"HIV" tests detects "antibodies" to the alleged virus.
What antibodies mean
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In 1890 von Behring and Kitazato discovered that laboratory animals exposed to bacteria developed substances in their sera capable of restoring the health of other infected animals. It was postulated that bacterial toxins “under certain conditions, will lead the organism to produce substances which render them harmless and which prevent the development of the bacteria”.
As a result, “antitoxins” were taken from laboratory to bedside and proved successful for the treatment of children dying from diphtheria. Subsequently von Behring was awarded the first Nobel Prize in Physiology and Medicine for his work on serum therapy.
The substances believed responsible for the therapeutic benefit became known as Antikörper (antibodies) and nowadays agents inducing their synthesis are encompassed under the generic title antigens (ANTIbody GENerating). Although the precise relationship between antigens, antibodies and immunity remains elusive, antigen/antibody interaction has found widespread acceptance as an indirect means of determining infection with a particular microbe. Indeed, data of this type are quintessential to the construction of the HIV theory of AIDS.
The "HIV" antibody tests
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There are two "HIV" antibody tests in common use, the ELISA and Western blot (WB).
In the ELISA a colour change occurs when a mixture of the proteins attributed to HIV reacts with antibodies in serum from a patient. The same principal applies to all generation ELISAs including the newer agglutination, immunofiltration (flow through tests) immunochromatographic (lateral flow tests) and dipstick tests.
The significant difference between the “screening” or “initial” ELISA and the “supplemental” or “confirmatory” Western blot is that in the latter the test proteins are electrophoretically separated along the length of a nitrocellulose strip. This enables reactions between antibodies and individual proteins to be visualized as a series of bands.
These are referred to with a small ‘p’ (for protein) followed by a number designating the protein’s molecular weight in thousands, for example, p24.
In the majority of countries the diagnosis of HIV infection consists of performing an initial ELISA which, if reactive, is repeated. Repeatedly reactive ELISAs are “confirmed” by a positive Western blot which is regarded as synonymous with HIV infection. In the United States “Reactive screening tests must be confirmed by supplemental test (e.g. the Western blot [WB]), yet in England and Wales and in Africa, HIV infection is diagnosed without a “confirmatory” Western blot test.
Criteria for a positive test
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the criteria for a positive test vary between laboratories, institutions and countries. This gives rise to the anomaly where, for example, an individual positive in New York City on the CDC criteria would not be positive in Sydney, Australia. Or an Australian positive with p41, p32, p24 and p18 bands would not be positive in Africa. Or an African positive with a p41 and p120 band would not be positive in Australia, parts of the US or Europe.
Confusion over antibody reactivity is confirmed in diagnostic laboratory manuals. The Genelabs Diagnostic HIV BLOT 2.2 Western blot Assay Instruction Manual advises, “Specific guidelines for interpretation may differ depending on the local policies, GENELABS recommends following the accepted policy to be in accordance with local regulations”. This is followed by seven different criteria for defining a positive Western blot issued by “different international regulatory bodies”. However, Genelabs also append, “We recommend the following guidelines for the interpretation of the Genelabs Diagnostic HIV BLOT 2.2” and list an eighth set of criteria for a positive Western blot.
One wonders how “different international regulatory bodies” or “local policies”, and not the presumed pathogen, determine patterns of antibody reactivity that prove a viral infection. And why such patterns are geographically determined. Manufacturer Bio-Rad advises “Each laboratory performing Western blot testing should develop its own criteria for band interpretation. Alternatively, band interpretation may be left to the clinician" (Bio-Rad Laboratory Manual 1993).
