of the ordinary, and no real explanation is necessary. If you don't, then you don't argue against these facts - you are forced to step back and argue against the existence of HIV-AIDS in the first place.

Richard, you are aware of

Richard, you are aware of what a strawman argument is, right? Because you've mastered it beautifully.

You are completely misstating the mainstream's position only to easily knock it down. Goes to show how insecure your own position is that you would need to resort to such tactics.

The mainstream's position is well documented by studies supporting the following:

1. Serodiscordant couples without the use of safer sex practices.
2. Children born to untreated HIV+ mothers have only a 25% chance of acquiring the virus from their mothers at birth.

The mainstream has always said 2 things about HIV:

1. HIV is not a highly infectious agent
2. HIV is lethal (since HAART, add "when untreated")

So to use the negative status of Robin and Charlie Scovill is not remotely inconsistent with the claims of the mainstream to begin with. As for Christine's good health, it's not so outrageous either. It has long been theorized that when leading a healthy lifestyle (exercise, good nutrition, controlled stress, etc.) an HIV+ person will fare better than one who does otherwise.

(of course, if Ms. Maggiore should develop PCP or PML or lose her sight from CMV, you will frantically look to Al-Bayati for any other explanation, no matter how implausible)

And I don't know why the Quest Diagnostics results of EJ's HIV test are relevant to you. Would you suddenly decide the child must have had AIDS? Would this change one single thing for you? Doubtful.

You would then just include Quest Diagnostics in the sinister conspiracy plot that the coroner and hundreds of thousands of HIV/AIDS experts are currently involved in. Honestly, I just don't know how you people leave the house in the morning. Aren't you concerned about the little green men disguised as "neighbors" taking you away for human experimentation?

Denialists are so convinced that everyone is lying (about HIV, the tests, the viral load, the parthenogenesis to AIDS - the list is endless!) that I just don't know why they bother having discourse with people who believe that a conspiracy this widespread and neatly organized is at the very least highly implausible and contrary to the most basic anecdotal evidence the past 25 years has produced.

Nobody is arguing "against

Nobody is arguing "against the existence of HIV/AIDS in the first place;" the argument is about "cause and effect," about the post 1984 PacMan model of HIV pathogenesis, about "Machine Model of Biology," and finally about WHICH FACTORS APART FROM HIV PROTEINS DETERMINE THE FATE OF PEOPLE WHO TEST POSITIVE.

I cannot believe that there are people on this planet who would castigate such an epidemiological quest, at this point.

Looking at the history of "AIDS" in the industrialized world, at sexually active non-IV drug using populations, and then at Africa, are you willing to tell me with a straight face that SEX, (not anything to do with living conditions, poverty, malnutrition, endemic microbes, rampant tropical diseases, malnutrition)is what throws the switch on AIDS?

Sex.

What KIND of sex are they having in Uganda that Christine and Robin failed to have? You can say that the question is inappropriate, but I would point out to you that you have not thought it in appropriate to deconstruct a dead three year old girl's brain matter and lung tissue, in order to sound your trumpet about the hideous AIDS denialists and what a pesky bother they are to rational thinking guys like you.

Don't call me dramatic. You are just as dramatic. The only difference is that my emotions are more transparent. You're still playing the role of the dispassionate, level-headed libertarian pathologist who knows how to spot a CRACKPOT. Like all those smarter than thou libertarian bloggers and REASON-ites and what have you.

You are so so so right on, aren't you? Skepticism!! Long live skepticism!

I see that you are born in 1977 so it is no wonder you haven't learned yet, what life is like, because you are too young. But keep it up. Don't let things get messy. Be rational for God's sake. Read Yevtushenko's poem "A Career," in case you start to wonder in the night.

Now get back to your little Libertarian smart guy fingerprint free lynching of a grieving mother you know nothing about. Put your hand in the ocean and see what kind of hole it leaves when you pull it out. That's how much any of us actually KNOW.

I ask a simple question (re:

I ask a simple question (re: PCP ubiquity). All those words, and you never addressed it. I'll assume you have no answer, no?

Again, one study claiming PC is histopathologically ubiquious. Just one.

And you will never ever ever

And you will never ever ever ever ever ever get that answer Trent.

The denialist movement is a mastery in deflection!

They make an outrageous claim, you ask them to provide evidence, they can't - they quickly deflect by making another outrageous claim, and so on.

Please define what exactly

Please define what exactly you mean by that phrase "histopathologically ubiquitous," and I will address it. I think you are saying that anybody with PC fungus is severely immune compromised, and that the other side (Esmay et al) are saying that PC is found in healthy controls, maybe even a majority.

If my understanding is correct then you are arguing that finding PC in EJ means de facto that her immune system was destroyed, and that the only possible way to said destruction of the immune system would be HIV, from her mother.

Am I correct thus far, lest 'Katy,' starts seeing strawmen again...?

Katy! You're back! I was

Katy! You're back!

I was hoping your arrogance would propel you to return...

Where do I begin,Katy?

You want to talk about "outrageous claims?

You truncate, amputate, and malign HIV/AIDS history, which I lived through, when you speak of "exercize, good nutrition, controlled stress," etc, causing an HIV + person to "fare better."

How dare you?

Tell that to my dead friends who were told by Robert Gallo in 1984 that HIv "kills like a truck," and would kill "Clark Kent" in less than two years. It was marketed as a 100% lethal virus that would kill all hosts within 2 years. Hence--AZT.

How else could anybody be persuaded to take the stuff?

How old are you?

Do you know anything at all about the received wisdom of the AIDS oracles from 1983 through to the early to mid 1990s?

You are all enaging in what you think is sober-mindedness but is in fact appalling revisionist history.

Be my guest. The great thing about the Internet is that nothing gets erased.

It is very reassuring to note how little you people know and have READ of AIDS history.

Keep it coming. Historians are collecting gems, with your names on them...

Richard, you are more or

Richard, you are more or less on track. IOW, PCP on histology is specific for severe immune-compromise. Not specific for AIDS, mind you - but given her history and autopsy findings, all the other differntials are rejected.

http://www.theperthgroup.com/

http://www.theperthgroup.com/MONOGRAPH/MTCTMay2005.pdf

Thank you Trent: I look forward to taking a bit of time to explore this question. The link above meanwhile, provides the most exhaustive reseatrch monograph to date on the question of breastfeeding and transmission. Have you read it? It is very long, but I would be very interested to hear what you think of it if you do read it.

One last thing-when you say 'histology,' can you put that in layman's terms? How is this different from all the papers that say PC is ubiquitous in healthy controls, like the 1978 Pifer papertitled: "Pneumocystis Carinii Infection: Evidence for High Prevalence in Normal and Immune suppressed Children) (Pediatrics, 61:35-41?)
I don't want to wwaste time looking for something that is not exactly what you meant.

Are you saying that PC is ONLY found in severely immune compromised people, in life and post mortem? Or is there another sub-division to the question?

No, I'm talking about only

No, I'm talking about only microscopic examination of stained tissue - either biopsy or autopsy. Ignore anything that talks instead about PC serology (or, IOW, antibodies to the organism), like the article you mention above.

For clarification: histology, histopathology, and pathology can be interchangeable terms. They mean study of tissue under a microscope.

http://justiceforej.com/ej-ch

http://justiceforej.com/ej-chronology.html#comment

In the meantime...here are some voices who say Christine Maggione saved their lives and the lives of their unborn children. In the interest of balance, if one might interest anybody in such things.

Read it at least?

With all due respect I don't

With all due respect I don't give a toss about PCP, ABC, JFK... All I want to know the answer to is (a) Was EJ HIV antibody tested at autopsy?
(b) What was the results, was she + or -?
Thats all, nothing more nothing less. I figured someone on this forum would know the answer.....Ben Eriksen.:wall:

Re: PCP and the 1978 Pifer

Re: PCP and the 1978 Pifer paper.
This piqued my interest so I pulled up the abstract on Medline. Pifer was detecting PC *antibodies*, using serological techniques, in normal children. He tested for PC *antigen*, again serologically, in normal children, but none was detected. In layman's terms, this means that normal children have been exposed to PC (because it's ubiquitous in our environment) and have developed a healthy immune response (antibody), which we can detect; however, we cannot detect the organism itself (antigen) in healthy children.
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A PC infection active enough to be apparent under microscopic examination is orders of magnitude more intense than the minimum antigen that could conceivably be detected serologically. That Pifer's serological assay detected no antigen at all in "normal" children supports Trent's point that we only see active PC infection in immunocompromised hosts.

Ben, You raise an excellent

Ben,

You raise an excellent point and it is quite diffuse. Why?

It seems the HIV that is alluded to consists of p24 proteins in brain tissue. Might we infer from that that no true solid HIV positive test was produced from EJ's blood, which was drawn at the time of her death or perhaps near death apparently. Could somebody write to the LA Times and ask why they omitted this information?

Christine herself has tested positive, negative, indeterminate, and positive again. Prior to EJ's death her opponents accused her of not really "having" HIV. One might say if one knows about the intricacies and mysteries of the WB test that at best she was a weak positive--few bands, not lighting up strongly. I would imagine that orthodox minds would say that since she was asymptomatic for 17 years (and still is) her viral load should be quite low. (right?) That would suggest she would be unlikely to transmit HIV (following orthodox logic here, again) since transmission is correlated with HIV viral load and up to 87% of mothers do not transmit HIV even with no supposedly HIV blocking ARVs during pregnancy. Her first child was negative and her husband is negative.

This proves nothing, but is all I have gleaned.

Also, apparently no CD4 count was done on EJ but she had very high total lymphocytes (10,800) and monocytes.

Why was no CD4 count done? Was an HIV blood test done? If so, what are the results? These results if they exist should be scrutinized by way of sophisticated breakdowns of proteins and band patterns, not just Pos or Neg. Many people fall into the grey zone, in between, and as we know there are over 11 different lab standards for which proteins equal a positive result. I will research this a bit. It is strange. Can a person "have" HIV in the brain but not in the blood?

Also, what do people make of Al Bayati's observation that EJ had lost 40% of her blood volume? He says this is due to anaphalactic shock. Is that absurd, Mr. Mcbride?

Bayati's report notes that EJ's lungs, heart, liver, and kidneys were grossly enlarged and weighed much more than normal. The enlargements were 184%, (above normal) 131%, 121% and 146% respectively, as Al Bayati and Fintan Dunne discussed on the radio show that has been dismissed here. I listened to it and found it very informative. It didn't sound like anybody was insane in what they were saying. Nor did I hear any sharp anti-HIV bias.

Anyway, those two gentlemen said that the lost 40% of the blood volume, which causes heart failure, was the cause of death, and that the "lost" fluid is what explains the enlarged organs.

Does anybody have any comment on all this? Some of us are seeking real answers, and hope we can continue to explore this in a climate of respect. I am not a pathologist or any kind of doctor so I am innocent of presuming to know what this all means. I am actually agnostic about The Truth on this, and hope to meet more agnostics, who think the questioins raised are valid and important rather than depraved.

1. The HIV test was

1. The HIV test was reported as done according to the report. However, it, or any of the other lab tests were included in the report I saw. It would be nice to know what happened with that. It's possible that the sample was inadequate for one reason for another. Post-mortem blood tests are difficult to get good info from.

2. As far as Maggiore's HIV status goes, I am ignorant of her medical history; additionally, I am unqualified to comment on the point you raised (other than to state that the transmission rate is commonly quoted as ~25%, not 13%). I will say this: if this child died of AIDS (and the evidence for that is really strong), then people who speculated in the past that Maggiore was not truly HIV positive were wrong.

3. A CD4 count would have likely been impossible. The test required for it needs the cells to be alive and well-reserved. Post-mortem blood would be inadequate for this purpose; you could conceivably measure certain non-living things like ions, proteins, and other chemicals in post-mortem blood. But all the blood cells would die quickly and a CD4 cout would be useless.

4. I think Al-Bayati's contention regard her decreased blood volume is a bad one. The methodology he used to determine this is faulty - it is based on a lot of assumptions and questionable logic. First of all, anaphylactic shock does not reek havock by causing that much blood volume shift. Instead (while some volume moves outside of the vasculature) it causes a severe relaxation of the muscles in the blood vessel walls. This causes a decrease in blood pressure.

His assertion that 40% fluid volume was lost is based on the additonal weights above the mean for age plus fluids found in body cavities. As far as the weights go, I can tell you that when we address weights in autopsy reports, we dont' look at averages, we look at normal ranges. The coroner was the one who actually stated the averages instead of the normal range (which I think was not a good idea). As I mentioned throughout my original post, most of the organs fell inside the normal range. Exceptions were the lungs (which is what you would expect in a PCP lung) and the kidneys (which is seen in AIDS). On top of this, it is important to understand that they were likely pumping her full of fluids when they were resuscitating her. The would add to fluid accumulation outside of vessels. In addition, Bennett, in his rebuttal addressed the possibility of a disease of the kidney that is seen in AIDS patients that a) causes edema to accumulate, and b) shows no changes under a light microscope (it requires an electron microscope, whcih is not routinely done at autopsy).

You should read Bennett's thoughts on the shock, organ weights, and the possibility of kideny disease. He did it more justice than I could.

Sorry, meant to add the link

Sorry, meant to add the link to his report:

http://catallarchy.net/blog/wp-content/images/A_report_on_Eliza_Ver2.pdf

A post from Dean's

A post from Dean's World

(link)jonny (mail):
Dean continues to make a very good point that has, to my increasingly unreliable eyes, gone unrefuted; namely, that Eliza Jane was not a sick child and that, if she did indeed die of AIDS, she died a very atypical AIDS death. How many children who die of AIDS decline from near-perfect health to morbid illness in a matter of weeks? Now, it remains possible and plausible that Christine and Robin concealed EJ's deteriorating health (I noticed a certain Katy in the Reason Hit and Run discussion claiming that EJ was a sickly child--but she never identified herself or offered evidence for her accusation), but I've seen no proof for this claim apart from mean-spirited attacks upon Christine's supposed "selfishness."

It also interests me that some of the very people who now call this woman a murderer not long ago questioned whether she was indeed infected with HIV. After all, their earlier argument went, she received both positive and negative results, and her long-term non-progressor status makes her something of a rare specimen. How interesting would it be if Christine were to submit to a new HIV test (I'm not encouraging her to) and test negative? Would the coroner still insist upon AIDS-related pneumonia? I raise the question because neither her son nor husband tests positive, despite the latter's unprotected sex and the former's "unprotected" breastfeeding.

As a sometimes-dissident, sometimes orthodoxist, I find myself once again torn--but in no way convinced.
11.29.2005 9:36pm

Ok guys, enough feather

Ok guys, enough feather fluffing, clucking and finding each other wildly convincing. It would appear there are about three of you in this Book and Snake anti-dissident cult...and one of you we refer to as ORK. The one called "Bennett," has developed dementia, or perhaps brain lesions, and is babbling to himself about burning dissidents along with the "Killer Mom." This is how the great man speaks, openly. He uses the word "burn," like third rate Klans man.

This is the best you've got?

Now we're going to commence the Making You Wish You'd Never Picked This Fight portion of the Opera. Who's ready to talk about dead people? No really. Can we? People dead from AZT and all the other Mono-poisons, followed by the early years of Ho Ho Ho, followed by perhaps...take your pick...nevirapine, Combivir? Can we include non-white people, like, say, Africans? Are they people?

ORK, Bennett and McBride are the three stooges of HIV apologia, and God gave them to us so that we would see what they are made of, and we are thrilled to see how small the bones, how puny the actual men.

We cannot tell you how delighted we were to discover this word "burn," that Bennett could not contain himself from writing.

Dosn't it just bring you back to the good old days of nigger-lynchings on a hot road at dusk?

C'mon boys, don't stop now. Show us what it means when little cowards like you get SOOOOO angry at your failing belief systems, at the horror of what you have been complicit in, that you reach for words like "burn." Poor impotent darlings. All you can do all day is tear down, tear down, demolish, discredit. Call people's work "rubbish" because they're not quite as white as you, not quite as desperate to be accepted in mainstream AIDS society.

This is like a throwback to the 60s. This is getting gooood.

Over the next few days you will have studies and data and papers and evidence of your raging bullshit that will expose what you are, who you are, and hopefully cause you to eventually roll back under the cold rocks you came out of in the first place. And when we are finished, there will be peace. Our goal is to force you to stop hurting people. And we shall prevail.

It's hard not to point out

It's hard not to point out now that it's been nearly a month, and "Sphinx" hasn't produced a single study or any data to rebut us "Three Stooges."

First of all Christains

First of all Christains child had low heomoglobin ? Does that not require a blood test ? Is it really "normal" ( excluding the Bangai Africain WHO "aids" definition where no "hiv" test is required to diagnose "aids") to diagnose someone in the USA with "aids" without a "hiv" test ?.

Most children born to positive mothers seroreconvert to negative around 85% thats using the UK MRC's figures before the wonder drugs "combo" came out. Even babies born PCR positive can seroreconvert to negative again from UK MRC's own research.

As someone who has lived with a "hiv-pos" "diagnosis for between 19 to 21 years depending which of the contradictory results you may choose to believe, its fascinating to see so much attention is always payed to any "hiv" "dissidents death, it is rather like a flock of vultures just waiting to pounce and say I told you so, lets celebrate and use this death to further are cause. Shame you dont pay so much attention to all the babies and children who have died on these meds, like all the black and latino orthan children buried in unmarked graves in New York who where forced against there will to take experimental levels of these still experimental drugs.

Its also interesting because many of the same people attacking Christain at this sad time for her where not to long ago accusing her of being a "false-positive" and this explained her stubborn good health, indeed some people writing here appear to have selective memory loss because they not to along with the gutter new york press where accusing christain of being a "false-positive" has everyone selectively forgot that ??????? How convient for you all. But then again I suppose selective memory loss serves some peoples propaganda well. So poor Christains a real "positive" when its convient and a "false-positive" when its not convient for your attacks on her.

Also the child was vistited by several docs and was said to be in good health, having taken many people myself to hospital with "pcp" I have never seen anyone go from good health to "pcp" in a matter of weeks, there was always other conditions first like candida, weight loss, loss of apetite, tiredness, KS, ect ect ect ect. Mind you the child wouldnt of had KS because KS in the west the "aids" type that is is 97% to 100% effecting gay me

And there was always breathing difficulties which usually required the individual to be put on oxygen therapy ASAP because the oxygen levels where well below normal in every case I have ever seen.

Now I get sick and tired of this everytime a "dissident" dies you all make a massive thing out of trying to prove your own arguements using the recentley dead .

As for the hatred shown here towards Christain its quite sad, christain is a loving caring person, she like anybody else on this plannet has a right to express herself, she has a right to say what she believes to be true, she has a right to decide what is best for her and her family. I am aware that there are people here who would like to take away freedom of speech for anyone who does not buy there discredited theories but then again science is no longer science its become a new religion with a new god ("hiv") that no one can question.

As for PCP wasnt it common in malnourished children after the first world war ? I remember reading a paper from the early 1920's on the subject. And just for the record many "aids" defining diseases are infact not caused by aquired immune defiency at all like Kaposi sarcoma the original signal disease of "aids" immune suppression is not either required for the developement of KS nor is it suffient to cause KS, KS is infact caused by oxidative stress and can be successfully treating with antioxidants like N- Acetyl Cysteine (NAC).

"James,

Perhaps you're remembering what the despicable Jeanne Bergman wrote about Christine in the NY Press a year ago. Here's the relevant paragraph:

"False-negative HIV tests are extremely rare, while false positives are much more common, though infrequent. This fact and all the other available evidence strongly indicate that Maggiore was never infected with HIV, and she herself emphasizes the term "positive" and avoids saying she is infected or has the virus, allowing others to draw that erroneous conclusion. Most people would be thrilled to learn they were uninfected, but Maggiore was unwilling to give up the spotlight. This HIV pretender twisted her good health and the marginal incidence of false positives into a lucrative new racket—selling HIV denialism and bragging about her good life "without pharmaceutical treatments or fear of AIDS." But of course Maggiore has no "fear of AIDS"—she doesn't have HIV. She has since had two children, now three and seven years old, whom she boasted to Scheff "have never been tested. … They don't take AIDS drugs. And they're not in the least bit sick." But of course Maggiore didn't want them to be tested: she knows that they are not at risk and that their being uninfected would lead people to question her own status. And of course they don't take "AIDS drugs"—they don't have HIV or AIDS."

http://www.nypress.com/18/25/news&columns/bergman.cfm

Of course, if you were to ask Bergman what she thought about Christine's status now I'm sure she'd change her tune while, at the same time, never admitting she was ever wrong."